bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mass Gathering Medicine: A Predictive Model for Patient Presentation and Transport Rates
Authors: Arbon Paul , Bridgewater Franklin H.G. , Smith Colleen 
Published: July 2016

AbstractIntroduction:This paper reports on research into the influence of environmental factors (including crowd size, temperature, humidity, and venue type) on the number of patients and the patient problems presenting to firstaid services at large, public events in Australia. Regression models were developed to predict rates of patient presentation and of transportation-to-a-hospital for future mass gatherings.Objective:To develop a data set and predictive model that can be applied across venues and types of mass gathering events that is not venue or event specific. Data collected will allow informed event planning for future mass gatherings for which health care services are required.Methods:Mass gatherings were defined as public events attended by in excess of 25,000 people. Over a period of 12 months, 201 mass gatherings attended by a combined audience in excess of 12 million people were surveyed through-out Australia. The survey was undertaken by St. John Ambulance Australia personnel. The researchers collected data on the incidence and type of patients presenting for treatment and on the environmental factors that may influence these presentations. A standard reporting format and definition of event geography was employed to overcome the event-specific nature of many previous surveys.Results:There are 11,956 patients in the sample. The patient presentation rate across all event types was 0.992/1,000 attendees, and the transportation-to-hospital rate was 0.027/1,000 persons in attendance. The rates of patient presentations declined slightly as crowd sizes increased. The weather (particularly the relative humidity) was related positively to an increase in the rates of presentations. Other factors that influenced the number and type of patients presenting were the mobility of the crowd, the availability of alcohol, the event being enclosed by a boundary, and the number of patient-care personnel on duty.Three regression models were developed to predict presentation rates at future events.Conclusions:Several features of the event environment influence patient presentation rates, and that the prediction of patient load at these events is complex and multifactorial. The use of regression modeling and close attention to existing historical data for an event can improve planning and the provision of health care services at mass gatherings.
Relational governance in outsourcing partnerships
Authors: Mathrani Anuradha , Mathrani Sanjay 
Published: July 2016

Purpose
The paper aims to capture the nuances of two client–supplier relationships to offer new insights on the influences of transactional, knowledge and social elements in outsourcing partnerships.

Design/methodology/approach
The study has used descriptive case studies with narrative storylines. Interviews were conducted with three relationship managers (boundary gatekeepers) to understand preferred governance practices between clients and suppliers in diverse economic markets.

Findings
Experiences of three real-life cases engaged in offshore outsourcing have helped to identify the market, operational knowledge and social influences in a relational exchange. Findings reveal that offshore partnerships are first constituted with service-level agreements, which set control measures and layout business expectations from both partners. Boundary gatekeepers bring further accountability across firms by designing social networks for capturing and sharing of knowledge, thereby reducing each partner’s perception of risk. As firms evaluate transactional, knowledge and social elements for building a futuristic relational exchange, more disaggregated and dispersed enterprises evolve as new opportunities are explored in foreign markets.

Research limitations/implications
The retrospective nature of the client–supplier partnership is a limitation in this research study. However, retrospection adds to experience, and to practice perspectives made in hindsight, and therefore has a positive influence in this study.

Originality/value
This paper shares real-world experiences that can be used by scholars and practitioners to better understand how relational governance practices operate in a global socio-economic setting.
Torque ripple reduction of switched reluctance motor using fuzzy control
Authors: Wang Ming-Shyan , Chen Seng-Chi , Fang Wei-Chin , Chuang Po-Hsiang 
Published: July 2016

Purpose
– Extensive efforts have been conducted on the improvement of torque ripple in switched reluctance motor (SRM) drive. The purpose of this paper is to estimate initial on time of pulse-width modulation (PWM) and turn-off angle using the motor speed and rotor angle by fuzzy logic.

Design/methodology/approach
– A fuzzy logic control together with the PWM technique and turn-off angle are used to improve torque ripple and dynamic response.

Findings
– After determining initial on time of PWM, the rise slope of phase current is increased.

Research limitations/implications
– Future work will consider to increase the complex of the fuzzy control to adaptively tune parameters and achieve excellent results.

Practical implications
– The experimental results of the proposed method are presented to show the effectiveness.

Originality/value
– This paper achieves SRM control by one special PWM technique which is seldom studied.
Exploring valid and reliable assessment methods for care management education
Authors: Gennissen Lokke , Stammen Lorette , Bueno-de-Mesquita Jolien , Wieringa Sietse , Busari Jamiu 
Published: July 2016

Purpose
It is assumed that the use of valid and reliable assessment methods can facilitate the development of medical residents’ management and leadership competencies. To justify this assertion, the perceptions of an expert panel of health care leaders were explored on assessment methods used for evaluating care management (CM) development in Dutch residency programs. This paper aims to investigate how assessors and trainees value these methods and examine for any inherent benefits or shortcomings when they are applied in practice.

Design/methodology/approach
A Delphi survey was conducted among members of the platform for medical leadership in The Netherlands. This panel of experts was made up of clinical educators, practitioners and residents interested in CM education.

Findings
Of the respondents, 40 (55.6 per cent) and 31 (43 per cent) participated in the first and second rounds of the Delphi survey, respectively. The respondents agreed that assessment methods currently being used to measure residents’ CM competencies were weak, though feasible for use in many residency programs. Multi-source feedback (MSF, 92.1 per cent), portfolio/e-portfolio (86.8 per cent) and knowledge testing (76.3 per cent) were identified as the most commonly known assessment methods with familiarity rates exceeding 75 per cent.

Practical implications
The findings suggested that an “assessment framework” comprising MSF, portfolios, individual process improvement projects or self-reflections and observations in clinical practice should be used to measure CM competencies in residents.

Originality/value
This study reaffirms the need for objective methods to assess CM skills in post-graduate medical education, as there was not a single assessment method that stood out as the best instrument.
Paid accommodation use of international VFR multi-destination travellers
Authors: Griffin Tom , Nunkoo Robin 
Published: July 2016

PurposeThe purpose of this paper is to explore the use of paid accommodation by international visitors who also stay with a friend or relative in another destination.Design/methodology/approachThis paper conducts analysis of secondary data to look at the proportion of person nights in paid accommodation attributable to visitors who also stay with a friend or relative in another destination, and comparison of different visitor groups and their likelihood to use paid accommodation.FindingsResults show that 14.5 per cent of all person nights spent by international visitors to Canada in paid accommodations were attributable to people who also stayed with a friend or relative in another destination. This proportion is higher for destinations outside of the largest cities and varies by source market.Research limitations/implicationsThis paper is limited the structure of the secondary data set, which does not separate visiting friends from visiting relatives, and does not capture host behaviour.Practical implicationsThis paper has implications for destination marketers and tourism businesses as a source for reflection on drivers of their local and international business.Social implicationsThis paper helps position residents in a more central role regarding tourism in their regions and should encourage marketers and service providers to appreciate and engage residents as hosts.Originality/valueThis paper offers an original position by combining concepts from visiting friends and relatives and multi-destination travel that provides a foundation for further research in this area.
Seasonal Variations of Nutritional Status in Maintenance Hemodialysis Patients
Authors: Ilić Begović Tanja , Radić Josipa , Radić Mislav , Kovačić Vedran , Šain Milenka , Ljutić Dragan 
Published: July 2016

AbstractNutritional status of hemodialysis (HD) patients is influenced by a multitude of factors and it strongly correlates with morbidity and mortality. The aim of this study was to investigate the influence of seasonal changes on nutritional status in maintenance HD patients. A selected population of 84 adult (40 females and 44 males, aged 68.98 ± 13.45 years) HD (5.94 ± 6.44 years) patients were investigated. Clinical, biochemical and nutritional parameters (BMI, creatinine, urea, serum albumin, total cholesterol and Dialysis Malnutrition Score (DMS) were measured in cold (January and December) and mild (June and September) months, altogether in 336 HD sessions. Statistically significant differences between cold and mild months were found in BMI (P= 0.046), creatinine before HD (P =0.011), urea before HD (P ≤ 0.001), urea after HD (P ≤ 0.001) and glucose (P =  0.001). Differences between male and female patients in DMS, serum albumin and creatinine level in cold and mild months were found; where females altogether had higher DMS score and lower serum albumin and creatinine levels. These results suggest that seasonal variations of clinical and laboratory variables that reflect nutritional status occur commonly among maintenance HD patients and might lead to biases in the interpretation of results in clinical studies in which measurement schedules vary during the year. Also, results suggested that female HD patients may constitute an especially vulnerable population for seasonal oscillations of nutritional status. The reasons for most of these variations are not apparent and require further investigation.
A Novel Vortex Tube‐Assisted Atmospheric Freeze‐Drying System: Effect of Osmotic Pretreatment on Biological Products
Authors: Md Atiqure Rahman S. , Enamul Hoque M. , Rahman Saidur , Mahbubur Rahman M. 
Published: July 2016

AbstractOsmotic pretreatment is an effective way of reducing water from the biological products as well as simultaneously accelerating the drying kinetics. This research investigates the effect of osmotic pretreatment on the biological products in a vortex tube atmospheric freeze–drying (AFD) system. To facilitate the atmospheric freeze–drying in a laboratory scale, a vortex tube was connected to the compressor. A multi‐mode heat input concept was tested successfully to study the drying kinetics without damaging the products. The products were compared with the samples that did not undergo the osmotic pretreatment process. In addition, the comparison was also made with the parallel studies on conventional vacuum freeze–drying (VFD). Results showed that the osmotic treatment enhanced the drying kinetics for both AFD and VFD systems.Practical ApplicationsThis paper investigated on how the osmotic pretreatment influences the quality of the product in a novel atmospheric vortex tube‐assisted atmospheric freeze–drying system, and compared with the parallel studies using conventional vacuum contact drying system. Osmotic treatment of biological products using concentrated sugar solution demonstrates enhanced osmotic dehydration as well as drying rate in this novel atmospheric freeze–drying technique. This information is aimed to help in selecting appropriate osmotic agent as well as suitable drying process at even industrial level for efficient drying specifically, for biological and heat sensitive products. In addition, this work focuses on quality analysis along i.e., drying behavior with the variation of process parameters e.g., drying time, temperature, and moisture content for subzero drying. This findings would be beneficial for critical analysis in osmotic dehydration process and would further serve as a guideline for optimum design.
Effect of nurse staffing variation and hospital resource utilization
Authors: Kim Yunmi , Kim Seon‐Ha , Ko Young 
Published: July 2016

AbstractIn this study, we examined the effect of variations in nurse staffing levels on the length of stay and medical expenses of patients who underwent hip or knee surgeries. A cross‐sectional study was conducted using the National Health Insurance database and hospital surveys from 2010. Patient length of stay and medical expenses by nurse staffing level and skill mix were compared after adjusting for hospital and patient characteristics. Nurse staffing was measured based on staffing grade, the bed‐to‐registered nurse/nurse aid ratio, the bed‐to‐nursing personnel ratio, and the RN proportion. Generalized estimation models were used to analyze the associations. Decreased nurse staffing was consistently associated with increased length of stay, regardless of nurse staffing measures. The medical expenses associated with the lowest staffing level were approximately $US 1142.2 more than those associated with the highest staffing level. The study results suggest that maintaining a high nurse staffing level could be a cost‐effective strategy for government and insurers, as well as for patients. We propose that policy makers implement more efficient nurse staffing strategies.
Subgroup analysis of Asian patients in the INPULSIS® trials of nintedanib in idiopathic pulmonary fibrosis
Authors: Taniguchi Hiroyuki , Xu Zuojun , Azuma Arata , Inoue Yoshikazu , Li Huiping , Fujimoto Tsuyoshi , Bailes Zelie , Schlenker‐Herceg Rozsa , Kim Dong S. 
Published: July 2016

ABSTRACTBackground and objectiveIn the two‐replicate randomized Phase III INPULSIS® trials in patients with idiopathic pulmonary fibrosis (IPF), nintedanib 150 mg bd significantly reduced the annual rate of decline in forced vital capacity (FVC) compared with placebo. The key secondary endpoints were time to first investigator‐reported acute exacerbation and change from baseline in St George's Respiratory Questionnaire total score, both over 52 weeks. Here, we assessed the effect of nintedanib in Asian patients.MethodsPre‐specified subgroup analyses of the effect of nintedanib on the primary and key secondary endpoints in Asian versus White patients were undertaken based on pooled data from the two INPULSIS® trials. Safety data were analyzed descriptively.ResultsOf the treated patients, 322 were Asian (nintedanib n = 194; placebo n = 128) and 608 were White (nintedanib n = 360; placebo n = 248). In Asian patients, the nintedanib versus placebo difference in the adjusted annual rate of decline in FVC was 94.1 mL/year (95% CI: 33.7, 154.6). The treatment effect of nintedanib on the annual rate of decline in FVC in Asian and White patients was similar (treatment‐by‐subgroup interaction P = 0.72) and consistent with the overall population. No significant treatment‐by‐subgroup interaction was observed for the key secondary endpoints between Asian and White patients. In Asian patients, the most common adverse event in the nintedanib group was diarrhoea (56.2% of patients vs 15.6% for placebo).ConclusionIn pre‐specified subgroup analyses of Asian versus White patients with IPF in the INPULSIS® trials, race did not influence the effect of nintedanib on disease progression.
Trade Activity Between the EU and Its Neighbouring Countries: Trends and Potential
Authors: Kallioras Dimitris , Pinna Anna Maria 
Published: July 2016

AbstractThe objective of the paper is to examine whether trade activity intensifies over time as the outcome of signed bilateral trade agreements. Focusing on (the trade component of) the European Neighbourhood Policy, the paper conducts a study of trade activity between the EU and its neighbouring countries, attempting to offer a detailed analysis in terms of trade patterns and to investigate whether proximity is combined with higher trade flows, within the framework of a free trade agreement. The analysis utilises data derived from BACI database and covers the period from 1995 to 2011. The findings of the paper indicate that there is a lot of potential for the expansion of trade activity between the EU and its neighbouring countries.
Protection Against Spikes in Workload With Aerobic Fitness and Playing Experience: The Role of the Acute:Chronic Workload Ratio on Injury Risk in Elite Gaelic Football
Authors: Malone Shane , Roe Mark , Doran Dominic A. , Gabbett Tim J. , Collins Kieran D. 
Published: July 2016

Purpose:To examine the association between combined session rating of perceived exertion (RPE) workload measures and injury risk in elite Gaelic footballers.Methods:Thirty-seven elite Gaelic footballers (mean ± SD age 24.2 ± 2.9 y) from 1 elite squad were involved in a single-season study. Weekly workload (session RPE multiplied by duration) and all time-loss injuries (including subsequent-wk injuries) were recorded during the period. Rolling weekly sums and wk-to-wk changes in workload were measured, enabling the calculation of the acute:chronic workload ratio by dividing acute workload (ie, 1-weekly workload) by chronic workload (ie, rolling-average 4-weekly workload). Workload measures were then modeled against data for all injuries sustained using a logistic-regression model. Odds ratios (ORs) were reported against a reference group.Results:High 1-weekly workloads (≥2770 arbitrary units [AU], OR = 1.63–6.75) were associated with significantly higher risk of injury than in a low-training-load reference group (<1250 AU). When exposed to spikes in workload (acute:chronic workload ratio >1.5), players with 1 y experience had a higher risk of injury (OR = 2.22) and players with 2–3 (OR = 0.20) and 4–6 y (OR = 0.24) of experience had a lower risk of injury. Players with poorer aerobic fitness (estimated from a 1-km time trial) had a higher injury risk than those with higher aerobic fitness (OR = 1.50–2.50). An acute:chronic workload ratio of (≥2.0) demonstrated the greatest risk of injury.Conclusions:These findings highlight an increased risk of injury for elite Gaelic football players with high (>2.0) acute:chronic workload ratios and high weekly workloads. A high aerobic capacity and playing experience appears to offer injury protection against rapid changes in workload and high acute:chronic workload ratios. Moderate workloads, coupled with moderate to high changes in the acute:chronic workload ratio, appear to be protective for Gaelic football players.
Background colour matching in a wild population of Alytes obstetricans
Authors: Polo-Cavia Nuria , Oliveira José Miguel , Redondo Villa Alberto José , Márquez Rafael 
Published: July 2016

The capacity for physiological colour change has long been described in anuran amphibians. Camouflage against predators seems to be the most relevant function of dynamic changes in skin colour of frogs, but key aspects such as the rate at which these changes occur, or the specific colour components involved are not completely clear. Whereas most research on the topic has been reported on tree frogs in laboratory conditions, studies in other anurans or in the field are much scarcer. Here we show a potentially plastic, adaptive response in coloration of common midwife toads,Alytes obstetricans, from a population of central Portugal, whose pigmentation varied with their natural backgrounds. Using quantitative image analysis, we compared hue, saturation and brightness of dorsal skin coloration of toads and the colour of the area of ground immediately around them. We found a positive correlation between coloration of toads and background colour for the three components of the colour. As well as other anuran species,A. obstetricansmight adjust skin coloration to match the surrounding environment, thus benefitting from short-term reversible crypsis strategies against predators. A less supported hypothesis would be that toads accurately select matching backgrounds to improve concealment as an antipredatory strategy.
Low Si-OH ORMOCER®s for Dielectrical and Optical
Interconnection Technology
Authors: Buestrich Ralf , Kahlenberg Frank , Popall Michael , Martin Adelheid , Rösch Oliver 
Published: July 2016

ABSTRACTORMOCER®*s (inorganic-organic hybrid polymers) with low Si-OH content were
synthesized by a new sol-gel route. Optimization of the sol-gel process
parameters (catalyst, temperature etc.) was performed in order to achieve
reproducible low cost materials which are photo-patternable even in higher
layer thicknesses up to 150 μm within one step without cracking or
delamination. The materials combine low losses in the NIR region (0.2 dB/cm
at 1310 nm and 0.5 dB/cm at 1550 nm without fluorination!) with low
dielectric constants (3.3 at 10 kHz).Beside the dielectric and optical properties the materials have a variety of
additional advantages for interconnection technology: good wetting and
adhesion on various substrates (e.g. glass, silicon and several polymers),
low processing temperatures (postbake below 160 °C), high thermal stability
(up to 270 °C) and a tunable refractive index.Details of chemical synthesis and characterization as well as
photo-lithographic processing of ORMOCER® materials are
presented.
Modelo comboio para suporte familiar pelo enfermeiro na atenção básica: estudo descritivo
Authors: Silva Lucilane Maria Sales da , Fernandes Marcelo Costa , Leite Sarah de Sá , Nogueira Mariana Correia Cadete , Lima Weverson de Abreu , Silva Maria Rocineide Ferreira da 
Published: July 2016

Objetivo: investigar a troca de suporte relacionado ao cuidado na saúde entre a família, inserida no centro do modelo comboio, e o enfermeiro da Atenção Básica. Método: estudo descritivo, realizado com 30 usuários da Atenção Básica de Maracanaú/CE, em julho de 2014. Recorreu-se ao Discurso do Sujeito Coletivo para organização dos dados e ao modelo comboio para visualização do suporte exercido pelo profissional. Resultado: o enfermeiro é referência secundária de suporte às famílias; suas ações são restritas às unidades de saúde, demonstrando papel equivocado de suas atribuições, além de terem como foco as atividades de orientação. Discussão: há distanciamento do enfermeiro em relação às famílias assistidas, como também influências do modelo médico hegemônico, que distanciam o enfermeiro da apropriação de suas reais atribuições. Conclusão: o enfermeiro é desvalorizado e apontado como referência secundária na relação com as famílias para resolver problemas de saúde.