bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequalities in Specialist Hand Surgeon Distribution across the United States
Authors: Rios-Diaz Arturo J. , Metcalfe David , Singh Mansher , Zogg Cheryl K. , Olufajo Olubode A. , Ramos Margarita S. , Caterson Edward J. , Talbot Simon G. 
Published: April 2016

Background:
Unequal access to hospital specialists for emergency care is an issue in the United States. The authors sought to describe the geographic distribution of specialist hand surgeons and associated factors in the United States.

Methods:
Geographic distributions of surgeons holding a Subspecialty Certificate in Surgery of the Hand and hand surgery fellowship positions were identified from the American Board of Medical Specialties Database and the literature (2013), respectively. State-level population and per capita income were ascertained using U.S. Census data. Variations in hand trauma admissions were determined using Healthcare Cost and Utilization Project national/state inpatient databases. Risk-adjusted generalized linear models were used to assess independent association between hand surgeon density and hand trauma admission density, fellowship position density, and per capita income.

Results:
Among 2019 specialist hand surgeons identified, 72.1 percent were orthopedic surgeons, 18.3 percent were plastic surgeons, and 9.6 percent were general surgeons. There were 157 hand surgery fellowship positions nationwide. There were 149,295 annual hand trauma admissions. The national density of specialist hand surgeons and density of trauma admission were 0.6 and 47.6, respectively. The density of specialist hand surgeons varied significantly between states. State-level variations in density of surgeons were independent and significantly associated with median per capita income (p < 0.001) and with density of fellowships (p = 0.014).

Conclusions:
Specialist hand surgeons are distributed unevenly across the United States. State-level analyses suggest that states with lower per capita incomes may be particularly underserved, which may contribute to regional disparities in access to emergency hand trauma care.
Shear test as calibration experiment for DEM simulations: a sensitivity study
Authors: Keppler Istvan , Safranyik Ferenc , Oldal Istvan 
Published: April 2016

Purpose
The effect of micromechanical parameters on the macromechanical behaviour of granular materials is analysed by using discrete element based model of the standard shear test.

Design/methodology/approach
Discrete element method based standard shear test simulations.

Findings
The approximate mathematical functions related to the effects of DEM micromechanical parameters density, Young-modulus, Poisson number, frictional angle, bond normal cohesion, bond tangential cohesion, rolling friction and particle shape on the macromechanical parameters of shear failure line (internal friction and cohesion) are determined by modelling large number of standard shear tests.

Originality/value
By knowing these effects of micromechanical parameters to the macromechanical behaviour of the simulated particle assembly, the calibration of discrete element models can be significantly accelerated.
Derivation of the material models for ultra-high molecular-weight polyethylene fiber-reinforced armor-grade composites with different architectures
Authors: Grujicic Mica , Snipes Jennifer , Ramaswami S. , Avuthu Vasudeva , Yen Chian-Fong , Cheeseman Bryan 
Published: April 2016

Purpose
To overcome the problem of inferior through-the-thickness mechanical properties displayed by armor-grade composites based on 2-D reinforcement architectures, armor-grade composites based on 3D fiber-reinforcement architectures have recently been investigated experimentally.

Design/methodology/approach
The subject of the present work is armor-grade composite materials reinforced using ultra-high-molecular-weight polyethylene fibers and having four (two 2D and two 3D) prototypical architectures, as well as the derivation of the corresponding material models. The effect of the reinforcement architecture is accounted for by constructing the appropriate unit cells (within which the constituent materials and their morphologies are represented explicitly) and subjecting them to a series of virtual mechanical tests. The results obtained are used within a post-processing analysis to derive and parameterize the corresponding homogenized-material models. One of these models (specifically, the one for 0°/90° cross-collimated fiber architecture) was directly validated by comparing its predictions with the experimental counterparts. The other models are validated by examining their physical soundness and details of their predictions. Lastly, the models are integrated as user-material subroutines, and linked with a commercial finite-element package, in order to carry out a transient non-linear dynamics analysis of ballistic transverse impact of armor-grade composite-material panels with different reinforcement architectures.

Findings
It is found that the reinforcement architecture plays a critical role in the overall ballistic limit of the armor panel, as well as in its structural and damage/failure response.

Originality/value
To the authors’ knowledge, the present work is the first reported attempt to assess, computationally, the utility and effectiveness of 3D fiber-reinforcement architectures for ballistic impact applications.
Seizing opportunities for change at the operational level
Authors: Restrepo Diana , Charron-Latour Julie , Pourmonet Hugo , Bassetto Samuel 
Published: April 2016

Purpose
This article presents a method for handling everyday opportunities for improvement, led by floor staff in health care institutions. More than 400,000 incidents and accidents were recorded in Quebec health care institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement.

Design/methodology/approach
Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l’Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature.

Findings
The proposed method presents a 68% increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41% better (lower) than in the reference case.

Research limitations/implications
The test lasted 15 weeks; a longer test is needed to collect more data.

Practical implications
The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed (1) the operational nature of the proposal (empowerment of the work team); (2) the operationalization of continuous improvement (71% of ideas were finalized while the initiative was monitored); (3) the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90% of cases); and (4) a shared feeling that intra- and inter-team communication had been strengthened.

Originality/value
The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.
Hospital administrative characteristics and volunteer resource management practices
Authors: Intindola Melissa , Rogers Sean , Flinchbaugh Carol , Della Pietra Doug 
Published: April 2016

Purpose– The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices.Design/methodology/approach– This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states.Findings– Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices.Research limitations/implications– First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes.Practical implications– Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization.Originality/value– The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors’ knowledge, this is the first empirical categorization of VRM practices.
Healthcare reform in China: making sense of a policy experiment?
Authors: Millar Ross , Jian Weiyan , Mannion Russell , Miller Robin 
Published: April 2016

Purpose
– The purpose of this paper is to explore recent healthcare reform in China. Reflecting on the current literature, the viewpoint argues that greater attention should be paid to healthcare reform in China as a public policy process, particularly one that is built on policy experimentation.

Design/methodology/approach
– The viewpoint argues that while recent efforts to understand the impact of reform have brought significant understanding of key issues and processes, such interest tends to focus on pragmatic concerns rather than pose wider theoretical and methodological questions about the nature and pace of reform.

Findings
– The authors suggest that the lens of public policy is particular relevant and insightful given what has been documented elsewhere regarding China’s unique policy process characterised by “policy experimentation”. The authors discuss how a policy experiment perspective can provide a useful heuristic for understanding healthcare reform in China.

Originality/value
– The viewpoint concludes by outlining possible applications of this approach and looks forward at the emerging research agenda in this area.
A response to Stone and Parker
Authors: Rutherford Brian A. 
Published: April 2016

Purpose
To respond to the comment by Stone and Parker on my paper “The struggle to fabricate accounting narrative obfuscation: An actor-network-theoretic analysis of a failing project”.

Design/methodology/approach
The paper responds to issues highlighted by Stone and Parker.

Findings
This response argues that there is at least one alternative to the augmentation of Flesch: that we bring our skills and experience as accountants directly to bear on narratives, to analyse and report on how accessible and informative they are – and even to what extent they obfuscate – in ways that will, at least according to some definitions, be subjective but perhaps no more subjective than asserting that some simple statistic represents a reliable proxy for a complex notion such as accessibility.

Originality/value
This comment adds to the necessary debate about how we should tackle research on accounting narratives.
The effects of food web structure on ecosystem function exceeds those of precipitation
Authors: Trzcinski M. Kurtis , Srivastava Diane S. , Corbara Bruno , Dézerald Olivier , Leroy Céline , Carrias Jean‐François , Dejean Alain , Céréghino Régis 
Published: April 2016

Summary

Ecosystems are being stressed by climate change, but few studies have tested food web responses to changes in precipitation patterns and the consequences to ecosystem function. Fewer still have considered whether results from one geographic region can be applied to other regions, given the degree of community change over large biogeographic gradients.

We assembled, in one field site, three types of macroinvertebrate communities within water‐filled bromeliads. Two represented food webs containing both a fast filter feeder–microbial and slow detritivore energy channels found in Costa Rica and Puerto Rico, and one represented the structurally simpler food webs in French Guiana, which only contained the fast filter feeder–microbial channel. We manipulated the amount and distribution of rain entering bromeliads and examined how food web structure mediated ecosystem responses to changes in the quantity and temporal distribution of precipitation.

Food web structure affected the survival of functional groups in general and ecosystem functions such as decomposition and the production of fine particulate organic matter. Ecosystem processes were more affected by decreased precipitation than were the abundance of micro‐organisms and metazoans. In our experiments, the sensitivity of the ecosystem to precipitation change was primarily revealed in the food web dominated by the single filter feeder–microbial channel because other top‐down and bottom‐up processes were weak or absent.

Our results show stronger effects of food web structure than precipitation change per se on the functioning of bromeliad ecosystems. Consequently, we predict that ecosystem function in bromeliads throughout the Americas will be more sensitive to changes in the distribution of species, rather than to the direct effects caused by changes in precipitation.
The effect of enoxaparin on seroma and mesh‐tissue adhesion in a hernia model
Authors: Ozkececi Ziya T , Gonul Yucel , Karavelioglu Afra , Bozkurt Mehmet F , Kacar Emre , Bal Ahmet , Ozsoy Mustafa , Turamanlar Ozan , Celep Bahadir 
Published: April 2016

SummaryThe aim of this study was to investigate whether enoxaparin (ENX) administration would increase seroma risk and worsen mesh tissue recovery in an experimental rat hernia repair model. Fifty‐six adult male Wistar–Albino rats were included in the study. Rats were equally and randomly separated into seven groups: Group 1, Control, only subcutaneous dissection was performed; group 2, Sham, Hernia defect was primary sutured; Group 3, Prolene mesh; Group 4, Dual mesh; Group 5, ENX + Sham; Group 6, ENX + Prolene mesh; Group 7, ENX + Dual mesh. ENX was subcutaneously injected at a dose of 180 U/kg per day for 7 days. Rats were killed after the amount of subcutaneous seroma was determined by ultrasound on day 7 following the surgical procedure. Mesh‐tissue healing was evaluated using histopathological and immunohistochemical (CD31) staining methods. The mean seroma amount significantly increased in Groups 5–7 compared to Groups 2–4. CD31 immunostaining showed a reduction in neovascularization in Groups 6 and 7, compared to Groups 3 and 4. Neovascularization decreased and hemorrhage, necrosis and oedema findings remarkably increased in Groups 6 and 7, when compared to Groups 3 and 4. Fibroblastic activity and inflammation were more prominent in Groups 3 and 4. It should be kept in mind that ENX interferes with inflammation, which is desired in the early period of healing and leads to an increase in overall seroma amount with anti‐coagulant effects, which in turn may disrupt wound healing and mesh‐tissue adhesions, as was indicated in our study.
Contrast‐marking prosodic emphasis in Williams syndrome: results of detailed phonetic analysis
Authors: Ito Kiwako , Martens Marilee A. 
Published: April 2016

AbstractBackgroundPast reports on the speech production of individuals with Williams syndrome (WS) suggest that their prosody is anomalous and may lead to challenges in spoken communication. While existing prosodic assessments confirm that individuals with WS fail to use prosodic emphasis to express contrast, those reports typically lack detailed phonetic analysis of speech data. The present study examines the acoustic properties of speech prosody, aiming for the future development of targeted speech interventions.AimsThe study examines the three primary acoustic correlates of prosodic emphasis (duration, intensity, F0) and determines whether individuals with WS have difficulty in producing all or a particular set of the three prosodic cues.Methods & ProceduresSpeech produced by 12 individuals with WS and 12 chronological age (CA)‐matched typically developing individuals were recorded. A sequential picture‐naming task elicited production of target phrases in three contexts: (1) no contrast: gorilla with a racket → rabbit with a balloon; (2) contrast on the animal: fox with a balloon → rabbit with a balloon; and (3) contrast on the object: rabbit with a ball → rabbit with a balloon. The three acoustic correlates of prosodic prominence (duration, intensity and F0) were compared across the three referential contexts.Outcomes & ResultsThe two groups exhibited striking similarities in their use of word duration and intensity for expressing contrast. Both groups showed the reduction and enhancement of final lengthening, and the enhancement and reduction of intensity difference for the animal contrast and for the object contrast conditions, respectively. The two groups differed in their use of F0: the CA group produced higher F0 for the animal than for the object regardless of the context, and this difference was enhanced when the animal noun was contrastive. In contrast, the WS group produced higher F0 for the object than for the animal when the object was contrastive.Conclusions & ImplicationsThe present data contradict previous assessment results that report a lack of prosodic skills to mark contrast in individuals with WS. The methodological differences that may account for this variability are discussed. The present data suggest that individuals with WS produce appropriate prosodic cues to express contrast, although their use of pitch may be somewhat atypical. Additional data and future speech comprehension studies will determine whether pitch modulation can be targeted for speech intervention in individuals with WS.
Is fertiliser use inconsistent with expected profit maximization in sub‐Saharan Africa? “Evidence from Nigeria”
Authors: Liverpool‐Tasie Lenis Saweda O. 
Published: April 2016

AbstractThis article revisits a conventional wisdom that inorganic fertiliser use across sub‐Saharan Africa is too low. This expectation that more farmers should be using inorganic fertiliser, and at higher rates, implies it is profitable to use rates higher than observed if farmers are rational expected profit maximisers. We obtain consistent estimates of the effects of applied nitrogen on rice production. We find the yield response to applied nitrogen to be low in the main rice growing farming system. Farmer behaviour is not inconsistent with expected profitability which is limited by a low yield response to applied fertiliser, high transportation costs, and low selling prices for rice in rural areas. In particular, we do not find any farmers for whom applied nitrogen is profitable that are not using fertiliser in the study sample for each of our survey years (2010 and 2012).
Radiofrequency ablation for recurrent versus first‐occurrence hepatocellular carcinoma
Authors: Chong Charing Ching‐Ning , Wong John , Cheung Yue‐Sun , Yu Simon Chun‐Ho , Hui Joyce Wai‐Yi , Lee Paul Sing‐Fun , Ip Philip Sing‐Tak , Lee Kit‐Fai , Lai Paul Bo‐San 
Published: April 2016

AimStudies comparing the efficacy of radiofrequency ablation (RFA) in terms of overall survival, disease‐free survival and local recurrence in recurrent hepatocellular carcinoma (HCC) are limited. We carried out the present study to compare the survival of recurrent HCC after RFA with that of first‐occurrence HCC.Patients and MethodsA total of 170 patients with HCC smaller than 5 cm who received RFA in a tertiary academic hospital were recruited. Clinical data were prospectively collected, reviewed and compared between recurrent and first‐occurrence HCC groups. Patients who received RFA for post‐ablation recurrent HCC were excluded.ResultsThere was no significant difference in the complication, incomplete ablation, recurrence and survival rates between the recurrent HCC and the first‐occurrence HCC groups. The tumour size in the recurrent HCC group was significantly smaller than that in the first‐occurrence group (1.8 vs 2.5 cm), and the recurrent HCC group had a significantly higher proportion of Child's A cirrhosis.ConclusionsWhen detected and treated early, the overall survival of recurrent HCC treated RFA was comparable to that of first‐occurrence HCC. The advantages of RFA, especially when percutaneous route is feasible, over hepatectomy should be extended to recurrent HCC in suitable cases.
Law and Negotiation: A Role for a Transformative Approach?
Authors: Swaine Aisling 
Published: April 2016

AbstractFeminist critique of negotiations that aim to bring about peaceful political settlements has consistently pointed to the glaring absence of the critical analysis of and response to gender relations as part of both the modus operandi and substantive output of those processes. Just as war is a gendered phenomenon war is a gendered phenomenon (working off gender relations that subordinate women), so too the processes that respond to it and aim to negotiate its end and create an aftermath, are inherently gendered. Where the goal is a peace that works for ‘everyone’, then negotiation needs to respond to structural gendered conditions that limit the potential that negotiation holds for women. The concept of transformation has been espoused by feminists as key to altering the structural inequalities that determine a systemic gendered order that works to de‐privilege women and women's interests. As a concept, ‘transformation’ holds great potential to regenerate processes of negotiation towards promoting women's ability to have agency over their lives. This article begins a consideration of what transformation might mean for the practice of negotiation and how it might be advanced to make negotiations responsive to gender relations so that a peace that serves women as well as men is worked towards.
Late reactions in food‐allergic children and adolescents after double‐blind, placebo‐controlled food challenges
Authors: Saleh‐Langenberg J. , Flokstra‐de Blok B. M. J. , AlAgla N. , Kollen B. J. , Dubois A. E. J. 
Published: April 2016

AbstractThe time during which children are observed following a double‐blind, placebo‐controlled food challenge (DBPCFC) varies in clinical practice. There are little data on late reactions (LRs) following DBPCFCs. Therefore, we determined the prevalence, severity and clinical characteristics of late reactions in food‐allergic children and adolescents after DBPCFC, and ascertained which factors are associated with, and may predict, LRs. Logistic regression analyses were performed to investigate which factors were associated with LRs and to develop the association and prediction models. A total of 1142 children underwent DBPCFCs (child–test combinations). Of these 1142 child–test combinations, 400 reported LRs following the DBPCFC. LRs in food‐allergic children after DBPCFC are poorly predictable and are generally not severe. All LRs, including those on the placebo day, are more frequently reported in younger children. Children who do not experience severe immediate reactions may be safely discharged home 2 h after a DBPCFC.