bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Primary Care Physicians and Other Providers on Key Process Measures in the Treatment of Diabetes
Authors: Morrison Fritha , Shubina Maria , Goldberg Saveli I. , Turchin Alexander 
Published: December 2012

OBJECTIVE
Studies have shown that patients without a consistent primary care provider have inferior outcomes. However, little is known about the mechanisms for these effects. This study aims to determine whether primary care physicians (PCPs) provide more frequent medication intensification, lifestyle counseling, and patient encounters than other providers in the primary care setting.

RESEARCH DESIGN AND METHODS
This retrospective cohort study included 584,587 encounters for 27,225 patients with diabetes and elevated A1C, blood pressure, and/or LDL cholesterol monitored for at least 2 years. Encounters occurred at primary care practices affiliated with two teaching hospitals in eastern Massachusetts.

RESULTS
Of the encounters documented, 83% were with PCPs, 13% were with covering physicians, and 5% were with midlevel providers. In multivariable analysis, the odds of medication intensification were 49% (P &lt; 0.0001) and 26% (P &lt; 0.0001) higher for PCPs than for covering physicians and midlevel providers, respectively, whereas the odds of lifestyle counseling were 91% (P &lt; 0.0001) and 21% (P = 0.0015) higher. During visits with acute complaints, covering physicians were even less likely, by a further 52% (P &lt; 0.0001), to intensify medications, and midlevel providers were even less likely, by a further 41% (P &lt; 0.0001), to provide lifestyle counseling. Compared with PCPs, the hazard ratios for time to the next encounter after a visit without acute complaints were 1.11 for covering physicians and 1.19 for midlevel providers (P &lt; 0.0001 for both).

CONCLUSIONS
PCPs provide better care through higher rates of medication intensification and lifestyle counseling. Covering physicians and midlevel providers may enable more frequent encounters when PCP resources are constrained.
Revisiting the construction of gap functions for variational inequalities and equilibrium problems via conjugate duality
Authors: Cioban Liana , Csetnek Ernö 
Published: December 2012

Abstract
Based on conjugate duality we construct several gap functions for general variational inequalities and equilibrium problems, in the formulation of which a so-called perturbation function is used. These functions are written with the help of the Fenchel-Moreau conjugate of the functions involved. In case we are working in the convex setting and a regularity condition is fulfilled, these functions become gap functions. The techniques used are the ones considered in [Altangerel L., Boţ R.I., Wanka G., On gap functions for equilibrium problems via Fenchel duality, Pac. J. Optim., 2006, 2(3), 667–678] and [Altangerel L., Boţ R.I., Wanka G., On the construction of gap functions for variational inequalities via conjugate duality, Asia-Pac. J. Oper. Res., 2007, 24(3), 353–371]. By particularizing the perturbation function we rediscover several gap functions from the literature. We also characterize the solutions of various variational inequalities and equilibrium problems by means of the properties of the convex subdifferential. In case no regularity condition is fulfilled, we deliver also necessary and sufficient sequential characterizations for these solutions. Several examples are illustrating the theoretical aspects.
Urological complications following use of recombinant human bone morphogenetic protein–2 in anterior lumbar interbody fusion
Authors: Lubelski Daniel , Abdullah Kalil G. , Nowacki Amy S. , Alvin Matthew D. , Steinmetz Michael P. , Chakka Srita , Li Yumeng , Gajewski Nicholas , Benzel Edward C. , Mroz Thomas E. 
Published: December 2012

Object
The goal of this study was to compare the urological complications in patients after anterior lumbar interbody fusion (ALIF) with and without the use of recombinant human bone morphogenetic protein–2 (rhBMP-2).

Methods
The authors retrospectively reviewed the medical records of all patients who underwent ALIF with and without rhBMP-2 between January 2002 and August 2010. Patient demographic, operative, and complication information was analyzed. Male patients who underwent ALIF between L-4 and S-1 were contacted to assess postoperative urological complications.

Results
Of the 110 male patients who underwent ALIF and were included in this study, 59 were treated with rhBMP-2 and 51 did not receive rhBMP-2. The mean follow-up duration was 17.5 months for the rhBMP-2 group and 30.8 months for the control group. No difference was found regarding the total number of urological complications in the rhBMP-2 group versus the control group (22% vs 20%, respectively; p = 1.0) or for retrograde ejaculation specifically (8% vs 8%, respectively; p = 1.0).

Conclusions
In this study, the use of rhBMP-2 with ALIF surgery was not associated with an increased incidence of urological complications and retrograde ejaculation when compared with control ALIF without rhBMP-2. Further prospective analyses that specifically look at these complications are warranted.
Oral Care Education in the Prevention of Ventilator-Associated Pneumonia: Quality Patient Outcomes in the Intensive Care Unit
Authors: Zurmehly Joyce 
Published: December 2012

Background:
Ventilator-associated pneumonia (VAP) is associated with high morbidity and mortality rates in mechanically ventilated patients in the United States. Routine oral care has been shown to have a direct effect on reducing VAP rates.

Methods:
Intensive care unit registered nurses attended educational sessions about oral care and also used online education modules. Nursing care involving 180 intubated patients was observed, and changes were noted in practices related to oral care.

Results:

After the education intervention, the frequency of oral care increased significantly (
p
= .001) to tooth brushing every 4 hours and swabbing every 12 hours with 0.12% chlorhexidine solution. The evidence-based practice education intervention decreased VAP rates by 62.5%.

Conclusion:
Significant reductions in VAP rates may be achieved through improved education and implementation of oral care protocols with 0.12% chlorhexidine solution.
Femtosecond Laser Correction of Presbyopia (INTRACOR) in Emmetropes Using a Modified Pattern
Authors: Thomas Bettina C. , Fitting Anna , Auffarth Gerd U. , Holzer Mike P. 
Published: December 2012

PURPOSE:
To evaluate functional results and corneal changes after femtosecond laser correction of presbyopia (INTRACOR, Technolas Perfect Vision GmbH) in emmetropes using a modified treatment pattern over a 12-month period.

METHODS:
Twenty eyes from 20 emmetropic patients were treated with a modified intrastromal INTRACOR pattern consisting of 5 central rings and 8 radial cuts in a prospective, nonrandomized, uncontrolled, open, single-center, clinical study. Refraction, visual acuity, endothelial cell density, corneal pachymetry, total corneal power, and stray light were evaluated preoperatively and 1 (except endothelial cell density and stray light), 3, 6, and 12 months postoperatively. Patients filled out a subjective questionnaire at 12 months postoperatively.

RESULTS:

Comparison of preoperative versus 12-month postoperative median values revealed a significant improvement in uncorrected near visual acuity (UNVA) from 0.60 (20/80) to 0.10 logMAR (20/25) (
P
<.0001) and a significant decrease in corrected distance visual acuity (CDVA) from −0.10 (20/16) to 0.00 logMAR (20/20), which equals a median loss of one line (
P
=.0005). Fifteen percent of patients lost two lines of CDVA in the treated eye. Subjective spherical equivalent refraction remained unchanged at 0.00 diopters (D) (
P
=.194). After INTRACOR treatment, significant corneal steepening of 1.40 D and midperipheral flattening of 0.50 D occurred (both
P
<.0001). Corneal pachymetry at the thinnest point and endothelial cell density did not change significantly (
P
=.829 and
P
=.058, respectively).

CONCLUSIONS:
After 12 months, the modified INTRACOR pattern improved UNVA in emmetropic patients without inducing a myopic shift or significant changes in endothelial cell density or pachymetry.
Pressure Management Under Arctic Operations
Authors: Karlsen Morten Roll , Hohler Erling , Kristiansen Ulrik , Petersen David Christian , Borgen Harald , Schmedlin Petter F. 
Published: December 2012

Abstract
The hunt for further oil and gas recovery from old wells isbooming, and the industry look to new and improved technology for addingseveral years of operational time to exicting wells. New methods like lightwell intervention procedures sets high stress on old wellheads andinfrastructure, and a general increase in development of marginal fields haveraised issues over safety aspects.
Aside from developing improved procedures around cementingoperations, leakage detection and oil spill recovery, additional successfactors will be the ability to monitor pressure and temperature fluctuations inB annulus, as well as finding models and produce technology to manage suchpressure build upsuccessfully.
This paper introduces a new method of B-annulus monitoring using ultrasoundsignals originating from a device in the A-annulus providing measurements basedon time of flight in chambers placed in the B-annulus as a means of determiningthe temperature and pressure in the B-annulus.
Ice Data Collection for Arctic Operation
Authors: Wilkman Goran , Leiviska Topi , Oikkonen Annu 
Published: December 2012

Abstract
Every operation site, oil and gas drilling, shipping, pipelines and loadingfacilities, need a design basis to be properly planned. Also monitoring of theenvironment when the operation has already started is of utmost importance. This became noticed already in late 1960ies during the Manhattan voyages. Eversince ice data has been collected around various projects both in the westernand eastern Arctic. In Canada the heat was on during the Polar Gas and ArcticPilot Project in the 1970ies and 80ies. The discoveries in the Russian Arcticlaunched systematic arrangements to collect ice data in the in thePechora Sea, Barents Sea, Kara Sea, Ob Bay and offshore Sakhalin Island duringthe last 25 years. This paper describes the main features of typicalarrangements made for a successful data collection expedition, how arrangementsworked and also difficulties met during the execution of such anexpedition.

Introduction
In a successful project the ice conditions play a significant role and it isof utmost importance to have sufficient data on the design conditions. Forinstance each component in an oil export system like onshore pipelines/terminals, underwater pipelines, offloading terminals, assistant icebreakersand export transportation vessels, has design requirements of its own. A designbasis must be made for each component of the system. This requires aconsiderable amount of work, both data collection in the field and reviews ofliterature as well as analyses to make a reliable design basis. This is thefirst step.
Planning of any offshore or transport project requires careful analyses ofsafety, impact and economics of the planned operations and equipment.
A lot of information is needed both on the environment as well as of theoperations themselves. Planning the operations and doing the design based oninadequate or unreliable data may lead to uneconomic operation or in worstcases severe damages of the environment or human life.
Exploring Cementing Practices Throughout the Arctic Region
Authors: DeBruijn Gunnar , Popov Mikhail , Bellabarba Mario 
Published: December 2012

Abstract
The development of arctic resources requires wells to be drilled, cased, andcemented through permafrost. Permafrost presents unique challenges, especiallyto cementing operations, requiring a cement system with the capability toperform in the subfreezing permafrost environment. The performance required isthat the cement provides isolation, exhibits low heat of hydration, and setswith sufficient strength to provide casing support. There are also specifictesting requirements detailed in API recommended practices.
In the polar region, there are several approaches used in the design of cementsystems. The approaches used in Russia, Canada, and USA (Alaska) areillustrated. The design considerations take into account local conditions andrequirements and use knowledge from cementing practices employed in thedrilling industry.
It is important to understand the current cementing practices in use withinthe arctic region. This will allow future improvements as more developmenttakes place and the resources become exploited.

Introduction
To be successful, hydrocarbon resource development in arctic regions mustmeet the challenges posed by drilling, casing, and cementing wells throughpermafrost layers in the remote arctic environment. The Russian Far East, forexample, is almost completely covered in permafrost and holds significant gasreserves that remain largely untapped due to the remoteness of the area and thecomplexity of drilling through the permafrost layers. Offshore operations areadditionally impacted by sea ice, which does not directly affect cementingoperations; however, the short operational window certainly requires detailedplanning and reliable performance.
The remoteness of arctic locations affects all aspects of development, impacting overall logistics: access, timing, and materials delivery andstorage. In addition, several of the challenges faced during the initialdevelopment phases affect the subsequent cement job and cementing practices. These challenges need to be addressed as part of the overall development plan;they include borehole maintenance, casing centralization, and mud conditioningand removal, and all require careful consideration of the permafrost.
Use of Jack-up Drilling Units in Arctic Seas with Potential Ice Incursions during Open Water Season
Authors: Wang Cynthia , Quah Matthew , Noble Peter G. , Shafer Randall , Soofi Khalid A. , Alvord Chip , Brassfield Tom 
Published: December 2012

Abstract
Jack-up drilling units have been used in Arctic open water seasons and areaswith icebergs. They have not been used in areas where significant sea ice canmove in with high concentrations. These areas have typically been drilled usinga floating mobile offshore drilling unit (MODU) although the water depths aretypically less than 50 meters. Floating MODUs in shallow water depths can havesignificant downtime due to the limited offset in shallow water and typicallyrequire placing the well control equipment in a seabed cellar. In these areas, jack-ups can improve both operational safety and efficiency as they havelimited weather related downtime.
Several studies were carried out to determine the feasibility of using amodern high capacity jack-up MODUs for exploratory drilling in these areas. This paper will review the studies including structural analysis, icemanagement approaches, and well control considerations. It will also review thefurther potential of jack-ups in the Arctic.
Studies showed that using a jack-up drilling unit is feasible in shallowArctic seas such as the Chukchi Sea when coupled with an effective icemanagement system. The jack-up unit has sufficient ice resistance to withstandinteraction with thin early winter ice. Specific designs of jack-ups arecapable of taking impact forces from thicker ice floes that may occur during anice incursion event during the open water season. The maximum floe size duringan ice incursion is limited and controlled by the associated icemanagement system.
An ice management system was developed using a combination of satelliteimagery, ice management vessels, and ice alert procedures. This system wasdetermined as effective in managing ice to allow the jack-up to operate in theChukchi Sea area.
Environmental and personnel safety is enhanced by the use of aPre-positioned Capping Device, an in place source control device. The device isindependent from the rig's well control system and provides another level ofprotection in additional to the jack-up's BOP.
The conclusion, based on structural and ice management studies, is thatmodern high capacity jack-up drilling units can be an effective way to drillwells during the open water season in shallow waters of Arctic seas includingareas in to which sea ice can move. The studies also show that there ispotential for use in other areas.
Advanced Design and Execution Techniques for Delivering High Data Rate MWD Telemetry for Ultradeep Wells
Authors: Caruzo A. , Hutin R. , Reyes S. , Tweel A. , Temple P. 
Published: December 2012

Abstract

Description.
The purpose of this paper is to describe innovativeimprovements to mud pulse telemetry in an ultra deep environment. This alignstelemetry services with the customer need to enhance drilling performancewithout data quality sacrifice through mud pulse technology, providing thecapability of drilling to 15 km and beyond.

Application.
The MWD pressure pulse signal suffers attenuation anddegradation while traveling uphole. Echoes and reflections, drill pipe IDchanges, pulsation dampener type and mud plastic viscosity, attenuates thepressure signal up 95% as it reaches surface. Planning becomes keystone for thetelemetry system where;–Quantification ofsignal attenuation enables a risk managed planning.–Hardware, improvesMWD Signal detection capabilities.–Software, allowspractical transmission and bandwidth utilization

Results.
This effort resulted in the development of comprehensivemodels for the telemetry signal; as it evolves with depth and is affected bythe different elements of the drilling system.–Integratingenhancements in software and hardware resulted in doubling of MWD transmissiondata rates.–Application ofcompression schemes increasing up to 7 times effective transmission speeds.

Significance of subject matter.
Successful drilling of deep wellsrelies heavily on the planning stage, to extract the maximum value from thedrilling investment. The initiatives outlined in this paper expand theoperating envelope of the more applicable telemetry technology, supporting thenew depth limits to be set. The effort of this investigation delivered areliable, high band-width transmission system designed for wells targeting 15kmreach and beyond.

Introduction
Arctic environments hold a big share of the world oil and gas reserves, locations where drilling performance and cost efficient operations become thekey factor for a successful drilling campaign. Several operators have adoptednew drilling capabilities to achieve production on geographically challengingreservoirs. Proliferation of extreme extended reach drilling wells increasedthe demands of reliable and enhanced mud pulse telemetry systems, aimed tosatisfy the new oilfield milestones.
Leveraging Air Cushion Technology to Transport Cargo in the Arctic
Authors: Turner Daniel G.W. , Turner Stuart J. , Ireland James E. 
Published: December 2012

Abstract
The paper provides information on a unique vehicle, the amphibiousHoverbarge which can be used for transporting heavy cargo, modules and drillingrigs over Arctic terrain, such as snow, ice and tundra. The paper draws uponexperience of Hoverbarge operations in Alaska back in the 1970s along withrecent technical developments of the Hoverbarge to make it more suitable forArctic operations, including skirt ice protection and selfpropulsion.

Application
The paper also highlights important environmental advantages the Hoverbargecan bring, hovering cargo and equipment above the tundra whilst only exerting1psi ground pressure. In addition the paper explains how the Hoverbarge canmeet current demands to extend operating seasons and transport heavy loads suchas pre fabricated modules without building new infrastructure.

Results, Observations and Conclusions
The paper also focuses on the potential of transporting cargo during summermonths when winter roads are not in use and the subsequent advantages that thisbrings.

Significance of Subject Matter
Although first developed over 35 years ago, the Hoverbarge remainsrelatively unknown to current day engineers. This paper seeks to increaseawareness of this technology which may solve a number of current logisticalissues.

Introduction

Overview of Hoverbarge Technology
The Hoverbarge is a marine barge which is designed to meet the localoperating conditions and will float safely when off hover. Resilience is built in, being able to operate on 50% of its lift fan capacityon good ground conditions.
The Hoverbarge is fully amphibious enabling it to operate during any season, at any water depth and without the need to build roads or to dredge rivers.
Finite Element Modeling of Iceberg Interaction with Subsea Protection Structures
Authors: Drover E. , Kenny S. 
Published: December 2012

Abstract
Ice feature interaction with subsea infrastructure or the seabed is acomplex nonlinear event, for which many analytical and advanced computationaltools have been developed with demonstrated application. Although subsea fieldshave been developed in ice gouge environments, such as the Grand Banks, consideration of alternative methods for protecting subsea infrastructure is ofgreat importance. A more in-depth understanding of ice feature mechanicalbehavior and interaction with subsea infrastructure is required.
For various iceberg shapes and loading conditions, the finite element modelspresented in this paper examine the interaction of free-floating ice featureswith protective structures located above or partially above the mudline. Apreliminary assessment of an interaction scenario involving a gouging icebergkeel with a buried protection structure is also presented. The outcome of thisstudy enhances understanding of the primary factors to be considered for thedesign of protection structures in ice environments and highlights some of thetechnical issues associated with the development and calibration of advancedsimulation tools.

Introduction
For conventional design scenarios, protection schemes have been developedfor pipelines and subsea wellheads that include rock placement, mattresses, andstructural frames comprised of steel or concrete (e.g. Alexander, 2008; Berntand Smedsrud, 2007; Copsey and Johnson, 1993; Faden et al., 1980; Figenschouand Wikdal, 1992; Kirkbride and Bloomer, 1994). Ice keel/seabed reactionforces, however, can be an order of magnitude greater than other pipelineloading events such as anchor dragging and pullover (Kenny et al., 2007a, b;Palmer et al., 1990). From this perspective, for subsea infrastructure such aspipelines and wellheads, positioned above or buried beneath the mudline, freelyfloating ice keel contact and seabed ice gouging events have the potential tocause damage or failure of these systems.
For large field developments, where technical, risk and economic factorsdemonstrate project viability, subsea facilities can be housed withinprotective offshore structures (e.g. Hibernia or Sakhalin gravity baseplatforms), or excavated drill centers (EDC), such as those used on the TerraNova and White Rose fields on the Canadian Grand Banks (e.g. Allen, 2011;Finch, 1998; Lever and Dunsmore, 2011; Norman et al., 2008). The primaryconcept for subsea protection was to place the infrastructure within an openexcavation within the seabed or within a drilled, cylindrical counter boredepression below the mudline. These ideas evolved in response to the drillingoperations and potential development of hydrocarbon resources in the BeaufortSea (e.g. Logsdon and Field, 1983; McKay et al., 1995; Meadows and Gilbert,1989; Shields, 1994; Stewart and Goldby, 1984; Todd, 1978).