bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanical Properties and Electronic Structure of Mullite Phases Using First‐Principles Modeling
Authors: Aryal Sitaram , Rulis Paul , Ching Wai‐Yim 
Published: April 2012

The alumino‐silicate series (Al4+2xSi2−2xO10‐x, x = 0–1), is an important class of structural ceramics with many applications. Except for the end member (x = 0), which is the crystalline phase sillimanite, the reported crystal structures of the other phases, called mullites, all have partially occupied sites which makes any theoretical calculation a formidable task. In this article, we describe a systematic and detailed theoretical investigation of the structures and properties of the phases in this series. We constructed stoichiometric supercell models for the four well‐known mullite phases 3Al2O3·2SiO2, 2Al2O3·SiO2, 4Al2O3·SiO2, 9Al2O3·SiO2, corresponding to x = 0.25, 0.40, 0.67, and 0.842. The construction of the models began with experimentally reported crystal structures followed by systematic removal of selected atoms at the partially occupied sites to maintain charge neutrality. A large number of models were built for each phase and fully relaxed to high accuracy using the Vienna ab initio simulation package program. The model with the lowest total energy for a given x was chosen as the representative structure for that phase. Together with sillimanite (x = 0) and the silica free ι‐Al2O3 (x = 1), this series' electronic structure and mechanical properties were studied via first‐principles calculations. Their elastic coefficients and mechanical properties (bulk modulus, shear modulus, Young's modulus, and Poisson's ratio) were evaluated. The electronic structure, effective charges, bonding, and optical properties of these mullite phases were calculated using the orthogonalized linear combination of atomic orbitals method. These first‐principles results provide the basis for an explanation of the experimentally observed structure and properties of mullite phases and their trends with x at the fundamental level.
2  Matters of Belief: Middle‐Range Theory, Religion, and the “State”
Authors: Kus Susan 
Published: April 2012

ABSTRACTIn early large‐scale polities religion played a critical role in giving conceptual form to new rules that trump social and economic principles of kinship and egalitarian reciprocity in order to justify the existence of privileged elites. How does one both do theoretical justice to the insidiousness of a religion used in service to the state and do justice to conviction in local knowledge and the efficaciousness of belief therein? These are important matters for middle‐range theory in the archaeology of religion. This contribution focuses on the latter half of the conundrum understood from contemporary ethnographic work by the author in the central highlands of Madagascar. It then examines the crafting of state religion during the unification and expansion of the Merina state under the reign of Andrianampoinimerina (1787–1810).
4  Technology and Morality—Rituals in Iron Working among the Fipa and Pangwa Peoples in Southwestern Tanzania
Authors: Barndon Randi 
Published: April 2012

ABSTRACTBased on ethnographic fieldwork in the 1990s among the Pangwa and Fipa peoples in southwestern Tanzania, this discussion focuses on the locally constructed collective and individual perceptions of technological processes in iron smelting and how these are connected to imagination. Of particular interest is the largely neglected aspect of morality involved in the rituals surrounding iron working. It is argued that aspects of morality, as well as magic and witchcraft, explain the concerns of the people engaged in the complex technology of making iron far better than does fertility symbolism.
9  Meanings and Functions of Enclosed Places in the European Neolithic: A Contextual Approach to Cult, Ritual, and Religion
Authors: Biehl Peter F. 
Published: April 2012

ABSTRACTThis chapter reevaluates theories and methodologies applied to the archaeology of religion stressing the symbolic meaningfulness of material culture, place, and landscape. In a case study—the Neolithic circular enclosure of Goseck in Germany—a contextual approach is used to highlight that ritual practices function both at a community and at an individual level, and as social and communicative acts. The chapter also demonstrates that ritual practice ought to be contextualized with the material culture and the place associated with it in order to better understand and theorize its complex meaning in prehistoric religious life.
Are Patients With Longer Emergency Department Wait Times Less Likely to Consent to Research?
Authors: Limkakeng Alexander T. , Glickman Seth W. , Shofer Frances , Mani Giselle , Drake Weiying , Freeman Debbie , Ascher Simon , Pietrobon Ricardo , Cairns Charles B. 
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 396–401 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  There are unique challenges to enrolling patients in emergency department (ED) clinical research studies, including the time‐sensitive nature of emergency conditions, the acute care environment, and the lack of an established relationship with patients. Prolonged ED wait times have been associated with a variety of adverse effects on patient care. The objective of this study was to assess the effect of ED wait times on patient participation in ED clinical research. The hypothesis was that increased ED wait times would be associated with reduced ED clinical research consent rates.Methods:  This was a retrospective cohort study of all patients eligible for two diagnostic clinical research studies from January 1, 2008, through December 31, 2008, in an urban academic ED. Sex, age, race, study eligibility, and research consent decisions were recorded by trained study personnel. The wait times to registration and to be seen by a physician were obtained from administrative databases and compared between consenters and nonconsenters. An analysis of association between patient wait times for the outcome of consent to participate was performed using a multivariate logistic regression model.Results:  A total of 903 patients were eligible for enrollment and were asked for consent. Overall, 589 eligible patients (65%) gave consent to research participation. The consent rates did not change when patients were stratified by the highest and lowest quartile wait times for both time from arrival to registration (68% vs. 65%, p = 0.35) and time to be seen by a physician (65% vs. 66%, p = 0.58). After adjusting for patient demographics (age, race, and sex) and study, there was still no relationship between wait times and consent (p > 0.4 for both wait times). Furthermore, median time from arrival to registration did not differ between those who consented to participate (15 minutes; interquartile range [IQR] = 9 to 36 minutes) versus those who did not (15.5 minutes; IQR = 10 to 39 minutes; p = 0.80; odds ratio [OR] = 1.00, 95% confidence interval [CI] = 0.99 to 1.01). Similarly, there was no difference in the median time to be seen by a physician between those who consented (25 minutes; IQR = 15 to 55 minutes) versus those who did not (25 minutes; IQR = 15 to 56 minutes; p = 0.70; OR = 1.00, 95% CI = 0.99 to 1.01).Conclusions:  Regardless of wait times, nearly two‐thirds of eligible patients were willing to consent to diagnostic research studies in the ED. These findings suggest that effective enrollment in clinical research is possible in the ED, despite challenges with prolonged wait times.
Epidemiology of 6.6 Million Knee Injuries Presenting to United States Emergency Departments From 1999 Through 2008
Authors: Gage Brett E. , McIlvain Natalie M. , Collins Christy L. , Fields Sarah K. , Dawn Comstock R. 
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:378–385 © 2012 by the Society for Academic Emergency MedicineAbstractBackground:  While knee injuries are treated by a wide range of clinicians, patients with knee injuries frequently present to emergency departments (EDs). The knee is the most commonly injured joint by adolescent athletes with an estimated 2.5 million sports‐related injuries presenting to EDs annually.Objectives:  The objective was to examine the epidemiology of knee injuries presenting to EDs in the United States from 1999 through 2008.Methods:  The Consumer Product Safety Commission National Electronic Injury Surveillance System database (NEISS) was used to examine causes of knee injuries treated in U.S. EDs from 1999 through 2008.Results:  An estimated 6,664,324 knee injuries presented to U.S. EDs from 1999 through 2008, for a rate of 2.29 knee injuries per 1,000 population. Those 15 to 24 years of age had the highest injury rate (3.83), while children younger than 5 years had the lowest rate (0.55). The most common diagnoses were strains and sprains (42.1%), contusions and abrasions (27.1%), and lacerations and punctures (10.5%). The most common general product categories causing injury were sports and recreation (49.3%), home structures (30.2%), and home furnishings (13.6%). Several sex and age group differences were identified. For example, males sustained a higher proportion of basketball‐related injuries (11.1%) than females (3.6%; injury proportion ratio [IPR] = 3.11, 95% confidence interval [CI] = 2.79 to 3.46, p < 0.001). Additionally, individuals 65 years and older sustained a higher proportion of injury due to stairs, ramps, landings, and floors (42.0%), compared to all other ages (20.1%; IPR = 2.09, 95% CI = 1.95 to 2.23, p < 0.001).Conclusions:  Rates and patterns of knee injuries vary by sex and age. Although knee injuries will likely continue to occur most frequently among youth and young adult athletes, anticipating and responding to trends such as an increase in the incidence of knee injuries among adult and senior patients will enable clinicians to better anticipate caseloads, allocate resources, and determine best practices for diagnosis and treatment of knee injuries in different age groups.
Factors That Influence Medical Student Selection of an Emergency Medicine Residency Program: Implications for Training Programs
Authors: Love Jeffrey N. , Howell John M. , Hegarty Cullen B. , McLaughlin Steven A. , Coates Wendy C. , Hopson Laura R. , Hern Gene H. , Rosen Carlo L. , Fisher Jonathan , Santen Sally A. 
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 455–460 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  An understanding of student decision‐making when selecting an emergency medicine (EM) training program is essential for program directors as they enter interview season. To build upon preexisting knowledge, a survey was created to identify and prioritize the factors influencing candidate decision‐making of U.S. medical graduates.Methods:  This was a cross‐sectional, multi‐institutional study that anonymously surveyed U.S. allopathic applicants to EM training programs. It took place in the 3‐week period between the 2011 National Residency Matching Program (NRMP) rank list submission deadline and the announcement of match results.Results:  Of 1,525 invitations to participate, 870 candidates (57%) completed the survey. Overall, 96% of respondents stated that both geographic location and individual program characteristics were important to decision‐making, with approximately equal numbers favoring location when compared to those who favored program characteristics. The most important factors in this regard were preference for a particular geographic location (74.9%, 95% confidence interval [CI] = 72% to 78%) and to be close to spouse, significant other, or family (59.7%, 95% CI = 56% to 63%). Factors pertaining to geographic location tend to be out of the control of the program leadership. The most important program factors include the interview experience (48.9%, 95% CI = 46% to 52%), personal experience with the residents (48.5%, 95% CI = 45% to 52%), and academic reputation (44.9%, 95% CI = 42% to 48%). Unlike location, individual program factors are often either directly or somewhat under the control of the program leadership. Several other factors were ranked as the most important factor a disproportionate number of times, including a rotation in that emergency department (ED), orientation (academic vs. community), and duration of training (3‐year vs. 4‐year programs). For a subset of applicants, these factors had particular importance in overall decision‐making.Conclusions:  The vast majority of applicants to EM residency programs employed a balance of geographic location factors with individual program factors in selecting a residency program. Specific program characteristics represent the greatest opportunity to maximize the success of the immediate interview experience/season, while others provide potential for strategic planning over time. A working knowledge of these results empowers program directors to make informed decisions while providing an appreciation for the limitations in attracting applicants.
Evaluating the Use of Existing Data Sources, Probabilistic Linkage, and Multiple Imputation to Build Population‐based Injury Databases Across Phases of Trauma Care
Authors: Newgard Craig , Malveau Susan , Staudenmayer Kristan , Wang N. Ewen , Hsia Renee Y. , Mann N. Clay , Holmes James F. , Kuppermann Nathan , Haukoos Jason S. , Bulger Eileen M. , Dai Mengtao , Cook Lawrence J. ,   the WESTRN investigators
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 469–480 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to evaluate the process of using existing data sources, probabilistic linkage, and multiple imputation to create large population‐based injury databases matched to outcomes.Methods:  This was a retrospective cohort study of injured children and adults transported by 94 emergency medical systems (EMS) agencies to 122 hospitals in seven regions of the western United States over a 36‐month period (2006 to 2008). All injured patients evaluated by EMS personnel within specific geographic catchment areas were included, regardless of field disposition or outcome. The authors performed probabilistic linkage of EMS records to four hospital and postdischarge data sources (emergency department [ED] data, patient discharge data, trauma registries, and vital statistics files) and then handled missing values using multiple imputation. The authors compare and evaluate matched records, match rates (proportion of matches among eligible patients), and injury outcomes within and across sites.Results:  There were 381,719 injured patients evaluated by EMS personnel in the seven regions. Among transported patients, match rates ranged from 14.9% to 87.5% and were directly affected by the availability of hospital data sources and proportion of missing values for key linkage variables. For vital statistics records (1‐year mortality), estimated match rates ranged from 88.0% to 98.7%. Use of multiple imputation (compared to complete case analysis) reduced bias for injury outcomes, although sample size, percentage missing, type of variable, and combined‐site versus single‐site imputation models all affected the resulting estimates and variance.Conclusions:  This project demonstrates the feasibility and describes the process of constructing population‐based injury databases across multiple phases of care using existing data sources and commonly available analytic methods. Attention to key linkage variables and decisions for handling missing values can be used to increase match rates between data sources, minimize bias, and preserve sampling design.
Patients Who Leave Without Being Seen in Emergency Departments: An Analysis of Predictive Factors and Outcomes
Authors: Tropea Joanne , Sundararajan Vijaya , Gorelik Alexandra , Kennedy Marcus , Cameron Peter , Brand Caroline A 
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 439–447 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to identify predictive factors and outcomes associated with patients who leave emergency departments (EDs) without being seen in Victoria, Australia.Methods:  This was a retrospective observational study of Victorian ED patient visits between July 1, 2000, and June 30, 2005, using linked hospital, ED, and death registration data. Index ED visits were identified for patients who left without being seen (LWBS) and for those who completed ED treatment and were discharged home. Statistical analyses included a general description and univariate analysis of patient, ED visit, temporal, and hospital‐level factors. Logistic regression models were developed to assess risk factors associated with LWBS status compared to patients who completed treatment, to assess 48 hour re‐presentations to ED; 48‐hour hospital admissions; and 2‐,7‐, and 30‐day mortality among those who LWBS compared to those who completed treatment. Adjusted odds ratios (ORs) and 99% confidence intervals (CIs) are presented.Results:  There were 239,305 LWBS episodes, for 205,500 patients over the 5‐year period. Independent factors associated with LWBS patients in comparison to those who completed treatment include patients who are younger (15 to 24 years, OR = 2.46, 99% CI = 2.37 to 2.56), male (OR = 1.07, 99% CI = 1.05 to 1.08), of Australian indigenous background (OR = 1.63, 99% CI = 1.53 to 1.73), of non–English‐speaking background (OR = 1.08, 99% CI = 1.06 to 1.10), noncompensable status (OR = 1.73, 99% CI = 1.68 to 1.79), self‐referring (OR = 1.46, 99% CI = 1.43 to 1.49), nonassisted arrival mode (OR = 1.35, 99% CI = 1.30 to 1.40), and those with a hospital admission in the 12 months before the ED presentation (OR = 1.53, 99% CI = 1.51 to 1.55). Patients who LWBS had triage categories of lower urgency (nonurgent, OR = 8.21, 99% CI = 8.00 to 8.43), attended during the evening (OR = 1.10, 99% CI = 1.08 to 1.12), on either Sunday (OR = 1.20, 99% CI = 1.18 to 1.23) or Monday (OR = 1.20, 99% CI = 1.17 to 1.23), in winter (OR = 1.14, 99% CI = 1.12 to 1.16), with higher rates occurring in higher volume EDs (OR = 2.20, 99% CI = 2.15 to 2.26). There was no greater risk of mortality for LWBS patients compared to patients who completed treatment. The risk of hospital admission within 48 hours of discharge was lower for LWBS patients (OR = 0.60, 99% CI = 0.58 to 0.62); however, ED re‐presentation risk was higher (OR = 1.63, 99% CI = 1.60 to 1.67).Conclusions:  Patients who leave EDs in Victoria, Australia, without being seen are at lower risk of hospital admission and at no greater risk of mortality, but are at higher risk of re‐presenting to an ED compared to patients who complete treatment and are discharged home.
Feasibility of Percutaneous Vagus Nerve Stimulation for the Treatment of Acute Asthma Exacerbations
Authors: Miner James R. , Lewis Lawrence M. , Mosnaim Giselle S. , Varon Joseph , Theodoro Daniel , Hoffmann Thomas J. 
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 421–429 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  This study assessed the feasibility of an investigational vagus nerve stimulation (VNS) device for treating acute asthma exacerbations in patients not responding to at least 1 hour of initial standard care therapy.Methods:  This was a prospective, nonrandomized study of patients treated in the ED for moderate to severe acute asthma (forced expiratory volume in 1 second [FEV1] 25% to 70% of predicted). Treatment entailed percutaneous placement of an electrode near the right carotid sheath and 60 minutes of VNS and continued standard care. VNS voltage was adjusted to perceived improvement, muscle twitching, or adverse events (AEs). All AEs, vital signs, FEV1, perceived work of breathing (WOB), and final disposition were recorded.Results:  Twenty‐five subjects were enrolled. There were no serious AEs and no significant changes in vital signs. No subject required terminating VNS. One patient had minor bleeding from the procedure, and one had a hematoma and withdrew prior to VNS. AEs related to VNS were temporary and included cough (1 of 24), swallowing difficulty (2 of 24), voice change (2 of 24), and muscle twitching (14 of 24). These resolved when VNS ended. The FEV1 improved at 15 minutes (median = 15.8%, 95% confidence interval [CI] = 9.3% to 22.4%), 30 minutes (median = 21.3%, 95% CI = 8.1% to 36.5%), and 60 minutes (median = 27.5%, 95% CI = 11.3% to 43.5%). WOB improved at 15 minutes (median = 53.9%, 95% CI = 33.7% to 73.9%), 30 minutes (median = 69.1%, 95% CI = 56.4% to 81.8%), and 60 minutes (median = 81.0%, 95% CI = 68.5% to 93.5%).Conclusions:  Percutaneous VNS did not result in serious AEs and was associated with improvements in FEV1 and perceived dyspnea. Percutaneous VNS appears to be feasible for use in the treatment of moderate to severe acute asthma in patients unresponsive to initial standard care treatment.
The Emergency Department Action in Smoking Cessation (EDASC) Trial: Impact on Delivery of Smoking Cessation Counseling
Authors: Katz David A. , Vander Weg Mark W. , Holman John , Nugent Andrew , Baker Laurence , Johnson Skyler , Hillis Stephen L. , Titler Marita 
Published: April 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 409–420 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The focus on acute care, time pressure, and lack of resources hamper the delivery of smoking cessation interventions in the emergency department (ED). The aim of this study was to 1) determine the effect of an emergency nurse–initiated intervention on delivery of smoking cessation counseling based on the 5As framework (ask–advise–assess–assist–arrange) and 2) assess ED nurses’ and physicians’ perceptions of smoking cessation counseling.Methods:  The authors conducted a pre–post trial in 789 adult smokers (five or more cigarettes/day) who presented to two EDs. The intervention focused on improving delivery of the 5As by ED nurses and physicians and included face‐to‐face training and an online tutorial, use of a charting/reminder tool, fax referral of motivated smokers to the state tobacco quitline for proactive telephone counseling, and group feedback to ED staff. To assess ED performance of cessation counseling, a telephone interview of subjects was conducted shortly after the ED visit. Nurses’ and physicians’ self‐efficacy, role satisfaction, and attitudes toward smoking cessation counseling were assessed by survey. Multivariable logistic regression was used to assess the effect of the intervention on performance of the 5As, while adjusting for key covariates.Results:  Of 650 smokers who completed the post‐ED interview, a greater proportion had been asked about smoking by an ED nurse (68% vs. 53%, adjusted odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3 to 2.9), assessed for willingness to quit (31% vs. 9%, adjusted OR= 4.9, 95% CI = 2.9 to 7.9), and assisted in quitting (23% vs. 6%, adjusted OR = 5.1, 95% CI = 2.7 to 9.5) and had arrangements for follow‐up cessation counseling (7% vs. 1%, adjusted OR = 7.1, 95% CI = 2.3 to 21) during the intervention compared to the baseline period. A similar increase was observed for emergency physicians (EPs). ED nurses’ self‐efficacy and role satisfaction in cessation counseling significantly improved following the intervention; however, there was no change in “pros” and “cons” attitudes toward smoking cessation in either ED nurses or physicians.Conclusions:  Emergency department nurses and physicians can effectively deliver smoking cessation counseling to smokers in a time‐efficient manner. This trial also provides empirical support for expert recommendations that call for nursing staff to play a larger role in delivering public health interventions in the ED.