bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality and financial outcomes from gainsharing for inpatient admissions: A three‐year experience
Authors: Leitman I. Michael , Levin Ruth , Lipp Michael J. , Sivaprasad Latha , Karalakulasingam Christine J. , Bernard David S. , Friedmann Patricia , Shulkin David J. 
Published: August 2010

AbstractBACKGROUND:Gainsharing is a way to provide incentives to physicians to decrease hospital costs without compromising quality.METHODS:A pay‐for‐performance program was instituted over a three‐year period from July 2006 to June 2009. Baseline length of stay (LOS) and case costs were developed during the year prior to the inception of the program. Best practice norms (BPNs) were established at the top 25th percentile of physicians for each all patient refined (APR)‐diagnosis related group (DRG). Hospital costs were analyzed in several areas, including operating room charge (OR), supplies and implants, nursing and per‐diem room costs. Payments were based upon case level performance compared to BPN's and the physician's historic performance. Eligible cases included commercial insurance only for the first 2 years but Medicare cases were included after October 2008 resulting from a Centers for Medicare and Medicaid Services (CMS)‐approved demonstration project. Payments to physicians required meeting quality thresholds, including chart completion, and compliance with core measures.RESULTS:A total of 184 (54%) physicians enrolled into the program. There was a $25.1 million reduction in hospital costs during the 3 years ($16 million from participating and $9.1 million from non‐participating physicians, P < 0.01). Most cost reductions were attributed to reduced LOS and reductions in medical supply costs. Total physician payouts were over $2 million (average $1,866 per quarter). Delinquent medical records decreased from an average of 43% in the second quarter 2006 to 30% (P < 0.0001) in the second quarter 2009. Quality measures improved during the study period but not by a statistical significance.CONCLUSIONS:Gainsharing provided an incentive for physicians to reduce hospital costs while maintaining hospital quality. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.
Advancing geriatrics education: An efficient faculty development program for academic hospitalists increases geriatric teaching
Authors: Mazotti Lindsay , Moylan Adam , Murphy Elizabeth , Harper G. Michael , Johnston C. Bree , Hauer Karen E. 
Published: August 2010

AbstractBACKGROUND:Hospitalists care for an increasing number of older patients. As teachers, they are uniquely positioned to teach geriatric skills to residents. Faculty development programs focused on geriatrics teaching skills are often expensive and time‐intensive, and may not enhance trainee learning.OBJECTIVES:To evaluate a train‐the‐trainer (TTT) model designed to equip hospitalists with knowledge and skills to teach geriatric topics to residents in a time‐constrained, resource‐limited environment.DESIGN:Cross‐sectional survey.SETTING:Academic tertiary hospital.INTERVENTION:A 10‐hour geriatric curriculum, the Reynolds Program for Advancing Geriatrics Education (PAGE), cotaught by geriatricians and hospitalists at preexisting noon conferences over 1 year that consisted of exportable teaching modules.MEASUREMENTS:Session leaders' and faculty participants' satisfaction, hospitalist geriatrics teaching self‐efficacy, residents' self‐report of frequency of geriatric teaching received, and frequency of geriatric skill use.RESULTS:The curriculum was highly rated by session leaders and hospitalist faculty. Hospitalists perceived improvement in geriatric teaching skills, indicating (1: “unlikely” to 5: “highly likely”) that they are likely to use these teaching tools in the future (M = 4.61, standard deviation [SD] = 0.53). Residents reported both significantly more geriatrics teaching by hospitalists (P < 0.05) and a borderline significant increase in their practice of geriatric clinical skills (P = 0.05).CONCLUSIONS:A time‐efficient geriatric faculty development program for hospitalists suggests improvement in the amount and quality of geriatrics teaching and skill practice among faculty and residents at an academic medical center. Concise faculty development programs within preexisting faculty meetings may be a feasible, successful method to increase geriatric skill development in the hospital setting. Journal of Hospital Medicine 2010; © 2010 Society of Hospital Medicine.
Gaining efficiency and satisfaction in the handoff process
Authors: Burton M. Caroline , Kashiwagi Deanne T. , Kirkland Lisa L. , Manning Dennis , Varkey Prathibha 
Published: August 2010

AbstractBACKGROUND:Handoffs, or transfers of patient care responsibility, occur frequently on hospitalist teams. The reliability and efficiency of the handoff process is a national and local concern. Most studies in the literature regard physicians‐in‐training. We studied the morning handoff process of hospitalist teams comprised of staff physicians and nurse practitioner and/or physician assistants.METHODS:An improvement team observed morning handoffs. Four problems were identified: unpredictable start and finish times, inefficiency, poor environment (hallway noise and distracting in‐room conversations), and poor communication. The team restructured the process and observed post‐intervention behavior at 15 and 90 days. A participant‐provider survey was conducted before and after the intervention regarding wasted time, total time‐in‐report, and satisfaction with the process.RESULTS:Pre‐intervention 60.5% of providers (23/38) believed morning handoff was performed in a timely fashion compared to 100% (15/15) post‐intervention (P = 0.005). Average time spent in morning report was 11 minutes, compared to 5 minutes after the intervention (P < 0.0028). Pre‐intervention 6.5 minutes were believed wasteful, compared to 0.5 minutes post‐intervention (P < 0.0001).CONCLUSIONS:This study identifies deficiencies in the handoff process that were addressed by enhancing the physical environment (smaller room, noise reduction, closed door), assigned seating (visual cues by table tent cards), non‐clinicians providing printed materials, standardization of written updates, team times (consistent & precise daily time for each team report), culture change including deference of attention to team receiving report with opportunity for questions, and minimization of side conversations. This intervention package resulted in an improvement in satisfaction and timeliness of clinicians involved. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.
Residue content of carbaryl applied on greenhouse cucumbers and its reduction by duration of a pre‐harvest interval and post‐harvest household processing
Authors: Hassanzadeh Nasrin , Bahramifar Nader , Esmaili‐Sari Abbas 
Published: August 2010

AbstractBACKGROUND: Carbaryl is widely used to control various insect pests on greenhouse cucumbers in Iran. Therefore the control of residual levels of this insecticide is highly necessary. The effects of the household processing such as washing, peeling and refrigeration storage, at 4 °C for 2 days on the reduction of residue levels in the plant tissues were investigated in the different groups. Samples were collected at 1 h to 14 days after application and analysed to determine the content and dissipation rate of carbaryl. Analysis was carried out by the QuEChERS method using HPLC‐UV.RESULTS: Carbaryl residue in samples, which were collected post‐application in different times showed a gradual and significant (P < 0.05) decrease. The half‐life (t1/2) of carbaryl applied on cucumbers was 3.2 days. Carbaryl residues were detected in concentration ranges of 0.22–4.91 mg kg−1. Also, the results indicated that the consumable safety time of carbaryl was found to be more than 14 days on cucumber.CONCLUSION: Household processing, such as washing and peeling and refrigeration storage, was effective in reducing the residue levels. Also, peeling was the most effective way to reduce the carbaryl residues of the cucumber samples. Washing and refrigerated storage also decreased carbaryl residues. Copyright © 2010 Society of Chemical Industry
Influence of the cultivar on the organic acid and sugar composition of potatoes
Authors: Rodríguez Galdón Beatriz , Ríos Mesa Domingo , Rodríguez Rodríguez Elena Mª , Díaz Romero Carlos 
Published: August 2010

AbstractBACKGROUND: Citric, malic, tartaric, oxalic, ascorbic, aconitic and fumaric acids, and sucrose, fructose and glucose, were determined in ten potato cultivars (Azucena negra, Bonita, Bonita negra, Borralla, Colorada de baga, Mora, Negra, Palmera lagarteada, Peluca blanca and Terrenta) from the Canary Islands in order to differentiate them. The influence of the production zone was also considered.RESULTS: Citric acid and sucrose were the most abundant organic acid and sugar, respectively. There were significant differences in all the analysed sugars and organic acids between the potato cultivars, except for oxalic and malic acids. Differences associated with the production zone were found in the contents of organic acids for some cultivars. Linear discriminant analysis is a useful tool to differentiate the potato samples according to the cultivar and the zone of production.CONCLUSIONS: Seven organic acids (citric, oxalic, malic, tartaric, aconitic, fumaric, and ascorbic acids) were identified and quantified in potatoes. The main sugars (sucrose, glucose and fructose) were also determined. The genetic information of the cultivars determines marked differences in sugars and organic acid contents among the analysed potato cultivars. The soil and climatic conditions affect the organic acid and sugar contents of some potato cultivars. Copyright © 2010 Society of Chemical Industry
Factors affecting usefulness of triticale grain for bioethanol production
Authors: Obuchowski Wiktor , Banaszak Zofia , Makowska Agnieszka , Łuczak Miłosz 
Published: August 2010

AbstractBACKGROUND: Triticale grain could be a useful material for bioethanol production. The aim of this study was to examine how grain cultivar, nitrogen fertilisation level, location and year affect the starch content in triticale grain and which method of starch determination, polarimetric, enzymatic or near‐infrared transmission (NIT), gives the best prediction of real bioethanol productivity from triticale grain.RESULTS: It was found that the starch content in triticale grain was correlated positively with test weight and 1000‐kernel weight but negatively with falling number and protein content. All factors, i.e. cultivar, nitrogen fertilisation level, location and year, as well as the intrinsic interaction between these factors, had a significant effect on the starch level in triticale grain. The NIT procedure of starch determination gave the best results in predicting the real yield of ethanol obtained on the basis of classic fermentation (95% match), while the enzymatic and polarimetric methods corresponded with the real results at levels of 89–90 and 78–82% respectively.CONCLUSION: Grain growth conditions related to location and nitrogen fertilisation level had the most noticeable effect on grain starch content, while grain yield per hectare had the most significant effect on ethanol productivity. Copyright © 2010 Society of Chemical Industry
Efficacy of leukotriene antagonists as concomitant therapy in allergic rhinitis
Authors: Cingi Cemal , Gunhan Kivanc , Gage‐White Linda , Unlu Halis 
Published: August 2010

AbstractObjectives/Hypothesis:The symptoms of allergic rhinitis result from an immunoglobulin E‐dependent mast cell activation cascade, marked by the release of inflammatory mediators, including histamine. Patients with perennial allergic rhinitis also have elevated levels of cysteinyl leukotrienes (CysLTs) in nasal lavage fluid. Histamine and CysLTs produce different responses in the pathogenesis of allergic rhinitis, and this study tested the hypothesis that the effects of combined antihistamine and leukotriene antagonist therapy would be more effective than antihistamine alone.Study Design:Multicentered, prospective, randomized, placebo‐controlled, parallel‐group.Methods:Three groups totaling 275 patients using: 1) fexofenadine alone, 2) fexofenadine with montelukast, or 3) fexofenadine with placebo, participated in a 21‐day trial conducted during the spring pollen season. Objective analysis included pre‐ and poststudy physical examination findings and nasal resistance measurements. Subjective data gathered included a daily patient diary and pre‐ and poststudy patient satisfaction measurements.Results:The group using both fexofenadine and montelukast showed significantly better control of nasal congestion both subjectively, using patient diary and visual analog scale evaluations, and objectively, using rhinomanometry and physical examination, compared to groups using antihistamine alone or with placebo.Conclusions:Our data provided both objective and subjective evidence that leukotriene receptor antagonist‐antihistamine combination therapy is more effective than antihistamine alone in the control of allergic rhinitis symptoms. Laryngoscope, 2010
Spontaneous cerebrospinal fluid rhinorrhea: A clinical and anatomical study
Authors: Tóth Miklós , Selivanova Oxana , Schaefer Steven , Mann Wolf 
Published: August 2010

AbstractObjectives/Hypothesis:Spontaneous nasal cerebrospinal fluid (CSF) fistula represents a rare clinical entity. The possible etiology and the localization of the rhinorrhea remain an ongoing clinical challenge. The purpose of this study was to evaluate the localization of spontaneous CSF fistula and to correlate it with anatomical studies.Study Design:Retrospective clinical study, prospective anatomical study.Methods:Twenty‐nine patients with spontaneous CSF rhinorrhea were retrospectively studied, 10 males and 19 females. Ages ranged from 10 to 92 years (mean, 50 years). In addition, 48 human skulls from newborns to adults were examined for the postnatal development of the anterior and middle cranial fossa.Results:In our study isolated cribriform plate defects were found in four patients. The lateral lamina of the ethmoid bone showed defects in three patients. In nine patients the bony defect could be found in the region of the fovea ethmoidalis. The bony defect between the extra‐ and intracranial space was found in the lateral recess of the sphenoid sinus in eight patients. Five patients had special sites (e.g., supraorbital recess and frontal recess).Conclusions:This study supports the theory that bony dehiscence in the lateral lamina of the ethmoid bone can be congenital and can also be spontaneously acquired later. The bony dehiscence in the lateral wall of the sphenoid sinus can only develop during pneumatization. Laryngoscope, 2010
The relationship between depressive symptoms and voice handicap index scores in laryngopharyngeal reflux
Authors: Elam Jackson C. , Ishman Stacey L. , Dunbar Kerry B. , Clarke John O. , Gourin Christine G. 
Published: August 2010

AbstractObjectives/Hypothesis:To determine if a relationship exists between depression and Voice Handicap Index (VHI) scores in patients with laryngopharyngeal reflux (LPR) disease.Study Design:Retrospective analysis of prospectively collected data.Methods:One hundred nineteen patients were prospectively evaluated with the VHI questionnaire and the Beck Depression Inventory Fast Screen (BDI‐FS) survey. Patients with a pre‐existing diagnosis of depression were excluded.Results:Complete data was available for 36 patients with LPR and 53 controls. No significant differences existed between groups with respect to age, race, or gender. Mild depressive symptoms were identified in 9% of controls and 3% of LPR patients by BDI‐FS screening (P = .4); no patients had moderate or severe depression symptoms. Compared to controls, patients with LPR had significantly higher mean scores for total VHI (16.2 vs. 6.6, P = .002), functional VHI (5.8 vs. 2.4, P = .02), and physical VHI (6.9 vs. 2.5, P = .008) domains. Mean scores for the VHI emotional domain (3.5 vs. 1.7, P = .2) and BDI‐FS (0.2 vs. 0.8, P = .3) did not differ between patients with LPR and controls. For all participants, a positive correlation was found between BDI‐FS score and VHI emotional domain score (r = 0.3, P = .008).Conclusions:Patients with LPR report poorer VHI functional and physical scores compared to controls; however, LPR symptoms do not result in significantly worse VHI emotional domain scores or depressive symptoms. There is a correlation between VHI emotional domain scores and BDI‐FS scores. These data suggest that LPR patients with poor VHI emotional domain scores might benefit from screening for depressive symptoms. Laryngoscope, 2010
Cyclooxygenase‐2 signaling in vocal fold fibroblasts
Authors: Branski Ryan C. , Zhou Hang , Sandulache Vlad C. , Chen Jie , Felsen Diane , Kraus Dennis H. 
Published: August 2010

AbstractObjectives/Hypothesis:Inflammation and its role in a coordinated fibroplastic response, which disrupts the structure of the vocal folds following injury, is critical. Cyclooxygenase‐2 (COX‐2) is an important enzyme involved in both inflammation and fibrosis; in addition, it is a prime target for therapeutic intervention. We sought to study this pathway in vocal fold fibroblasts to provide a foundation for future interventional studies.Study Design:In vitro.Methods:Human vocal fold fibroblasts were incubated with IL‐1β to determine the effects on COX‐2 signaling, along with upstream regulatory mechanisms and downstream mediators of wound healing. In vitro methods to assess mRNA expression, as well as intracellular and secreted protein (sodium dodecyl sulfate polyacrylamide gel electrophoresis and enzyme‐linked immunosorbent assay) were employed.Results:IL‐1β regulation of COX‐2 mRNA and protein levels was dose and time dependent and IL‐1β altered PGE2 metabolism, via regulation of both synthetic and degradative enzymes. IL‐1β increased nuclear factor (NF)‐κB activation and nuclear translocation. Inhibition of the p50 and p65 subunits of NF‐κB decreased IL‐1β‐induced COX‐2 transcription. IL‐1β also altered mRNA expression of four cell‐surface prostaglandin receptors.Conclusions:Inflammation and fibrosis are important in the vocal fold pathophysiologic response to injury. Our data suggest that COX‐2 and PGE2 are inducible in human vocal fold fibroblasts, and this response appears to be NF‐κB‐dependent. We purport this fundamental investigation will lead to increased insight regarding injury and repair in the vocal folds, with the ultimate goal of developing novel clinical care paradigms. Laryngoscope, 2010
Implementation of an efficient shooting and bouncing rays scheme
Authors: Dikmen Fatih , Ergin A.Arif , Sevgili A. Levent , Terzi Bilgin 
Published: August 2010

AbstractImplementation of the shooting and bouncing rays (SBR) method for radar cross section or scattering center prediction of complex electrically large objects is studied with a focus on the computational efficiency. A triangulated CAD model is assumed and SBR is processed by a ray‐triangle intersection algorithm. An octree space partitioning, which might be based on either rectangular boxes or spheres as bounding volumes, is used to speedup the intersection decision. The effect of proper implementation and choice of the bounding volume to reduce “the constant in front” of the leading order complexity is demonstrated. It is shown that the required computer resources can be reduced drastically using the techniques outlined in this article. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52:2409–2413, 2010; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25492
A low‐power X‐band free electron laser by prebunching of the electrons
Authors: Malek Fareq , Lucas James , Huang Yi 
Published: August 2010

AbstractWe are developing a prototype free electron laser that is compact, low cost, and low power. The design, setup, and results of a novel X‐band rectangular waveguide prebunched free electron laser (PFEL) are presented in this article. Our initial device operates at 10 GHz and uses two rectangular waveguide cavities (one for velocity modulation and the other for energy extraction). The electron beam used in this experiment is produced by thermionic electron gun, which operates at 3 kV and up to 50 μA. The nominal beam diameter is 1 mm passing across the X‐band cavity resonators. The resonant cavity consists of a thin gap section of height 1.5 mm, which reduces the beam energy required for beam wave interaction. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52:2483–2486, 2010; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25493
Benefits of using conductive plastics in shielding configurations to reduce radiated electromagnetic interference
Authors: Lozano‐Guerrero Antonio José , Robinson Martin Paul , Díaz‐Morcillo Alejandro , Balbastre‐Tejedor Juan Vicente 
Published: August 2010

AbstractConductive plastic cabinets have become an alternative to traditional metallic enclosures to shield electronic equipment from electromagnetic interference. These materials allow a wide range of conductivities that can satisfy any particular design. In this article, the benefits of using conductive plastics in enclosure configurations have been evaluated. A design with an outer metallic layer and an inner layer of conductive dielectric can provide advantages from both materials as a conductive plastic box is lighter and its shielding properties may have advantages over metallic materials. An optimum for resonance suppression has been obtained for the hybrid structure. These shielding structures have been evaluated with the help of measurements and simulations. Shielding effectiveness andQfactor have been used to compare the capabilities of these enclosures with the metallic ones showing their benefits and possibilities. Resonance suppression and shielding levels provided by conductive plastics are discussed. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52:2476–2480, 2010; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25499
Wideband multibeam formation using fully spatial signal processing for indoor communications
Authors: Uthansakul Monthippa , Attakitmongkol Kitti , Bunsanit Chayanit , Uthansakul Peerapong 
Published: August 2010

AbstractRecently, an outstanding wideband beamformer utilizing only space domain, not time or frequency domain, has been proposed, so‐called wideband spatial beamformer. The advantage of this beamformer is that it requires only attenuators or amplifiers to perform beam formation in wide frequency band as its weighting coefficients become real values. As a result, tapped delay lines, frequency filters, or phase shifters are avoidable. This article presents an extension work for the mentioned wideband spatial beamformer. The beamforming algorithm is modified to produce multibeam patterns with one set of real‐valued weights for the purpose of energy saving. The proposed concept is tested through simulated and measured results to confirm beamforming capability. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52:2423–2427, 2010; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25506
Single‐shot all‐optical sampling oscilloscope using a polarization‐maintaining resonator for pulse replication
Authors: Komanec Matěj , Honzátko Pavel , Zvánovec Stanislav 
Published: August 2010

AbstractAn all‐optical single‐shot sampling oscilloscope with a picosecond resolution is developed. An innovative approach for data pulse replication using a polarization‐maintaining resonator is used. Pulses are sampled in a highly nonlinear fiber. Acquired data are used for pulse shape reconstruction. Proposed setup eliminates the need of a delay line. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52:2452–2456, 2010; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25509