bluuebunny/crossref_metadata_2025_split huggingface dataset:
Child and Provider Restraints in Ambulances: Knowledge, Opinions, and Behaviors of Emergency Medical Services Providers
Authors: Johnson Timothy D. , Lindholm Daniel , Dowd M. Denise 
Published: July 2006

Background:
Approximately 16,000 children are transported by ambulances each day, and there are an estimated 4,500 ambulance crashes each year. Information about emergency medical services (EMS) provider knowledge, opinions, and behaviors regarding occupant restraint is lacking.
Objectives:
To measure the knowledge, opinions, and behaviors of EMS personnel regarding child and provider restraint use in ambulances.
Methods:
A survey was given to all EMS providers in two large ambulance‐service organizations and in a hospital‐based pediatric ambulance service in a midsized urban area.
Results:
A total of 302 EMS providers were surveyed, for a return rate of 67.7%. Nearly half were involved in an ambulance crash at least once; of those, 7.6% were injured and 1% had patients in their care injured. The majority (91%) reported some training in child‐restraint use in ambulances, and half reported that they know a lot or very much about securing a critically ill child for transport. However, 30% did not identify the correct method of transport for a stable 2‐year‐old, and 40% did not choose the correct method of securing a child seat to the ambulance cot. Securing a child seat to the cot was viewed by 81% to not take too much time from patient care, and 63% did not view caring for a child in a car seat as difficult. Although 80% of providers regularly transported children in a car seat, 23% transported them on an adult's lap at least sometimes. Specialized pediatric‐transport providers were more likely to report safe pediatric and occupant restraint practices than were community EMS providers. Pediatric restraint behaviors were not associated with years of service or history of a crash. Two thirds of respondents reported not wearing their seatbelt on the squad bench while treating patients, and half believe that wearing a seatbelt interferes with patient care. A total of 95% report wearing seatbelts in the front seat of the ambulance. Provider seatbelt use in the patient compartment was not associated with years of service, with number of crashes, or with reporting correct use of pediatric restraints.
Conclusions:
This study indicates that the frequency of crashes in ambulances, and therefore the potential for injury, may be underappreciated. Current restraint practices of some of the study group are outside recommendations and may be placing at risk some children who are being transported by ambulances. This problem is complicated by the relative infrequency of pediatric ambulance transports compared with adults. Improved equipment and education may help providers safely transport pediatric patients. In addition, providers are risking their own safety by not wearing seatbelts in the rear ambulance compartment. Improved equipment may help alleviate this risk and allow providers to take care of patients safely.
Systematic Delays in Antibiotic Administration in the Emergency Department for Adult Patients Admitted with Pneumonia
Authors: Pines Jesse M. , Morton Melinda J. , Datner Elizabeth M. , Hollander Judd E. 
Published: July 2006

Abstract
Objectives:
The authors sought to determine the contribution of delays in care on time to antibiotics for patients admitted from the emergency department (ED) with pneumonia and to identify patients at risk for delayed antibiotics.
Methods:
This was a retrospective cohort study of patients admitted to the Hospital of the University of Pennsylvania (HUP) and to Pennsylvania Presbyterian Hospital (Presbyterian) with an admission diagnosis of pneumonia in 2004.
Results:
A total of 393 patients were included. Ninety percent had antibiotics documented as given in the ED. Eighty‐three (43%) of 209 at HUP and 104 (64%) of 161 patients at Presbyterian received antibiotics within four hours. Patients who received antibiotics more than four hours after ED arrival experienced longer waits for radiograph orders (HUP, 54 min [95% confidence interval {CI} = 33 to 76 min]; Presbyterian, 43 min [95% CI = 29 to 58 min]), for radiograph performance (HUP, 21 min [95% CI = 4 to 39 min], Presbyterian, 24 min [95% CI = 8 to 47 min]), for antibiotic orders (HUP, 56 min [95% CI = 38 to 95 min]; Presbyterian, 67 min [95% CI = 33 to 103 min]), and for antibiotic administration (HUP, 28 min [95% CI = 17 to 39 min]; Presbyterian, 30 min [95% CI = 21 to 38 min]). Patients with lower severity scores (p = 0.005) and patients with nonclassic clinical presentations for pneumonia were at increased risk for delayed antibiotics (odds ratio, 2.2; 95% CI = 1.1 to 4.4).
Conclusions:
Antibiotic delays for patients admitted with pneumonia occur across multiple care processes. Less severely ill patients and patients with nonclassic presentations are at higher risk for delayed antibiotic administration. Hospitals should consider performing a similar analysis to evaluate hospital‐specific and patient‐specific care delays.
Optimization of Train Departure Times at an Interchange Considering Passenger Flows
Authors: Takagi R , Goodman C J , Roberts C 
Published: July 2006

The authors of this paper present the results of the numerical optimization of departure times of trains at an interchange station when services are disrupted. The evaluation function is based on accumulated, or aggregated, passenger delays and the dynamic model of the interchange accounts for variations in passenger walking times. The authors have developed a passenger flow model using petri nets, which enables the representation of passenger flows inside a station to be made with sufficient accuracy and short calculation times. The evaluation function of aggregated passenger times is defined, and the optimization is carried out using the multi-dimensional downhill simplex method. The results show that the optimized train departure times essentially represent compromises between the benefit generated by the extended holding of trains to allow more passengers to catch an earlier service and the disbenefit generated by longer waiting times of passengers already on the train being held. This paper concludes with recommendations for combining these techniques with other models and evaluation criteria in order to move towards a practical train controller. Examples of refinements are a model of passenger behaviour when guidance information is provided, variations in dwell times when different numbers of passengers get on or off a train, congestion inside trains, and the impact of holding a train on the overall operation of trains on the line.
Synthesis, Structure, and Reactivities of cis-Dimethyl(η1-allyl)gold(III) Complex. Diastereoselective Allylation of Aromatic Aldehyde
Authors: Sone Takuo , Ozaki Satoshi , Kasuga Noriko C , Fukuoka Atsushi , Komiya Sanshiro 
Published: July 2006

Abstract
cis-Dimethyl(η1-allyl)(triphenylphosphine)gold(III), cis-[AuMe2(η1-allyl)(PPh3)] (η1-allyl = allyl (1), crotyl (2), methallyl (3)) has been synthesized by reaction of cis-[AuMe2X(PPh3)] (X = I, NO3) with corresponding Grignard reagents. X-Ray structure analysis of 2 shows that 2 has a typical square planar cis configuration and the crotyl ligand binds to Au by η1-mode: orthorhombic, space group P212121, a = 9.816(2), b = 23.208(4), c = 9.5290(9) Å, Z = 4, R(Rw) = 0.037(0.041) with use of 2551 reflections. Reactions of 2 with HCl and Br2 selectively give 1-butene and 3-bromo-1-butene, respectively, indicating γ-regioselectivity of the reactions. Compounds 1—3 react with aldehydes and ketones to give the corresponding homoallyl alcohols. C–C bond formation also takes place at the γ-position of η1-allyl moiety selectively. The rate of the allylation reaction of carbonyl compounds decreases in the order of methallyl (3) &gt; allyl (1) &gt; crotyl (2) gold(III) complexes. The homoallyl alcohol formed by the reaction of 2 with benzaldehyde is a diastereoisomeric mixture of 2-methyl-1-phenyl-3-buten-1-ol, with high anti selectivity. Both the reaction rate and anti selectivity in the allylation reaction were reduced by addition of tertiary phosphines such as PPh3 and PCy3, and a 6-membered transition state has been proposed, which indicates coordination of the carbonyl group to a T-shape Au intermediate produced by dissociation of the PPh3 ligand.
Effect of Heat and Gases on the Photoluminescence of CdS Quantum Dots Confined in Silicate Glasses Prepared by the Sol–Gel Method
Authors: Fujii Tsuneo , Hisakawa Yuichiro , Winder Edmund J , Ellis Arthur B 
Published: July 2006

Abstract
The effects of heat (130, 200, and 600 °C) and added gases (NH3 and SO2) on the photoluminescence of CdS particles prepared by the sol–gel method were examined in order to elucidate the influence of the chemical environment on photoluminescence. Green and red photoluminescence (PL) were observed in non-heated samples. Exposure of the added gasses to the samples caused characteristic decreases of the green and red PLs. The intensity ratio of the green PL to that of the red PL for a 600-R sample (heated at 600 °C in H2S) showed a reversible behavior against exposure to SO2. These results indicate that there is adduct formation between CdS and SO2. The PL changes were fitted to the Langmuir adsorption isotherm model, and yielded the adduct formation constants. There are three emitting and three final states in the specimen.
Theoretical Study of the Transition Energies of the Visible Absorption Spectra of [RhCl6]3− and [RhCl5(H2O)]2− Complexes in Aqueous Solution
Authors: Endo Kazunaka , Saikawa Masahiko , Sugimoto Manabu , Hada Masahiko , Nakatsuji Hiroshi 
Published: July 2006

Abstract
Electron absorption spectra of [RhCl6]3− and [RhCl5(H2O)]2− complexes are studied theoretically by the ab initio symmetry adapted cluster (SAC)/SAC-CI method. Two maximum peaks of the visible absorption spectra in the range of 300—600 nm observed in aqueous solution are assigned to (1T1g; 1T2g) and mixing-(1B1, 1A2, 1B2; 2B1, 2A2, 2B2) states for [RhCl6]3− and [RhCl5(H2O)]2− complexes, respectively, in good agreement. These states are due to the forbidden d–d transitions from the Rh(dπ) + Ligand(pπ) bonding MOs to the Rh(dσ)-Ligand(pσ) antibonding MOs, leading to an weakening of the metal–ligand bonds.
Synthesis and Ion-Exchange Behavior of a New Three-Component Ion-Exchange Material: Zirconium(IV) Arsenate Vanadate
Authors: Qureshi Saidul Zafar , Khan Mubeen Ahmad , Rahman Nafisur 
Published: July 2006

Abstract
Zirconium(IV) arsenate vanadate was prepared by adding a mixture comprising 0.05 M sodium hydrogen arsenate and 0.05 M sodium metavanadate to an aqueous solution of zirconium(IV) dichloride oxide (0.05 M) in different volume ratios at pH 1. The material possessed a good ion-exchange capacity of 1.20 and 1.30 meq g−1 of exchanger for the Na+ and K+ ion, respectively, and was fairly stable in dilute mineral acids, but insoluble in water, acetic acid, formic acid, ethanol, and 1,4-dioxane. The distribution coefficients of a large number of metal ions were determined in different solvent systems.
Preparation and Characterization of Mononuclear Palladium(II) and Dinuclear Palladium(I) Complexes Containing a New Phosphine-Imine-Type Didentate Ligand, 8-(Dimethylphosphino)quinoline (Me2Pqn). Molecular Structures of cis-[Pd(Me2Pqn)2](BF4)2 and [Pd2Cl2(Me2Pqn)2]
Authors: Suzuki Takayoshi , Kashiwabara Kazuo , Fujita Junnosuke 
Published: July 2006

Abstract
A new phosphine ligand, 8-(dimethylphosphino)quinoline (Me2Pqn), and its palladium(I or II) complexes, [PdX2(Me2Pqn)] (X = Cl (1a), Br (1b), and I (1c)), [Pd(Me2Pqn)2](BF4)2 (2b), and [Pd2Cl2(Me2Pqn)2] (3), have been prepared and characterized. The structures of 2b and 3 have been determined by X-ray analysis. The crystal data and final R values are: for 2b, FW = 658.42, monoclinic, P21/n, a = 17.453(2), b = 10.453(2), c = 14.928(2) Å, β = 105.63(1)°, V = 2622.8(5) Å3, Dx = 1.667 Mg m−3, and Z = 4, R = 0.071 for 3908 reflections (|Fo| ≥ 3σ(|Fo|)); for 3, MW = 662.64, monoclinic, P21/n, a = 16.429(1), b = 12.191(1), c = 12.821(1) Å, β = 92.673(8)°, V = 2565.1(4) Å3, Dx = 1.714 Mg m−3, and Z = 4, R = 0.056 for 5136 reflections (|Fo| ≥ 3σ(|Fo|)). In 2b the square coordination plane formed by two long Pd–N (2.138(9) and 2.135(8) Å) and two Pd–P bonds (2.243(3) and 2.237(3) Å) is slightly distorted towards tetrahedral geometry, the dihedral angle between the two chelate planes formed by the Pd, P, and N atoms being 10.3(2)°. 3 is a dinuclear complex with a Pd–Pd bond (2.542(1) Å), Me2Pqn chelates to one Pd(I) center, and the N donor atom occupies the trans position to the Pd–Pd bond. The dihedral angle between the two coordination planes linked by the Pd–Pd bond is nearly a right angle, 82.13(6)°.
Chemistry of Organo Halogenic Molecules. 140. Role of the Reagent Structure on the Transformations of Hydroxy Substituted Organic Molecules with the N-Fluoro Class of Fluorinating Reagents
Authors: Zupan Marko , Iskra Jernej , Stavber Stojan 
Published: July 2006

Abstract
Hydroxy-substituted organic molecules were used as target molecules in investigations of the role of the reagent structure on the reactivity of three types of N–F class fluorinating reagents: 1-chloromethyl-4-fluoro-1,4-diazoniabicyclo[2.2.2]octane bis(tetrafluoroborate) F-TEDA (1a), N-fluorobis(phenylsulfonyl)amine NSF (1b), and N-fluoropyridinium heptafluorodiborate–pyridine (1/1) NFP (1c). Methanol is stable, but hydroquinone is very quickly transformed in acetonitrile to quinone with F-TEDA at room temperature; on the other hand, NSF is less reactive, while oxidation with NFP is achieved only at an elevated temperature; a structure variation of the hydroquinone derivatives did not influence oxidation. Fluorination was achieved with monohydroxy-substituted aromatic compounds; a similar trend concerning the reactivity of N–F reagent (1) was also observed in reactions with 1- and 2-naphthol, while 9-phenanthrol gave 10,10-difluoro-9-(10H)-phenanthrenone with F-TEDA in acetonitrile and 9,10-phenanthrenequinone with NSF. Dealkylation was observed in a reaction with 4-methoxyphenol; although the thio analogue gave bis(4-methoxyphenyl) disulfide, the reactivity was changed and NSF was more reactive than F-TEDA and NFP.
Laser Flash Photolysis in High-Speed Photopolymer Coating Layers
Authors: Urano Toshiyuki , Nagasaka Hideki , Tsuchiyama Masaaki , Shimizu Shigeki , Kawazoe Katsurou , Shimizu Makoto , Yamaoka Tsuguo 
Published: July 2006

Abstract
The sensitization mechanisms of two systems of ketocoumarin dyes with a radical-generating reagent (10,10′-carbonylbis[1,1,7,7-tetramethyl-2,3,6,7-tetrahydro-1H,5H,11H-[1]benzopyrano [6,7,8-ij]quinolizin-11-one] (KCD-J), 3,3′-carbonylbis]7-(diethylamino)coumarin] (KCD-DA) with 3,3′,4,4′-tetrakis(t-butyldioxycarbonyl)benzophenone (I) in poly(methylmethacrylate) film) and of two systems of coumarin dyes (10-(2-benzothiazolyl)-1,1,7,7-tetramethyl-2,3,6,7-tetrahydro-1H,5H,11H-[1]benzopyrano[6,7,8-ij]quinolizin-11-one (CD-J), 3-(2-benzothiazolyl)-7-(diethylamino)coumarin (CD-DA) with I in the film) have been investigated by laser flash photolysis using a total-reflection cell. The fluorescence of the dyes was efficiently quenched by I with static quenching distances of 8.1, 8.6, 15.0, and 10.9 Å for KCD-J, KCD-DA, CD-J, and CD-DA. The decay time of the triplet was moderately quenched by I with a quenching rate (kq) of 5.8 × 105 mol−1 dm3 s−1 for KCD-DA, and slightly with a kq of less than 1 × 105 mol−1 dm3 s−1 for KCD-J; none of the triplet was detected on CD-J and CD-DA. These results suggested that a static sensitization from the fluorescent-excited dyes to I is predominant in photoinitiation systems.
Reaction of Ketene Alkyl Trimethylsilyl Acetals with Dimethyl Acetylenedicarboxylate Catalyzed with Zirconium Tetrachloride
Authors: Mitani Michiharu , Sudoh Takahiro , Koyama Kikuhiko 
Published: July 2006

Abstract
When dimethyl acetylenedicarboxylate is reacted with ketene alkyl trimethylsilyl acetals in the presence of a catalytic amount of zirconium tetrachloride, dimethyl 2-alkoxycarbonyl-3-alkylidenebutanedioates are afforded. Although the silyl enol ether from acetophenone undergoes the same type of reaction, other trisubstituted silyl enol ethers such as those from butyrophenone and 3-pentanone fail to react with dimethyl acetylenedicarboxylate under these conditions.
A Facile and Quantitative Preparation of Activated Cyclic Sugar Derivatives Using HgBr2 and 2,4,6-Collidine
Authors: Matsuoka Koji , Nishimura Shin-Ichiro , Lee Yuan C 
Published: July 2006

Abstract
A combination of mercury(II) bromide (HgBr2) and 2,4,6-collidine was found to promote the formation of activated cyclic sugar derivatives such as 1,2-orthoesters and an oxazoline derivative in quantitative yields at room temperature. A slightly hindered skew like conformation of the lactose orthoester derivative was revealed by 1H NMR analysis. It was also suggested that the reaction of a lactose 1,2-orthoester with trimethylsilyl azide proceeded smoothly to give β-lactosyl azide stereoselectively which is a useful intermediate for constructing glycopeptides and neoglycoconjugates.
Stereospecific Acetolysis of threo- and erythro-2-Aryl-2-[1-(methylthio)ethyl]oxiranes
Authors: Miyauchi Hiroshi , Nakamura Toshio , Ohashi Naohito 
Published: July 2006

Abstract
Threo-2-aryl-2-[1-(methylthio)ethyl]oxiranes (1a—d) were reacted with acetic acid to give two types of unexpected ring-opening products, threo-1-acetoxy-2-aryl-3-methylthio-2-butanols (4a—d) and mono-O-acetyl derivatives of threo-2-aryl-2-methylthio-1,3-butanediol (5a—d and 6a—d). On the other hand, erythro-2-aryl-2-[1-(methylthio)ethyl]oxiranes (2a—d) gave erythro-1-acetoxy-2-aryl-3-methylthio-2-butanols (7a—d) and mono-O-acetyl derivatives of erythro-2-aryl-2-methylthio-1,3-butanediol (8a—d and 9a—d). It is suggested that these products are generated from thiiranium ionic intermediates, because they all completely retain the relative configuration of the starting oxiranes.
Stoichiometric Oxidation of Benzene to Phenol with Copper(II) Salts
Authors: Mori Miki , Nakai Toshihiro , Yahiro Hidenori , Nitta Masahiro , Sasaki Kazuo 
Published: July 2006

Abstract
Phenol is readily produced by some stoichiometric reactions of benzene with certain copper(II) salts. The main part of the reaction using copper(II) sulfate is estimated to be expressed by the following equation:

This reaction was carried out in a flow system at 300 °C, where a vapor mixture of benzene and water flowed through a packed bed of copper(II) sulfate supported on silica gel. The products were mainly phenol and CO2 with a trace amount of biphenyl. The phenol yield became appreciable at temperatures higher than 250 °C, and reached a maximum at ca. 300 °C. At higher temperatures, the CO2 yield increased along with the consumption of phenol. The percentage yield of phenol based on copper(II) salt was 86% at the highest. Although copper(II) phosphate was similarly useful, it required a higher reaction temperature (ca. 500 °C).
Cost Benefit with Early Operative Fixation of Unstable Ankle Fractures
Authors: Pietzik P , Qureshi I , Langdon J , Molloy S , Solan M 
Published: July 2006

INTRODUCTION Ankle fractures are common and many require surgical intervention. It has been well documented that a delay in fracture fixation results in increased length of hospital stay and increased complication rate. Initial delay can also allow swelling or blistering to develop which may necessitate a further delay in operative fixation for up to 1 week. The aim of the current study was to review the length of hospital in-patient stay for operative ankle fractures over the previous 12-month period at our hospital and compare this to the length of hospital stay following the introduction of a fast-track system for the fixation of these fractures (all fractures fixed within 48 h). PATIENTS AND METHODS A retrospective review of all ankle fractures managed by open reduction and internal fixation over a 12-month period was undertaken. A protocol was then agreed to openly reduce and fix these fractures at the earliest possible opportunity over the next 6-month period. We then collected the data on all ankle fractures that needed open reduction and internal fixation over this 6-month period. The pre-protocol and post-protocol groups were then compared for total hospital length of stay and complication rate. RESULTS In the 12-month retrospective review, there were 83 ankle fractures that required surgical intervention. Sixty-two of these had surgery within 48 h (mean length of stay, 5.4 days), and 21 had surgery after 48 h (mean length of stay, 9.5 days). There were 39 ankle fractures in the post-protocol group who all had surgery within 48 h (mean length of stay, 5 days). There was no increase in complication rate after implementation of the fast-track system. CONCLUSIONS This study shows that early operative intervention for ankle fractures reduces the length of hospital stay. Intensive physiotherapy and co-ordinated discharge planning are also essential ingredients for early discharge. Early operative fixation for unstable ankle fractures has substantial cost-saving implications with no increase in complication rate.
Ball Bearing (BB) Guns, Ease of Purchase and Potential for Significant Injury
Authors: Grocock C , McCarthy R , Williams DJ 
Published: July 2006

INTRODUCTION Ball bearing guns are used in the UK for war games, but they have the potential to cause severe injury if used incorrectly. MATERIALS AND METHODS A search was made for availability of these weapons, the ease of purchase and the potential for tissue damage. RESULTS These weapons are widely available on the Internet and are easy to purchase with no security checks. Once fully charged, an electric BB gun is capable of penetrating a cadaveric animal model at distances up to 5 m (1 m = 25 mm penetration, 3 m = 20 mm penetration, 5 m = 15 mm penetration). CONCLUSIONS BB guns are not toys and have a significant potential to cause injury.
Left Internal Mammary Artery Usage in Coronary Artery Bypass Grafting: A Measure of Quality Control
Authors: Karthik S , Fabri BM 
Published: July 2006

INTRODUCTION Over the last two decades, many studies have shown better long-term patency rates and survival in patients undergoing coronary artery bypass grafting (CABG) with left internal mammary artery (LIMA) to the left anterior descending artery (LAD). World-wide, LIMA is accepted as the ‘gold standard’ for surgical revascularisation and its usage has been steadily increasing. PATIENTS AND METHODS Between April 1997 and September 2001, a total of 4406 consecutive patients underwent coronary artery bypass grafting with revascularisation to the left anterior descending artery. RESULTS Of the study group, 4047 (91.8%) patients received LIMA to LAD, leaving 359 (8.2%) who did not. Six sub-groups of patients in whom LIMA usage was significantly less were the elderly (> 70 years of age), females, diabetics, patients having emergency CABG, poor left ventricular (LV) function (ejection fraction [EF] < 30%) and patients with respiratory disease. CONCLUSIONS Although the current focus in the UK is on mortality rates, we believe that it will not be long before this will also include the incidence of major morbidity after CABG such as stroke, myocardial infarction (MI), renal failure and sternal wound problems. We also believe that we should now consider LIMA usage as a marker of quality control after CABG.