Sample records for hmo radiologie unter
-
Energy Technology Data Exchange (ETDEWEB)
Schmidt, C. [Universitaet Kiel (Germany). Klinik fuer Allgemeine Chirurgie und Thoraxchirurgie; Mohr, A. [University of California, San Francisco (United States). Dept. of Radiology; Universitaet Kiel (Germany). Klinik fuer Radiologische Diagnostik; Moeller, J. [Universitaet Bielefeld (Germany). Fakultaet fuer Gesundheitswissenschaften; Levin-Scherz, J. [Tufts Healthplan, Boston (United States); Heller, M. [Universitaet Kiel (Germany). Klinik fuer Radiologische Diagnostik
2003-09-01
: Darstellung des Einsparungspotenzials, welches einer effizienten Nutzung von Radiologieleistungen in einer Health-Maintenance-Organisation (HMO) innewohnt, und der zur Realisierung verwendeten Managed-Care-Techniken. Material und Methoden: Im Rahmen eines Projektes zur Kostenreduktion an einer HMO in den USA wurden die Ursachen fuer gestiegene Ausgaben im Bereich Radiologie (''Radiology-Utilisation-Line'') untersucht. Durch umfassende Datenanalysen, Ueberpruefungen der Kodierlogik, Interviews mit Angestellten sowie kritische Beleuchtung der Vertragsbeziehungen zu Leistungserbringern konnte das Einsparpotenzial beziffert werden. Saemtliche Daten wurden in Microsoft Excel {sup trademark} dokumentiert und unter Verwendung von SPSS 8.0 (Statistical Package for the Social Sciences) fuer Windows {sup trademark} mithilfe nicht-parametrischer Tests ausgewertet. Ergebnisse: Hauptursache war eine verstaerkte Verordnung von Radiologieleistungen pro versichertem Patienten, wobei die Kosten pro Untersuchung annaehernd gleich blieben. Ein wesentlicher Kostenhebel lag in der Verbesserung des elektronischen Abrechnungssystems, welches fuer eine Ueberbezahlung von Leistungen verantwortlich war. Die Gestaltung der vertraglichen Risikovereinbarungen zwischen Versicherer und Leistungserbringer sowie die Qualitaet der Managementstrukturen innerhalb der radiologischen Einrichtungen hatten einen signifikanten Einfluss auf deren Wirtschaftlichkeit. Ferner konnte nachgewiesen werden, dass Aerzte mit eigenen Roentgenanlagen bis zu 4-5-mal mehr Untersuchungen veranlassen als Aerzte ohne eigene Roentgenausstattung und so einen erheblichen Kostentreiber darstellen. (orig.)
-
Health Maintenance Organization (HMO) Plan
... Find & compare doctors, hospitals, & other providers Health Maintenance Organization (HMO) Plan In most HMO Plans, you generally ... certain service when needed. Related Resources Preferred Provider Organization (PPO) Private Fee-for-Service (PFFS) Special Needs ...
-
The troubled HMO industry: what's next?
Cerone, J R
1988-01-01
The fortunes of health maintenance organizations (HMOs) have been on a roller coaster ride for the last 15 years. Growth rates in the number and total enrollments of HMOs surged in 1973 and 1974 following passage of the federal HMO Act. Growth rates abated over the next 8 years. Several favorable factors converged in 1983 to push growth rates back up. Some 15 for-profit HMO companies went public with initial stock offerings during the 1983-85 period. Their stock prices soared as they compiled astounding records of enrollment, revenue and profit growth. In the next 2 years, however, stock prices dropped as quickly as they had risen. Intense price competition and inexperienced managers were important factors contributing to sharp descents in HMO earnings in 1986 and 1987. Some analysts now see positive signs pointing to an industry recovery. However, investors are not convinced of this as HMO stock prices remain severely depressed.
-
42 CFR 417.153 - Offer of HMO alternative.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Offer of HMO alternative. 417.153 Section 417.153... § 417.153 Offer of HMO alternative. (a) Basic rule. An employing entity that is subject to this subpart and that elects to include one or more qualified HMOs must offer the HMO alternative in accordance...
-
HMO penetration and the geographic mobility of practicing physicians.
Polsky, D; Kletke, P R; Wozniak, G D; Escarce, J J
2000-09-01
In this study, we assessed the influence of changes in health maintenance organization (HMO) penetration on the probability that established patient care physicians relocated their practices or left patient care altogether. For physicians who relocated their practices, we also assessed the impact of HMO penetration on their destination choices. We found that larger increases in HMO penetration decreased the probability that medical/surgical specialists in early career stayed in patient care in the same market, but had no impact on generalists, hospital-based specialists, or mid career medical/surgical specialists. We also found that physicians who relocated their practices were much more likely to choose destination markets with the same level of HMO penetration or lower HMO penetration compared with their origin markets than they were to choose destination markets with higher HMO penetration. The largely negligible impact of changes in HMO penetration on established physicians' decisions to relocate their practices or leave patient care is consistent with high relocation and switching costs. Relocating physicians' attraction to destination markets with the same level of HMO penetration as their origin markets suggests that, while physicians' styles of medical practice may adapt to changes in market conditions, learning new practice styles is costly.
-
Growth in HMO share of the Medicare market, 1989-1994.
Welch, W P
1996-01-01
Between 1989 and 1994 the health maintenance organization (HMO) share of the Medicare market grew rapidly. It is still heavily concentrated geographically, however. The most influential factor in this growth is HMO penetration into an area's general health care market. Medicare payment rates and prior Medicare HMO penetration also have an impact, but their effects are much weaker. Thus, payment rate reform is likely to have only a modest impact on Medicare HMO growth in the short term. In the longer term, the HMO share of the Medicare market will continue to grow, because HMO penetration in the general health care market is growing rapidly.
-
HMO market penetration and costs of employer-sponsored health plans.
Baker, L C; Cantor, J C; Long, S H; Marquis, M S
2000-01-01
Using two employer surveys, we evaluate the role of increased health maintenance organization (HMO) market share in containing costs of employer-sponsored coverage. Total costs for employer health plans are about 10 percent lower in markets in which HMOs' market share is above 45 percent than they are in markets with HMO enrollments of below 25 percent. This is the result of lower premiums for HMOs than for non-HMO plans, as well as the competitive effect of HMOs that leads to lower non-HMO premiums for employers that continue to offer these benefits. Slower growth in premiums in areas with high HMO enrollments suggests that expanded HMO market share may also lower the long-run growth in costs.
-
Management information systems in the HMO environment.
Neal, P A
1982-01-01
Realization of the unique potential of a health maintenance organization is dependent on the availability of adequate, accurate, and timely information. The particular data needed are determined by the structure of the organization; the physician compensation plans; requirements for state, federal, or other reporting; and many other factors. The author introduces the concept and objectives of the HMO, and presents the management information systems necessary for planning and monitoring HMO performance: patient information, utilization information, and management information for the staff and nonstaff HMO.
-
Betoninstandsetzung unter Wasser : Mörtelentwicklung und Applikationstechniken
Nguyen-Sauerbaum, Lina Phan Anh
2017-01-01
Für die Instandsetzung von Betonbauteilen unter Wasser stehen aktuell keine gängigen Verfahren zur Verfügung, die ohne Trockenlegung oder Einschalen des Bauteils auskommen. Diese Arbeit legt die Grundlagen für eine Betoninstandsetzung unter Wasser ohne Einschalen des Bauwerks. Es wurden neue Mörtel entwickelt, die unter Wasser einsetzbar sind und Applikationstechniken untersucht, die eine Applikation unter Wasser mit erfolgreichem Haftverbund erlauben. There are currently no established...
-
Impact of HMO mergers and acquisitions on financial performance.
Weech-Maldonado, Robert
2002-01-01
This study examines the effect of health maintenance organization (HMO) mergers and acquisitions on financial performance, as indicated by cash flow returns, profitability ratios, and efficiency indicators. Pooled, cross-sectional files of financial performance data were created for HMO mergers occurring in the period of 1988 to 1994. The study uses a time-series design involving the analysis of pre- and post-acquisition financial performance measured over a period of four years. Change scores for the industry-adjusted financial performance measures were calculated and then evaluated using t-tests. The study showed that HMO mergers had a positive effect on financial performance and efficiency. This effect disappeared, however, after adjusting for HMO industry returns. Potential synergies arising from HMO mergers have been largely illusory. Mergers may have been a result of non-value enhancing motives or management overconfidence.
-
The role of service recovery in HMO satisfaction.
Sarel, D; Marmorstein, H
1999-01-01
Complaint handling and service recovery by HMOs may be more efficient to implement and more determinant of customer satisfaction and retention than other approaches such as improving access to care. The current findings are consistent with research on recovery efforts in other industries. Complaint handling systems must achieve rapid and comprehensive identification and resolution of HMO member problems. Both cultural change and appropriate incentives to re-educate employees within HMO organizations are additional requisites to effective service recovery. The benefits to the HMO of expenditures on service recovery should be more immediate and sustainable than the benefits derived from other methods of increasing member satisfaction.
-
HMO market penetration and hospital cost inflation in California.
Robinson, J C
1991-11-20
OBJECTIVE--Health maintenance organizations (HMOs) have stimulated price competition in California hospital markets since 1983, when the state legislature eliminated barriers to selective contracting by conventional health insurance plans. This study measures the impact of HMO-induced price competition on the rate of inflation in average cost per admission for 298 private, non-HMO hospitals between 1982 and 1988. DATA--HMO market penetration was calculated using discharge abstract data on insurance coverage, ZIP code of residence, and hospital of choice for 3.35 million patients in 1983 and 3.41 million patients in 1988. Data on hospital characteristics were obtained from the American Hospital Association and other sources. -HMO coverage grew from an average of 8.3% of all admissions in local hospital markets in 1983 to 17.0% of all admissions in 1988. The average rate of growth in costs per admission between 1982 and 1988 was 9.4% lower in markets with relatively high HMO penetration compared with markets with relatively low HMO penetration (95% confidence interval, 5.2 to 13.8). Cost savings for these 298 hospitals are estimated at $1.04 billion for 1988. CONCLUSION--Price competition between HMOs and conventional health insurers can significantly reduce hospital cost inflation if legislative barriers to selective contracting are removed. The impact of competition in California was modest, however, when evaluated in terms of the 74.5% average rate of California hospital cost inflation during these years.
-
Impact of HMO market structure on physician-hospital strategic alliances.
Burns, L R; Bazzoli, G J; Dynan, L; Wholey, D R
2000-04-01
To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four models present in the hospital. Because managed care and physician-hospital integration are endogenous (e.g., some hospitals also sponsor HMOs), we used an instrumental variables approach to model the determinants of HMO penetration and HMO numbers. These instruments were then used with other predictors of alliance formation: physician supply characteristics, the extent of hospital competition, hospital-level descriptors, population size and demographic characteristics, and indicators for each year. All equations were estimated at the MSA level using mixed linear models and first-difference models. Contrary to conventional wisdom, alliance formation is shaped by the number of HMOs in the market rather than by HMO penetration. This confirms a growing perception that hospital-sponsored alliances with physicians are contracting vehicles for managed care: the greater the number of HMOs to contract with, the greater the development of alliances. The models also show that alliance formation is
-
Energy Technology Data Exchange (ETDEWEB)
Ebel, K D [ed.; Willich, E [ed.; Richter, E [ed.; Benz-Bohm, G; Bliesener-Harzheim, J A; Ebel, K D; Oestreich, A E; Reinwein, H; Schaper, J; Schumacher, R; Stoever, B
1995-06-01
The book presents in-depth material covering the full scope of tasks and problems of differential diagnostic radiology in children. The particular approach chosen by the authors provides information that will solve even the most difficult cases, guiding the reader on his way from radiographic findings to appropriate diagnosis. All radiographic findings have been characterized and classified and put into a tabulated system relating them to the relevant differential diagnosis. The system of reference adopted specifies a given lesion or disease by reference to the most significant diagnostic keywords obtained from anamnesis, clinical data, and further diagnostic evaluation. The tentative diagnosis is taken as the basis for further specification illustrated by the characteristic X-ray pictures and full-text descriptions. Almost all diagnoses are accompanied by a comprehensive image documentation obtained by all currently available imaging methods. (MG) [Deutsch] Das vorliegende Buch gibt einen kompletten Ueberblick ueeber die gesamte Bandbreite der Differentialdiagnostik in der Paediatrischen Radiologie und soll so auch in schwierigen Faeellen den Weg vom Roentgensymptom zur Diagnose ermoeglichen. Alle relevanten Roentgensymptome werden systematisch charakterisiert und die entsprechenden Differentialdiagnosen tabellarisch zusammengestellt. Jede Erkrankung wird durch Verweise auf die wichtigsten differentialdiagnostischen Stichworte aus Anamnese, Klinik und weiterfuehrende Diagnostik naeher eingegrenzt. Ausgehend von der Verdachtsdiagnose werden wegweisende Roentgenbefunde in Wort und Bild dargestellt. Fast alle erwaehnten Befunde werden durch Abbildungen unter Beruecksichtigung aller moderner bildgebenden Verfahren dokumentiert. (MG)
-
HMO marketing and selection bias: are TEFRA HMOs skimming?
Lichtenstein, R; Thomas, J W; Watkins, B; Puto, C; Lepkowski, J; Adams-Watson, J; Simone, B; Vest, D
1992-04-01
The research evidence indicates that health maintenance organizations (HMOs) participating in the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) At-Risk Program tend to experience favorable selection. Although favorable selection might result from patient decisions, a common conjecture is that it can be induced by HMOs through their marketing activities. The purpose of this study is to examine the relationship between HMO marketing strategies and selection bias in TEFRA At-Risk HMOs. A purposive sample of 22 HMOs that were actively marketing their TEFRA programs was selected and data on organizational characteristics, market area characteristics, and HMO marketing decisions were collected. To measure selection bias in these HMOs, the functional health status of approximately 300 enrollees in each HMO was compared to that of 300 non-enrolling beneficiaries in the same area. Three dependent variables, reflecting selection bias at the mean, the low health tail, and the high health tail of the health status distribution were created. Weighted least squares regressions were then used to identify relationships between marketing elements and selection bias. Subject to the statistical limitations of the study, our conclusion is that it is doubtful that HMO marketing decisions are responsible for the prevalence of favorable selection in HMO enrollment. It also appears unlikely that HMOs were differentially targeting healthy and unhealthy segments of the Medicare market.
-
HMO penetration: has it hurt public hospitals?
Clement, J P; Grazier, K L
2001-01-01
The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care.
-
Impact of HMO ownership on management processes and utilization outcomes.
Ahern, M; Molinari, C
2001-05-01
To examine the effects of health maintenance organization (HMO) ownership characteristics on selected utilization outcomes and management processes affecting utilization. We used 1995 HMO data from the American Association of Health Plans. Using regression analysis, we examined the relation between HMO utilization (hospital discharges, days, and average length of stay; cardiac catheterization procedures; and average cost of outpatient prescriptions) and the structural characteristics of HMOs: ownership type (insurance company, hospital, physician, independent, and national managed care company), HMO size, for-profit status, model type, geographic region, and payer mix. HMO ownership type is significantly associated with medical management processes, including risk sharing by providers, risk sharing by consumers, and other management strategies. Relative to hospital-owned HMOs, insurance company-owned HMOs have fewer hospital discharges, fewer hospital days, and longer lengths of stay. National managed care organization-owned HMOs have fewer cardiac catheterizations and lower average outpatient prescription costs. Independently owned HMOs have more cardiac catheterizations. For-profit HMOs have lower prescription costs. Relative to hospital-owned HMOs, insurance company-owned HMOs are more likely to use hospital risk sharing and provider capitation and less likely to use out-of-pocket payments for hospital use and a closed formulary. National managed care organization-owned HMOs are less likely to use provider capitation, out-of-pocket payments for hospital use, catastrophic case management, and hospital risk sharing. Physician-hospital-owned HMOs are less likely to use catastrophic case management. For-profit HMOs are more likely to use hospital risk sharing and catastrophic case management. HMO ownership type affects utilization outcomes and management strategies.
-
Does anyone understand HMO advertising?
Bisinger, J M
1986-12-01
Much HMO advertising is executed with technical proficiency, but a high level of technical skill cannot compensate for poor objectives, an inadequate analysis of the business situation, or a lack of advertising effectiveness. Industrial marketing techniques often involve person-to-person selling via a sales staff, sales reps, on-site technical assistance and informational meetings, team selling, etc. Some HMOs also employ these techniques. In general, the promotional focus in these situations is not on mass media; communication tends to be in support of personal sales activities. These personal techniques are used because of the difficulty of selling complicated products or services. Is an HMO a simple product/service? If it is not, consumer promotional tactics will probably be ineffective. If used, these promotional tactics probably will be unintelligible because "consumers" do not select HMOs; their employers do.
-
Segmentation of hospital markets: where do HMO enrollees get care?
Escarce, J J; Shea, J A; Chen, W
1997-01-01
Commercially insured and Medicare patients who are not in health maintenance organizations (HMOs) tend to use different hospitals than HMO patients use. This phenomenon, called market segmentation, raises important questions about how hospitals that treat many HMO patients differ from those that treat few HMO patients, especially with regard to quality of care. This study of patients undergoing coronary artery bypass graft surgery found no evidence that HMOs in southeast Florida systematically channel their patients to high-volume or low-mortality hospitals. These findings are consistent with other evidence that in many areas of the country, incentives for managed care plans to reduce costs may outweigh incentives to improve quality.
-
Tootelian, Dennis H; Mikhailitchenko, Andrey; Holst, Cindy; Gaedeke, Ralph M
2016-01-01
The health care landscape has changed dramatically. Consumers now seek plans whose benefits better fit their health care needs and desires for access to providers. This exploratory survey of more than 1,000 HMO and non-HMO customers found significant differences with respect to their selection processes for health plans and providers, and their expectations regarding access to and communication with health care providers. While there are some similarities in factors affecting choice, segmentation strategies are necessary to maximize the appeal of a plan, satisfy customers in the selection of physicians, and meet their expectations regarding access to those physicians.
-
Economic and organizational determinants of HMO mergers and failures.
Feldman, R; Wholey, D; Christianson, J
1996-01-01
This study analyzed data from all operational health maintenance organizations (HMOs) in the United States from 1986 through 1993. Eighty HMOs disappeared through mergers and 149 failed over that period. We estimated a multinomial logit model to predict whether an HMO would merge and survive, merge and disappear, or fail, relative to the probability of no event. We found that enrollment and profitability play a critical role in explaining HMO mergers and failures: large and profitable HMOs were more likely to merge and survive, but less likely to merge and disappear or fail. These results explain why HMO merger and failure rates fell after 1988, as most surviving HMOs became larger and more profitable. Among several market-area variables in the model, state anti-takeover regulations had a negative impact on mergers. Mergers were more likely in markets with more competing HMOs, but the overall market penetration of HMOs had no effect on mergers. This result may have important implications for the current debate over the future of the competitive health care strategy. If public policy successfully stimulates the development of large numbers of new HMOs, another wave of mergers and failures is likely to occur. But it appears that growth in overall HMO penetration will not lead inevitably to increased market concentration.
-
The impact of HMO penetration on the rate of hospital cost inflation, 1985-1993.
Gaskin, D J; Hadley, J
1997-01-01
This paper provides evidence that growth in health maintenance organization (HMO) enrollment slows hospital cost inflation. During the period 1985-1993, hospitals in areas with high rates of HMO penetration and growth had a slower rate of growth in expenses (8.3%) than hospitals in low penetration areas (11.2%). From 1992-1993, HMO growth lowered the rate of hospital cost inflation by .34 to 3.40 percentage points, depending on the base-year level and the annual change in HMO penetration. Declines in Medicare Prospective Payment System (PPS) margins also lowered hospital cost inflation; over the time period, annual hospital cost inflation was reduced by .38 percentage points. The estimates imply that the cumulative effect of HMO growth on hospital costs has been a $56.2 billion reduction (in 1993 dollars).
-
Health insurance reform and HMO penetration in the small group market.
Buchmueller, Thomas C; Liu, Su
This study uses data from several national employer surveys conducted between the late 1980s and the mid-1990s to investigate the effect of state-level underwriting reforms on HMO penetration in the small group health insurance market. We identify reform effects by exploiting cross-state variation in the timing and content of reform legislation and by using mid-sized and large employers, which were not affected by the legislation, as within-state control groups. While it is difficult to disentangle the effect of state reforms from other factors affecting HMO penetration in the small group markets, the results suggest a positive relationship between insurance market regulations and HMO penetration.
-
International Nuclear Information System (INIS)
Su, Qing; Pan, Bingcai; Pan, Bingjun; Zhang, Qingrui; Zhang, Weiming; Lv, Lu; Wang, Xiaoshu; Wu, Jun; Zhang, Quanxing
2009-01-01
In the current study, a new hybrid adsorbent HMO-001 was fabricated by impregnating nanosized hydrous manganese dioxide (HMO) onto a porous polystyrene cation exchanger resin (D-001) for enhanced lead removal from aqueous media. D-001 was selected as a support material mainly because of the potential Donnan membrane effect exerted by the immobilized negatively charged sulfonic acid groups bound to the polymeric matrix, which would result in preconcentration and permeation enhancement of lead ions prior to their effective sequestration by the impregnated HMO. HMO-001 was characterized by scanning electron micrograph (SEM), transmission electron micrograph (TEM), and X-ray diffraction (XRD). Lead adsorption onto HMO-001 was dependent upon solution pH due to the ion-exchange nature, and it can be represented by the Freundlich isotherm model and pseudo-first order kinetic model well. The maximum capacity of HMO-001 toward lead ion was about 395 mg/g. As compared to D-001, HMO-001 exhibited highly selective lead retention from waters in the presence of competing Ca 2+ , Mg 2+ , and Na + at much greater levels than the target toxic metal. Fixed-bed column adsorption of a simulated water indicated that lead retention on HMO-001 resulted in a conspicuous decrease of this toxic metal from 1 mg/L to below 0.01 mg/L (the drinking water standard recommended by WHO). The exhausted adsorbent particles are amenable to efficient regeneration by the binary NaAc-HAc solution for repeated use without any significant capacity loss. All the results validated the feasibility of HMO-001 for highly effective removal of lead from contaminated waters.
-
Do HMO penetration and hospital competition impact quality of hospital care?
Rivers, P A; Fottler, M D
2004-11-01
This study examines the impact of HMO penetration and competition on hospital markets. A modified structure-conduct-performance paradigm was applied to the health care industry in order to investigate the impact of HMO penetration and competition on risk-adjusted hospital mortality rates (i.e. quality of hospital care). Secondary data for 1957 acute care hospitals in the USA from the 1991 American Hospital Association's Annual Survey of Hospitals were used. The outcome variables were risk-adjusted mortality rates in 1991. Predictor variables were market characteristics (i.e. managed care penetration and hospital competition). Control variables were environmental, patient, and institutional characteristics. Associations between predictor and outcome variables were investigated using statistical regression techniques. Hospital competition had a negative relationship with risk-adjusted mortality rates (a negative indicator of quality of care). HMO penetration, hospital competition, and an interaction effect of HMO penetration and competition were not found to have significant effects on risk-adjusted mortality rates. These findings suggest that when faced with intense competition, hospitals may respond in ways associated with reducing their mortality rates.
-
Competition among hospitals for HMO business: effect of price and nonprice attributes.
Young, Gary J; Burgess, James E; Valley, Danielle
2002-10-01
To investigate patterns of competition among hospitals for the business of health maintenance organizations (HMOs). The study focused on the relative importance of hospital price and nonprice attributes in the competition for HMO business. The study capitalized on hospital cost reports from Florida that are unique in their inclusion of financial data regarding HMO business activity. The time frame was 1992 to 1997. The study was designed as an observational investigation of acute care hospitals. Results indicated that a hospital's share of HMO business was related to both its price and nonprice attributes. However, the importance of both price and nonprice attributes diminished as the number of HMOs in a market increased. Hospitals that were market share leaders in terms of HMO business (i.e., 30 percent or more market share) were superior, on average, to their competitors on both price and nonprice attributes. Study results indicate that competition among hospitals for HMO business involves a complex set of price and nonprice attributes. The HMOs do not appear to focus on price alone. Hospitals likely to be the most attractive to HMOs are those that can differentiate themselves on the basis of nonprice attributes while being competitive on price as well.
-
The impact of HMO and hospital competition on hospital costs.
Younis, Mustafa Z; Rivers, Patrick A; Fottler, Myron D
2005-01-01
This study examines the impact of HMO penetration and competition on health system performance, as measured by hospital cost per adjusted admissions. The study population consisted of acute-care hospitals in the United States. The findings of this study suggest that there is no relationship between HMO competition and hospital cost per adjusted admission. Governmental efforts to stimulate competition in the hospital market, if focused on promoting HMOs, are not likely to produce cost-containing results quickly.
-
Market and plan characteristics related to HMO quality and improvement.
Scanlon, Dennis P; Swaminathan, Shailender; Chernew, Michael; Lee, Woolton
2006-12-01
Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.
-
Shen, Yu-Chu; Wu, Vivian Y; Melnick, Glenn
2010-02-01
Analyze trends in hospital cost and revenue, as well as price and quantity (1994-2005) as a function of health maintenance organization (HMO) penetration, HMO concentration, and for-profit (FP) HMO market share. Medicare hospital cost reports, AHA Annual Surveys, HMO data from Interstudy, and other supplemental data. A retrospective study of all short-term, general, nonfederal hospitals in metropolitan statistical areas (MSAs) in the United States from 1994 to 2005, using hospital/MSA fixed-effects translog regression models. A 10 percentage point increase in HMO enrollment is associated with 4.1-4.2 percent reduction in costs and revenues in the pre-2000 period but only a 2.1-2.5 percent reduction in the post-2000 period. Hospital revenue in HMO-dominant markets (highly concentrated HMO market and competitive hospital market) is 19-27 percent lower than other types of markets, and the difference is most likely due mainly to lower prices and to a lesser extent lower utilization. The historical difference of lower spending in high HMO penetration markets compared with low HMO markets narrowed after 2000 and the relative concentration between HMO and hospital markets can substantially influence hospital spending. Additional research is needed to understand how different aspects of these two markets have changed and interacted and how they are causally linked to spending trends.
-
HMO penetration and physicians' earnings.
Hadley, J; Mitchell, J M
1999-11-01
The goal of this study is to estimate whether cross-sectional variations in enrollment in health maintenance organizations (HMOs) affected physicians' earnings and hourly income in 1990. Using data from a nationally representative sample of 4,577 younger physicians (penetration is endogenous and used the instrumental variables approach to obtain unbiased estimates. HMO penetration had a negative and statistically significant impact on physicians earnings in 1990. A doubling of the average level of HMO penetration in the market is estimated to reduce annual earnings by 7% to 10.7%, and hourly earnings by approximately 6% to 9%. It appears that HMOs were successful in reducing physicians' annual and per hour earnings in 1990, presumably through a combination of fewer visits and lower payment rates for people covered by HMOs. Although these results cannot be generalized to all physicians, the experience of a younger cohort of physicians may still be a good indicator of the future effects of HMOs because younger physicians may be more susceptible to market forces than older and more established physicians. Moreover, these results may be somewhat conservative because they reflect market behavior in 1990, several years before the rapid growth and more aggressive market behavior of HMOs in recent years.
-
The Journal de Radiologie is 100 years old
International Nuclear Information System (INIS)
Devreda, P.; Nahumb, H.
2014-01-01
In January 1914, the first edition of Le Journal de Radiologie et d'Electrologie, a monthly medical review, was published by Masson. It was organized by a committee of ten members, whose general secretary was J. Belot. The members of the committee were the pioneers of radiology in France at the time and remained leaders in the field for three decades. The relationships between the Journal and the Societe de Radiologie are obvious: J. Belot was president of the Society and remained so until 1920, G. Haret, a committee member, was the general secretary of the Society from 1909 and remained so until 1928. The Journal at the time did not claim to be national and all of its committee members were Parisian. There was, nonetheless, an impressive list of contributors from throughout France and from several foreign countries. The table of contents of this first edition clearly shows the many skills of these first generation radiologists who saw themselves not only as radio-diagnosticians, radiotherapists, and electrologists, but also as physicians. From this first edition, the ambitions of the Journal's chiefs were clear: unquestionable competence and the need for research, and the importance of innovation. Certainly the founders of this new journal saw themselves as the masters of French radiology, but they were nevertheless wide open to the world. The Journal reported several European meetings, book reviews and articles, particularly from Germany and Austria, but also from England, Belgium, Italy, Cuba, Egypt, the Philippines and the United States. America, however, was very far from being preeminent in 1914. French radiology books also began to be published. Radiology was everywhere. Above all, however was the advertising, promoting the products of innumerable companies producing radiology instrumentation: in the following decades, these merged and concentrated until the French radiology industry had almost completely disappeared after a merger with an American company
-
Shen, Yu-Chu; Wu, Vivian Y; Melnick, Glenn
2010-01-01
Objective Analyze trends in hospital cost and revenue, as well as price and quantity (1994–2005) as a function of health maintenance organization (HMO) penetration, HMO concentration, and for-profit (FP) HMO market share. Data Medicare hospital cost reports, AHA Annual Surveys, HMO data from Interstudy, and other supplemental data. Study Design A retrospective study of all short-term, general, nonfederal hospitals in metropolitan statistical areas (MSAs) in the United States from 1994 to 2005, using hospital/MSA fixed-effects translog regression models. Principal Findings A 10 percentage point increase in HMO enrollment is associated with 4.1–4.2 percent reduction in costs and revenues in the pre-2000 period but only a 2.1–2.5 percent reduction in the post-2000 period. Hospital revenue in HMO-dominant markets (highly concentrated HMO market and competitive hospital market) is 19–27 percent lower than other types of markets, and the difference is most likely due mainly to lower prices and to a lesser extent lower utilization. Conclusions The historical difference of lower spending in high HMO penetration markets compared with low HMO markets narrowed after 2000 and the relative concentration between HMO and hospital markets can substantially influence hospital spending. Additional research is needed to understand how different aspects of these two markets have changed and interacted and how they are causally linked to spending trends. PMID:19840134
-
Rethfeldt, Mira
2006-01-01
1999 wurden erstmals sogenannte Schlafattacken bei Parkinson-Patienten unter der Therapie mit Nonergolin-Dopaminagonisten berichtet. Später zeigten Studien, dass diese Schlafattacken unter jeglicher dopaminerger Therapie auftreten können. Bis heute ist jedoch die Pathophysiologie dieses Phänomens nicht hinreichend geklärt. Es wird diskutiert, ob diese Attacken als paroxysmales Symptom überhaupt bestehen oder nicht vielmehr ...
-
A longitudinal study of adult-onset asthma incidence among HMO members.
Sama, Susan R; Hunt, Phillip R; Cirillo, C I H Priscilla; Marx, Arminda; Rosiello, Richard A; Henneberger, Paul K; Milton, Donald K
2003-08-07
HMO databases offer an opportunity for community based epidemiologic studies of asthma incidence, etiology and treatment. The incidence of asthma in HMO populations and the utility of HMO data, including use of computerized algorithms and manual review of medical charts for determining etiologic factors has not been fully explored. We identified adult-onset asthma, using computerized record searches in a New England HMO. Monthly, our software applied exclusion and inclusion criteria to identify an "at-risk" population and "potential cases". Electronic and paper medical records from the past year were then reviewed for each potential case. Persons with other respiratory diseases or insignificant treatment for asthma were excluded. Confirmed adult-onset asthma (AOA) cases were defined as those potential cases with either new-onset asthma or reactivated mild intermittent asthma that had been quiescent for at least one year. We validated the methods by reviewing charts of selected subjects rejected by the algorithm. The algorithm was 93 to 99.3% sensitive and 99.6% specific. Sixty-three percent (n = 469) of potential cases were confirmed as AOA. Two thirds of confirmed cases were women with an average age of 34.8 (SD 11.8), and 45% had no evidence of previous asthma diagnosis. The annualized monthly rate of AOA ranged from 4.1 to 11.4 per 1000 at-risk members. Physicians most commonly attribute asthma to infection (59%) and allergy (14%). New-onset cases were more likely attributed to infection, while reactivated cases were more associated with allergies. Medical charts included a discussion of work exposures in relation to asthma in only 32 (7%) cases. Twenty-three of these (72%) indicated there was an association between asthma and workplace exposures for an overall rate of work-related asthma of 4.9%. Computerized HMO records can be successfully used to identify AOA. Manual review of these records is important to confirm case status and is useful in evaluation of
-
The impact of HMO competition on private health insurance premiums, 1985-1992.
Wickizer, T M; Feldstein, P J
1995-01-01
A critical unresolved health policy question is whether competition stimulated by managed care organizations can slow the rate of growth in health care expenditures. We analyzed the competitive effects of health maintenance organizations (HMOs) on the growth in fee-for-service indemnity insurance premiums over the period 1985-1992 using premium data on 95 groups that had policies with a single, large, private insurance carrier. We used multiple regressions to estimate the effect of HMO market penetration on insurance premium growth rates. HMO penetration had a statistically significant (p market whose HMO penetration rate increased by 25% (e.g., from 10% to 12.5%), the real rate of growth in premiums would be approximately 5.9% instead of 7.0%. Our findings indicate that competitive strategies, relying on managed care, have significant potential to reduce health insurance premium growth rates, thereby resulting in substantial cost savings over time.
-
International Nuclear Information System (INIS)
Sanghwa Oh; Won Sik Shin; Sang-June Choi
2015-01-01
Hydrous manganese oxide-polyacrylonitrile (HMO-PAN) composite was applied for the removal of Co 2+ , Sr 2+ and Cs + from radioactive laundry wastewater. Single- and multi-solute competitive sorptions onto HMO-PAN were investigated. The maximum sorption capacity was in the order of Co 2+ (0.573) > Cs + (0.551) > Sr 2+ (0.310 mmol g -1 ). Sorption of the metals occurred via physical adsorption due to weak van der Waals force and ion exchange with Mn 2+ in HMO-PAN. Sorption behaviors were not related to the types of the surfactants. Among the tested surfactants, SDBS and SOBS remarkably increased the distribution coefficient of Co 2+ and Sr 2+ , respectively. (author)
-
A longitudinal study of adult-onset asthma incidence among HMO members
Directory of Open Access Journals (Sweden)
Rosiello Richard A
2003-08-01
Full Text Available Abstract Background HMO databases offer an opportunity for community based epidemiologic studies of asthma incidence, etiology and treatment. The incidence of asthma in HMO populations and the utility of HMO data, including use of computerized algorithms and manual review of medical charts for determining etiologic factors has not been fully explored. Methods We identified adult-onset asthma, using computerized record searches in a New England HMO. Monthly, our software applied exclusion and inclusion criteria to identify an "at-risk" population and "potential cases". Electronic and paper medical records from the past year were then reviewed for each potential case. Persons with other respiratory diseases or insignificant treatment for asthma were excluded. Confirmed adult-onset asthma (AOA cases were defined as those potential cases with either new-onset asthma or reactivated mild intermittent asthma that had been quiescent for at least one year. We validated the methods by reviewing charts of selected subjects rejected by the algorithm. Results The algorithm was 93 to 99.3% sensitive and 99.6% specific. Sixty-three percent (n = 469 of potential cases were confirmed as AOA. Two thirds of confirmed cases were women with an average age of 34.8 (SD 11.8, and 45% had no evidence of previous asthma diagnosis. The annualized monthly rate of AOA ranged from 4.1 to 11.4 per 1000 at-risk members. Physicians most commonly attribute asthma to infection (59% and allergy (14%. New-onset cases were more likely attributed to infection, while reactivated cases were more associated with allergies. Medical charts included a discussion of work exposures in relation to asthma in only 32 (7% cases. Twenty-three of these (72% indicated there was an association between asthma and workplace exposures for an overall rate of work-related asthma of 4.9%. Conclusion Computerized HMO records can be successfully used to identify AOA. Manual review of these records is
-
A physician role typology: colleague and client dependence in an HMO.
Barr, J K; Steinberg, M K
1985-01-01
This paper reports on physicians' role definitions in one prepaid group practice, a health maintenance organization (HMO). Colleague and client dependence are reviewed and analyzed as separable dimensions of physician role definitions. Data are derived from documents, interviews, and staff questionnaires collected in 1979-1980. The evidence reported suggests widespread colleague dependence in the HMO. Physicians consulted with one another about patient care and engaged in informal referral and review, developing practice standards; and some of these physicians relied on colleagues for handling their patient visits when needed. In relation to their patients, some physicians viewed themselves as bureaucratic officials relatively dependent on client approval in carrying out their health care activities, while others saw themselves as trusted medical experts in a setting free of nonmedical constraints in patient care. The relationship of organizational structure to these different role definitions is discussed. Classifying these HMO physicians according to a fourfold typology of professional dependence shows that most are Organizational Physicians (Type I), who are both colleague and client dependent. Collegial Physicians (Type II) are colleague dependent and, at the same time, do not perceive clients as demanding. Implications for quality of care and physician satisfaction and turnover are considered.
-
Effects of HMO market penetration on physicians' work effort and satisfaction.
Hadley, J; Mitchell, J M
1997-01-01
We investigate whether geographic variations in health maintenance organization (HMO) market penetration are associated with three aspects of physicians' practices: number of hours worked per year, number of patients seen per week, and satisfaction with the current practice. Based on multivariate regression analysis of data for 4,373 patient care physicians (under age forty-five) from a national random sample surveyed in 1991, we estimate that a doubling of the average level of HMO penetration is associated with statistically significant differences of 4 percent fewer annual hours, 13.7 percent fewer patients seen per week, and a 20 percent greater likelihood of not being very satisfied with one's current practice.
-
Energy Technology Data Exchange (ETDEWEB)
Mutschler, W.; Kanz, K.G. [Chirurgische Klinik und Poliklinik, Klinikum Innenstadt der Universitaet Muenchen (Germany)
2002-07-01
Efficient resuscitation of major trauma requests an interdisciplinary communication between trauma surgeons, anaesthesiologists and radiologists. Trauma outcome is significantly influenced by horizontal trauma team organisation and coherence to clinical algorithms, which allow fast diagnosis and intervention. A radiologist present on patients arrival in the trauma room provides a major impact on trauma care. Nevertheless optimal integration in the trauma team implies profound knowledge of the priorities of advanced trauma life support and trauma algorithms. His or her involvement is not limited to patient care only, also active participation in trauma room design, interdisciplinary algorithm development and trauma research are essential tasks for radiologists devoted to emergency radiology. Based on the pathophysiology of polytrauma and the structure of German trauma system, current concepts and proven clinical algorithms with special regard to the radiologist and his duties and tasks will are presented. (orig.) [German] Modernes Schockraummanagement mit dem Auftrag der zeitoptimierten Vernetzung diagnostischer und therapeutischer Handlungsablaeufe erfordert eine direkte Einbindung der Radiologie in das Schockraumteam im Sinne einer horizontalen Kommunikation zwischen Unfallchirurgie, Radiologie und Anaesthesie. Direkte Einbindung bedeutet dabei Einflussnahme auf Struktur- und Prozessqualitaet, Qualitaetsmanagement und interdisziplinaere Weiterentwicklung von Schockraumalgorithmen. Ausgehend von der Pathophysiologie des Polytraumas und der an Zeitgewinn orientierten Versorgungskette werden aktuelle diagnostische und therapeutische Algorithmen dargestellt und daraus die Aufgaben und Bedeutung der Radiologie im Schockraum abgeleitet. (orig.)
-
Adams, E Kathleen; Herring, Bradley
2008-02-01
To use changes in Medicaid health maintenance organization (HMO) penetration across markets over time to test for effects on the extent of Medicaid participation among physicians and to test for differences in the effects of increased use of commercial versus Medicaid-dominant plans within the market. The nationally representative Community Tracking Study's Physician Survey for three periods (1996-1997, 1998-1999, and 2000-2001) on 29,866 physicians combined with Centers for Medicare and Medicaid Services (CMS) and InterStudy data. Market-level estimates of Medicaid HMO penetration are used to test for (1) any participation in Medicaid and (2) the degree to which physicians have an "open" (i.e., nonlimited) practice accepting new Medicaid patients. Models account for physician, firm, and local characteristics, Medicaid relative payment levels adjusted for geographic variation in practice costs, and market-level fixed effects. There is a positive effect of increases in commercial Medicaid HMO penetration on the odds of accepting new Medicaid patients among all physicians, and in particular, among office-based physicians. In contrast, there is no effect, positive or negative, from expanding the penetration of Medicaid-dominant HMO plans within the market. Increases in cost-adjusted Medicaid fees, relative to Medicare levels, were associated with increases in the odds of participation and of physicians having an "open" Medicaid practice. Provider characteristics that consistently lower participation among all physicians include being older, board certified, a U.S. graduate and a solo practitioner. The effects of Medicaid HMO penetration on physician participation vary by the type of plan. If states are able to attract and retain commercial plans, participation by office-based physicians is likely to increase in a way that opens existing practices to more new Medicaid patients. Other policy variables that affect participation include the presence of a federally
-
Ausländerfeindlichkeit unter Jugendlichen in Leipzig
Petermann, Sören; Goldenberg, Olga
2017-01-01
In kommunalen Umfragen erhobene Einstellungen gegenüber Ausländern repräsentieren ein Bild gelebter Toleranz. Selten werden Jugendliche zu ihren ausländerbezogenen Einstellungen gefragt und mit altersspezifischen Faktoren in Verbindung gesetzt. Dieser Beitrag bezieht sich auf theoretische Ansätze der Anomietheorie, der Sozialisations- und Deprivationsforschung, um Kompensationsprozesse und Konfliktpotenziale als Wirkungsmechanismen für Ausländerfeindlichkeit unter Leipziger Jugendlichen zu un...
-
The effect of practitioner compensation on HMO consumer satisfaction.
Scoggins, John F
2002-04-01
To test the hypothesis that a health maintenance organization (HMO) consumer's satisfaction depends on the way his or her health plan compensates practitioners. Consumer Assessment of Health Plans (CAHPS) survey data from 1999 and 2000 were provided by the Office of Public Insurance Counsel for the state of Texas. These data were combined with the Health Plan Employer Data and Information Set (HEDIS) quality measures of managed care health plans in Texas published by the Texas Health Care Information Council. The study fitted the CAHPS survey data to an ordered-probit model. The dependent variable was customer satisfaction with the health plan, using a rating scale from 0-10. The independent variables included the percentage of health plan practitioners compensated with capitated fees, the percentage compensated with a bonus or withholding incentive, and other health plan and consumer characteristics. Consumer satisfaction with HMOs is negatively correlated with the percentage of practitioners who are compensated on a capitated-fee basis and positively correlated with the percentage of practitioners compensated with a fee-withholding incentive (e.g., a fraction of fees that are withheld until specific quality and cost-control goals are reached). Neither the percentage compensated under a bonus incentive system nor the percentage of general practitioners with board certification correlated with HMO consumer satisfaction. A managed health plan's method of practitioner compensation can affect participant satisfaction in a predictable manner.
-
Strategic marketing applications of conjoint analysis: an HMO perspective.
Rosko, M D; DeVita, M; McKenna, W F; Walker, L R
1985-01-01
The purpose of this article is to demonstrate how data from a conjoint analysis study can be used to help determine the most appropriate marketing mix for an operational HMO which is entering a new market--the geriatric population. Included are two features which are absent in previous articles on health care applications of conjoint analysis: external validation of results, and a demonstration of how conjoint analysis can be used to simulate market responses to changes in the provider's marketing mix.
-
Model citizens. Outsourcing helps start-up Medicare HMO.
Slavic, B; Adami, S
1999-04-01
Health Plans of Pennsylvania (HPP), the managed care arm of Crozer-Keystone Health System, in Media, Pa. Selecting the information systems and building the infrastructure to support the start-up of a new Medicare HMO product. HPP chose to outsource the information systems needed to integrate all the components of managed care administration into a cost-effective and cohesive program. Because of its aggressive programming and start-up of the MedCarePlus product offering, HPP became the first plan in the country to submit Medicare claims data electronically for encounter reporting to the Health Care Financing Administration (HCFA). "Through an integrated team approach, an organization truly can benefit from the economies of scale gained through outsourcing."
-
Paperny, D M; Maeser, J D; Artz, K; Stroh, M J; Jackson, L; Cohen, K; Lancaster, M S; Heyer, A L; Clevenson, D S
1991-01-01
The editors of HMO PRACTICE asked clinicians and health educators in HMOs across the country to submit reports on their unique, successful patient education programs. The following HMO Innovations testify to the wide range of new technologies, enterprising partnerships, and creative ideas that are shaping health education in HMOs today.
-
Marketing in the HMO industry: an analysis of spending patterns and enrollment growth results.
Menges, J J
1988-01-01
The purpose of this paper is to assess the level of marketing spending in the HMO industry and the enrollment growth HMOs have achieved in return for their marketing dollars. This study identifies industry norms that are designed to assist HMOs in the evaluation of their marketing performance. The study is based on data from 1985 to 1986 covering approximately half the HMOs in the country and comprising a substantial proportion of industry-wide enrollment (Table 1). The analyses are designed to allow operational HMOs to compare their marketing efforts, enrollment growth, and marketing costs per new member with industry norms within similar age, model type, enrollment level, and geographic categories. The marketing expenses provided by each HMO are an aggregate figure including sales staff salaries, benefits and commissions, advertising, costs for the production and printing of marketing materials, and all other expenses directly related to the marketing effort. Components of the aggregate marketing expenses, such as the amount spent on advertising versus sales staff compensation, were not available.
-
42 CFR 417.155 - How the HMO option must be included in the health benefits plan.
2010-10-01
... printed materials that meet the requirements of § 417.124(b). (ii) Access may not be more restrictive or... benefits plan. 417.155 Section 417.155 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... Organizations in Employee Health Benefits Plans § 417.155 How the HMO option must be included in the health...
-
Olbrich, Bernhard
2008-01-01
Ziel dieser Arbeit ist es, die Bewegung intraabominaler Organe am Beispiel der Leber unter den Bedingungen maschineller Beatmung zu quantifizieren. Ein Messverfahren mit Hilfe eines elektromagnetischen Trackingsystems, wurde hierzu im Tierversuch neu entwickelt. Im Anschluss wurden die Messdaten mit Hilfe einer Explorativen Datenanalyse, validiert und ein einfaches Modell entwickelt, das die virtuelle Kompensation der Atemverschiebung ermöglicht. Zusätzlich wird eine praktische Anwendungsmögl...
-
The impact of HMO penetration on the relationship between nurse staffing and quality.
Mark, Barbara A; Harless, David W; McCue, Michael
2005-07-01
While there are a number of studies examining the relationship between nurse staffing and quality, none has examined structural differences in the relationship between nurse staffing and quality contingent upon the level of managed care penetration. We used administrative data, and a dynamic panel data model to examine this relationship in a panel of 422 acute care hospitals from 1990 to 1995. We found that there were significant differences in the relationship between nurse staffing and both mortality and length of stay depending upon the level of HMO penetration in the hospital's market.
-
Radiology in managed care environment: Opportunities for cost savings in an HMO
International Nuclear Information System (INIS)
Schmidt, C.; Heller, M.
2003-01-01
Purpose: A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. Materials and methods: We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were documented in Microsoft Excel trademark and analyzed by non-parametric tests using SPSS trademark 8.0 (Statistical Package for the Social Sciences) for Windows trademark . Results: The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. (orig.) [de
-
Ponce, Ninez A; Huh, Soonim; Bastani, Roshan
2005-11-01
Few studies have explored health care market structure and colorectal cancer (CRC) screening test use, and little is known whether market factors contribute to racial/ethnic screening disparities. We investigated whether HMO market level factors, controlling for individual covariates, differentially impact Asian American and Pacific Islander (AAPI) subjects' access to CRC screening compared with white subjects. We used random intercept hierarchical models to predict CRC test use. Individual-level survey data was linked to market data by metropolitan statistical areas from InterStudy. Insured first-degree relatives, ages 40-80, of a random sample of colorectal cancer cases identified from the California Cancer Registry: 515 white subjects and 396 AAPI subjects residing in 36 metropolitan statistical areas (MSAs). Dependent variables were receipt of (1) annual fecal occult blood test only; (2) sigmoidoscopy in the past 5 years; (3) colonoscopy in the past 10 years; and (4) any of these tests over the recommended time interval. Market characteristics were HMO penetration, HMO competition, and proportion of staff/group/network HMOs. Market characteristics were as important as individual-level characteristics for AAPI but not for white subjects. Among AAPI subjects, a 10% increase in the percent of group/staff/network model HMO was associated with a reduction in colonoscopy use (28.9% to 20.5%) and in receipt of any of the CRC tests (53.2% to 45.4%). The prevailing organizational structure of a health care market confers a penalty on access to CRC test use among high-risk AAPI subjects but not among high-risk white subjects. Identifying the differential effect of market structure on race/ethnicity can potentially reduce the cancer burden among disadvantaged racial groups.
-
Energy Technology Data Exchange (ETDEWEB)
Nissen-Meyer, S.; Wieser, B.; Huber, S.; Wirth, S.; Treitl, M.; Hartmannsgruber, A.; Witt, C.; Kaysser, A.M.; Kuettner, B.; Hoffmann, R.T.; Reiser, M. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie (Germany); Werner, M. [Siemens AG, Geschaeftsfeld Medizintechnik, Wien (Austria)
2005-08-01
Reimbursement for inpatient services rendered based on comparable daily care rates, case-based flat rates, and special fees as practiced until now has been replaced by the system of diagnosis-related groups. Up until 2004, operation and procedure system (OPS 301) codes could be processed completely automatically by appropriate adaptation of the radiology information system (RIS). Because of further differentiation of OPS codes in the 2005 version, it is no longer possible to unambiguously determine OPS codes automatically. Our goal was to fulfill these additional requirements with as little extra effort as possible. In 36 of 2138 procedures during an observation period of 12 days, i.e., 4/day, manual input on the part of the radiology technical assistant and quality assurance by the diagnosing physician were necessary. This is only needed in complicated procedures for which the minor added effort is negligible in comparison to the entire effort expended for the procedure. We were thus able to achieve the goal of near automation of ascertaining OPS codes. (orig.) [German] Die bisherige Erstattung stationaerer Krankenhausleistungen auf Basis tagesgleicher Pflegesaetze, Fallpauschalen und Sonderentgelte ist durch das Diagnosis-related-groups- (DRG-)System abgeloest worden. Operationen- und Prozeduren- (OPS-)Schluessel 301 konnten in der Radiologie bis 2004 mit entsprechender Anpassung des ''Radiologie-Informations-System'' (RIS) vollautomatisiert erfasst werden. Durch die immer feinere Differenzierung der OPS-Codes in der Version 2005 ist eine eindeutige Ermittlung der OPS-Codes jedoch nicht mehr vollautomatisch moeglich. Ziel ist es, diese zusaetzlichen Aufgaben mit so wenig Mehraufwand wie moeglich zu erbringen. Bei 36 von 2138 Verfahren waren in einem Beobachtungszeitraum von 12 Tagen, d. h. 4/Tag, manuelle Eingaben durch die MTRA sowie eine Qualitaetskontrolle durch den befundenden Arzt notwendig. Dies ist nur bei aufwaendigen Verfahren noetig
-
Die Analyse der Wertschöpfungskette Schweinefleisch unter den Aspekten des Supply Chain Management
Schönberger, Wolfgang
2008-01-01
Inhalt der Arbeit ist die vergleichende Analyse der Wertschöpfungskette Schweinefleisch unter den Aspekten des Supply Chain Management für Bayern sowie für Dänemark als dem weltweit größten Nettoexporteur von Schweinefleisch. Wichtige Wettbewerbsfaktoren und die Strukturen der Wertschöpfungskette werden untersucht. Die Produktionskosten werden nach der Methode der Vollkostenrechnung ermittelt. In Dänemark haben sich auf allen Stufen der Wertschöpfungskette Strukturen entwickelt, die die...
-
Directory of Open Access Journals (Sweden)
Anina Mischau
2002-07-01
Full Text Available Die Solidarität unter Frauenforscherinnen wird bis heute als politisch-ideologisches Postulat der Frauenforschung aufrechterhalten, obwohl im Zuge einer zunehmenden Institutionalisierung und Professionalisierung bei einer gleichzeitig nahezu unveränderten Marginalisierung der Frauenforschung an deutschen Hochschulen eine stärker werdende Konkurrenz auch unter Frauenforscherinnen zu beobachten ist. Sünne Andresen geht der Frage nach den möglichen Ursachen von Konkurrenz unter Frauenforscherinnen in der Hochschule nach. Diese Fragestellung ist in der Frauen- und Geschlechterforschung nicht neu, wenngleich sie bislang eher allgemein auf die Konkurrenz unter Wissenschaftlerinnen bezogen worden ist. Innovativ ist jedoch, dass die Autorin hierfür den subjektwissenschaftlichen Ansatz der Kritischen Psychologie und die Habitus-Feld-Konzeption Bourdieus als theoretischen Bezugsrahmen auswählt und damit deutlich über die vorherrschenden subjektzentrierten oder strukturtheoretischen Erklärungsansätze hinausgeht. Die empirische Basis ihrer Studie sind sechs qualitative Interviews mit Habilitandinnen der geistes- und sozialwissenschaftlichen Fächer, die sich auf die Frauen- und Geschlechterforschung spezialisiert haben. Insgesamt arbeitet die Autorin interessante Aspekte möglicher Ursachen des Konkurrenzverhaltens unter und der Konkurrenzerfahrungen von Frauenforscherinnen heraus. Sie bleibt der Leserin aber mindestens genauso viele Antworten schuldig, wie sie durch die dargestellten „empirischen Ergebnisse" zu geben vermag.Until the present day, solidarity among feminist scholars is upheld as an ideological-political postulate in this particular scholarly community. These views continue to be upheld despite the increasing institutionalisation and professionalisation of research in women’s studies research. These institutional changes result in an increased sense of competition among feminist scholars, while women’s studies continue to
-
[Radiology in managed care environment: opportunities for cost savings in an HMO].
Schmidt, C; Mohr, A; Möller, J; Levin-Scherz, J; Heller, M
2003-09-01
A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were docu-mented in Microsoft Excel(R) and analyzed by non-parametric tests using SPSS(R) 8.0 (Statistical Package for the Social Sciences) for Windows(R). The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. We identified initiatives with estimated potential savings of approximately $ 5.5 million. Some of these
-
Reschovsky, James D; Hargraves, J Lee; Smith, Albert F
2002-06-01
Surveys that rate how persons enrolled in HMOs and other types of health coverage feel about their health care are used to bolster claims that HMOs provide inferior quality care, providing justification for patient protection legislation. This research illustrates that the conventional wisdom regarding inferior care in HMOs may color how people assess their health care in surveys, resulting in survey findings biased toward showing HMOs provide inferior care and reinforcing existing stereotypes. Using merged data from the Community Tracking Study Household and Insurance Followback surveys, we identify privately insured persons who correctly and incorrectly know what kind of health plan they are covered by. Nearly a quarter misidentified their type of health coverage. Differences between responses by HMO and non-HMO enrollees to questions covering satisfaction with health care and physician choice, the quality of the last physician's visit, and patient trust in their physician shrink or disappear when we control for beliefs about what type of plan they are covered by. Results suggest that researchers and policy makers should be cautious about using consumer surveys to assess the relative quality of care provided under different types of health insurance.
-
Impact of HMO penetration and other environmental factors on hospital X-inefficiency.
Rosko, M D
2001-12-01
This study examined the impact of health maintenance organization (HMO) market penetration and other internal and external environmental factors on hospital X-inefficiency in a national sample (N = 1,966) of urban U.S. hospitals in 1997. Stochastic frontier analysis, a frontier regression technique, was used to measure X-inefficiency and estimate parameters of the correlates of X-inefficiency. Log-likelihood restriction tests were used to test a variety of assumptions about the empirical model that guided its selection. Average estimated X-inefficiency in study hospitals was 12.96 percent. Increases in managed care penetration, dependence on Medicare and Medicaid, membership in a multihospital system, and location in areas where competitive pressures and the pool of uncompensated care are greater were associated with less X-inefficiency. Not-for-profit ownership was associated with increased X-inefficiency.
-
Thiel, Jörg
2017-01-01
Beeinflusst von der Volatilität der Märkte, ergänzt um gesellschaftspolitische wie absatzorientierte Maßnahmen, ist die Landtechnikbranche seit jeher einem permanenten Wandel ausgesetzt. Insbesondere unter dem derzeit im Fokus stehenden Aspekt der Nachhaltigkeit in landwirtschaftlichen Produktionssystemen bedarf es der Gestaltung innovativer Ansätze für effizientere sowie gleichzeitig ressourcenschonende Verfahren. Zusätzlich verstärkt durch die seit geraumer Zeit anhaltend angespannten Situa...
-
Hamilton, John; Daleiden, Eric; Dopson, Sue
2011-05-01
A qualitative study of child clinicians in a non-profit HMO examined implementation of evidence-based practices (EBPs) for anxiety and oppositional defiant disorders using interviews and focus groups with 33 clinicians (97% of participants), and ethnography of emails and meetings. Analysis showed statistical measures of access and service-key elements of rating organizations' "report cards"- were central in creating "pressure" making transition to EBPs difficult. EBPs were secondary to access and service targets. "Research" and "statistics" were perceived as unrealistic, "literature" as lacking authority. Rating organizations should include outcome and fidelity metrics to align market share pressures with children's health.
-
"America first": die Außen- und Sicherheitspolitik der USA unter Präsident Trump
2017-01-01
"Donald J. Trump ist der 45. Präsident der Vereinigten Staaten - und auch zehn Wochen nach der Wahl hat sich die Aufregung über das Wahlergebnis nicht gelegt. Diesseits des Atlantiks interessiert vor allem eine Frage: Wie wird die amerikanische Außen- und Sicherheitspolitik unter Präsident Trump aussehen? Wird sie von Kontinuität geprägt sein? Oder wird es gravierende Brüche geben? In diesem Report werfen HSFK-Autorinnen und -Autoren Blicke auf Themen, die aus Sicht der Friedens- und Konflikt...
-
Hadley, J; Mitchell, J M; Sulmasy, D P; Bloche, M G
1999-04-01
To estimate the effects of physicians' personal financial incentives and other measures of involvement with HMOs on three measures of satisfaction and practice style: overall practice satisfaction, the extent to which prior expectations about professional autonomy and the ability to practice good-quality medicine are met, and several specific measures of practice style. A telephone survey conducted in 1997 of 1,549 physicians who were located in the 75 largest Metropolitan Statistical Areas in 1991. Eligible physicians were under age 52, had between 8 and 17 years of post-residency practice experience, and spent at least 20 hours per week in patient care. The response rate was 74 percent. Multivariate binomial and multinomial ordered logistic regression models were estimated. Independent variables included physicians' self-reported financial incentives, measured by the extent to which their overall financial arrangements created an incentive to either reduce or increase services to patients, the level of HMO penetration in the market, employment setting, medical specialty, exposure to managed care while in medical training, and selected personal characteristics. About 15 percent of survey respondents reported a moderate or strong incentive to reduce services; 70 percent reported a neutral incentive; and 15 percent reported an incentive to increase services. Compared to physicians with a neutral incentive, physicians with an incentive to reduce services were from 1.5 to 3.5 times more likely to be very dissatisfied with their practices and were 0.2 to 0.5 times as likely to report that their expectations regarding professional autonomy and ability to practice good-quality medicine were met. They were also 0.2 to 0.6 times as likely to report having the freedom to care for patients the way they would like along several specific measures of practice style, such as sufficient time with patients, ability to hospitalize, ability to order tests and procedures, and ability
-
Radiation protection in interventional radiology; Strahlenschutz in der interventionellen Radiologie
Energy Technology Data Exchange (ETDEWEB)
Adamus, R.; Loose, R.; Galster, M. [Klinikum Nuernberg Nord, Institut fuer Diagnostische und Interventionelle Radiologie, Nuernberg (Germany); Wucherer, M. [Klinikum Nuernberg Nord, Institut fuer Medizinische Physik, Nuernberg (Germany); Uder, M. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institut fuer Radiologie, Erlangen (Germany)
2016-03-15
The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x-ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X-ray protection measures plus lead-containing eyeglasses. (orig.) [German] Die Anwendung ionisierender Strahlung in der Medizin scheint sowohl fuer Patienten als auch fuer beruflich exponierte Personen sicher zu sein. Die interventionellen Entwicklungen der letzten Jahre mit sehr durchleuchtungs- und dosisintensiven Eingriffen erfordern allerdings eine Intensivierung des Strahlenschutzes. Es empfiehlt sich, die zur Verfuegung stehenden Moeglichkeiten auszuschoepfen. Neben den Geraeteoptionen muss der Strahlenschutz am Eingriffstisch durch Bleilamellenaufstecker und montiertes Bleiglas intensiv betrieben werden. Besonderen Fokus muss auf den Schutz der Augen zur Kataraktvermeidung gelegt werden. Da dessen Ausbildung nach neuen Erkenntnissen moeglicherweise nicht mehr deterministisch zu sehen ist, hat die Internationale Strahlenschutzkommission (IRCP) den Grenzwert von 150 auf 20 Mikrosievert (mSv)/Jahr erniedrigt. Messungen belegen, dass unter Einhaltung aller Strahlenschutzmassnahmen plus Bleiglasbrille dieser einzuhalten ist. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Uhl, M. [Freiburg Univ. (Germany). Radiologische Klinik
1999-05-01
The contributions in the section on ``advanced training`` reflect the knowledge required of doctors specializing in diagnostic radiology and may also serve as a revision course for medical practicioners. It presents clinically validated information on the following subjects: Rheumatoid arthritis (radiological model) - four classes of radiological signs of arthritis - hydrarthrosis, haemarthrosis and serosynovitis - osteopenia near the joints (where direct signs may not be available until several months or years after the onset of the disease) - `signal cysts` - changes in the limiting lamina (which require careful observation under a magnifying glass) - pannus (an indication of arthritis of the joints) - mutilation - false positions of the joints. [Deutsch] Die Beitraege der Rubrik `Weiterbildung` sollen dem Stand des zur Facharztpruefung fuer den Arzt fuer Diagnostische Radiologie notwendigen Wissens entsprechen und zugleich dem niedergelassenen Facharzt als Repetitorium dienen. Die Rubrik beschraenkt sich auf klinisch gesicherte Aussagen zu den Themen: - Rheumatoide Arthritis (Radiologisches Modell) - Vier Klassen der radiologischen Arthritiszeichen. - Gelenkerguss - `Gelenknahe Osteopenie` (Direktzeichen sind erst Wochen bis Monate bzw. Jahre nach Krankheitsbeginn erkennbar.) - `Signalzysten` - Grenzlamellenveraenderungen (Sorgfaeltige Lupenbetrachtung ist entscheidend.) - Pannus (Beweis fuer eine arthritische Gelenkerkrankung.) - Mutilation - Gelenkfehlstellungen. (orig./AJ)
-
Evaluating employee assistance policy in an HMO-based alcoholism project.
Putnam, S L; Stout, R L
1985-01-01
One aspect of successful employee assistance program (EAP) implementation is the adoption of a formal, written policy, reflecting company commitment to EAP guidelines and goals. This study of criteria predictive of such policy adoption was conducted at the occupational alcoholism project of a New England health maintenance organization (HMO). Data on nearly 400 organizations contacted by occupational program consultants (OPCs) over a 20-month period were collected by questionnaire and interview. One third of these organizations adopted employee assistance policies and set about establishing formal programs. Stepwise multiple regression is the principal method used to pinpoint the correlates of policy adoption. Two of the most important of these are the attitudes of contact persons within the organization toward alcoholism and employee assistance programs, particularly their admission of alcohol problems within their social networks; and the consultants' persistence and marketing skills. The adopting organizations also had reputations for being progressive, and actively concerned about employee welfare; they tended to be large, their executives autonomous, and their union membership rates high. Inhibiting policy acceptance were fears that a written policy would jeopardize the reputation and image of the organization, and that an employee assistance program would remove internal control of personal procedures. The adequacy of the evaluative data and methods are discussed, and recommendations are offered in the interests of streamlining the efforts of OPCs and of achieving greater penetration of targeted organizations.
-
Directory of Open Access Journals (Sweden)
Perabo FGE
2000-01-01
Full Text Available Die orale Medikation mit Sildenafil (Viagra™ hat sich zur Therapie der erektilen Dysfunktion etabliert und relativiert die Differentialdiagnose zwischen psychogener und organischer Dysfunktion mit den entsprechenden therapeutischen Konsequenzen. Diesem Problem widmet sich diese Studie zur Prüfung der erektilen Antwort unter RigiScan®-Monitoring ohne/mit 50 mg Viagra™. 64 Patienten (mittleres Alter 48 Jahre mit einer erektilen Dysfunktion arteriogener (n = 10, venöser (n = 7, gemischt neurogen/vaskulärer (n = 15 und psychogener (n = 32 Genese von mehr als 6 Monaten Dauer wurden in die Studie aufgenommen. Alle Patienten wurden eingehend diagnostisch abgeklärt, inklusive Hormonlabor, dynamischer Pharmako-Duplexsonographie und, falls indiziert, mit einer Cavernosometrie/ -graphie. Zur Testung der penilen Rigidität und zur Objektivierung der Erektion wurde das "real-time" RigiScan® verwendet. In zwei konsekutiven Messungen wurden sowohl die direkte erektile Antwort auf visuelle Stimulation als auch die nächtlichen Erektionen abgeleitet und die Meßergebnisse mit den Begleiterkrankungen, "lifestyle"-Faktoren und dem Ergebnis der Pharmako-Duplexsonographie korreliert. Es fand sich keine Korrelation zwischen der Ätiologie der erektilen Dysfunktion in bezug auf organische oder psychogene Genese und dem Alter der Patienten, der Dauer der Erektionsstörung, dem Nikotinabusus, den Blutfetten, den Testosteronwerten, dem klinischen Ergebnis der Pharmakotestung (Erektionsgrad und dem duplexsonographisch gemessenen Fluß der penilen Arterien. Hingegen zeigte sich eine positive Korrelation zwischen Genese der erektilen Dysfunktion (organisch bzw. psychogen und dem RigiScan®-Meßergebnis (r = 0,29. Patienten mit psychogen bedingter Erektionsstörung profitierten am meisten von Viagra™, während Patienten mit vaskulärer Genese oder gemischt neurogener/vaskulärer Genese deutlich schlechter auf Viagra™ ansprachen. Es bestand keine Korrelation
-
Energy Technology Data Exchange (ETDEWEB)
NONE
1998-12-31
Technologies for mechanical-biological treatment of waste in the Land of Hessen were compared including thermal processes like combustion and gasification. The new and more rigid limiting values specified in the Technical Guide for Municipal Waste Treatment (Technische Anleitung Siedlungsabfall - TASI) get a special mention. [Deutsch] Verschiedene Technologien der mechanisch-biologischen Restabfallbehandlung im Raum Hessen wurden unter Einbezug thermischer Verfahren (Verbrennung, Vergasung) miteinander verglichen. Dabei wurden besonders auf die verschaerften Grenzwerte der Technischen Anleitung Siedlungsabfall (TASI) eingegangen. (ABI)
-
Energy Technology Data Exchange (ETDEWEB)
Hackert, G.; Kremer, H.; Wirtz, S. [Bochum Univ. (Germany). Lehrstuhl fuer Energieanlagentechnik
1999-09-01
The short-range flame burner and the KOALA reactor of DMT are experimental facilities for realistic simulation of coal conversion processes at high temperatures and pressures in atmospheric conditions. The TOSCA system enable measurements of temperatures, sizes, shapes and velocities of the fuel particles, which serve as a basis for a three-dimensional simulation model of coal combustion. In the future, further parameter studies will deepen the present knowledge of coal dust combustion under pressure and enable optimisation of the numerical models for simulation of industrial-scale systems for coal dust combustion under pressure. [Deutsch] Mit dem Flachflammenbrenner und dem KOALA-Reaktor der DMT stehen Versuchsapparaturen zur Verfuegung, mit deren Hilfe die Kohleumwandlungsprozesse bei hohen Temperaturen unter Druck und unter atmosphaerischen Bedingungen realistisch wiedergegeben werden. Das TOSCA-System erlaubt dabei die Bestimmung von Temperaturen, Groessen, Formen und Geschwindigkeiten der Brennstoffpartikel. Diese Daten liefern die Grundlage fuer die Erstellung eines dreidimensionalen Simulationsmodells zur Modellierung der Kohleverbrennung. In Zukunft werden weitere Parameterstudien das Verstaendnis der Kohlenstaubdruckverbrennung vertiefen und ein Optimierung der numerischen Modelle ermoeglichen, so dass die Simulation grosstechnischer Kohlenstaubdruckverbrennungsanlagen realisiert werden kann. (orig.)
-
Radiology of the primary systemic vasculitides; Radiologie der primaeren systemischen Vaskulitiden
Energy Technology Data Exchange (ETDEWEB)
Reuter, M.; Biederer, J.; Both, M.; Heller, M.L. [Universitaetsklinikum Kiel (Germany). Klinik fuer Diagnostische Radiologie; Schnabel, A. [Universitaetsklinik Luebeck (Germany). Poliklinik fuer Rheumatologie; Medizinische Krankenhausabteilung Rheumaklinik Bad Bramstedt GmbH (Germany); Sana Rheumazentrum Baden-Wuerttemberg (Germany). Klinik fuer Internistische Rheumatologie und Klinische Immunologie; Reinhold-Keller, E.; Gross,W. [Universitaetsklinik Luebeck (Germany). Poliklinik fuer Rheumatologie; Medizinische Krankenhausabteilung Rheumaklinik Bad Bramstedt GmbH (Germany)
2003-09-01
Determination of disease extension and disease activity are in the foreground of diagnostic imaging in vasculitides. There are several radiologic modalities available each having specific indications. Magnetic resonance imaging (MRI) readily depicts granulomas and mucosal inflammations in the paranasal sinuses, nasal cavity and orbits. Computed tomography detects osseous lesions of the skull. Due to its superb sensitivity MRI is an established screening modality for CNS vasculitides, although there are limitations with regard to specificity. In spite of its limited accuracy in most institutions angiography is still required for radiological confirmation of CNS vasculitis. Perfusion and diffusion MR-imaging may combine the advantages of ''conventional'' MRI and angiography. By now the method is not fully validated for vasculitides, however. Vascular disease in Takayasu's arteritis and in giant cell arteritis involving predominantly large and medium sized vessels is readily diagnosed by non invasive magnetic resonance angiography. Percutaneous transluminal angioplasty has proven to be an effective and save therapeutic modality for the cure of vascular stenoses and occlusions. Plain film radiography in two planes is the established modality for pulmonary imaging. In pulmonary vasculitides a more thorough analysis of lung disease is provided by high resolution computed tomography. Diagnostic imaging does substantially assist in the interdisciplinary management of patients suffering from vasculitides. (orig.) [German] Die Bestimmung der Krankheitsausdehnung und die Festlegung der Krankheitsaktivitaet stehen im Vordergrund der bildgebenden Diagnostik von Vaskulitiden. Fuer die eigentliche Diagnosefindung ist die Radiologie von untergeordneter Bedeutung. Die verschiedenen radiologischen Methoden weisen jeweils spezifische Indikationen auf. Die Magnetresonanztomographie (MRT) hat sich als hilfreich fuer die Diagnostik von Granulomen und
-
Directory of Open Access Journals (Sweden)
Jasna Makovec
1983-01-01
Full Text Available Die vorliegende Arbeit wurde durch das Bestreben motiviert, weitere Ergänzungen zum Phänornen "Ausrahrnung in der modernen deutschen Schriftsprache der Gegenwart" zu leisten. Der Ausgangspunkt dieses "fakultativ" geregelten Bereiches ist die Annahme bzw. die Arbeitshypothese, daß sich linguistische und außerlinguistische Faktoren einander zuordnen lassen. Das bedeutet, daß die Linearität innerhalb des Kornrnunikationspro zesses auch einige wichtige kommunikative Funktionen auszuüben hat, und daß die kontextuellen Modifikationen der Stellungsva rianten bei gleichern Denotatsbezug unter diesern Blickwinkel untersucht werden müssen, und nicht gleich als stilistische Varianten qualifiziert werden.
-
Energy Technology Data Exchange (ETDEWEB)
Gruen, C.
1996-12-01
The high temperatures of use in drive units, such as the combustion chamber or the hot gas turbine, for example, usually cause high temperature changes. Great temperature differences occur for short periods in the components, and thermal shock is produced. In this work, theoretical and experimental investigations are introduced on crack initiation and crack growth in high temperature materials under cyclic thermal stresses. The experiments were carried out with the inter-metallic phase Ni{sub 3}Al, the nickel-based alloy Nimonic 80A and the iron-based alloy PM 2000 strengthened by oxide dispersion (ODS). A characteristic crack appearance picture was found for each material, which was examined more closely. The stresses occurring in the sample during one cycle were calculated with the aid of the finite element program ABAQUS, knowing the specific material parameters. Based on the linear-elastic fracture mechanics, stress intensity factors were calculated on the superimposition principle. Using the material data from isothermal crack propagation experiments, the prediction of fatigue crack spread with cyclic thermal stresses is compared with the experimental findings. (orig./AKF) [Deutsch] Die hohen Einsatztemperaturen in Antriebsaggregaten wie z.B. der Brennkammer oder der Heissgasturbine bedingen in der Regel hohe Temperaturwechsel. Dabei treten kurzzeitig grosse Temperaturunterschiede in den Bauteilen auf, ein Thermoschock wird erzeugt. In der vorliegenden Arbeit werden theoretische und experimentelle Untersuchungen zur Rissinitiierung und zum Risswachstum in Hochtemperaturwerkstoffen unter zyklisch thermischer Belastung vorgestellt. Die Experimente wurden mit der intermetallischen Phase Ni{sub 3}Al, der Nickelbasislegierung Nimonic 80A und der oxid-dispersionsverfestigten (ODS) Eisenbasislegierung PM2000 durchgefuehrt. Fuer jeden Werkstoff stellte sich ein charakteristisches Risserscheinungsbild dar, das naeher untersucht wurde. Die in der Probe auftretenden
-
Trost, Benjamin
2015-01-01
Ziel der Arbeit ist die Gesamtbilanzierung der Treibhausgasemissionen eines Anbausystems unter Bewässerung auf einem Sandboden. Die dazu aufgestellte Treibhausgasbilanz basiert auf langjährigen Datenreihen zu Erträgen und Corg-Vorräten eines Dauerfeldversuchs sowie auf zweijährigen im Feldversuch durchgeführten N2O-Messungen. Die durchgeführten Untersuchungen zum Einfluss der Bewässerung auf die Corg-Vorräte zeigen, dass der Einsatz von mineralischem Stickstoffdünger und Bewässerung auf einem...
-
The HMO Research Network Virtual Data Warehouse: A Public Data Model to Support Collaboration.
Ross, Tyler R; Ng, Daniel; Brown, Jeffrey S; Pardee, Roy; Hornbrook, Mark C; Hart, Gene; Steiner, John F
2014-01-01
The HMO Research Network (HMORN) Virtual Data Warehouse (VDW) is a public, non-proprietary, research-focused data model implemented at 17 health care systems across the United States. The HMORN has created a governance structure and specified policies concerning the VDW's content, development, implementation, and quality assurance. Data extracted from the VDW have been used by thousands of studies published in peer-reviewed journal articles. Advances in software supporting care delivery and claims processing and the availability of new data sources have greatly expanded the data available for research, but substantially increased the complexity of data management. The VDW data model incorporates software and data advances to ensure that comprehensive, up-to-date data of known quality are available for research. VDW governance works to accommodate new data and system complexities. This article highlights the HMORN VDW data model, its governance principles, data content, and quality assurance procedures. Our goal is to share the VDW data model and its operations to those wishing to implement a distributed interoperable health care data system.
-
Energy Technology Data Exchange (ETDEWEB)
Nestle, E.
2000-06-01
A tensile test facility for simultaneous thermal, mechanical and corrosive loading was developed and constructed for the purpose of characterizing the damage characteristics of ceramic high-temperature materials. Apart from tensile tests for up to 830 h, tests were also carried out on four-point bending test pieces and disk-shaped oxidation test pieces. The experiments were made at 1450 - 1550 C in dry or moist air. The materials investigated were one hot-pressed silicon carbide and two sintered silicon carbides. [German] Um keramische Hochtemperaturwerkstoffe bezueglich ihres Schaedigungsverhaltens charakterisieren zu koennen, wurde im Rahmen der vorliegenden Arbeit eine Zugpruefanlage zur gleichzeitigen Beanspruchung unter thermischen, mechanischen und korrosiven Bedingungen entwickelt und aufgebaut. Neben den in dieser Anlage durchgefuehrten Zugpruefungen mit Versuchszeiten bis zu 830 h wurden begleitende Untersuchungen an Vierpunkt-Biegeproben und scheibenfoermigen Oxidationsproben durchgefuehrt. Die Versuche konzentrierten sich auf den Temperaturbereich 1450-1550 unter trockenen und feuchten Luftatmosphaeren. Bei den untersuchten Werkstoffen handelte es sich um eine heissgepresste und zwei gesinterte Siliciumcarbid-Qualitaeten. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Hansmann, J.; Richter, G.M.; Hallscheidt, P.; Duex, M.; Noeldge, G.; Kaufmann, G.W. [Heidelberg Univ. (Germany). Abt. Radiodiagnostik
1999-05-01
parallel to further refinement of embolization material has aided to use superselective occlusivion techniques in benign vascular lesions and renal trauma. (orig.) [Deutsch] In der Diagnostik von pathologischen Veraenderungen der Nieren konkurrieren die Katheterangiographie, der Ultraschall, die Computertomographie und die Kernspintomographie. In der Abklaerung renaler Raumforderungen stehen die Schnittbildverfahren heute im Vordergrund. In der Diagnostik von Nierenarterienstenosen ist die Angiographie bis heute der Goldstandard. Die weniger invasiven angiographischen Techniken der CT und der MRT sind in aufwendigen Studien der Angiographie der Nierenarterien ebenbuertig, es mangelt jedoch insbesondere fuer die immer haeufiger zum Einsatz kommende MR-Angiographie an verbindlichen Qualitaetskriterien. In der interventionellen Radiologie der Nieren sind die angiographischen Techniken der Nierenarterienangioplastie inklusive der Stentimplantation und die Embolisationstechniken ausgereift. Die klinischen Ergebnisse koennen gut gegen die der operativen Verfahren bestehen. Die interventionellen Verfahren haben somit ihren festen Platz im Spektrum der modernen minimal invasiven Medizin. (orig.)
-
Luts-Sootak, Marju, 1966-
2011-01-01
Arvustus: Dimitri Steinke. Die Zivilrechtsordnungen des Baltikums unter dem Einfluss ausländischer, insbesondere deutscher Rechtsquellen. (Osnabrücker Schriften zur Rechtsgeschichte ; 16). Göttingen, 2009
-
Energy Technology Data Exchange (ETDEWEB)
Fink, R.
2001-05-01
The development of new combustor concepts for aero engines to meet future emissions regulations in based on a detailed knowledge of the combustion process and the velocity field. In the presented thesis, non intrusive measurements were performed in a model combustion chamber under almost realistic pressure and temperature conditions. The species OH, NO, unburned hydrocarbons and fuel droplets were detected in 2 dimensions with the Laser Induced Fluorescence (LIF). The velocity field was measured with the Particle Image Velocimetry technique (PIV). [German] Die Weiterentwicklung neuer Brennkammerkonzepte zur Erfuellung zukuenftiger Schadstoffemissionsrichtlinien erfordert genaue Kenntnisse der ablaufenden Verbrennungs- und Stroemungsvorgaenge in der Brennkammer. Bei den in der Arbeit vorgestellten Untersuchungen wurden in einer LPP-Modellbrennkammer unter annaehernd realistischen Eintrittsbedingungen die Spezies OH, NO, unverbrannte Kohlenwasserstoffe sowie noch fluessiger Brennstoff zweidimensional anhand der Laserinduzierten Fluoreszenz (LIF) nachgewiesen. Das Stroemungsfeld wurde mit Hilfe der Particle Image Velocimetry (PIV) gemessen.
-
Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients
Directory of Open Access Journals (Sweden)
Dube Shanta R
2008-06-01
Full Text Available Abstract Background Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs, which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce. Method We used the ACE Score (an integer count of 8 different categories of ACEs as a measure of cumulative exposure to traumatic stress during childhood. We prospectively assessed the relationship of the Score to prescription drug use in a cohort of 15,033 adult HMO patients (mean follow-up: 6.1 years and assessed mediation of this relationship by documented ACE-related health and social problems. Results Nearly 1.2 million prescriptions were recorded; prescriptions rates increased in a graded fashion as the ACE Score increased (p for trend Conclusion ACEs substantially increase the number of prescriptions and classes of drugs used for as long as 7 or 8 decades after their occurrence. The increases in prescription drug use were largely mediated by documented ACE-related health and social problems.
-
Energy Technology Data Exchange (ETDEWEB)
Willenbrink, J.; Schatten, T.
1992-12-31
In this project, effects of long-term, low-level ozone exposure on CO{sub 2}fixation and assimilate partitioning in 4-years spruces old were studied. 1. In October, ozone exposure resulted in a 40% decrease of photosynthesis. Chlorophyll content was not altered. Depression of net photosynthesis by ozone exposure fluctuates. At least partly, this depression of net photosynthesis might reflect an increase of respiration. After 6 weeks of ozone exposure, both stomatal conductivity and transpiration seemed to be lowered. However, internal [CO{sub 2}] and water use efficiency were not significantly altered. 2. Compared with the control, needles of ozone-exposed plants exhibited a shift of the {sup 14}C-ratio of {beta}-carotene/xanthophylls which effect faded away with the season (October). 3. In August and October, translocation of {sup 14}C-assimilates from the {sup 14}C-fed source leaves seems to be impeded by ozone exposure. 4. No O{sub 3}-related differences were found for the lipophilic as well as for the fractions of organic or amino acids. For the sink tissues (twig, stem, root), less label was found in non-starch residue in August (main growth season), in O{sub 3}-exposed plants. 5. Starch and sugar content of cortex, cambium, xylem, and of the root follow annual cycles. Under ozon exposure, levels of {sup 14}C-starch and {sup 14}C-sucrose are lowered whereas in the needles, build-up of {sup 14}C-starch was detected. 6. Obviously, long-term low-level ozone affects allocation of assimilates. Secondary effects on chloroplasts by the treatment cannot be excluded. (orig./UWA) [Deutsch] Unter Labor- bzw. Gewaechshausbedingungen wurde der Einfluss einer kontrollierten Ozonexposition auf die Photosyntheseleistung und die Assimilatverteilung in 4-jaehrigen Fichten untersucht. 1. Unter Ozon-Exposition wird die Netto-Photosyntheserate in den jungen Nadeln zum Herbst hin reduziert, waehrend der Chlorophyllgehalt unbeeinflusst bleibt. Die Photosyntheserate der jungen Nadeln
-
African Journals Online (AJOL)
ebutamanya
17 janv. 2016 ... Budd-Chiari syndrome: a rare complication of hepatic sarcoidosis (about one case). Ismael Ait Sghier1,&, Nabil Moatassim Billah1. 1Service de Radiologie Centrale, Hôpital Avicenne, Rabat, Maroc. &Corresponding author: Ismael Ait Sghier, Service de Radiologie Centrale, Hôpital Avicenne, Rabat, Maroc.
-
Energy Technology Data Exchange (ETDEWEB)
Lenk, Christian Alexander
2009-08-13
The author attempted a time-resolved detection of raised hydrogen concentrations in the plastic deformation region of fatigue cracks in an aluminium test piece deformed by cyclic stress in a corrosive environment. Mechanical material parameters like the crack propagation velocity under cyclic stress change dramatically in a corrosive environment. This is assumed to be caused by hydrogen diffusion, but so far there is no method that reliably measures additional hydrogen from the corrosive environment. For this reason, a special analytical configuration was set up which makes use of the thermal desorption method. First, chips with a thickness of about 20 micrometers are sawed out of the test specimen in high-vacuum conditions. The chips fall into a hot melting vessel in a UHV chamber, where the hydrogen contained in the chips is released. The resulting pressure increase is recorded by a mass spectrometer. A hydrogen profile of the test specimen is obtained by assigning the chip position to the signal. For the corrosive medium in which the test specimen is immersed during crack initiation, i.e. NaCl solution, heavy water was used. This makes it possible to distinguish between the hydrogen contained in a piece of technical aluminium alloy (AA6013) and the deuterium diffusing in from the corrosive fluid. The deuterium is found exclusively in the test piece volume in the strongly plastically deformed region surrounding the fatigue crack. (orig.) [German] Das Ziel der vorliegenden Arbeit besteht im ortsaufgeloesten Nachweis einer erhoehten Wasserstoffkonzentration im plastisch deformierten Bereich von Ermuedungsrissen einer unter korrosiver Umgebung zyklisch verformten Aluminiumprobe. Mechanische Materialparameter wie z.B. die Rissausbreitungsgeschwindigkeit unter zyklischer Belastung aendern sich drastisch in korrosiver Umgebung. Als Ursache fuer dieses Verhalten wird eine Eindiffusion von Wasserstoff vermutet, jedoch gibt es bisher keine Messung die den zusaetzlichen
-
African Journals Online (AJOL)
abp
30 déc. 2015 ... Gastrinome duodénal sporadique. Hicham Sator1,&, Leila Sbihi1. 1Hôpital Avicenne, Service de Radiologie Centrale, CHU Ibn Sina, Rabat, Maroc. &Corresponding author: Hicham Sator, Hôpital Avicenne, Service de Radiologie Centrale, CHU Ibn Sina ,Rabat, Maroc. Key words: Duodénum, gastrinome, ...
-
Directory of Open Access Journals (Sweden)
Aeberli D
1999-01-01
Full Text Available Das primäre Ziel dieser retrospektiven Studie war die Evaluation von routinemäßig anwendbaren Kriterien, welche die Fragmentierung von Nierensteinen unter extrakorporaler Stoßwellenlithotripsie (ESWL voraussagen können. Die Serie umfaßte 202 konsekutive Patienten (121 Männer, 81 Frauen mit einem medianen Alter von 48 Jahren (19-81 Jahre, die an der Urologischen Universitätsklinik Bern mit dem originalen Dornier HM-3 behandelt wurden. Einschlußkriterien waren Einzelsteine von 10-30 mm Größe mit Lage im Nierenbeckenkelchsystem. Die Steine wurden im Abdomen-Leerbild nach ihrer Lage, Größe, Form, Dichte (im Vergleich zur 12. Rippe, Struktur und Oberfläche beurteilt. Weiter wurden Alter, Geschlecht und Body-Mass-Index des Patienten berücksichtigt. Die Desintegration wurde am 1. Tag nach ESWL mittels Abdomen-Leerbild dokumentiert. Zielwert der Analyse war die binäre Variable steinfrei versus Restfragmente, gegen die alle präoperativen Parameter mittels multivariater logistischer Regression getestet wurden. Die Erfolgsrate betrug 95,5 %; 42 Patienten (20,8 % waren steinfrei und 151 Patienten (74,7 % hatten sog. klinisch insignifikante Restfragmente (5 mm oder kleiner. Von den Männern waren 14,9 %, von den Frauen 29,6 % steinfrei (p = 0,01. Alle anderen Parameter erreichten keine statistische Signifikanz, möglicherweise aufgrund zu kleiner Subgruppen (fehlende statistische Macht. Die Desintegrationsrate des HM-3 für Nierensteine ist insgesamt ausgezeichnet, bei Frauen noch besser als bei Männern. Gerade wegen dieser hohen Erfolgsrate wären größere Patientenzahlen notwendig, um eventuelle Unterschiede zwischen den präinterventionellen Parametern definieren zu können.
-
Energy Technology Data Exchange (ETDEWEB)
Bruecher, H.; Curtius, H.; Fachinger, J.; Kaiser, G.; Mazeina, L.; Nau, K.
2003-12-01
From the present report 'Untersuchungen zur Radionuklidfreisetzung und zum Korrosionsverhalten von bestrahltem Kernbrennstoff aus Forschungsreaktoren unter Endlagerbedingungen' with the code number FKZ 9108 carried out in the time periode 01.06.1998 till 30.11.2001 the following results can be withdrawn: U/Al-RR-fuel elements corroded slowly in granite water (Grimsel-West) at 90 C under anaerobic conditions. For a complete dissolution of the fuel element a time period of 10{sup 3} years is assumed according to present conservative results. In salt brines, especially in magnesium chloride rich brines the corrosion rate is high. Addition of GGG40 (basic material of the fuel element container with iron as main element) had an acceleration effect. A complete dissolution of the fuel is achieved within a couple of months. Under aerobic and under anaerobic conditions the bulk of released radionuclides were fixed by the corrosion products formed (secondary phases). The actinides were mobilised by variation of the ionic strength of the leaching solution. This process can be explained by phase conversion reactions within the secondary phases. Secondary phases formed by corrosion of a non-irradiated U/Al-RR-fuel element, were analysed and hydrotalcites were identified as phase components. This result justifies the assumption, that hydrotalcites are components of the corrosion products from irradiated fuels. To clarify the questions which bindings exist between radionuclides and secondary phases, sorption experiments were performed. The sorption experiments were performed in salt brines and in granite water using repository relevant radionuclides and minerals which are considered to represent thermodynamic final components of the secondary phases. Pu sorbed as cationic species quantitatively and the binding is covalent. In granite water the same behaviour was found for Am. (orig.) [German] Aus dem vorliegenden Bericht 'Untersuchungen zur Radionuklidfreisetzung
-
Energy Technology Data Exchange (ETDEWEB)
Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen, Innenstadt (Germany); Kanz, K.G. [Chirurgische Klinik, Klinikum der Universitaet Muenchen, Innenstadt (Germany)
2002-07-01
Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [German] Fragestellung. Entwicklung eines strukturierten Konzeptes zur radiologischen Diagnostik polytraumatisierter Patienten.Methodik. Die Datenevaluation erfolgte auf Basis einer prospektiven interdisziplinaere Polytraumastudie mit ueber 2400 Patienten. Alle diagnostischen und therapeutischen Schritte werden jeweils unter Angabe von Zeitpunkt und auftretenden Komplikationen erfasst, ein primaeres oder sekundaeres Versterben und die 90-Tage-Letalitaet werden dokumentiert.Die strukturierte radiologische Diagnostik von Mehrfachverletzen verlangt die Integration eines erfahrenen Radiologen in
-
Directory of Open Access Journals (Sweden)
Franziska Linke
2017-09-01
Full Text Available Der Beitrag diskutiert die dem Themenheft zugrundeliegende Fragestellung nach der Konstitution der Medienpädagogik aus einer systemtheoretischen Perspektive. Dabei wird im Anschluss an Stichweh (2013 Ansatz der funktionalen Differenzierung ein Untersuchungsrahmen aufgezeigt, der es ermöglicht, die Medienpädagogik sowohl aus wissenschaftssoziologischer als auch professionssoziologischer Perspektive zu betrachten. Gerade die zentrale Rolle der (digitalen Medien für Lern- und Bildungsprozesse sowie für den Arbeitsmarkt (u. a. KMK 2016 verlangt eine stetige Reflexion professioneller Handlungssysteme der Medienpädagogik, die nicht losgelöst von der Frage nach dem Selbstverständnis der Medienpädagogik als Wissenschaftsdisziplin gelingen kann (u. a. Hugger 2001. Divergierende theoretische Positionierungen der Akteurinnen und Akteure sowie verschiedene Zielvorstellungen zur Medienpädagogik selbst und zu dem, was sie praktisch leisten kann, erschweren ein solches Vorhaben. Die Autorinnen des Beitrags begeben sich daher, unter Berücksichtigung der Differenzierung zwischen Disziplin und Profession, auf die Suche nach möglichen Antworten. Vorgeschlagen wird eine erweiterte Betrachtungsweise, welche die Medienpädagogik als wissenschaftliche Produktionsgemeinschaft beschreibt und dadurch Potenziale eröffnet theoretische und empirische Erkenntnisse von Akteurinnen und Akteuren unterschiedlicher wissenschaftlicher Disziplinen mit Medienzusammenhang zu berücksichtigen. Ferner wird dargelegt, dass ein solcher Beschreibungsansatz neue Forschungsperspektiven auf die professionstheoretische Einordnung praktischer Handlungssysteme der Medienpädagogik eröffnen kann.
-
Energy Technology Data Exchange (ETDEWEB)
Libra, J.A.; Biskup, M.; Wiesmann, U. [Technische Univ. Berlin (Germany). Inst. fuer Verfahrenstechnik; Sahlmann, C.; Gnirss, R. [Berliner Wasserbetriebe, Berlin (Germany)
1999-07-01
The largest single energy consumer at sewage treatment plants is the ventilation system of activated sludge tanks. This is why controlling and optimizing ventilation systems is the most appropriate approach to the cutting down of energy costs. The present paper reports on measurements of dynamic oxygen transfer by means of the off-gas method under operating conditions at the Berlin-Ruhleben sewage treatment plant. (orig.) [German] Der groesste Einzelenergieverbraucher auf Klaerwerken ist das Belueftungssystem von Belebungsbecken. Deshalb ist die Kontrolle und Optimierung der Belueftungssysteme der geeignete Weg zur Verringerung der Energiekosten. In diesem Beitrag wird ueber Messungen des dynamischen Sauerstoffeintrags mit der Abluft-Methode unter Betriebsbedingungen im Klaerwerk Berlin-Ruhleben berichtet. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Foit, W. [DMT-Gesellschaft fuer Forschung und Pruefung mbH, Dortmund (Germany). Fachstelle fuer Brand- und Explosionsschutz unter Tage - Versuchsgrube Tremonia
1998-12-01
The mining countries of the EC still have different regulations for fire testing of conveyor belts. The test methods will be harmonized for the Common Market, and requirements on conveyor belts will be standardized within the EC. A new EC standard will be drawn up. [Deutsch] Zur Zeit sind in den bergbaubetreibenden Laendern der EG noch unterschiedliche Verfahren zur brandtechnischen Pruefung von Foerdergurten vorgeschrieben. Mit dem Inkrafttreten des Gemeinsamen Marktes und der damit zusammenhaengenden Forderung nach Abbau von Handelshemmnissen sollen diese Pruefverfahren harmonisiert werden. Ziel ist es, die an die Foerdergurte zu stellenden brandtechnischen Anforderungen innerhalb der EG zu vereinheitlichen. Es soll deshalb eine europaeische Norm zur Beurteilung des Brandverhaltens und der Brandausbreitung an Foerdergurten fuer den Kohlenbergbau unter Tage erstellt werden. (orig./MSK)
-
Endovascular interventions for multiple trauma; Endovaskulaere Interventionen beim Polytrauma
Energy Technology Data Exchange (ETDEWEB)
Kinstner, C.; Funovics, M. [Klinik fuer Radiologie und Nuklearmedizin, Medizinische Universitaet Wien, Klinische Abteilung fuer Kardiovaskulaere und Interventionelle Radiologie, Wien (Austria)
2014-09-15
oder mittels Stent zu schienen. Speziell beim Polytrauma wird die Planung dieser Eingriffe wann immer moeglich nach einem praeinterventionellen Multidetektor-CT durchgefuehrt. Der Einsatz der endovaskulaeren Intervention ermoeglicht neben einer Verringerung des operativen Traumas auch eine wesentliche Verkuerzung der Behandlungszeit. Beim vaskulaeren Trauma am Stamm oder an den Extremitaeten, wo ein operativer Zugang nur unter erhoehtem Risiko durchfuehrbar erscheint, aber auch beim pelvinen Trauma und bei arteriellen Verletzungen parenchymatoeser Organe, die nicht gaenzlich geopfert werden sollen, sowie in anderen schwer zugaenglichen Regionen wie der oberen Thoraxapertur, ist die interventionelle Versorgung mittlerweile Standardmethode geworden. Heute kann die interventionelle Radiologie in praktisch allen vaskulaeren Territorien in einem interdisziplinaeren Zugang neben der offenen chirurgischen Versorgung dazu beitragen, eine schnellere Stabilisierung der Situation herbeizufuehren. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Verius, M. [LKH Innsbruck, Universitaetsklinik fuer Radiologie, Innsbruck (Austria)
2015-08-15
vollstaendige Erfassung der applizierten Dosen aller Modalitaeten und Optimierung der radiologischen Untersuchungen, was eine Senkung der applizierten Dosis zur Folge haben soll. Erreicht werden kann dies durch automatisierte Systeme, welche nicht nur die Erfassung der Dosisparameter uebernehmen, sondern auch die Bewertung und Analyse dieser Daten. Mit Warnlevels versehen, sollte ein solches System den Anwender (und weitere Personen) ueber moegliche bereits erfolgte und im besten Fall auch ueber zukuenftige Ueberschreitungen informieren und warnen koennen. Abhaengig von der bereitgestellten Information der Modalitaet koennen Dosismanagementsysteme auf verschieden tiefen Ebenen im Picture Archiving and Communication System (PACS), Radiologie-/Krankenhausinformationssystem (RIS/KIS) oder auf die Headerinformation der Digital-Imaging-and-Communications-in-Medicine(DICOM)-Bilddaten zugreifen und auswerten. Ein praxistauglicher Einsatz solcher Systeme ist nur in enger Zusammenarbeit von medizinischem Personal, Medizinphysikern und IT-Administratoren moeglich. Es sind verschiedene Systeme kommerziell oder frei erhaeltlich, jedoch abhaengig von den Anforderungen der radiologischen Praxis bzw. Klinik ist eine individuelle Adaptierung sinnvoll und noetig. (orig.)
-
Determinants of information technology outsourcing among health maintenance organizations.
Wholey, D R; Padman, R; Hamer, R; Schwartz, S
2001-09-01
We analyze the determinants of HMO information technology outsourcing using two studies. Study 1 examines the effect of asset specificity on outsourcing for development and operation activities, using HMO specific fixed effects to control for differences between HMOs. Study 2 regresses the HMO specific fixed effects from Study 1, which measure an HMO's propensity to outsource, on HMO characteristics. The data comes from a 1995 InterStudy survey about information technology organization of HMOs. While HMOs split roughly equally in outsourcing information technology development activities, they are extremely unlikely to outsource the day-to-day operation of information systems. The greater an HMO's information technology capability and the complexity of information systems supported, the less likely is an HMO to outsource. While HMOs less than two years old, for-profit HMOs, local or Blue Cross-affiliated HMOs, and mixed HMOs are more likely to outsource, federally qualified HMOs are less likely to outsource. Policy and managerial implications for the adoption and diffusion of new ways of organizing information technology, such as application service providers (ASPs), are discussed.
-
Farias,Robson Fernandes de
1999-01-01
By using DSC data, the enthaplies of sublimation for ethyleneurea and propyleneurea, are calculated as 84 and 89 kJ mol-1 respectively. Using the vaporization enthalpy values for dimethylethyleneurea and dimethylprophyleneurea, as obtained from literature, the empirical relation: Dcrg Hmo (1)/ Dcrg Hmo (2) = Dlg Hmo (1)/ Dlg Hmo(2) = constant, that relate sublimation or vaporization enthalpies of two different substances and of its methylated derivatives, is obtained. Correlations like that a...
-
Energy Technology Data Exchange (ETDEWEB)
Martin, M; Seibt, A [TU Bergakademie Freiberg (Germany). Inst. fuer Bohrtechnik und Fluidbergbau; Hoth, P [GeoForschungsZentrum Potsdam (Germany)
1997-12-01
The injection of fluids into sandstone reservoirs leads to interactions between these waters, the reservoir rocks, and the formation fluids. Estimations about possible permeability reducing processes caused by these interactions are therefore of great importance for the exploitation of sandstone aquifers as geothermal reservoirs. Percolation experiments under in situ conditions with core samples from North German geothermal boreholes were done in order to investigate these fluid-rock interactions. (orig./AKF) [Deutsch] Die Injektion von Fluiden in Aquiferspeicher fuehrt zu Wechselwirkungen zwischen dem Speichergestein, den Formationsfluiden und den injizierten Loesungen. Fuer die Bewirtschaftung der Speicher sind insbesondere Kenntnisse ueber moegliche Permeabilitaetsreduzierungen durch diese Wechselwirkungen von Bedeutung. Mit Hilfe von Kern-Durchstroemungsexperimenten, durchgefuehrt unter lagerstaettenaehnlichen Bedingungen mit Original- bzw. modifizierten Fluiden, wurde daher das Durchstroemungsverhalten von unterschiedlich ausgebildeten Reservoirsandsteinen aus norddeutschen Geothermiebohrungen untersucht. (orig./AKF)
-
Ruiz-Moyano, Santiago; Totten, Sarah M; Garrido, Daniel A; Smilowitz, Jennifer T; German, J Bruce; Lebrilla, Carlito B; Mills, David A
2013-10-01
Human milk contains a high concentration of complex oligosaccharides that influence the composition of the intestinal microbiota in breast-fed infants. Previous studies have indicated that select species such as Bifidobacterium longum subsp. infantis and Bifidobacterium bifidum can utilize human milk oligosaccharides (HMO) in vitro as the sole carbon source, while the relatively few B. longum subsp. longum and Bifidobacterium breve isolates tested appear less adapted to these substrates. Considering the high frequency at which B. breve is isolated from breast-fed infant feces, we postulated that some B. breve strains can more vigorously consume HMO and thus are enriched in the breast-fed infant gastrointestinal tract. To examine this, a number of B. breve isolates from breast-fed infant feces were characterized for the presence of different glycosyl hydrolases that participate in HMO utilization, as well as by their ability to grow on HMO or specific HMO species such as lacto-N-tetraose (LNT) and fucosyllactose. All B. breve strains showed high levels of growth on LNT and lacto-N-neotetraose (LNnT), and, in general, growth on total HMO was moderate for most of the strains, with several strain differences. Growth and consumption of fucosylated HMO were strain dependent, mostly in isolates possessing a glycosyl hydrolase family 29 α-fucosidase. Glycoprofiling of the spent supernatant after HMO fermentation by select strains revealed that all B. breve strains can utilize sialylated HMO to a certain extent, especially sialyl-lacto-N-tetraose. Interestingly, this specific oligosaccharide was depleted before neutral LNT by strain SC95. In aggregate, this work indicates that the HMO consumption phenotype in B. breve is variable; however, some strains display specific adaptations to these substrates, enabling more vigorous consumption of fucosylated and sialylated HMO. These results provide a rationale for the predominance of this species in breast-fed infant feces and
-
Directory of Open Access Journals (Sweden)
Robson Fernandes de Farias
1999-07-01
Full Text Available By using DSC data, the enthaplies of sublimation for ethyleneurea and propyleneurea, are calculated as 84 and 89 kJ mol-1 respectively. Using the vaporization enthalpy values for dimethylethyleneurea and dimethylprophyleneurea, as obtained from literature, the empirical relation: Dcrg Hmo (1/ Dcrg Hmo (2 = Dlg Hmo (1/ Dlg Hmo(2 = constant, that relate sublimation or vaporization enthalpies of two different substances and of its methylated derivatives, is obtained. Correlations like that are found to another ureas and thioureas.
-
Simões, Ricardo G; Agapito, Filipe; Diogo, Hermínio P; da Piedade, Manuel E Minas
2014-11-20
Significant discrepancies in the literature data for the enthalpy of formation of gaseous anisole, ΔfHmo(PhOCH3, g), have fueled an ongoing controversy regarding the most reliable enthalpy of formation of the phenoxy radical and of the gas phase O-H bond dissociation enthalpy, DHo(PhO-H), in phenol. In the present work ΔfHmo(PhOCH3, g) was reassessed using a combination of calorimetric determinations and high-level (W2-F12) ab initio calculations. Static-bomb combustion calorimetry led to the standard molar enthalpy of formation of liquid anisole at 298.15 K, ΔfHmo(PhOCH3, l) = −(117.1 ± 1.4) kJ·mol(-1). The corresponding enthalpy of vaporization was obtained as, ΔvapHmo(PhOCH3) = 46.41 ± 0.26 kJ·mol(-1), by Calvet-drop microcalorimetry. These results give ΔfHmo(PhOCH3, g) = −(70.7 ± 1.4) kJ·mol(-1), in excellent agreement with ΔfHmo(PhOCH3, g) = −(70.8 ± 3.2) kJ·mol(-1), obtained from the W2-F12 calculations. The ΔfHmo(PhOCH3, g) here recommended leads to ΔfHmo(PhO•, g) = 55.5 ± 2.4 kJ·mol(-)1 and DH°(PhO-H) = 368.1 ± 2.6 kJ·mol(-1).
-
DEFF Research Database (Denmark)
Rasmussen, Stine O.; Martin, Lena; Østergaard, Mette V.
2017-01-01
(IF) improves intestinal function, bacterial colonization and NEC resistance immediately after preterm birth, as tested in a preterm pig model. Mixtures of HMOs were investigated in intestinal epithelial cells and in preterm pigs (n=112) fed IF supplemented without (CON) or with a mixture of four HMOs...... (4-HMO) or >25 HMOs (25-HMO, 5-10 g/L given for 5 or 11 days). The 25-HMO blend decreased cell proliferation and both HMO blends decreased lipopolysaccharide-induced interleukin-8 secretion in IPEC-J2 cells, relative to control (P
-
C-A1-04: Challenges Faced as New Members of the HMO Research Network Virtual Data Warehouse
Godwin, Debbie; Mahajan, Bhushan; Silcott, Monica; Kjar, Dean
2011-01-01
Background/Aims This presentation will focus on challenges faced by new HMO Research Network (HMORN) sites and their experiences with the Virtual Data Warehouse (VDW) tables for version 3 specifications. The step-by-step procedure developed by Scott and White will be showcased to provide a head start for new incoming sites. Sharing lessons learned during our one year in the HMORN VDW, our objective is to provide best practices regarding resources, time allocation, priorities, schedules, financing, backups, and possible available alternatives. Methods The comprehensive procedure followed by Scott & White to build VDW V3 tables: Setting up your SAS Environment Establishing an architecture and components Analyzing and forecasting server specifications; Identifying and understanding the multiple data sorces embedded in your organization Claims data EMR Lab Pharmacy Other; Detailed variable mapping of sources to VDW specifications; Assessment of source data availability; Getting your site’s first feed from the source and following through with quality checks; Methods for building transformation logic for the table; Choosing the methodology to approach table-building. Results We will showcase Scott & White metrics for building a VDW starting with version 3 and best practices used. We improved the validity and completeness of the data through person-to-person interactions with claims personnel who often were disinterested in the needs of research. Having strong advocates who think of research as a part of the institutional mission was helpful. The VDW data team included a sole programmer for the first 6 months along with the Site Data Manager; adding a second programmer improved the rate of progress. Conclusions A structured, step-by-step, approach is recommended for new incoming sites joining the HMORN. This approach will optimize efficiency and effectiveness. The more information and guidance the existing members can provide, the better the achieved results will be
-
Metabolic fate of neutral human milk oligosaccharides in exclusively breast-fed infants.
Dotz, Viktoria; Rudloff, Silvia; Meyer, Christina; Lochnit, Günter; Kunz, Clemens
2015-02-01
Various biological effects have been postulated for human milk oligosaccharides (HMO), as deduced from in vitro, animal, and epidemiological studies. Little is known about their metabolic fate in vivo in the breast-fed infant, which is presented here. Human milk and infant urine and feces were collected from ten mother-child pairs and analyzed by MALDI-TOF MS (/MS), accompanied by high-performance anion-exchange chromatography with pulsed amperometric detection. Previously, we detected intact small and complex HMO in infant urine, which had been absorbed from gut, as verified via intrinsic (13) C-labeling. Our current work reveals the presence of novel HMO metabolites in urine and feces of breast-fed infants. The novel metabolites were identified as acetylated HMOs and other HMO-like structures, produced by the infants or by their gut microbiota. The finding of secretor- or Lewis-specific HMO in the feces/urine of infants fed with nonsecretor or Lewis-negative milk suggested a correspondent modification in the infant. Our study reveals new insights into the metabolism of neutral HMO in exclusively breast-fed infants and provides further indications for multiple factors influencing HMO metabolism and functions that should be considered in future in vivo investigations. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
-
Directory of Open Access Journals (Sweden)
Giovanni Mosti
2017-09-01
Full Text Available Severe forms of chronic venous insufficiency and lymphedema require strong compression-pressure, which exceeds the pressure exerted by medical compression stockings (>40 mmHg. The aim was to investigate if patients are able to apply a Velcro-band compression device (Circaid Juxta Lite™ themselves with sufficient pressure. Thirty-one patients (CEAP C6=23, C5=5, C3=2, mixed ulcer=1 applied Juxta Lite™ on their own legs after a short instruction and were asked to readjust the pressure by their subjective feeling. Sub- bandage pressure was measured after application and 24 h later. In 30 patients without arterial occlusive disease the median sub- bandage pressure values on day 1 and day 2 were 44,5 mmHg (IQR 42-48, and 46 mmHg (IQR 44-48,25 respectively. One patient with an arterialvenous leg ulcer showed pressures of 34 and 36 mmHg. All measured pressure values corresponded to the pursued target range, demonstrating that adequate self application of Velcro bands is feasible and that patents can maintain this pressure by re-adjustment. Source: this paper is an abridged translation of Mosti G, Partsch H. Druckmessungen unter Klettverschluss-Kompression - Selbstbehandlung durch feste, unelastische Beinwickelung. Vasomed 2017;5:212-6.
-
Energy Technology Data Exchange (ETDEWEB)
Bielitza-Mimjaehner, Ralf
2007-03-01
With the background of the threatening global warming that requires a reduction of greenhouse gas emission by 20 % until 2010 und by 80% until 2050 in Germany, t is reasonable to consider local or municipal climate protection activities. A climate protection politics ''from the bottom'' is not only contributing to a real greenhouse gas reduction, but also triggering the stagnant international climate politics and enhances the sustainable development on a local level. Due to this fact amongst others the Enquete commission of the German Bundestag ''sustainable energy supply under the conditions of globalization and liberalization'' identifies the municipal climate protection activities as important part within the mix of measures that will allow the initiation of an alteration of the actual energy system toward a sustainable energy supply in the long-run. The consequences of globalization and liberalization on the municipal level have not yet been discussed or considered by the Enquete commission. This thesis analyses the conditions induced by the globalization and liberalization on the municipal climate protection activities as constituent of a sustainable energy supply. The project is focusing on the municipal actors and the public utility companies as central point of the considerations. [German] Vor dem Hintergrund einer drohenden globalen Erwaermung, die eine Reduktion der klimawirksamen Treibhausgase bundesweit um 20 % bis 2010 und um 80 % bis 2050 noetig macht, sind Klimaschutzaktivitaeten auf einer lokalen oder kommunalen Ebene in mehreren Dimensionen sinnvoll. Den tatsaechlichen, bezifferbaren Reduktionen von CO2, die hier geleistet werden, gesellt sich ein ''vorbildhafter'' Druck auf eine stockende internationale Klimapolitik hinzu, ebenso leistet die ''Klimaschutzpolitik von unten'' einer nachhaltigen Entwicklung der lokalen Ebene durch Lerneffekte Vorschub. Unter anderem aus
-
Energy Technology Data Exchange (ETDEWEB)
Lorenzen, J.; Welger, J.; Krupski, G.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Lisboa, B.W. [Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Universitaetsklinikum Hamburg-Eppendorf (Germany)
2003-04-01
Introduction: To evaluate changes of contrast medium enhancement of the breast parenchyma due to menstrual cycle in healthy volunteers with oral contraceptive use in MR-imaging of the breast. Material and Methods: 15 healthy volunteers (age: 22 - 36, mean 28,2) without breast disease were examined two times during one menstrual cycle (days 7 - 14 and days 21 - 2). Two volunteers were examined only in the second part of the cycle (days 21 - 2). All volunteers used oral contraceptives for more than 6 month continuously. Examinations were performed with a 0,5 T magnet (dynamic 3D-gradient echo protocol with subtraction postprocessing). We evaluated the number of enhancing foci and the parenchymal contrast medium enhancement during the different phases of the cycle by region of interest. Results: Only a total of two enhancing foci were found in 2 of 17 volunteers. Time/signal intensity diagrams in these both cases were not suspicious (< 80% initial signal increase after of contrast medium injection, no wash-out phenomenon) and sonography of the breast in these two cases was inconspicuous. Contrast medium enhancement of breast parenchyma in cycle days 7 - 14 (mean enhancement: 0.12 - 0.26, minutes 1 - 9 p.i.) was not significantly different (p = 0.2209; Wilcoxon signed rank test) from cycle days 21 - 2 (mean: 0.13 - 0.32). Conclusion: Menstrual cycle dependency of parenchymal contrast medium enhancement seems to be of minor relevance for premenopausal women with use of oral contraceptives. (orig.) [German] Fragestellung: Untersuchung der Kontrastmittelaufnahme des Brustparenchyms in Abhaengigkeit vom Menstruationszyklus bei gesunden Probandinnen unter oraler Kontrazeption. Material und Methode: Bei 15 gesunden Probandinnen ohne Brusterkrankung in der Anamnese wurde eine MR-Mammographie zweimal waehrend eines Menstruationszyklus durchgefuehrt (Zyklustag: 7 - 14 und 21 - 2). Bei zwei weiteren Probandinnen erfolgte die MR-Mammographie nur in der zweiten Zyklushaelfte
-
Energy Technology Data Exchange (ETDEWEB)
Berkowitz, B.; Lueneburg, B.; Liu, J.
1994-12-31
Connecting rod and main bearings of internal combustion engines are among the most heavily stressed components in modern engines. It was found that these engine components are increasingly reaching the limits of their strength and therefore become the components limiting engine life. However, there is no known process which makes a calculated prediction of the service life of modern connecting rod and main bearings possible, taking into account various engine loads. In this research project, a new concept for the calculated prediction of the service life of non-static highly loaded radial sliding bearings is worked out. The basis is a process of calculation which realistically determines the pressure and gap course in highly loaded sliding bearings. Apart from the viscosity depending on pressure and temperature, the elastic deformations of the system sliding bearing/conn rod are also taken into account. Calculations are done for different operating points for a complete cycle of a four stroke Diesel engine (Daimler-Benz OM 364 LA). The results are compared with the present conventional process of calculation and the effects which occur are discussed. Based on the elasto-hydrodynamic calculation, a method of calculating the service life of non-statically loaded sliding bearings, taking into account various motor loads, is worked out. (orig./HW) [Deutsch] Pleuel- und Hauptlager von Verbrennungskraftmaschinen zaehlen mit zu den spezifisch am hoechsten beanspruchten Bauteilen in modernen Motoren. Es hat sich gezeigt, dass vor allem diese Maschinenelemente zunehmend an die Grenzen ihrer Belastbarkeit stossen und so zum lebensdauerbegrenzenden Bauteil werden. Es ist jedoch kein Verfahren bekannt, das eine rechnerische Lebensdauervorhersage moderner Pleuel- und Hauptlager unter Beruecksichtigung unterschiedlicher Motorlastkollektive ermoeglicht. Im vorliegenden Forschungsvorhaben wird daher ein neuartiges Konzept zur rechnerischen Lebensdauervorhersage von instationaeren
-
Provider-sponsored HMOs: make, buy, or joint venture?
Clay, S B
1997-03-01
Providers can sponsor their own HMOs in one of three ways: by creating their own HMO, by joint venturing with an existing HMO, or by purchasing an existing HMO. When selecting the best option, providers must consider various market conditions. Managed care penetration in the area, potential competitive responses of existing HMOs, market demand, provider reputation, and provider marketing ability will all influence the feasibility of each option. Providers also must examine their own organizational identity, their ability to raise the necessary capital to start an HMO, their managed care expertise and risk contracting experience, and their information systems capabilities.
-
नैनो टेक्नोलॉजी - मत्स्य क्षेत्र मे रामबाण
Digital Repository Service at National Institute of Oceanography (India)
Abidi, S.A.H.; Ansari, Z.A.; Bhagat, D.; Gupta, N.
$ebVmnyd©H$ Cn`moJ H$aVm h¡ & Bg n¡‘mZo na gm‘J«r H$m ì`dhma Am¡a g§aMZm ‘| àH$Q> Z`o Vah H$mo JwU A{YH$m§e ‘m‘bm| go AbJ h¡ & nXmW© H$mo Vab `m R>mog AdñWm ‘| Z¡ZmoH$Um| ‘| em{‘b {H$`m Om gH$Vm h¡& Z¡ZmoH$Um| H$mo dar`Vm Bg{b¶o Xr OmVr h¡ Š`m|{H$ `o g{H«$` gm...‘J«r Ho$ gVh joÌ H$mo ~‹T>mVo h¢, H$‘ g{H«$` gm‘J«r H$s Amdí`H$Vm hmoVr h¡ Am¡a Bg H$maU go H$‘ {dfmº$Vm Ed§ H$‘ bmJV hmoVr h¡, O¡d CnbãYVm ‘| d¥{Õ Ho$ H$maU gm‘J«r H$m H$‘ Anì``, `m¡{JH$ àmdaU H$s {Z`§{ÌV [ahmB©, nXmWm] Ho$ JwU n[adV©Z H$mo KwbZerb d...
-
Sato, Keiko; Yamazaki, Shin; Hayashino, Yasuaki; Takegami, Misa; Tokuda, Yasuharu; Takahashi, Osamu; Shimbo, Takuro; Hinohara, Shigeaki; Fukui, Tsuguya; Fukuhara, Shunichi
2011-01-01
To investigate the association between hours worked, symptoms experienced, and health resource utilization. Data were collected from a nationally representative sample of households in Japan. We studied full-time male workers aged 18-65 yr who worked 100 h or more per month. First, we examined the association between hours worked and symptoms experienced. Second, we examined the association between hours worked and the type of health resource utilized, such as physician visits, over-the-counter (OTC) medication use, dietary supplement use, and complementary and alternative medicine (CAM) provider visits. We used a multivariable negative binominal model in each analysis. Of the 762 male workers, 598 reported experiencing symptoms at least once a month. We categorized participants based on the number of hours worked per month (h/mo): 100-200 h/mo, 201-250 h/mo, and over 250 h/mo. Compared with those working 201-250 h/mo, those working 100-200 h/mo had more frequent physician visits (rate ratio:1.67, 95% CI: 1.17 to 2.38) and those working over 250 h/mo had significantly lower rates of CAM provider visits and tended to use dietary supplements for symptoms. Participants who worked 201-250 h/mo used OTC medication most frequently. No significant association was observed between the number of hours worked and number of symptoms experienced. The more hours worked by full-time male workers, the more likely they were to use health resources that had a lower time requirement. Greater attention should be paid to patterns of health resource utilization among workers and their consequent influence on long-term health status.
-
Genome of a SAR116 bacteriophage shows the prevalence of this phage type in the oceans.
Kang, Ilnam; Oh, Hyun-Myung; Kang, Dongmin; Cho, Jang-Cheon
2013-07-23
The abundance, genetic diversity, and crucial ecological and evolutionary roles of marine phages have prompted a large number of metagenomic studies. However, obtaining a thorough understanding of marine phages has been hampered by the low number of phage isolates infecting major bacterial groups other than cyanophages and pelagiphages. Therefore, there is an urgent requirement for the isolation of phages that infect abundant marine bacterial groups. In this study, we isolated and characterized HMO-2011, a phage infecting a bacterium of the SAR116 clade, one of the most abundant marine bacterial lineages. HMO-2011, which infects "Candidatus Puniceispirillum marinum" strain IMCC1322, has an ~55-kb dsDNA genome that harbors many genes with novel features rarely found in cultured organisms, including genes encoding a DNA polymerase with a partial DnaJ central domain and an atypical methanesulfonate monooxygenase. Furthermore, homologs of nearly all HMO-2011 genes were predominantly found in marine metagenomes rather than cultured organisms, suggesting the novelty of HMO-2011 and the prevalence of this phage type in the oceans. A significant number of the viral metagenome sequences obtained from the ocean surface were best assigned to the HMO-2011 genome. The number of reads assigned to HMO-2011 accounted for 10.3%-25.3% of the total reads assigned to viruses in seven viromes from the Pacific and Indian Oceans, making the HMO-2011 genome the most or second-most frequently assigned viral genome. Given its ability to infect the abundant SAR116 clade and its widespread distribution, Puniceispirillum phage HMO-2011 could be an important resource for marine virus research.
-
Production of human milk oligosaccharides by enzymatic and whole-cell microbial biotransformations.
Sprenger, Georg A; Baumgärtner, Florian; Albermann, Christoph
2017-09-20
Human milk oligosaccharides (HMO) are almost unique constituents of breast milk and are not found in appreciable amounts in cow milk. Due to several positive aspects of HMO for the development, health, and wellbeing of infants, production of HMO would be desirable. As a result, scientists from different disciplines have developed methods for the preparation of single HMO compounds. Here, we review approaches to HMO preparation by (chemo-)enzymatic syntheses or by whole-cell biotransformation with recombinant bacterial cells. With lactose as acceptor (in vitro or in vivo), fucosyltransferases can be used for the production of 2'-fucosyllactose, 3-fucosyllactose, or more complex fucosylated core structures. Sialylated HMO can be produced by sialyltransferases and trans-sialidases. Core structures as lacto-N-tetraose can be obtained by glycosyltransferases from chemical donor compounds or by multi-enzyme cascades; recent publications also show production of lacto-N-tetraose by recombinant Escherichia coli bacteria and approaches to obtain fucosylated core structures. In view of an industrial production of HMOs, the whole cell biotransformation is at this stage the most promising option to provide human milk oligosaccharides as food additive. Copyright © 2017 Elsevier B.V. All rights reserved.
-
Molecular orbital calculations using chemical graph theory
Dias, Jerry Ray
1993-01-01
Professor John D. Roberts published a highly readable book on Molecular Orbital Calculations directed toward chemists in 1962. That timely book is the model for this book. The audience this book is directed toward are senior undergraduate and beginning graduate students as well as practicing bench chemists who have a desire to develop conceptual tools for understanding chemical phenomena. Although, ab initio and more advanced semi-empirical MO methods are regarded as being more reliable than HMO in an absolute sense, there is good evidence that HMO provides reliable relative answers particularly when comparing related molecular species. Thus, HMO can be used to rationalize electronic structure in 1t-systems, aromaticity, and the shape use HMO to gain insight of simple molecular orbitals. Experimentalists still into subtle electronic interactions for interpretation of UV and photoelectron spectra. Herein, it will be shown that one can use graph theory to streamline their HMO computational efforts and to arrive...
-
The determinants of HMOs' contracting with hospitals for bypass surgery.
Gaskin, Darrell J; Escarce, José J; Schulman, Kevin; Hadley, Jack
2002-08-01
Selective contracting with health care providers is one of the mechanisms HMOs (Health Maintenance Organizations) use to lower health care costs for their enrollees. However, are HMOs compromising quality to lower costs? To address this and other questions we identify factors that influence HMOs' selective contracting for coronary artery bypass surgery (CABG). Using a logistic regression analysis, we estimated the effects of hospitals' quality, costliness, and geographic convenience on HMOs' decision to contract with a hospital for CABG services. We also estimated the impact of HMO characteristics and market characteristics on HMOs' contracting decision. A 1997 survey of a nationally representative sample of 50 HMOs that could have potentially contracted with 447 hospitals. About 44 percent of the HMO-hospital pairs had a contract. We found that the probability of an HMO contracting with a hospital increased as hospital quality increased and decreased as distance increased. Hospital costliness had a negative but borderline significant (0.10 penetration did not affect the probability of contracting. HMO characteristics also had significant effects on contracting decisions. The results suggest that HMOs value quality, geographic convenience, and costliness, and that the importance of quality and costliness vary with HMO. Greater HMO competition encourages broader hospital networks whereas greater hospital competition leads to more restrictive networks.
-
Energy Technology Data Exchange (ETDEWEB)
Bernhard, U.; Herrmann, G.; Schmidt, G.O. [Adam Opel AG, Ruesselsheim (Germany)
2002-07-01
The change of value orientation in Western Europe lead to an increase of emotions buying a car. In addition to classic factors like design, today the carmakers use elements of emotion like brand sound to inspire the customers. On the one hand the job of the acoustic engineers is to meet the acoustic expectations depending on driving conditions. On the other hand there are to develop both combining elements over the whole portfolio and elements which allow a defined position of a carline-powertrain combination in the market. (orig.) [German] Im Zuge der Wandlung der westlichen Gesellschaften spielen Emotionen beim Kauf eines Automobils eine immer staerkere Rolle. Zur Unterstuetzung klassischer Mittel wie dem Design werden heute weitere emotionalisierende Elemente zur Begeisterung der Kunden eingesetzt, unter anderem auch das Klangbild eines Fahrzeugs. Dabei liegt die Aufgabe einerseits darin, der unterschiedlichen Erwartungshaltung in Abhaengigkeit vom Fahrzustand des Fahrzeugs gerecht zu werden. Andererseits die Gestaltung des Klangbildes so durchzufuehren, dass innerhalb des Portfolios sowohl verbindende Elemente als markentypisch zu finden sind als auch der Marktpositionierung gerecht werdende Elemente der einzelnen Fahrzeugtypen zu generieren. (orig.)
-
Management of Powdery Mildew in Squash by Plant and Alga Extract Biopesticides.
Zhang, Shouan; Mersha, Zelalem; Vallad, Gary E; Huang, Cheng-Hua
2016-12-01
Although many fungicides are registered for use to control powdery mildew on cucurbits, management of resistance to fungicides in pathogen populations still remains a major challenge. Two biopesticides Regalia SC and HMO 736 were evaluated in the greenhouse and field for their efficacy against powdery mildew in squash. In greenhouses, Regalia SC alone significantly ( P powdery mildew compared to the nontreated control, and was as effective as the chemical standard Procure 480SC (triflumizole). In alternation with Procure 480SC, Regalia SC demonstrated greater or equivalent effects on reducing the disease. HMO 736 alone showed varying levels of disease control, but alternating with Procure 480SC significantly improved control efficacy. In addition, application of Regalia SC or HMO 736 each in alternation with Procure 480SC significantly increased the chlorophyll content in leaves and the total fresh weight of squash plants, when compared with the water control, Regalia SC and HMO 736 alone. In field trials, application of Regalia SC and HMO 736 each alone significantly reduced disease severity in one of two field trials during the early stage of disease development, but not during later stages when disease pressure became high. Both Regalia SC and HMO 736 each applied in alternation with Procure 480SC significantly improved the control efficacy compared to Procure 480SC alone. Results from this study demonstrated that an integrated management program can be developed for powdery mildew in squash by integrating the biopesticides Regalia SC, HMO 736 with the chemical fungicide Procure 480SC.
-
Management of Powdery Mildew in Squash by Plant and Alga Extract Biopesticides
Directory of Open Access Journals (Sweden)
Shouan Zhang
2016-12-01
Full Text Available Although many fungicides are registered for use to control powdery mildew on cucurbits, management of resistance to fungicides in pathogen populations still remains a major challenge. Two biopesticides Regalia SC and HMO 736 were evaluated in the greenhouse and field for their efficacy against powdery mildew in squash. In greenhouses, Regalia SC alone significantly (P < 0.05 reduced powdery mildew compared to the nontreated control, and was as effective as the chemical standard Procure 480SC (triflumizole. In alternation with Procure 480SC, Regalia SC demonstrated greater or equivalent effects on reducing the disease. HMO 736 alone showed varying levels of disease control, but alternating with Procure 480SC significantly improved control efficacy. In addition, application of Regalia SC or HMO 736 each in alternation with Procure 480SC significantly increased the chlorophyll content in leaves and the total fresh weight of squash plants, when compared with the water control, Regalia SC and HMO 736 alone. In field trials, application of Regalia SC and HMO 736 each alone significantly reduced disease severity in one of two field trials during the early stage of disease development, but not during later stages when disease pressure became high. Both Regalia SC and HMO 736 each applied in alternation with Procure 480SC significantly improved the control efficacy compared to Procure 480SC alone. Results from this study demonstrated that an integrated management program can be developed for powdery mildew in squash by integrating the biopesticides Regalia SC, HMO 736 with the chemical fungicide Procure 480SC.
-
Valle, Javier A.; Shetterly, Susan; Maddox, Thomas M.; Ho, P. Michael; Bradley, Steven M.; Sandhu, Amneet; Magid, David; Tsai, Thomas T.
2016-01-01
Background Bleeding following hospital discharge from percutaneous coronary intervention (PCI) is associated with increased risk of subsequent myocardial infarction (MI) and death, however the timing of adverse events following these bleeding events is poorly understood. Defining this relationship may help clinicians identify critical periods when patients are at highest risk. Methods and Results All patients undergoing PCI from 2004–2007 who survived to hospital discharge without a bleeding event were identified from the HMO Research Network-Stent Registry. Post-discharge rates and timing of bleeding-related hospitalizations, MI and death were defined. We then assessed the association between post-discharge bleeding-related hospitalizations with death and MI using Cox proportional hazards models. Among 8,137 post-PCI patients surviving to hospital discharge without in-hospital bleeding, 391 (4.8%) suffered bleeding-related hospitalization after discharge, with the highest incidence of bleeding-related hospitalizations occurring within 30 days of discharge (n=79, 20.2%). Post-discharge bleeding-related hospitalization after PCI was associated with subsequent death or MI (hazard ratio [HR] 3.09; 95% confidence interval [CI] 2.41–3.96), with the highest risk for death or MI occurring in the first 60 days after bleeding-related hospitalization (HR 7.16, CI 3.93–13.05). Conclusions Approximately 1 in 20 post-PCI patients are readmitted for bleeding, with the highest incidence occurring within 30 days of discharge. Patients suffering post-discharge bleeding are at increased risk for subsequent death or MI, with the highest risk occurring within the first 60 days following a bleeding-related hospitalization. These findings suggest a critical period after bleeding events when patients are most vulnerable for further adverse events. PMID:27301394
-
Impact of a hospitalist system on length of stay and cost for children with common conditions.
Srivastava, Rajendu; Landrigan, Christopher P; Ross-Degnan, Dennis; Soumerai, Stephen B; Homer, Charles J; Goldmann, Donald A; Muret-Wagstaff, Sharon
2007-08-01
This study examined mechanisms of efficiency in a managed care hospitalist system on length of stay and total costs for common pediatric conditions. We conducted a retrospective cohort study (October 1993 to July 1998) of patients in a not-for-profit staff model (HMO 1) and a non-staff-model (HMO 2) managed care organization at a freestanding children's hospital. HMO 1 introduced a hospitalist system for patients in October 1996. Patients were included if they had 1 of 3 common diagnoses: asthma, dehydration, or viral illness. Linear regression models examining length-of-stay-specific costs for prehospitalist and posthospitalist systems were built. Distribution of length of stay for each diagnosis before and after the system change in both study groups was calculated. Interrupted time series analysis tested whether changes in the trends of length of stay and total costs occurred after implementation of the hospitalist system by HMO1 (HMO 2 as comparison group) for all 3 diagnoses combined. A total of 1970 patients with 1 of the 3 study conditions were cared for in HMO 1, and 1001 in HMO 2. After the hospitalist system was introduced in HMO 1, length of stay was reduced by 0.23 days (13%) for asthma and 0.19 days (11%) for dehydration; there was no difference for patients with viral illness. The largest relative reduction in length of stay occurred in patients with a shorter length of stay whose hospitalizations were reduced from 2 days to 1 day. This shift resulted in an average cost-per-case reduction of $105.51 (9.3%) for patients with asthma and $86.22 (7.8%) for patients with dehydration. During the same period, length of stay and total cost rose in HMO 2. Introduction of a hospitalist system in one health maintenance organization resulted in earlier discharges and reduced costs for children with asthma and dehydration compared with another one, with the largest reductions occurring in reducing some 2-day hospitalizations to 1 day. These findings suggest that
-
Directory of Open Access Journals (Sweden)
Jung P
2001-01-01
Full Text Available Die Magnet-Resonanz-Urographie (MRU ist ein relativ neues Verfahren in der Diagnostik des oberen Harntraktes. Das Ziel dieser Studie war der Vergleich der Aussagefähigkeit der MRU unter Gabe von Gadolinium und Furosemid und dem konventionellen Urogramm (IVU in der Diagnostik der Ursache von Obstruktionen im Bereich des Harnleiters. 82 Patienten mit im IVU nachgewiesener Obstruktion des oberen Harntraktes oder urographisch stummer Niere bei sonographisch nachgewiesener Dilatation wurden der MRU zugeführt. Die Bilder beider Untersuchungsmethoden wurden von voneinander unabhängigen Untersuchern befundet. Zwei Urologen befundeten die IVU-Bilder, zwei Radiologen die MRU-Bilder, die Radiologen kannten die IVU-Diagnose nicht. Bei unklarer Diagnose wurden weitere Untersuchungen wie Computertomographie, retrograde Pyelographie oder Ureteroskopie durchgeführt. Die Diagnosen waren: Harnleitersteine bei 72 Patienten, Harnleitertumore bei 8 Patienten und extraureterale Tumore bei 2 Patienten. Eine richtige Diagnose bei den Steinpatienten wurde durch IVU bei 49 von 72 Patienten und durch MRU bei 64 von 72 Patienten gestellt. In dieser Patientengruppe wurden durch die MRU zwei falsche Diagnosen gestellt. Fehlende Kontrastmittelausscheidung war der Hauptgrund für Versagen der IVU. 3 der 8 Patienten mit Harnleitertumoren wurden durch die IVU richtig dignostiziert, bei dreien wurde eine falsche Diagnose gestellt. Durch die MRU konnten in dieser Gruppe 7 von 8 Patienten korrekt diagnostiziert werden, es wurde keine falsche Diagnose erhoben. IVU wird zunächst die Standarduntersuchungstechnik zur Darstellung des oberen Harntraktes bleiben, aber durch diese Studie konnte die Möglichkeit gezeigt werden, die in der MRU in Kombination mit Gadolinium und Furosemid liegt. Die größte Bedeutung dieser Untersuchung liegt in der urographisch stummen Niere, bei Untersuchungen in der Schwangerschaft, bei Kindern und bei Patienten mit Kontrastmittelunverträglichkeit.
-
The effects of Medicare Health Management Organizations on hospital operating profit in Florida.
Large, John T; Sear, Alan M
2005-02-01
Between 1992 and 1997, the number of members enrolled in Medicare Health Management Organizations (HMOs) nationwide in the USA more than doubled. During this period, managed care organizations wielded considerable influence over the health care of a large segment of the Medicare population in Florida. This study examined the impact on operational profit of 148 short-term, acute-care Florida hospitals in this period from Medicare HMO patients, as part of a hospital's payer mix. Three measures of hospital profitability were used: operating profit per actual bed, total operating profit with no adjustment for bed size, and operating margins. The multivariate statistical model employed in this study was a linear mixed model with an autoregressive order one (AR[1]) parametric structure on the covariance matrix. The results of the study indicate that Florida hospitals experienced greater profit pressures from Medicare HMO inpatients than from traditional Medicare inpatients. Further, these hospitals could have experienced positive profit effects with greater traditional Medicare participation and negative financial effects with greater Medicare HMO participation. Additionally, Medicare HMO patients appear to have been admitted to hospitals in worse health condition than those in traditional Medicare. Medicare HMO patients were more likely to have used emergency rooms as the source of admission than traditional Medicare patients. Also, Medicare HMO patients were more likely to have been admitted as emergent cases than traditional Medicare patients. Other research has shown that Medicare HMO patients, at the time of enrolment, are probably healthier than traditional Medicare enrollees, but here they appear to have been admitted to hospitals with higher levels of severity of illness. Explanations are offered for these findings.
-
Jiang, H Joanna; Friedman, Bernard; Jiang, Shenyi
2013-03-01
Managed care substantially transformed the U.S. healthcare sector in the last two decades of the twentieth century, injecting price competition among hospitals for the first time in history. However, total HMO enrollment has declined since 2000. This study addresses whether managed care and hospital competition continued to show positive effects on hospital cost and quality performance in the "post-managed care era." Using data for 1,521 urban hospitals drawn from the Healthcare Cost and Utilization Project, we examined hospital cost per stay and mortality rate in relation to HMO penetration and hospital competition between 2001 and 2005, controlling for patient, hospital, and other market characteristics. Regression analyses were employed to examine both cross-sectional and longitudinal variation in hospital performance. We found that in markets with high HMO penetration, increase in hospital competition over time was associated with decrease in mortality but no change in cost. In markets without high HMO penetration, increase in hospital competition was associated with increase in cost but no change in mortality. Overall, hospitals in high HMO penetration markets consistently showed lower average costs, and hospitals in markets with high hospital competition consistently showed lower mortality rates. Hospitals in markets with high HMO penetration also showed lower mortality rates in 2005 with no such difference found in 2001. Our findings suggest that while managed care may have lost its strength in slowing hospital cost growth, differences in average hospital cost associated with different levels of HMO penetration across markets still persist. Furthermore, these health plans appear to put quality of care on a higher priority than before.
-
PS3-18: Use of Antidepressant and Anti-Anxiety Medications Among Breast Cancer Survivors in a HMO
Avila, Chantal; Haque, Reina; Quinn, Virginia; Schottinger, Joanne; Fisher, Alice
2010-01-01
Background: Almost 200,000 U.S. women are diagnosed each year with breast cancer and over 40,000 women will die of the disease. In addition to the medical and functional consequences of the diagnosis and treatment, women experience worry, persistent anxiety, fear and depressive disorders. Overall, 30% of women diagnosed with breast cancer suffer significant distress at some point in their illness trajectory. National health organizations including the Institute of Medicine and National Cancer Institute call for treatment of common symptoms among breast cancer patients such as depression and anxiety. To date, there are only limited reports on the prevalence of treatment, and even fewer studies have examined potential differences by race/ethnicity, age, or tumor characteristics. Aim: To describe the prevalence of pharmacotherapy for depressive symptoms/anxiety among patients diagnosed with breast cancer in a large HMO. Methods: We identified all women diagnosed with primary breast cancer between 2000–2006 (n=10,408) who had been members of Kaiser Permanente Southern California (KPSC) for 1+ years prior to diagnosis. KPSC is a nonprofit comprehensive prepaid health plan serving 3.2 million socioeconomically diverse members. Data was obtained from the KPSC SEER-affiliated cancer registry and automated clinical, pharmacy, and membership databases. We examined patient and tumor characteristics associated with new use of pharmacotherapy for depression/anxiety. Univariate odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Results: We found 35% of women (3,611 of 10,408) were newly prescribed either anti-depressant or anti-anxiety medications within a year of breast cancer diagnosis. Younger women (e.g., OR=1.44, CI=1.28–1.63 for 40–49 year olds v. 60–69) and women with higher stage (e.g., OR=3.40, CI=2.87–4.04 for Stage 3 v. Stage 0) were more likely to be prescribed these medications, while African-American (OR=0.81, CI
-
यूनिकोड: भाषा प्रोद्योगिकी में हिन्दी का नया औजार
Digital Repository Service at National Institute of Oceanography (India)
Sharma, R.
Úmo{JH$s ‘| qhXr H$m Z`m Am¡Oma E amHo$e e‘m© H$åß`yQ>a, ‘yb ê$n go, Z§~am| go gå~§Y aIVo h¢& `o àË`oH$ Aja Am¡a dU© Ho$ {bE EH$ Z§~a {ZYm©[aV H$aHo$ Aja Am¡a dU© g§J«{hV H$aVo h¢& `y{ZH$moS> H$m Am{dîH$ma hmoZo go nhbo, Eogo Z§~a XoZo Ho$ {bE g...$s Anojm A{YH$ g‘` bJoJm& `y{ZH$moS> go Am`m h¡ ~Xbmd! `y{ZH$moS>, àË`oH$ Aja Ho$ {bE EH$ {deof Z§~a àXmZ H$aVm h¡, Mmho H$moB© ^r ßb¡Q>’$m°‘© hmo, Mmho H$moB© ^r àmoJ«m‘ hmo, Mmho H$moB© ^r ^mfm hmo& `y{ZH$moS> ñQ>¢S>S©> H$mo Eonb, EM.nr., Am...
-
Energy Technology Data Exchange (ETDEWEB)
Koenig, H. [Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, Univ.-Klinikum Steglitz, FU Berlin (Germany); Stahl, H. [Radiologische Klinik, Univ.-Klinikum Rudolf-Virchow, FU Berlin (Germany); Sieper, J. [Medizinische Klinik und Poliklinik, Univ.-Klinikum Steglitz, FU Berlin (Germany); Wolf, K.J. [Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, Univ.-Klinikum Steglitz, FU Berlin (Germany)
1995-01-01
This report deals with a prospective study of 21 patients with finger osteoarthritis treated over a period of three months with either Ademetionin (therapy group: 14/21) or without (control group: 7/21). MR-Imaging was carried out before and after treatment using spin-echo and 3D-Flash sequences. Morphological parameters and signal intensity changes of the hyaline cartilage were evaluated. The increase of the cartilage signal intensity was significant in the therapy group, this can be interpreted as an structural improvement. Also a decrease of the cartilage signal intensity with age was found. The morphological parameters showed no significant changes in the therapy and control groups. (orig.) [Deutsch] Im Rahmen einer prospektiven Studie wurden magnetresonanztomographische Untersuchungen bei Patientinnen mit Fingerpolyarthrose vor und nach Ademetionintherapie durchgefuehrt. Es erfolgten zwei Messungen an einer Kontrollgruppe (n=7, keine Ademetionintherapie) und an der Therapiegruppe (n=14) im Abstand von drei Monaten. Zur Anwendung kamen eine Doppel-Spin-Echo-Sequenz sowie eine 3D-Flash-Sequenz. Ausgewertet wurden neben morphologischen Parametern auch der Signalintensitaetsverlauf im Bereich des hyalinen Gelenkknorpels der Interphalangealgelenke. Signifikant war der Knorpelsignalzuwachs unter Ademetionintherapie, dies kann als Zeichen einer strukturellen Befundbesserung interpretiert werden. Ebenfalls signifikant zeigte sich die Abnahme der Knorpelsignalintensitaet mit zunehmendem Lebensalter der Patientinnen. Bei den morphologischen Befundaenderungen konnte kein signifikanter Therapieeffekt festgestellt werden. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Kater, H.; Preiss, F. [Preussag Wireline- und Messservice, Edemissen (Germany)
1998-12-31
So-called extended reach boreholes with horizontal sections of more than 2000 m, short radius drilling, multilaterals and other variations are common enough. Problems occur when this type of borehole needs to be surveyed or modified. The contribution describes the newly developed ``Well Tracotor{sup circledR}`` technology and outlines its potential. (orig.) [Deutsch] Sogenannte Extended Reach Bohrungen mit Horizontalsektionen von mehr als 2.000 Meter Laenge, Short Radius Drilling, Multilaterals und andere Variationen sind bohrtechnisch einwandfrei durchfuehrbar und gehoeren zum gaengigen Repertoire der Bohrfirmen. Grosse Probleme entstehen jedoch wenn dieser Bohrungstyp vermessen, komplettiert oder aufgewaeltigt werden soll. Insbesondere Bohrlochmessfirmen haben es in den letzten ca. 20 Jahren versaeumt Innovationen zwecks oekonomischen Einsatzes ihrer Technologie in diesen Bohrungen bereitzustellen. Die Durchfuehrung von Perforationen und Bohrlochmessungen, das Setzen von Stopfen, Schneiden von Rohren und auch einfachste Slickline-Operationen sind bei einer Bohrlochneigung beginnend bei ca. 60 bis 80 nur unter Anwendung von kosten- und zeitintensiven Verfahren moeglich. Eine guenstige Alternative zu diesen Verfahren bietet der Well Tractor. Diese Technologie ermoeglicht das Einfahren von Geraeten, die ueblicherweise am Kabel oder Draht eingesetzt werden, in Horizontalbohrungen. Im Folgenden werden das technische Konzept, ein Vergleich mit alternativen Verfahren, und verschiedene Referenzen des Well Tracotors {sup trademark} dargestellt. Weiterhin wird auf die Modifikationen eingegangen, die noetig waren, um dieses Geraet den Gegebenheiten in tiefen, heissen Gasbohrungen anzupassen. Abschliessend soll durch einen Ausblick auf zum Teil schon im Feldtest befindliche Weiterentwicklungen das weitere Potential dieser Technologie aufgezeichnet werden. (orig.)
-
Social Health Maintenance Organizations: assessing their initial experience.
Newcomer, R; Harrington, C; Friedlob, A
1990-08-01
The Social/Health Maintenance Organization (S/HMO) is a four-site national demonstration. This program combines Medicare Part A and B coverage, with various extended and chronic care benefits, into an integrated health plan. The provision of these services extends both the traditional roles of HMOs and that of long-term care community-service case management systems. During the initial 30 months of operation the four S/HMOs shared financial risk with the Health Care Financing Administration. This article reports on this developmental period. During this phase the S/HMOs had lower-than-expected enrollment levels due in part to market competition, underfunding of marketing efforts, the limited geographic area served, and an inability to differentiate the S/HMO product from that of other Medicare HMOs. The S/HMOs were allowed to conduct health screening of applicants prior to enrolling them. The number of nursing home-certifiable enrollees was controlled through this mechanism, but waiting lists were never very long. Persons joining S/HMOs and other Medicare HMOs during this period were generally aware of the alternatives available. S/HMO enrollees favored the more extensive benefits; HMO enrollees considerations of cost. The S/HMOs compare both newly formed HMOs and established HMOs. On the basis of administrator cost, it is more efficient to add chronic care benefits to an HMO than to add an HMO component to a community care provider. All plans had expenses greater than their revenues during the start-up period, but they were generally able to keep service expenditures within planned levels.
-
Advances in digital chest radiography: impact on reader performance
De Boo, D.W.
2012-01-01
Digitalisering binnen de radiologie heeft de nodige verbeteringen opgeleverd, onder andere voor de longfoto. Vroege stadia van longkanker en kleine uitzaaiingen naar de longen worden geregeld gemist op scans, maar computerprogramma’s kunnen deze gemiste afwijkingen soms wel detecteren. De
-
Directory of Open Access Journals (Sweden)
Jae-Han Kim
Full Text Available Bifidobacterium longum subsp. infantis is a common member of the intestinal microbiota in breast-fed infants and capable of metabolizing human milk oligosaccharides (HMO. To investigate the bacterial response to different prebiotics, we analyzed both cell wall associated and whole cell proteins in B. infantis. Proteins were identified by LC-MS/MS followed by comparative proteomics to deduce the protein localization within the cell. Enzymes involved in the metabolism of lactose, glucose, galactooligosaccharides, fructooligosaccharides and HMO were constitutively expressed exhibiting less than two-fold change regardless of the sugar used. In contrast, enzymes in N-Acetylglucosamine and sucrose catabolism were induced by HMO and fructans, respectively. Galactose-metabolizing enzymes phosphoglucomutase, UDP-glucose 4-epimerase and UTP glucose-1-P uridylytransferase were expressed constitutively, while galactokinase and galactose-1-phosphate uridylyltransferase, increased their expression three fold when HMO and lactose were used as substrates for cell growth. Cell wall-associated proteomics also revealed ATP-dependent sugar transport systems associated with consumption of different prebiotics. In addition, the expression of 16 glycosyl hydrolases revealed the complete metabolic route for each substrate. Mucin, which possesses O-glycans that are structurally similar to HMO did not induced the expression of transport proteins, hydrolysis or sugar metabolic pathway indicating B. infantis do not utilize these glycoconjugates.
-
Vertebroplasty - state of the art; Vertebroplastie - ''state of the art''
Energy Technology Data Exchange (ETDEWEB)
Wilhelm, K. [Akademisches Lehrkrankenhaus der Rheinischen Friedrich-Wilhelms-Universitaet Bonn, Radiologie und Nuklearmedizin, Johanniter-Krankenhaus - Johanniter GmbH, Bonn (Germany)
2015-10-15
Percutaneous vertebroplasty (PVP) using PMMA (polymethyl methacrylate) was first described in 1987 by Gallibert and Deramond for the treatment of vertebral body instability in patients with aggressive forms of vertebral hemangioma. Other types of painful osteolytic bone lesions, such as osteoporotic vertebral fractures and vertebral metastasis are in the meantime more commonly treated using this method. Within the last few years, this technique has become widely accepted and it is proposed for osteolytic bone lesions in areas that are more difficult to approach surgically, e.g., the pelvis and sacrum. Rapid pain relief and resulting stability have conferred an important role upon osteoplasty especially in palliative tumor-treatment for patients with shortened expected life spans. In addition, combined treatment of painful osteolytic metastases with image-guided thermoablation and percutaneous cement injection has been shown to be a safe palliative modality in the therapy of nonresectable tumors. (orig.) [German] Die Vertebroplastie ist ein minimal-invasives Verfahren, bei dem unter Durchleuchtung oder im CT Knochenzement mithilfe einer Hohlnadel in einen schmerzhaften Wirbelkoerper eingebracht wird. Die Technik wurde initial zur Behandlung aggressiver Wirbelkoerperhaemangiome beschrieben. Inzwischen stellen andere schmerzhafte Wirbelkoerperprozesse, vornehmlich osteolytische Metastasen sowie osteoporotische Wirbelkoerperfrakturen die haeufigsten Indikationen zur Durchfuehrung einer Vertebroplastie dar. Methode und Technik der Zementapplikation werden zwischenzeitlich erfolgreich auch bei ausserhalb der Wirbelsaeule bestehenden gutartigen Pathologien, z. B. bei Ermuedungsfrakturen des Os sacrum in Form der Sakroplastie sowie insbesondere schmerzhaften, metastatisch-osteolytischen Befunden als palliative Therapiemassnahme (Osteoplastie) eingesetzt. Im Rahmen palliativer Therapiekonzepte wird die Vertebroplastie in der Radiologie zunehmend in Kombination mit
-
42 CFR 417.124 - Administration and management.
2010-10-01
... program, administrative and management aspects of the HMO. (3) At a minimum, management by an executive... Administration and management. (a) General requirements. Each HMO must have administrative and managerial... 42 Public Health 3 2010-10-01 2010-10-01 false Administration and management. 417.124 Section 417...
-
42 CFR 417.480 - Maintenance of records: Cost HMOs and CMPs.
2010-10-01
... or CMP, and operation of the HMO's or CMP's financial, medical, and other recordkeeping systems. (2..., sale, or other action. (5) Agreements, contracts, and subcontracts. (6) Franchise, marketing, and management agreements. (7) Schedules of charges for the HMO's or CMP's fee-for-service patients. (8) Matters...
-
Bacteroides in the infant gut consume milk oligosaccharides via mucus-utilization pathways.
Marcobal, Angela; Barboza, Mariana; Sonnenburg, Erica D; Pudlo, Nicholas; Martens, Eric C; Desai, Prerak; Lebrilla, Carlito B; Weimer, Bart C; Mills, David A; German, J Bruce; Sonnenburg, Justin L
2011-11-17
Newborns are colonized with an intestinal microbiota shortly after birth, but the factors governing the retention and abundance of specific microbial lineages are unknown. Nursing infants consume human milk oligosaccharides (HMOs) that pass undigested to the distal gut, where they may be digested by microbes. We determined that the prominent neonate gut residents, Bacteroides thetaiotaomicron and Bacteroides fragilis, induce the same genes during HMO consumption that are used to harvest host mucus glycans, which are structurally similar to HMOs. Lacto-N-neotetraose, a specific HMO component, selects for HMO-adapted species such as Bifidobacterium infantis, which cannot use mucus, and provides a selective advantage to B. infantis in vivo when biassociated with B. thetaiotaomicron in the gnotobiotic mouse gut. This indicates that the complex oligosaccharide mixture within HMOs attracts both mutualistic mucus-adapted species and HMO-adapted bifidobacteria to the infant intestine that likely facilitate both milk and future solid food digestion. Copyright © 2011 Elsevier Inc. All rights reserved.
-
International Nuclear Information System (INIS)
Rao, S.V.S.; Lekshmi, R.; Mani, A.G.S.; Sinha, P.K.
2010-01-01
Composite ion-exchange resins were prepared by coating copper-ferrocyanide (CFC) and hydrous manganese oxide (HMO) powders on polyurethane (PU) foam. Polyvinyl acetate/Acetone was used as a binder. The foam was loaded with about five times its weight with CFC and HMO powders. The distribution coefficients of CFC-PU foam and HMO-PU foam for cesium and strontium respectively were estimated. Under similar conditions the HMO-PU foam showed higher capacity as well as better kinetics for removal of strontium than CFC-PU foam for Cs. The pilot plant scale studies were conducted using a mixed composite ion-exchange resin bed. About 1000 bed volumes could be passed before attaining a DF of 10 from an initial value of 60-80. The spent resin was digested in alkaline KMnO 4 and the digested liquid was fixed in cement matrix. The matrices were characterized with respect to compressive strength and leach resistance. (author)
-
Energy Technology Data Exchange (ETDEWEB)
Erath, W.; Nowotny, B.; Maetz, J. [KED, Rodenbach (Germany)
1998-11-01
Measurements of an experiment in a pipe system with pump shutdown and valve closing have been performed in the nuclear power plant KRB II. Comparative calculations of fluid and structure including interaction show an excellent agreement with the measured results. Theory and implementation of the fluid/structure interaction and the results of the comparison are described. It turns out that the consideration of the fluid/structure interaction is mostly a significant increase of the effective structural damping. (orig.) [Deutsch] Es wurden Messungen am nuklearen Nachkuehlsystem des Kernkraftwerks Gundremmingen (KRB II) bei einem Versuche mit Pumpenabschalten und Ventilschliessen durchgefuehrt. Vergleichsrechnungen der Fluid-Strukturdynamik unter echter Beruecksichtigung der Wechselwirkung ergaben eine ausgezeichnete Uebereinstimmung der Rechnung mit den Messungen. Es werden Theorie und Implementierung der Koppelung der Fluid- und Struktur-Berechnungen sowie die Vergleiche von Messung und Rechnung beschrieben. Es ergibt sich, dass die Beruecksichtigung der Wechselwirkung notwendig ist zur genaueren Berechnung von `weichen` Rohrleitungsystemen. Eine wichtige Folge der Wechselwirkung ist meist eine deutliche Erhoehung der effektiven Strukturdaempfung. (orig.)
-
Directory of Open Access Journals (Sweden)
Hohenberg, Gregor
2009-11-01
Full Text Available [english] Purpose: This article presents partial results of an evaluation study which compared a three-year blended learning scenario with traditional face-to-face training for medical technical assistants specialising in radiology. Methods: The blended learning approach investigated here is based on an individual tutoring approach, i.e. students work on the necessary training units during self-learning periods, while a tutor is available at all times via the Internet. Following the theory of constructivism, the tutor should see him- or herself as a coach supporting the learner working on the individual training units. As the Saarland University Hospital offers both face-to-face training and the blended learning course, it was possible to perform direct comparative tests. Results: On the basis of the final state examination results, it could be shown that the participants of the blended learning course achieved equivalent or slightly better exam results. Conclusion: The positive results of the blended learning participants gain increased significance against the backdrop of the demographic data of both groups of participants: with an average age of 43 (median: 43, the blended learning participants show a significantly higher life experience compared to the face-to-face training participants, who had an average age of 28 (median: 25. That shows that the blended learning method is a good method to be used by people working in radiology. [german] Zielsetzung: Dieser Artikel stellt Teilergebnisse einer Evaluationsstudie dar, deren Zielsetzung es ist, ein dreijähriges Blended learning-Szenario mit einer klassischen Präsenzausbildung für medizinisch-technische Assistenten der Fachrichtung Radiologie zu vergleichen. Methodik: Der hier untersuchte Blended Learning-Ansatz beruht auf einem individuellen Betreuungsansatz, d. h. während die Teilnehmenden in den Selbstlernphasen die Unterrichtseinheiten bearbeiten, steht jederzeit via Internet ein
-
Head-neck-radiology; Kopf-Hals-Radiologie
Energy Technology Data Exchange (ETDEWEB)
Cohnen, Mathias (ed.) [Staedtische Kliniken Neuss Lukaskrankenhaus GmbH (Germany). Institut fuer klinische Radiologie
2012-11-01
The book on head-neck-radiology covers the following issues: (1) Methodic fundamentals: conventional radiography, angiography, sonography, computerized tomography, digital volume tomography, NMR imaging, nuclear medicine. (2) Base of the skull. (3) Petrous bone. (4) Pharynx. (5) Paranasal sinuses. (6) Eye socket. (7) Temporomandibular joint. (8) Salivary gland. (9) Oral cavity. (19) Parynx. (11) Neck soft tissue and lymph nodes. (12) Thyroid and parathyroid. (13) Teeth and jaw. (14) Interventions.
-
Human Milk Oligosaccharides and the Preterm Infant: A Journey in Sickness and in Health.
Moukarzel, Sara; Bode, Lars
2017-03-01
Human milk oligosaccharides (HMOs) are a group of approximately 200 different unconjugated sugar structures in human milk proposed to support infant growth and development. Data from several preclinical animal studies and human cohort studies suggest HMOs reduce preterm infant mortality and morbidity by shaping the gut microbiome and protecting against necrotizing enterocolitis, candidiasis, and several other immune-related diseases. Current feeding practices and clinical algorithms do not consider infant HMO intake when assessing dietary adequacy or disease risk. Advancements in HMO analytical methodologies and HMO synthesis facilitate cohort and intervention studies to investigate which particular HMOs are most relevant in supporting preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.
-
Energy Technology Data Exchange (ETDEWEB)
Hattingen, U.; Adt, H.U. [Kaiserslautern Univ. (Germany). Arbeitsgruppe Verbrennungskraftmaschinen; Sauer, B.; Ruhl, C.; Huber, M. [Kaiserslautern Univ. (Germany). Lehrstuhl fuer Maschinenelemente und Getriebetechnik; Regitz, M.; Weber, B. [Kaiserslautern Univ. (Germany). Lehrstuhl fuer Organische Chemie; Bereswill, S. [Motoren-Werke Mannheim AG (Germany); Luther, R.; Acker, I. [Fuchs Mineraloelwerke GmbH, Eschweiler (Germany)
1999-05-01
Detailed rheological analyses of lubricants are carried out with a view to the temperature dependence of the viscosity functions. Two sliding bearings of similar design but made of different materials were tested on a test bench after lubrication with an oil of the SAE grade 10W-40 diluted with increasing concentrations of rapeseed oil methyl ester. The results were analyzed and compared with the bearings characteristics calculated according to DIN 31652. The measurements were found to be in good agreement with calculated values. [German] Im Rahmen dieses Projektes wurden zunaechst detaillierte rheologische Untersuchungen der Schmierstoffeigenschaften unter Beruecksichtigung der Schmieroelverduennung mit RME und DK vorgenommen und die Temperaturabhaengigkeit der jeweiligen Viskositaetsfunktion ermittelt. Auf einem geeigneten Gleitlagerpruefstand wurden zwei bezueglich der Motorenhauptlager geometrisch aehnliche Lager unterschiedlichen Werkstoffes untersucht. Die Schmierung erfolgte dabei mit einem Motorenoel der SAE-Klasse 10W-40, welches zuvor jeweils mit einem im Verlauf der Versuchsreihe ansteigenden Anteil an Rapsoelmethylester verduennt wurde. Die Messergebnisse wurden ausgewertet und den nach DIN 31652 berechneten Lagerkennzahlen gegenuebergestellt. Danach ergeben sich fuer die gemessenen Lagerkenngroessen qualitativ aehnliche Abhaengigkeiten von der Schmieroelverduennung wie berechnet. (orig.)
-
Does competition improve health care quality?
Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton; Chernew, Michael
2008-12-01
To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey(R) (CAHPS) data (calendar years 1998-2002). All plans submitting data to the National Committee for Quality Assurance (NCQA) were included regardless of their decision to allow NCQA to disclose their results publicly. NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Fixed-effects models were estimated that relate HMO competition to HMO quality controlling for an unmeasured, time-invariant plan, and market traits. Results are compared with estimates from models reliant on cross-sectional variation. Estimates suggest that plan quality does not improve with increased levels of HMO competition (as measured by either the Herfindahl index or the number of HMOs). Similarly, increased HMO penetration is generally not associated with improved quality. Cross-sectional models tend to suggest an inverse relationship between competition and quality. The strategies that promote competition among HMOs in the current market setting may not lead to improved HMO quality. It is possible that price competition dominates, with purchasers and consumers preferring lower premiums at the expense of improved quality, as measured by HEDIS and CAHPS. It is also possible that the fragmentation associated with competition hinders quality improvement.
-
A new measure of the impact of managed care on healthcare markets.
Pawlson, L G; Moy, E M; Kim, J I; Griner, P F
2001-11-01
Most studies of managed care impact have used health maintenance organization (HMO) penetration or index of competition as the marker of managed care impact. However, little empirical evidence has been found to support the validity of these or other measures in current use. In addition, as managed care evolves to forms other than HMOs and managed care penetration in large metropolitan areas approaches 100% of commercially insured patients, the utility of the most commonly used measure, HMO penetration, will decrease still further. To provide a preliminary analysis of the use of premiums as a measure of market impact of managed care. Retrospective analysis (quartile, correlation, multiple-variable linear regression) of publicly available datasets. Labor market-adjusted HMO premiums from 3 publicly available sources, for the 56 largest metropolitan areas in the United States, were compared with penetration and index of competition as predictors of the dependent market variable, hospital bed-days per 1000 population. Health maintenance organization premiums in the Federal Employees Health Benefits Program emerged as the best predictor of HMO market impact. Average HMO premiums reported in the Interstudy database and for the Medicare+Choice program also outperformed penetration or index of competition in relating to several commonly available markers of competition such as bed-days per 1000. Premiums charged by HMOs are a useful measure of the impact of managed care on healthcare markets in large metropolitan areas.
-
42 CFR 417.584 - Payment to HMOs or CMPs with risk contracts.
2010-10-01
... CMP. (a) Principle of payment. CMS makes monthly advance payments equivalent to the HMO's or CMP's per... subsequent monthly payments to take account of the difference. (d) Reduction of payments. If an HMO or CMP... 1998, HMOs or CMPs with risk contracts will be paid in accordance with principles contained in subpart...
-
Energy Technology Data Exchange (ETDEWEB)
Prott, F.J.; Schlehuber, E.; Scharding, B.J.; Rinast, E. [Strahlentherapie Wiesbaden, St.-Josefs-Hospital (Germany); Micke, O. [Klinik und Poliklinik fuer Strahlentherapie - Radioonkologie, Universitaetsklinikum Muenster (Germany)
2002-05-01
Is magnetic resonance imaging (MRI) based target volume definition for treatment planning of vertebral metastasis effective under economic considerations.From 1994 to 1999, a total of 137 patients with bone metastases affecting the vertebral column underwent MRI of the cercival, thoracic, or lumbar spine for the treatment planning of palliative radiation therapy. The following radiation treatment consisted in a irradiation of the affected vertebral region up to a total dose of 30-40 Gy.The cost calculation for radiotherapy and magnetic resonance tomography was done using the common tariff model (EBM) of the German Health Insurances.In 73% of patients (101 patients), magnetic resonance imaging resulted in marked corrections of the irradiation fields which would have resulted in the necessity of treatment for recurrence in the case of treatment planning without MRI.Consequently, the higher cost of MRI of 345.00 DEM (176,40 EUR) lead to a saving of 497.00 DEM (254,11 EUR) compared to a recurrence treatment of 10 fractions and of 1,428.00 DEM (730,12 EUR) compared to 20 fractions. The transport expenses for the second treatment could be saved as well.Even under economic considerations MRI is effective. (orig.) [German] Ist eine MRT-gestuetzte Zielvolumendefinition bei der Strahlentherapie von Knochenmetastasen ein sinnvolles Vorgehen unter oekonomischen Gesichtspunkten?1994-1999 wurde bei 137 Patienten mit einem ossaer metastasierenden Tumor und Befall der Wirbelsaeule eine Magnetresonanztomographie (MRT) zur Planung einer palliativen Radiatio durchgefuehrt. Die nachfolgende Strahlentherapie bestand aus einer Radiatio des betroffenen Wirbelkoerperabschnitts bis zu einer Gesamtherddosis von 30-40 Gy. Fuer die Berechnung der Kosten wurde der einheitliche Bewertungsmassstab der Deutschen Krankenkassen zugrunde gelegt.Aufgrund der MRT-Untersuchungen wurde bei 73% der Patienten eine Veraenderung des Bestrahlungsfeldes vorgenommen, die im Falle einer nicht MRT
-
Effects of Mineral Oils on Host Selection Behavior of Diaphorina citri
Directory of Open Access Journals (Sweden)
Mofit Eko Poerwanto
2008-07-01
Full Text Available Response of Diaphorina citri Kuwayama (Hemiptera: Psyllidae on citrus leaves treated with horticultural and agricultural mineral oil (HMO & AMO was evaluated under laboratory condition in choice and non-choice trials. Combination of HMO and AMO at concentration of 0 up to 2% was applied to citrus leaves. Mineral oil applications significantly reduced the proportion of D. citri stayed on citrus leaves for feeding with the proposed mechanisms: 1 oils covered leaves thus hampered it for releasing volatile compounds, 2 oil film preventing the direct contact of tarsus or palpus to leaf surfaces, and 3 the volatile compounds produced by mineral oils also blended with plant volatiles in the atmosphere and reduced the probability of olfactory receptors capturing the olfactory cues for locating the feeding site. Mineral oils also increased the mortality of D. citri due to the refusion for feeding on the treated citrus leaves. The effect of AMO was more prominent than HMO. Tanggapan Diaphorina citri Kuwayama (Hemiptera: Psyllidae pada daun jeruk yang diperlakukan dengan minyak mineral (HMO dan AMO dievaluasi dengan metode pilihan maupun tanpa pilihan di laboratorium. Kombinasi antara HMO dan AMO pada konsentrasi 0% sampai dengan 2% diaplikasikan pada daun jeruk. Minyak mineral secara nyata menurunkan proporsi D. citri hinggap untuk makan pada daun jeruk, yang mungkin disebabkan oleh mekanisme: 1 minyak melapisi daun sehingga tidak mampu melepaskan senyawa volatil, 2 lapisan minyak menghalangi kontak langsung antara tarsus atau palpus pada permukaan daun, dan 3 senyawa volatil dari minyak bercampur dengan volatil tanaman di udara sehingga menurunkan probabilitas reseptor olfaktori menangkap sinyal penanda lokasi inang. Minyak mineral juga meningkatkan mortalitas, akibat dari penolakan makan pada daun jeruk yang diperlakukan. Pengaruh AMO lebih besar dari pada HMO.
-
Hybrid Metaheuristic Approach for Nonlocal Optimization of Molecular Systems.
Dresselhaus, Thomas; Yang, Jack; Kumbhar, Sadhana; Waller, Mark P
2013-04-09
Accurate modeling of molecular systems requires a good knowledge of the structure; therefore, conformation searching/optimization is a routine necessity in computational chemistry. Here we present a hybrid metaheuristic optimization (HMO) algorithm, which combines ant colony optimization (ACO) and particle swarm optimization (PSO) for the optimization of molecular systems. The HMO implementation meta-optimizes the parameters of the ACO algorithm on-the-fly by the coupled PSO algorithm. The ACO parameters were optimized on a set of small difluorinated polyenes where the parameters exhibited small variance as the size of the molecule increased. The HMO algorithm was validated by searching for the closed form of around 100 molecular balances. Compared to the gradient-based optimized molecular balance structures, the HMO algorithm was able to find low-energy conformations with a 87% success rate. Finally, the computational effort for generating low-energy conformation(s) for the phenylalanyl-glycyl-glycine tripeptide was approximately 60 CPU hours with the ACO algorithm, in comparison to 4 CPU years required for an exhaustive brute-force calculation.
-
Magnetic and electronic properties of single-walled Mo2C nanotube: a first-principles study
Jalil, Abdul; Sun, Zhongti; Wang, Dayong; Wu, Xiaojun
2018-04-01
The structural, electronic, and magnetic properties of single-walled Mo2C nanotubes are investigated by using first-principles calculations. We establish that single-walled Mo2C nanotubes can be rolled up from a graphene-like Mo2C monolayer with H- or T-type phase, i.e. H-Mo2C and T-Mo2C nanotubes. The armchair-type T-Mo2C nanotubes are more energetically stable than H-Mo2C nanotubes with the same diameter, while zigzag-type H-Mo2C nanotubes are more energetically stable than T-Mo2C nanotubes. In particular, (8, 0) H-Mo2C nanotube are more stable than Mo2C monolayer due to structural deformation. All Mo2C nanotubes are magnetic metals, independent of their chirality, and the magnetic moments of Mo atoms in the outer layer are larger than the inner. The ionic and metallic bonds in Mo2C nanotubes and delocalized electrons around Mo atoms lead to the versatile electronic and magnetic properties in them, endowing them potential applications in catalysts and electronics.
-
Dynamic cost shifting in hospitals: evidence from the 1980s and 1990s.
Clement, J P
The purpose of this paper is to determine whether dynamic cost shifting occurred among acute care hospitals during the period from the early 1980s to the early 1990s and, if so, whether market factors affected the ability to shift costs. Evidence from this study of California acute care hospitals during three time intervals shows that the hospital did practice dynamic cost shifting, but that their ability to shift costs decreased over time. Surprisingly, hospital competition and HMO penetration did not influence cost shifting. However, increasing HMO penetration (measured as the HMO percentage of hospital discharges) did decrease both net prices and costs for the early part of the study, but later was associated with increases in both.
-
African Journals Online (AJOL)
abp
11 mars 2016 ... &Corresponding author: Youssef Omor, Service d'Imagerie Médicale, Radiologie Centrale, CHU Avicenne, Rabat, Maroc. Key words: Sarcome d´Ewing, parties molles, région cervicale. Key words: Ewing's sarcoma, soft parts, cervical region. Received: 02/11/2015 - Accepted: 03/01/2016 - Published: ...
-
1995-09-01
This rule clarifies and updates portions of the HCFA regulations that pertain to the following: The conditions that an HMO or CMP must meet to qualify for a Medicare contract (Subpart J). The contract requirements (Subpart L). The rules for enrollment, entitlement, and disenrollment of Medicare beneficiaries in a contracting HMO or CMP (Subpart K). How a Medicare contract is affected when there is change of ownership or leasing of facilities of a contracting HMO or CMP (Subpart M). These are technical and editorial changes that do not affect the substance of the regulations. They are intended to make it easier to find particular provisions, to provide overviews of the different program aspects, and to better ensure uniform understanding of the rules.
-
African Journals Online (AJOL)
abp
27 avr. 2016 ... Dysphagia revealing aberrant right subclavian artery: about a case. Abdelilah Mouhsine1,&, Oualid Bakzaza2, El Mehdi Atmane1, Ahmed Belkouch3, Redouane Rokhssi1, Youssef Berrada1, Mostapha. Alaoui2, M'barek Mahfoudi1, Abdelghani El Fikri1. 1Service de Radiologie, HMA, Marrakech, Maroc, ...
-
[HADASSAH MEDICAL ORGANIZATION - A PIONEER IN POPULATION HEALTH].
Calderon-Margalit, Ronit; Levine, Hagai; Israeli, Avi; Paltiel, Ora
2018-03-01
Population health is a term encompassing "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." Only recently have hospitals viewed themselves as focal points for promoting health in a community, involving themselves with population health. Hadassah Medical Organization (HMO), however, has been in the business of population health since its founding. Its early programs, promoting and delivering nutritional support, maternal-child health and other services to the Yishuv's inhabitants, showed that the HMO defined its community broadly. Hospital care came later. The HMO was established together with the Hebrew University Israel's first School of Public Health and Community Medicine in the 1960's, contributing >1200 Israeli alumni, and exposing thousands of medical students to population health. The School's founders developed Community-Oriented Primary Care, aimed at assessing and addressing health determinants and outcomes at the community level implemented in many centers worldwide. Reaching beyond Israel's borders, the School has trained a global public health workforce through its International Masters in Public Health with >820 graduates from 92 countries. HMO's researchers have made important contributions in the fields of epidemiology, health economics and policy and population health methodology as well as hospital and community quality of care. This article reviews HMO's contribution to population health at local, municipal, national and international levels. We will demonstrate the unique circumstances in Hadassah, Jerusalem and Israel which have enabled world-class research and training in population health, identifying important contributions to policy and service provision, as well as addressing future population health challenges.
-
Human milk oligosaccharides: Every baby needs a sugar mama
Bode, Lars
2012-01-01
Human milk oligosaccharides (HMOs) are a family of structurally diverse unconjugated glycans that are highly abundant in and unique to human milk. Originally, HMOs were discovered as a prebiotic “bifidus factor” that serves as a metabolic substrate for desired bacteria and shapes an intestinal microbiota composition with health benefits for the breast-fed neonate. Today, HMOs are known to be more than just “food for bugs”. An accumulating body of evidence suggests that HMOs are antiadhesive antimicrobials that serve as soluble decoy receptors, prevent pathogen attachment to infant mucosal surfaces and lower the risk for viral, bacterial and protozoan parasite infections. In addition, HMOs may modulate epithelial and immune cell responses, reduce excessive mucosal leukocyte infiltration and activation, lower the risk for necrotizing enterocolitis and provide the infant with sialic acid as a potentially essential nutrient for brain development and cognition. Most data, however, stem from in vitro, ex vivo or animal studies and occasionally from association studies in mother–infant cohorts. Powered, randomized and controlled intervention studies will be needed to confirm relevance for human neonates. The first part of this review introduces the pioneers in HMO research, outlines HMO structural diversity and describes what is known about HMO biosynthesis in the mother's mammary gland and their metabolism in the breast-fed infant. The second part highlights the postulated beneficial effects of HMO for the breast-fed neonate, compares HMOs with oligosaccharides in the milk of other mammals and in infant formula and summarizes the current roadblocks and future opportunities for HMO research. PMID:22513036
-
Fucosylated but not sialylated milk oligosaccharides diminish colon motor contractions.
Directory of Open Access Journals (Sweden)
John Bienenstock
Full Text Available Human milk oligosaccharides (HMO are being studied by different groups exploring a broad range of potential beneficial effects to the breastfed infant. Many of these effects have been attributed to a growth promotion effect on certain gut organisms such as bifidobacteria. Additionally, evidence indicates that HMO are able to directly promote positive changes in gut epithelium and immune responses under certain conditions. This study utilizes a standardized ex vivo murine colon preparation to examine the effects of sialylated, fucosylated and other HMO on gut motor contractions. Only the fucosylated molecules, 2'FL and 3'FL, decreased contractility in a concentration dependent fashion. On the basis of IC50 determinations 3'FL was greater than 2 times more effective than 2'FL. The HMO 3'SL and 6'SL, lacto-N-neotetraose (LNnT, and galactooligosaccharides (GOS elicited no effects. Lactose was used as a negative control. Fucosylation seems to underlie this functional regulation of gut contractility by oligosaccharides, and L-fucose, while it was also capable of reducing contractility, was substantially less effective than 3'FL and 2'FL. These results suggest that specific HMO are unlikely to be having these effects via bifidogenesis, but though direct action on neuronally dependent gut migrating motor complexes is likely and fucosylation is important in providing this function, we cannot conclusively shown that this is not indirectly mediated. Furthermore they support the possibility that fucosylated sugars and fucose might be useful as therapeutic or preventative adjuncts in disorders of gut motility, and possibly also have beneficial central nervous system effects.
-
DEFF Research Database (Denmark)
Elison, Emma; Vigsnæs, Louise K.; Rindom Krogsgaard, Laura
2016-01-01
The gut microbiota has been established as an important player influencing many aspects of human physiology. Breast milk, the first diet for an infant, contains human milk oligosaccharides (HMO) that shape the infant's gut microbiota by selectively stimulating the growth of specific bacteria...... that supplementing the diet with HMO is a valuable strategy to shape the human gut microbiota and specifically promote the growth of beneficial bifidobacteria....
-
Energy Technology Data Exchange (ETDEWEB)
Dreele, H. von; Hartwich, D.; Rolke, D. [RWE Energie AG, Regionalversorgung Nike, Osnabrueck (Germany); Leidig, R. [PLS Unternehmensberatung GmbH, Duesseldorf (Germany)
1998-02-23
The DP software system Plantour is used to optimize truck operations meeting the transportation needs of a regional supply utility taking into account the specific operational requirements. The chance to centralized scheduling was based on logistic principles. New practice-oriented software had to be developed using standards. (orig.) [Deutsch] Mit Hilfe des DV-Software-Systems Plantour werden die Einsaetze der Lkw fuer das Transportwesen einer Regionalversorgung unter Beruecksichtigung der spezifischen betrieblichen Belange optimiert. Dabei wurde die Umstellung auf eine zentrale Einsatzplanung unter Beruecksichtigung logistischer Prinzipien vorgenommen. Die erforderliche Software musste neu unter Verwendung von Standards praxisnah entwickelt werden. (orig.)
-
Connaissances et attitudes des manipulateurs radio du Togo sur l ...
African Journals Online (AJOL)
Objectif : Evaluer les connaissances et les attitudes des manipulateurs togolais sur l'irradiation médicale des grossesses. Matériels et Méthode : Etude transversale menée en Avril 2011 chez 72 manipulateurs de radiologie des structures sanitaires publiques et privées du Togo. Résultats : Le quart des manipulateurs ...
-
Kertesz, L
1997-08-25
Fans of Kaiser Permanente, the nation's oldest and largest HMO, consider the company a cost-effective healthcare delivery system that supports its patients, caregivers and the practice of high-quality medicine. Its detractors see Kaiser as an evil HMO empire that hoards money, mistreats doctors and skimps on care. The dichotomy shows that Kaiser is like a giant mirror, reflecting the struggles and uncertainties of the evolving U.S. healthcare system.
-
Women authorship in radiology research in France: An analysis of the last three decades.
Pyatigorskaya, N; Di Marco, L
2017-11-01
The aim of this study was to evaluate the evolution of women authorship in France and to analyze the recent trends of the evolution of gender differences in French academic radiology. A retrospective bibliometric analysis was performed by searching for articles published in Diagnostic and Interventional Imaging (Diagn Interv Imaging) and in Journal de Radiologie (J Radiol) in Pubmed over the last three decades. For each of these articles, we determined the gender of the first and last author. The specific radiological field of each article was also determined. The proportion of women authors has significantly increased from 12% in 1984 to 34% in 2014 (Pauthorship in Diagnostic and Interventional Imaging has increased over the last years together with the proportion of women first authors. However, the fraction of women last authors is still underrepresented. More women need to become leaders in radiological research to contribute to stimulate women authorship. Copyright © 2017 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
-
Radiology. 3. rev. and enl. ed.; Radiologie
Energy Technology Data Exchange (ETDEWEB)
Reiser, Maximilian [Klinikum der Universitaet Muenchen (Germany). Inst. fuer Klinische Radiologie; Kuhn, Fritz-Peter [Klinikum Kassel (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Debus, Juergen [Radiologische Universitaetsklinik, Heidelberg (Germany). Abt. Radioonkologie und Strahlentherapie
2011-07-01
The text book on radiology covers the following issues: Part A: General radiology: Fundamental physics: radiation biology; radiation protection fundamentals: radiologic methods; radiotherapy; nuclear medicine. Part B: Special radiology: Thorax; heart; urogenital tract and retroperitoneum; vascular system and interventional radiology; esophagus, stomach, small and large intestines; liver, biliary system, pancreas and spleen; mammary glands; central nervous system; spinal cord and spinal canal; basis of the skull, facial bones and eye socket; neck; pediatric imaging diagnostics.
-
Energy Technology Data Exchange (ETDEWEB)
Vries, A. de; Griebel, J.; Gneiting, T.; Hoflehner, J.; Brandl, M.; Lukas, P. [Leopold-Franzens-Univ. Innsbruck (Austria). Universitaetsklinik fuer Strahlentherapie - Radioonkologie; Judmaier, W.; Kremser, C.; Schocke, M.; Aichner, F. [Leopold-Franzens-Univ. Innsbruck (Austria). Inst. fuer Magnetresonanztomographie; Peer, S.; Rettl, G. [Leopold-Franzens-Univ. Innsbruck (Austria). Universitaetsklinik fuer Radiodiagnostik I; Oefner, D. [Leopold-Franzens-Univ. Innsbruck (Austria). Universitaetsklinik fuer Chirurgie; Debbage, P. [Leopold-Franzens-Univ. Innsbruck (Austria). Inst. fuer Histologie und Embryologie
1999-11-01
procedures. (orig.) [German] Ziel: Entwicklung und Anwendung dynamischer Magnetresonanztomographiemessungen zur Erhebung von Perfusionsparametern bei Rektumkarzinomen unter Bestrahlung in der klinischen Routine. Patienten und Methode: Bei Rektumkarzinompatienten (n=8), die sich einer praeoperativen kombinierten Radiochemotherapie unterzogen, wurden Perfusionsdaten erhoben. An einem 1,5-Tesla-Ganzkoerperkernspintomographen wurden ultraschnelle T1-Mapping-Sequenzen zum Erhalt von T1-Maps mit Intervallen von 14 und 120 Sekunden implementiert. Die Messzeit der dynamischen Messungen betrug 40 Minuten. Die Messschicht (Schichtdicke 5 mm) wurde so gewaehlt, dass sowohl Tumor als auch arterielle Gefaesse dargestellt wurden. Gadolinium-DTPA-(Gd-DTPA-)Konzentrations-Zeit-Kurven wurden nach einem prolongierten Bolus im arteriellen Blut und im Tumor berechnet. Die angewendete Methode erlaubte eine raeumliche Aufloesung von 2x2x5 mm und eine zeitliche Aufloesung von 14 Sekunden. Die Messdaten wurden vor und in konstanten Intervallen waehrend Therapie erhoben. Ergebnisse: Die raeumliche und zeitliche Aufloesung der T1-Maps war ausreichend, um Areale mit unterschiedlicher Kontrastmittelkinetik innerhalb des Tumors zu erfassen sowie die grossen Beckenarterien sicher zu identifizieren. Bei sechs Patienten konnten Gd-DTPA-Konzentrationskurven im Tumor unter Therapie erhoben werden. Der Perfusionsindex (Pi) versus Strahlendosis zeigte eine signifikante Zunahme in der ersten oder zweiten Woche der Bestrahlung, bevor er entweder kontinuierlich absank oder nach anfaenglichem Abfall einen erneuten Anstieg aufwies. Der durchschnittliche Pi-Ausgangswert betrug 0,16 ({+-}0,049), das durchschnittliche Pi-Maximum war 0,23 ({+-}0,058). Die relativen Perfusionsveraenderungen betrugen zwischen 20 und 83%. Schlussfolgerung: Unsere Ergebnisse zeigen, dass sich die verwendete Methode zur Erfassung von Perfusionsparametern unter Bestrahlung eignet und in der klinischen Routine anwendbar ist. In der Zukunft
-
Cost analysis of a novel interdisciplinary model for advanced illness management.
Hopp, Faith P; Trzcinski, Eileen; Roth, Roxanne; Deremo, Dorothy; Fonger, Evan; Chiv, Sokchay; Paletta, Michael
2015-05-01
This research project evaluated cost outcomes for patients in the @HOMe Support program, a novel interdisciplinary home-based program for patients and caregivers facing advanced illness drawing on the Chronic Care Model. Cost analysis involved paired sample t-tests to examine pre-post differences in health care expenditures obtained from Health Maintenance Organization (HMO) claims data for program participants. Average 6-month costs per month significantly declined for patients older than 65 years of age from 1 HMO (US$9300-US$5900, P = .001). Evaluation of the second HMO showed that patients less than 65 years of age with lower preentry costs (costs (US$18 787-US$13 781, P = .08). Study findings suggest @HOMe Support is associated with reductions in the use and cost for most health services over time. © The Author(s) 2014.
-
DEFF Research Database (Denmark)
Dornonville de la Cour, Morten; Lux, Anja; Heegaard, Steffen
2010-01-01
Silicone oil is used as intravitreal tamponading agent in surgery for rhegmatogenous retinal detachment (RRD) cases complicated with proliferative vitreoretinopathy (PVR). Recently, a number of case series have appeared where profound central visual loss has been found in eyes after uncomplicated...... vitrectomy with silicone tamponade for RRD in eyes with seemingly good visual potential. Several reports have demonstrated the migration of silicone oil droplets into the retina and the optic nerve, others the widespread loss of myelinated optic nerve fibres. These reports are reviewed, and it is concluded...... that caution is warranted when silicone oil is used in eyes with good visual potential. Finally the additional danger of central visual loss should be taken into consideration when deciding to use silicone oil or gas as intravitreal tamponade....
-
Heterotopic mesenteric ossification: Report of two cases with review of the literature
Directory of Open Access Journals (Sweden)
Mussatto J
2016-02-01
Full Text Available Very few cases of heterotopic mesenteric ossification (HMO have been reported in the literature. We describe two cases, one at an early phase and the other at a more advanced stage of the disease. Both patients developed HMO after multiple major abdominal surgeries. The value of monitoring serum alkaline phosphatase and calcium in a setting of previous abdominal surgery or trauma along with other clinical, radiological and pathologic findings is discussed.
-
Die Parlamentswahlen 2008 in Malaysia
DEFF Research Database (Denmark)
Reher, Stefanie; Knirsch, Thomas
2008-01-01
aus diversen Parteien bestehende Oppositionsbündnis erfuhr überraschend eine klare Stärkung. Während die aus der UMNO und 13 weiteren Koalitionären bestehende BN unter dem Motto „Sicherheit, Frieden, Wohlstand” für Premier Badawi warb, führten die Oppositionsparteien DAP, PAS und PRK – letztere unter...
-
Energy Technology Data Exchange (ETDEWEB)
Dilthey, U.; Biesenbach, M.
2000-06-19
The authors investigated the boundary conditions in which a fine-grained ferritic needle structure with sufficient low-temperature toughness is obtained in conditions of extreme heating and cooling. Alloy compositions and welding boundary conditions were investigated for laser welding, electron beam welding in a vacuum and electron beam welding at atmospheric pressure. [German] Im Rahmen dieser Arbeit soll untersucht werden, welche Randbedingungen erfuellt sein muessen, damit sich unter extremen Aufheiz- und Abkuehlbedingungen, wie sie bei den Strahlschweissverfahren vorliegen, ein feinkoerniges nadelferritisches Gefuege mit ausreichend hoher Tieftemperaturzaehigkeit bildet. Diesbezueglich ist fuer die Strahlschweissverfahren Laserstrahlschweissen, Elektronenstrahlschweissen im Vakuum und Elektronenstrahlschweissen unter Atmosphaerendruck zu ermitteln, welche Legierungszusammensetzungen diese Voraussetzungen erfuellen und wie sie unter realen Schweissbedingungen verwirklicht werden koennen. (orig.)
-
Organisation der Lektoratsarbeit in Öffentlichen Bibliotheken, ihre Stärken und Schwächen
Umlauf, Konrad
2011-01-01
Die Praxis der Lektoratsarbeit an Öffentlichen Bibliotheken wurde 2010 mit einer Online-Befragung unter Biblothekspersonal erhoben. Die Fragen richten sich auf die Aufbauorganisation (Anteil der Lektoren unter dem Personal, den am Bestandsaufbau beteiligten Personalgruppen, die Lektoratsaufgaben im Einzelnen, typische Aufgaben der Lektoren neben den Lektoratsaufgaben, insbes. Verbindung von Lektoratsaufgaben mit Auskunftsdienst), die Ablauforganisation (Entscheidungsablauf und Kaufsitzungen, ...
-
Les fractures pathologiques secondaires des tumeurs bénignes ...
African Journals Online (AJOL)
Les fractures pathologiques secondaires des tumeurs bénignes chez l'enfant: à propos de 20 cas. ... La prise en charge de ces fractures dépend surtout de la tumeur causale et des caractéristiques de la fracture. Le rôle de la radiologie est incontournable et let traitement doit se faire selon une méthodologie précise.
-
African Journals Online (AJOL)
abp
4 nov. 2015 ... alimentaire. Le diagnostic préopératoire est difficile et fait appel à la radiologie. La mortalité liée aux complications varie entre 80% et 100%. Nous rapportons .... douleurs étaient consécutives à une alimentation importante suite à la rupture du jeûn .... gastric bypass operation in long-standing type I diabetic.
-
Directory of Open Access Journals (Sweden)
Walter Leutz
2005-10-01
Full Text Available Purpose: Our objective was to describe the utilization and costs of services from 1985 to 2002 of a Social Health Maintenance Organization (SHMO demonstration project providing a benefit for home-based and community-based as well as short-term institutional (HCB care at Kaiser Permanente Northwest (KPNW, serving the Portland, Oregon area. The HCB care benefit was offered by KPNW as a supplement to Medicare's acute care medical benefits, which KPNW provides in an HMO model. KPNW receives a monthly per capita payment from Medicare to provide medical benefits, and Medicare beneficiaries who choose to join pay a supplemental premium that covers prescription drugs, HCB care benefits, and other services. A HCB care benefit of up to $12,000 per year in services was available to SHMO members meeting requirement for nursing home certification (NHC. Methods: We used aggregate data to track temporal changes in the period 1985 to 2002 on member eligibility, enrollment in HCB care plans, age, service utilization and co-payments. Trends in the overall costs and financing of the HCB care benefit were extracted from quarterly reports, management data, and finance data. Results: During the time period, 14,815 members enrolled in the SHMO and membership averaged 4,531. The proportion of SHMO members aged 85 or older grew from 12 to 25%; proportion meeting requirements for NHC rose from 4 to 27%; and proportion with HCB care plans rose from 4 to 18%. Costs for the HCB care benefit rose from $21 per SHMO member per month in 1985 to $95 in 2002. The HCB care costs were equivalent to 12% to 16% of Medicare reimbursement. The HCB program costs were covered by member premiums (which rose from $49 to $180 and co-payments from members with care plans. Over the 18-year period, spending shifted from nursing homes to a range of community services, e.g. personal care, homemaking, member reimbursement, lifeline, equipment, transportation, shift care, home nursing, adult day
-
Quality of care in investor-owned vs not-for-profit HMOs.
Himmelstein, D U; Woolhandler, S; Hellander, I; Wolfe, S M
1999-07-14
The proportion of health maintenance organization (HMO) members enrolled in investor-owned plans has increased sharply, yet little is known about the quality of these plans compared with not-for-profit HMOs. To compare quality-of-care measures for investor-owned and not-for-profit HMOs. Analysis of the Health Plan Employer Data and Information Set (HEDIS) Version 3.0 from the National Committee for Quality Assurance's Quality Compass 1997, which included 1996 quality-of-care data for 329 HMO plans (248 investor-owned and 81 not-for-profit), representing 56% of the total HMO enrollment in the United States. Rates for 14 HEDIS quality-of-care indicators. Compared with not-for-profit HMOs, investor-owned plans had lower rates for all 14 quality-of-care indicators. Among patients discharged from the hospital after myocardial infarction, 59.2% of members in investor-owned HMOs vs 70.6% in not-for-profit plans received a beta-blocker (Pinvestor-owned plans vs 47.9% in not-for-profit plans had annual eye examinations (PInvestor-owned plans had lower rates than not-for-profit plans of immunization (63.9% vs 72.3%; Pinvestor ownership was consistently associated with lower quality after controlling for model type, geographic region, and the method each HMO used to collect data. Investor-owned HMOs deliver lower quality of care than not-for-profit plans.
-
Pricing and performance in health maintenance organizations: a strategic management perspective.
Conant, J S; Mokwa, M P; Burnett, J J
1989-03-01
Innovative, consumer-oriented pricing strategies have contributed to the impressive growth of health maintenance organizations (HMOs). In a national study of HMO marketing directors, the relationships between strategic management style and (1) the relative importance of pricing in competitive marketing strategy, (2) the effectiveness of price strategy planning, and (3) financial performance are examined. The findings indicate that HMOs practicing effective price planning also perform well on an overall basis. Insight into the content and substance of HMO pricing strategies is also provided.
-
Gold, M
1993-10-01
In sum, the potential that managed care will grow under health systems reform creates an opportunity for the HMO industry but also serves as a challenge and a threat. Faced with greater scrutiny and growing demands, HMOs increasingly are being forced to demonstrate their potential and live up to their expectation. At the same time, the changing nature of the health care system creates a challenge for HMOs. Cost pressures create needs to review the entire delivery system, including the ambulatory component, with a focus on enhancing cost-effectiveness. Greater visibility also creates demands; growing market penetration argues for the creation of a new paradigm to define an appropriate structure for public accountability and management. Finally, the transformation of an HMO industry into a managed care industry is not without its risks as HMO performance becomes evaluated not only against itself but as part of the performance of the broader managed care industry in which HMOs have become embedded.
-
Managed care and the delivery of primary care to the elderly and the chronically ill.
Wholey, D R; Burns, L R; Lavizzo-Mourey, R
1998-06-01
To analyze primary care staffing in HMOs and to review the literature on primary care organization and performance in managed care organizations, with an emphasis on the delivery of primary care to the elderly and chronically ill. Analysis of primary care staffing: InterStudy HMO census data on primary care (n = 1,956) and specialist (n = 1,777) physician staffing levels from 1991 through 1995. Primary care organization and performance for the chronically ill and elderly were analyzed using a review of published research. For the staffing-level models, the number of primary care and specialist physicians per 100,000 enrollees was regressed on HMO characteristics (HMO type [group, staff, network, mixed], HMO enrollment, federal qualification, profit status, national affiliation) and community characteristics (per capita income, population density, service area size, HMO competition). For the review of organization and performance, literature published was summarized in a tabular format. The analysis of physician staffing shows that group and staff HMOs have fewer primary care and specialist physicians per 100,000 enrollees than do network and mixed HMOs, which have fewer than IPAs. Larger HMOs use fewer physicians per 100,000 enrollees than smaller HMOs. Federally qualified HMOs have fewer primary care and specialist physicians per 100,000 enrollees. For-profit, nationally affiliated, and Blue Cross HMOs have more primary care and specialist physicians than do local HMOs. HMOs in areas with high per capita income have more PCPs per 100,000 and a greater proportion of PCPs in the panel. HMO penetration decreases the use of specialists, but the number of HMOs increases the use of primary care and specialist physicians in highly competitive markets. Under very competitive conditions, HMOs appear to compete by increasing access to both PCPs and specialists, with a greater emphasis on access to specialists. The review of research on HMO performance suggests that access
-
Energy Technology Data Exchange (ETDEWEB)
Mueller, U.
1998-12-31
Based on the analysis of existing dams with asphaltic diaphragm and investigations in the three-phase-system of asphaltic concrete a recipe for the composition of asphaltic cores is recommended. For the construction, rest and operating period of an embankment dam the load and the reaction of the asphaltic concrete cores as well as the appearing stress and deformations are described. Extensive material testings have been performed and at 41 asphaltic concrete specimens triaxial stress controlled pressure and creeping tests have been carried out. The evaluation of the triaxial tests led to proportions of the main stress and deformation limits as criteria of breaking. Under application of the standard equation for nonlinear viscoelastic element-laws a rheonom element formulation was developed from the experiment data and transformed into its differential form. With this approach the stress and deformation behavior of watertight asphaltic diaphragm can be precalculated for a period up to 10 years. The applicability of this approach, which can be also used within FE-calculations as well, is illustrated in four examples. (orig.) [Deutsch] Nach der Analyse bestehender Staudaemme mit Asphaltbetonkerndichtung und Untersuchungen zum Dreiphasensystem Asphaltbeton wird eine Rezepturempfehlung fuer den Asphaltkerndichtungsbau aufgestellt. Fuer die Bau-, Ruhe- und Betriebsphase eines Staudammes werden die Beanspruchungen und Reaktionen der Asphaltbetonkerndichtung sowie die auftretenden Spannungen und Verformungen beschrieben. Nach umfangreichen Materialpruefungen sind an 41 Asphaltbetonpruefkoerpern triaxiale spannungsgesteuerte Druck-Kriechversuche durchgefuehrt worden. Die Auswertung der Triaxialversuche ergab ein Grenzhauptspannungsverhaeltnis und Deformationsgrenzen als Bruchkriterien. Unter Verwendung der Standarformulierung fuer nichtlineare viskoelastische Stoffgesetze wurde aus den Versuchsdaten ein rheonomer Stoffansatz entwickelt und in seine differentielle Form
-
Evaluation de la mise en oeuvre des mesures de radioprotection ...
African Journals Online (AJOL)
Résultats : Sur les 62 services de radiologie recensés, 27.4% avaient des surfaces des salles comprises entre 10-20 m2 et 87.6% avaient des parois en briques pleines. Les portes des services étaient en bois dans 67.7% et en aluminium dans 32.3%. La grande majorité (95.2%) de ses portes étaient plombées.
-
Energy Technology Data Exchange (ETDEWEB)
Brandt, M.
1999-05-01
The evaporation and mixing of a kerosine spray in the turbulent airstream of a prevaporizer is investigated at conditions prevailing in the combustion chamber of gas turbines. An experiment is described that allows to study an evaporating fuel spray downstream a prefilming airblast atomizer with Phase-Doppler anemometry, laser-induced fluorescence and an infrared light absorption technique. At an air pressure of 9 bars, an air temperature of 750 K, a mean air velocity of 120 m/s and a fuel flow rate of 1 g/s the kerosine spray evaporates completely without autoignition. At this operating condition the parameters air pressure, air temperature and air turbulence are varied. The influence of these parametric variations on the dropsize distribution, the evaporation rate and the concentration profiles of liquid and evaporated fuel is presented and discussed. (orig.) [German] Die Verdampfung und Vermischung eines Kerosinsprays in der turbulenten Luftstroemung eines Vorverdampfers wird unter Bedingungen untersucht, die in Brennkammern fuer Gasturbinen vorherrschen. Ein Experiment wird vorgestellt, welches es erlaubt, ein verdampfendes Kraftstoffspray stromab eines ebenen Luftstromzerstaeubers mit Filmleger mittels der Phasen-Doppler-Anemometrie, Laser-induzierter Fluoreszenz und einer Infrarotabsorptionsmesstechnik zu untersuchen. Bei einem Luftdruck von 9 bar, einer Vorwaermetemperatur der Luft von 750 K, einer mittleren Luftgeschwindigkeit von 120 m/s und einem Kraftstoffmassenstrom von 1 g/s verdampft das Kerosinspray vollstaendig, ohne die Selbstzuendungszeit zu erreichen. Bei dieser Betriebsbedingung werden die Parameter Luftdruck, Lufttemperatur und Turbulenzgrad variiert. Der Einfluss dieser Parameter auf das Tropfengroessenspektrum, den Verdampfungsgrad und die Konzentrationsprofile des fluessigen sowie des verdampften Kraftstoffs wird dargestellt und diskutiert. (orig.)
-
Experimentelle Untersuchungen zur Verteilung endokriner Stoffe auf Boden/Wasser- Systeme.
Kohne, Danuta
2010-01-01
Unter „endokrinen Stoffen“ (Endocrin Disruptors) versteht man synthetisch erzeugte und in die Umwelt gelangte Chemikalien, die in die hormonellen Regelkreise von Mensch und Tier eingreifen. Sie entfalten ihre Wirkung i. d. R. bereits bei geringer Konzentration. Die aus der Einwirkung solcher Stoffe resultierenden negativen Folgen (z. B. Wachstumsstörungen, sinkende Fruchtbarkeit) werden unter dem Begriff „endokrine Effekte“ zusammengefasst. Die Untersuchung endokriner Effekte von Chemikalien ...
-
Energy Technology Data Exchange (ETDEWEB)
Schulze, Christian; Kaiser, Christian [TLK-Thermo GmbH, Braunschweig (Germany); Tegethoff, Wilhelm; Koehler, Juergen [TU Braunschweig (Germany). Inst. fuer Thermodynamik
2011-07-01
In the development of physically based models for dynamic simulations of cycle processes, a good equilibrium must be chosen between the degree of detailing and the speed of calculation. Dynamic modelling of mult-evaporator air conditioners is a special challenge as the interaction of several heat transfer fluides at one pressure level may result in numerically challenging effects like reflux. The contribution goes into the simulation of the heat transfer fluids in such systems in highly dynamic boundary conditions, e.g. after shutoff of the compressor. There are different modelling methods, e.g. finite volume, moving boundary, or finite element analysis. The methods are presented and evaluated. For the 1-D finite volume method, various established simplification strategies are presented that may enhance numerical efficiency. It is also shown that the equation system will not always be solvable with these strategies, and an approach to ensure solvability is presented. The new approach is illustrated by the example of a multi-evaporator bus air conditioner. [German] Bei der Erstellung von physikalisch basierten Modellen fuer die dynamische Simulation von Kreisprozessen muss ein gutes Gleichgewicht zwischen Detaillierungsgrad und Rechengeschwindigkeit gewaehlt werden: Das Modell muss die Realitaet hinreichend genau abbilden, im Gegenzug jedoch auch innerhalb eines angemessenen Zeitraums Ergebnisse liefern sowie in allen Betriebszustaenden loesbar sein. Die dynamische Modellierung von Mehrverdampfer-Klimaanlagen stellt im Vergleich zu einfachen Kreisprozessen eine besondere Herausforderung dar, da in diesen Systemen die Interaktion mehrerer Waermeuebertrager auf einem Druckniveau zu numerisch herausfordernden Effekten wie z. B. Rueckstroemung fuehren kann. Dieser Beitrag beschaeftigt sich mit der Simulation der Waermeuebertrager in diesen Systemen unter hochdynamischen Randbedingungen wie z. B. einer Abschaltung des Verdichters. Zur Modellierung der Waermeuebertrager
-
Energy Technology Data Exchange (ETDEWEB)
Kuschel, N.
2000-07-01
The optimization of structures with respect to cost, weight or performance is a well-known application of the nonlinear optimization. However reliability-based structural optimization has been subject of only very few studies. The approaches suggested up to now have been unsatisfactory regarding general possibility of application or easy handling by user. The objective of this thesis is the development of general approaches to solve both optimization problems, the minimization of cost with respect to constraint reliabilty and the maximization of reliability under cost constraint. The extented approach of an one-level-method will be introduced in detail for the time-invariant problems. Here, the reliability of the sturcture will be analysed in the framework of the First-Order-Reliability-Method (FORM). The use of time-variant reliability analysis is necessary for a realistic modelling of many practical problems. Therefore several generalizations of the new approaches will be derived for the time-variant reliability-based structural optimization. Some important properties of the optimization problems are proved. In addition some interesting extensions of the one-level-method, for example the cost optimization of structural series systems and the cost optimization in the frame of the Second-Order-Reliabiity-Method (SORM), are presented in the thesis. (orig.) [German] Die Optimierung von Tragwerken im Hinblick auf die Kosten, das Gewicht oder die Gestalt ist eine sehr bekannte Anwendung der nichtlinearen Optimierung. Die zuverlaessigkeitsorientierte Strukturoptimierung wurde dagegen weit seltener untersucht. Die bisher vorgeschlagenen Ansaetze koennen bezueglich ihrer allgemeinen Verwendbarkeit oder ihrer nutzerfreundlichen Handhabung nicht befriedigen. Das Ziel der vorliegenden Arbeit ist nun die Entwicklung allgemeiner Ansaetze zur Loesung der beiden Optimierungsprobleme, einer Kostenminimierung unter Zuverlaessigkeitsrestriktionen und einer
-
20. meeting of the Gesellschaft fuer Paediatrische Radiologie
International Nuclear Information System (INIS)
The 54 papers presented at the meeting deal with the methods, reliability and specific problems of paediatric radiology. Sonography is given particular attention. Apart from conventional radiological techniques, also CT and nuclear techniques are reviewed. (MG) [de
-
Pricing strategies for capitated delivery systems
Gruenberg, Leonard; Wallack, Stanley S.; Tompkins, Christopher P.
1986-01-01
This article discusses alternative methods for establishing a fairer pricing mechanism for Medicare recipients who enroll in health maintenance organizations and other competitive medical plans. The current method, based upon the adjusted average per capita cost, is inadequate because it fails to adjust premium levels for differences in health status; it establishes undesirable incentives that may lead to underservice, and it is tied to costs in the fee-for-service system. Alternative methods would incorporate health status, have Medicare share the risk with HMO's, and base payment on HMO experience. PMID:10311925
-
Wholey, D R; Christianson, J B
1994-01-01
Open-ended products that allow an HMO enrollee to use providers who are not affiliated with the HMO have become an important component of the Clinton administration's health reform proposal, because these products maintain consumer freedom of choice of any provider. However, little is known about the consequences of offering an open-ended product from an organizational standpoint. This paper uses a theory of "spatial competition" to examine the decisions of health maintenance organizations to offer an open-ended product and the effect of offering an open-ended product on their enrollment.
-
3D-Druck: Wie additive Fertigungsverfahren die Wirtschaft und deren Supply Chains revolutionieren
Hofmann, Erik; Oettmeier, Katrin
2016-01-01
Die additive Fertigung – weitläufig bekannt unter dem Begriff »3D-Druck« – erfreut sich zunehmender Aufmerksamkeit. Obwohl diese Technologien vielfältige Potenziale in unterschiedlichen Branchen haben, ist deren Nutzung zur Herstellung industrieller Produkte bislang wenig verbreitet. Anhand einer Befragung unter 195 Schweizer Unternehmen untersucht dieser Artikel Faktoren, die einen Einfluss auf die Nutzung von additiven Fertigungstechnologien haben. Die Ergebnisse lassen darauf schließen, da...
-
Energy Technology Data Exchange (ETDEWEB)
Hiese, W
2000-01-01
The investigations aimed at the development of criteria for measuring valid shearing fracture toughness data K{sub IIc} in analogy to the measurement of mode-I fracture toughness K{sub Ie}. Details are presented, and practical recommendations are given. [German] Die Brucheigenschaften von Werkstoffen werden ueblicherweise unter Zugbeanspruchungsbedingungen (Mode-I) bestimmt. Im Anwendungsbereich der linear-elastischen Bruchmechanik bzw. des Kleinbereichsfliessens geschieht dieses in Form der Bruchzaehigkeit K{sub Ic}. Es existieren entsprechende Richtlinien zur Durchfuehrung des Tests sowie zur Registrierung und Auswertung der Daten. Diese Kriterien sind in Standards festgelegt. Empfehlungen zur Bestimmung der Bruchzaehigkeit K{sub IIc} unter ebener Scherbelastung (Mode-II) fuer Werkstoffe mit im wesentlichen linear-elastischem Verhalten existieren nicht. Im Rahmen dieser Arbeit werden durch den Vergleich der Groesse der plastischen Rissspitzenzonen im Verhaeltnis zu den Abmessungen von Probe bzw. Bauteil Kriterien zur Messung gueltiger Scherbruchzaehigkeiten K{sub IIc} analog zur Messung der Mode-I-Bruchzaehigkeit K{sub Ic} entwickelt. Der Groessenvergleich der plastischen Rissspitzenzonen fuer beide Beanspruchungsarten zeigt unter aequivalenten Beanspruchungen, d.h. K{sub II}=K{sub I}, dass bei Mode-II beanspruchten Rissen die plastischen Zonen groesser, aber die Differenzen in der Groesse der plastischen Zonen fuer die Zustaende ebener Spannung und ebener Dehnung kleiner sind als unter entsprechenden Mode-I-Beanspruchungen.
-
Energy Technology Data Exchange (ETDEWEB)
Schmitz-Rode, T.; Alzen, G.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)
1997-07-01
Purpose: The clinical evaluation of digital subtraction angiography with carbon dioxide using a newly developed low-tech CO{sub 2}-dosage- and injection system. Method and patients: The hand-held system (CO{sub 2} angio set) consists of a dosage chamber in connection with a special stopcock to apportion the gas. By optimising injection volume and pressure steady gas flow characteristics are approximated. A safety design prevents unintentional gas injection volume and pressure steady gas flow characteristics are approximated. A safety design prevents unintentional gas injection. CO{sub 2} arteriographies were performed on 185 patients. Main indications were renal insufficiency and a history of adverse reactions to iodinated contrast media. In patients with femoral connula access, catheterless reflux angiography was performed. Results: The injection system provided complete and coherent visualisation of the abdominal aorta, visceral, pelvic, and lower limb arteries via catheter (71 cases) or via femoral cannula using reflux technique (114 cases). Stenoses, occlusions, and collaterals were assessable. Employing the gas reflux over the aortic bifurcation bilateral run-off studies up to the calf trifurcation were performed via unilateral femoral cannula. Use of a dedicated stacking software improved image quality of distal femoral, popliteal and calf arteries. Conclusion: The CO{sub 2} management system allows adequate imaging of the arteries below the diaphragm. Ease and safety of use and low costs are advantageous. (orig.) [Deutsch] Ziel: Die klinische Erprobung der digitalen Subtraktionsangiographie mit Kohlendioxid unter Verwendung eines neuentwickelten, einfachen Gasdosier- und Injektionssystems. Methode und Patienten: Eine Dosierkammer mit einstellbarem Volumen in Verbindung mit einem Spezial-Hahn (CO{sub 2}-Angio-Set) portioniert das Gas. Durch Optimierung von Injektionsvolumen und -druck wurde eine konstante Ausstroemcharakteristik angenaehert. Das System wurde
-
Energy Technology Data Exchange (ETDEWEB)
Zimmermann, Joerg-Rainer
2013-04-15
The urbanization is a global trend. Today, 22 of the 30megacities, each with more than 10 million inhabitants, are located in developing countries and emerging countries. These megacities consume the most electricity: About two-thirds of the global consumption of electricity and heat are consumed in megacities. At the same time, the prosperity is concentrated in monopolies: In the last 50 years, the per capita income of the urban population has increased by about 150 %. The productivity of urban areas increases. Thus, cities are of central importance to our culture. If global warming is not stopped, climate change hits them with full force.
-
Ironieentwicklung unter interaktionslinguistischer Perspektive
Kotthoff, Helga
2007-01-01
Der vorliegende Aufsatz gibt Einblick in ein Pilotprojekt zur Entwicklung von Ironie und vergleichbaren Formen der Kommunikation einer Bewertungskluft in Interaktionssituationen mit Schulkindern. Um Ironie zu verstehen, muss man davon ausgehen, dass Äußerungen verschiedene Bedeutungsschichten haben können. Man kann diesem Typus indirekten Sprechens nur Sinn zuordnen, wenn man generelle Haltungen des Sprechers inferieren kann, und diese Haltung dann gleichzeitig zum Ausgangspunkt nimmt, auch s...
-
Zuordnungsprozesse bei Fußballzuschauern - Zur Salienz teambezogener Kategorien
Roschmann, Regina
2013-01-01
Sport im Allgemeinen und Fußball im Besonderen erfreuen sich nicht nur unter aktiven Sportlern, sondern auch unter Zuschauern aktuell hoher Beliebtheit. Angesichts teils enormer Einschaltquoten scheint es wahrscheinlich, dass Fußballspiele nicht nur von Fans der beteiligten Mannschaften verfolgt werden. Dies kann sowohl gänzlich neutrale Zuschauer als auch Anhänger anderer Teams betreffen. Während Fans allerdings durch die Literatur bereits ausführliche Aufmerksamkeit erfahren haben und durch...
-
Pricing of Surgeries for Colon Cancer: Patient Severity and Market Factors
Dor, Avi; Koroukian, Siran; Xu, Fang; Stulberg, Jonah; Delaney, Conor; Cooper, Gregory
2012-01-01
Study Objective Examine effects of HMO penetration, hospital competition, and patient severity on the uptake of laparoscopic colectomy and its price relative to open surgery for colon cancer. Methods We used 2002-2007 the MarketScan Database to identify admissions for privately insured colorectal cancer patients undergoing laparoscopic or open partial colectomy (n=1,035 and n=6,389, respectively). Patient and health plan characteristics were retrieved from these data; HMO market penetration rates and an index of hospital market concentration, Herfindahl-Hirschman Index (HHI), were derived from national databases. Logistic and logarithmic regressions were used to examine the odds of having laparoscopic colectomy, effect of covariates on colectomy prices, and the differential price of laparoscopy. Results Adoption of laparoscopy was highly sensitive to market forces, with a 10% increase in HMO penetration leading to a 10.3% increase in the likelihood of undergoing laparoscopic colectomy (Adjusted Odds Ratio (AOR): 1.109, 95% Confidence Interval: 1.062, 1.158), and a 10% increase in HHI resulting in 6.6% lower likelihood (AOR: 0.936 (0.880, 0.996)). Price models indicated that the price of laparoscopy was 7.6% lower than for open surgery (transformed coefficient (Coeff): 0.927 (0.895, 0.960)). A 10% increase in HMO penetration was associated with 1.6% lower price (Coeff: 0.985 (0.977, 0.992)), while a 10% increase in HHI was associated with 1.6% higher price (Coeff: 1.016 (1.006, 1.027), p Impact Laparoscopic surgery may result in cost savings, while market pressures contribute to its adoption. PMID:22569703
-
Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J
2006-06-01
Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.
-
In the Belly of the Beast: A Case Study of Social Work in a Managed Care Organization
Directory of Open Access Journals (Sweden)
Lisa S. Patchner
2002-05-01
Full Text Available The employment of social workers within managed care organizations is a new phenomenon. As such, this case study utilized an exploratory-descriptive design that assessed social workers as case managers within a Medicaid HMO. The semi-structured interviews, focus groups, and participant observation suggested that the use of case management services, delivered primarily by social workers,was effective in addressing the bio-psychosocial needs of Medicaid consumers within a provider-driven HMO. Study findings recommend specific knowledge and skills that social workers need in order to prepare for practice within managed care environments.
-
Energy Technology Data Exchange (ETDEWEB)
Block, W.; Traeber, F.; Kuhl, C.K.; Keller, E.; Rink, H.; Schild, H.H. [Bonn Univ. (Germany). Radiologische Klinik; Lamerichs, R. [Philips Medical Systems, Best (Netherlands); Karitzky, J. [Bonn Univ. (Germany). Neurologische Klinik
1998-03-01
Purpose: {sup 31}P-MR spectroscopy of skeletal muscle under ecercise was used to obtain the range of normal variation and comparison was made for different neuromascular diseases. Methods: 41 examinations of 24 volunteers and 41 investigations in 35 patients were performed on 1.5 T MR systems (Gyroscan S15 und S15/ACSII, Philips). Localised {sup 31}P-MR spectra of the calf muscle were obtained in time series with a resolution of 12 s. Results: Two types of muscle energy metabolism were identified from the pattern of spectroscopic time course in volunteers: While the first group was characterised by a remarkable decline to lower pH values during exercise, the second group showed only small pH shifts (minimum pH: 6.48{+-}0.13 vs 6.87{+-}0.07, p<10{sup -6}) although comparable workload conditions were maintained. The pH-values correlated well with blood lactate analysis. Patients with metabolic disorders and chronic fatigue syndrome (CFS) showed decreased resting values of PCr/(PCr+P{sub i}) and increased pH levels during exercise. PCr recovery was significantly delayed (0.31 vs 0.65 min{sup -1}, p<0.00005) in metabolic muscle disorders but was normal in CFS patients. Conclusion: Findings in volunteers indicate utilisation of different metabolic pathways which seems to be related to the fibre type composition of muscle. Reduced resting levels for PCr/(PCr+P{sub i}), altered pH time courses, and decreased PCr recovery seem to be helpful indicators for diagnosis of metabolic muscle disorders. (orig./MG) [Deutsch] Ziel: Bestimmung der Bandbreite des gesunden Energiestoffwechsels der peripheren Skelettmuskulatur mit Hilfe der {sup 31}P-MR-Spektroskopie als Grundlage der Diagnostik neuromuskulaerer Erkrankungen. Methoden: In Mehrfachuntersuchungen an 24 Probanden und 35 Patienten in 1,5 T MR-Systemen (Gyroscan S15 und S15/ACSII, Philips) wurden {sup 31}P-MR-Spektren unter Belastung akquiriert. Ergebnisse: Die Probanden liessen sich streng in zwei Gruppen einteilen
-
Psychosocial Stress and Addison's Disease
Wolf, Jutta Manuela
2006-01-01
Die Psychoneuroimmunologie beschäftigt sich unter anderem mit der Frage, ob und unter welchen Bedingungen psychosozialer Stress krank macht. Humanstudien, die dieser Frage nachgehen, können dabei meist nur korrelative Zusammenhänge aufdecken. Um trotzdem Aussagen zu Mechanismen, Ursache-Wirkungsbeziehungen und klinische Relevanz treffen zu können, muss z.B. auf Befunde aus der Tierforschung oder aus in vitro-Studien zurückgegriffen werden. Ziel der vorliegenden Arbeit war es, eine Methode zu ...
-
Rezension: Felix Heidenreich: Theorien der Gerechtigkeit - Eine Einführung
Kramer, Hans-Ulrich
2012-01-01
Schon vor der griechischen Antike, nämlich bei den alten Ägyptern und im alten Israel ansetzend, werden unter dem Titel „Antike: Gegebene Gerechtigkeit“ (Kapitel 2) anschließend die Theorien der griechischen Klassiker Platon und Aristoteles sowie des Römers Cicero behandelt. Weiter geht es in chronologischer, übersichtlicher Gliederung mit den zwei Gerechtigkeiten des Mittelalters (Kapitel 3), die auf der Zwei-Reiche-Lehre des Augustinus‘ aufbauen. Kapitel 4 steht unter dem Motto: „N...
-
Review: Felix Heidenreich (2011): Theorien der Gerechtigkeit - Eine Einführung
Kramer, Hans-Ulrich
2012-01-01
Schon vor der griechischen Antike, nämlich bei den alten Ägyptern und im alten Israel ansetzend, werden unter dem Titel „Antike: Gegebene Gerechtigkeit“(Kapitel 2) anschließend die Theorien der griechischen Klassiker Platon und Aristoteles sowie des Römers Cicero behandelt. Weiter geht es in chronologischer, übersichtlicher Gliederung mit den zwei Gerechtigkeiten des Mittelalters (Kapitel 3), die auf der Zwei-Reiche-Lehre des Augustinus‘ aufbauen. Kapitel 4 steht unter dem Motto: „Neuzeit: Ge...
-
Fusion Culture : Fashion beyond Orientalism and Occidentalism
Lehnert, Gertrud; Mentges, Gabriele
2017-01-01
Tagungsbericht zu 'Fusion Culture: Fashion beyond Orientalism and Occidentalism', Universität Potsdam, 5. bis 7. November 2009 Die von Gabriele Mentges (Dortmund) und Gertrud Lehnert (Potsdam) veranstaltete und von der Volkswagen Stiftung geförderte Tagung befasste sich mit dem Thema 'Orientalismus und Mode' zum einen unter historischen Aspekten, zum anderen unter gegenwärtigen Bedingungen, in denen von 'Orientalismus' kaum noch die Rede sein kann. Denn längst haben wechselseitige Bezüge ...
-
Skype for Business - Eine Einschätzung: Kurzstudie
Messerer, Thomas
2016-01-01
Die Firma Microsoft bietet mit Skype for Business ein Kommunikationssystem für die geschäftliche Nutzung an. Die Entwicklung von Skype for Business begann im Jahre 2002/2003 unter dem Namen Live Communications Server (LCS). Spätere Versionen wurden unter den Bezeichnungen OCS (Office Communications Server) und schließlich Lync vertrieben. Das System ist ein lokal installierter VoIP- und IM-Server, der in lokale Windows-Infrastrukturen eingebunden ist. Die Kommunikation im lokalen Netz erfolgt...
-
Energy Technology Data Exchange (ETDEWEB)
Dockhorn, T. [Technische Univ. Braunschweig (Germany). Inst. fuer Siedlungswasserwirtschaft
1999-07-01
Three semi-technical pilot plants (completely mixed reactor, cascade, SBR) were operated in parallel under equal starting conditions. The influence of the type of reactor on the processes COD elimination, nitrification, denitrification and biological P elimination under operating conditions was studied. (orig.) [German] Es wurden drei halbtechnische Versuchsanlagen (volldurchmischter Reaktor, Kaskade, SBR) unter gleichen Ausgangsbedingungen parallel betrieben. Hierbei wurde der Einfluss des Reaktortyps auf die Prozesse CSB-Elimination, Nitrifikation, Denitrifikation sowie biologische P-Elimination unter Betriebsbedingungen untersucht. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Steffin, C.R.; Wanzl, W.; Heek, K.H. van [DMT-Gesellschaft fuer Forschung und Pruefung mbH, Essen (Germany). Geschaeftsbereich FuelTec - Kokerei- und Brennstofftechnik
1999-09-01
Investigations and model calculations have shown that water-soluble alkaline substances (in German coal, mostly NaCl) are released by a desorption process rather than a purely physical evaporation process. Sorption takes place in the presence of reactive oxygen species (H{sub 2}O or O{sub 2}), but only the reaction with water vapour is applicable to technical processes. Soorption is preferred to desorption at low temperatures both kinetically and thermodynamically. Metakaolin has a high alkali sorption capacity and potential depending significantly on the chemical properties of the clay mineral. With increasing basicity, the sorption potential decreases drastically, which has a significant effect in terms of fuel selection and mode of operation of the process of coal dust combustion under pressure. A fuel with low alkali emissions would be a coal grade with a small fraction of water-soluble alkalis and a high fraction of acid clay minerals. Intensive scrubbing in a wet chemical treatment stage may serve to reduce the water-soluble alkalis. [Deutsch] Die Untersuchungen und Modellrechnungen haben gezeigt, dass die Freisetzung der wasserloeslichen Alkalien, was in deutschen Steinkohlen hauptsaechlich NaCl ist, ein Desorptionsmechanismus zugrunde liegt und die Vorstellung eines rein physikalischen Verdampfungsprozesses verworfen werden muss. Die Einbindung der Alkalien findet unter Teilnahme reaktiver Sauerstoffspezies (H{sub 2}O oder O{sub 2}) statt, wobei aber nur die Reaktion mit Wasserdampf auch auf technische Prozesse uebertragbar ist. Die Einbindung ist gegenueber der Desorption bei niedrigen Temperaturen kinetisch und thermodynamisch bevorzugt. Metakaolin besitzt eine hohe Kapazitaet und ein hohes Potential zur Einbindung von Alkalien, wobei die Faehigkeit zur Einbindung ganz entscheidend von den chemischen Eigenschaften des Tonminerals abhaengig ist. Mit steigender Basizitaet nimmt das Einbindungspotential der Mineralsubstanz drastisch ab. Das hat auch
-
Energy Technology Data Exchange (ETDEWEB)
Oberste-Brandenburg, C.
1999-06-01
In this thesis, a model to describe the austenite martensite transformation was developed. The transformation induced plasticity (TRIP) was taken into consideration. The model can be used to design complex structures. A local examination of the energy and entropy balance at the phase boundary serves as the starting point for the identification of the thermodynamical driving force and the thermodynamic flow. For both, a tensorial description is necessary for a general nonhydrostatically stressed solid. In the second part, a material law for the description of TRIP-Steels was developed based on the values derived in the first part. The different mechanical behavior of the phases, especially the differing yield stresses, was taken into account. The model developed was implemented into the finite element program MARC. Simulations of the material and the structural behavior were performed. The experimentally observed strong dependence of the transformation kinetics on the yield stress of the austenite and the dependence of the orientation of the martensite inclusion on the stress state could be verified. (orig.) [German] Im Rahmen dieser Arbeit wurde ein Materialmodell zur Beschreibung der Austenit-Martensit Phasenumwandlung unter Beruecksichtigung der transformationsinduzierten Plastizitaet (TRIP) entwickelt. Das Modell ist zur Berechnung ausgedehnter Strukturen einsetzbar. Eine lokale Betrachtung der Energie- und Entropiebilanz an der Phasengrenze bildet den Ausgangspunkt zur Identifikation der thermodynamischen Kraft und des thermodynamischen Flusses bei Beschreibung der Transformationskinetik. Fuer beide Groessen muss fuer den allgemein nichthydrostatischen Spannungszustand eine tensorielle Beschreibung verwendet werden. Im zweiten Teil der Arbeit bilden diese Groessen die Basis zur Entwicklung eines Stoffgesetzes zur Beschreibung des TRIP-Phaenomens. Es wird das unterschiedliche mechanische Verhalten der Phasen, insbesondere die stark unterschiedlichen
-
Scattering of plane waves by rough surfaces in the sense of Born approximation
Arnold, Thomas
2014-01-01
Das Thema dieser Arbeit ist die Streuung elektromagnetischer ebener Wellen an rauen Oberflächen, also an ebenen Oberflächen mit glatten und beschränkten Störungen. Darüber hinaus wird ein kleiner Kontrast der Materialkonstanten zwischen dem Deckmaterial und dem Material unter der rauen Oberfläche angenommen. Unter diesen Voraussetzungen wird ein Fernfeld-Formel für das gestreute Feld mit Hilfe von Born-Approximation und Fourier-Techniken hergeleitet. Dieser Ansatz basiert auf einer Modifikati...
-
The growth of medical groups paid through capitation in California.
Robinson, J C; Casalino, L P
1995-12-21
In California, it is common for health maintenance organizations (HMOs) to contract with large medical groups that are paid through capitation and are responsible for managing a full spectrum of medical services. We studied six large medical groups in California--Bristol Park Medical, Friendly Hills HealthCare Network, HealthCare Partners Medical Group, Mullikin Medical Centers, Palo Alto Medical Foundation, and San Jose Medical Group--that are paid through capitation and that are growing as a result of contracts with managed-care organizations. We conducted interviews and obtained data on factors such as patient enrollment, capitation and other revenue, numbers of days spent by enrollees in the hospital, and numbers of visits to physicians per enrollee. Between 1990 and 1994, the number of HMO enrollees whose care was paid for through capitation in the six medical groups increased by 91 percent, from 398,359 to 759,474. In 1994, the mean number of hospital days per 1000 HMO enrollees ranged from 120 to 149 for non-Medicare patients and from 643 to 936 days for Medicare patients. By comparison, in 1993 the mean numbers of hospital days per 1000 HMO enrollees not covered by Medicare were 232 for California and 297 for the United States; for HMO enrollees covered by Medicare, the numbers were 1337 for California and 1698 for the United States. In 1994, the average annual number of visits to physicians for HMO patients in the six groups not covered by Medicare ranged from 3.1 to 3.9; for Medicare patients, it ranged from 7.2 to 9.3; these rates were slightly lower than statewide and national rates. Four of the groups have sold their assets (such as facilities, supplies, equipment, and patients' charts) to outside investors; the physicians remain employed by physician-owned professional corporations. Medical groups paid through capitation offer a model for the status of physicians in managed-care systems that differs from the employee status offered by staff-model HMOs
-
Timely Health Service Utilization of Older Foster Youth by Insurance Type.
Day, Angelique; Curtis, Amy; Paul, Rajib; Allotey, Prince Addo; Crosby, Shantel
2016-01-01
To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of first well-child visits (health care physicals). A three-year retrospective study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 1,657 youth, ages 10-20 years, who were in foster care during the 2009-2012 study period was used to examine the odds of receiving a timely well-child visit within the recommended 30-day time frame controlling for race, age, days from foster care entry to Medicaid enrollment, and number of foster care placements. Youth entering foster care during the HMO period were more likely to receive a timely well-child visit than those in the FFS period (odds ratio, 2.46; 95% confidence interval, 1.84-3.29; p foster care during the FFS period to 29 days for the HMO period. Among the other factors examined, more than 14 days to Medicaid enrollment, being non-Hispanic black and having five or more placements were negatively associated with receipt of a timely first well-child visit. Those youth who entered foster care during the HMO period had significantly greater odds of receiving a timely first well-child visit; however, disparities in access to preventive health care remain a concern for minority foster care youth, those who experience delayed Medicaid enrollment and those who experienced multiple placements. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
-
Consumer cost sharing and use of biopharmaceuticals for rheumatoid arthritis.
Robinson, James C
2013-06-01
To evaluate the effect of consumer cost sharing on use of physician-administered and patient self-administered specialty drugs for rheumatoid arthritis. Multivariate statistical analysis of probability and use of physician-administered specialty drugs, patient self-injected specialty drugs, non-biologic disease-modifying anti-rheumatic drugs, and symptom relief drugs. Analyses were conducted for patients enrolling in preferred provider organization (PPO) plans and health maintenance organization (HMO) plans with different cost-sharing requirements, adjusted for patient demographics, health status, and geographical location. Professional, facility, and pharmaceutical claims for beneficiaries of CalPERS, the public employee insurance purchasing alliance in California, for 2008-2009. Consumer cost-sharing requirements were obtained for each type of drug and service for each type of insurance plan. PPO insurance enrollees face substantially higher cost sharing for physician-administered specialty drugs, compared with HMO enrollees in CalPERS. PPO patients with rheumatoid arthritis are only half as likely as HMO enrollees to choose a physician-administered specialty drug (4.2% vs 9.3%) (P ≤.05), and use 25% less of the drugs if they use any ($10,356 vs $13,678) (P ≤.05). They are 30% more likely to use a self-administered specialty drug than are HMO enrollees (29.3% vs 22.1%) (P ≤.05), and use 35% more of the drugs if any ($16,015 vs $12,378) (P ≤.05). Consumer cost sharing reduces the use of physician-administered specialty drugs for rheumatoid arthritis. The higher use of patient self-administered specialty drugs suggests that the disincentives for use of physician-administered drugs were offset by an increased incentive to use self-administered drugs.
-
Akkerman, Renate; Faas, Marijke M; de Vos, Paul
2018-01-15
Human milk (HM) is the golden standard for nutrition of newborn infants. Human milk oligosaccharides (HMOs) are abundantly present in HM and exert multiple beneficial functions, such as support of colonization of the gut microbiota, reduction of pathogenic infections and support of immune development. HMO-composition is during lactation continuously adapted by the mother to accommodate the needs of the neonate. Unfortunately, for many valid reasons not all neonates can be fed with HM and are either totally or partly fed with cow-milk derived infant formulas, which do not contain HMOs. These cow-milk formulas are supplemented with non-digestible carbohydrates (NDCs) that have functional effects similar to that of some HMOs, since production of synthetic HMOs is challenging and still very expensive. However, NDCs cannot substitute all HMO functions. More efficacious NDCs may be developed and customized for specific groups of neonates such as pre-matures and allergy prone infants. Here current knowledge of HMO functions in the neonate in view of possible replacement of HMOs by NDCs in infant formulas is reviewed. Furthermore, methods to expedite identification of suitable NDCs and structure/function relationships are reviewed as in vivo studies in babies are impossible.
-
International Nuclear Information System (INIS)
Coppolecchia, V.D.; Jasner, M.; Rockel, M.B.
1988-01-01
Highly alloyed stainless steels, such as 1925 hMo UNS N08925 with 6 percent molybdenum, are finding widespread use in high chloride cooling water and process environments. This alloy has good general corrosion resistance to a variety of chloride environments but it's main attraction is excellent resistance to all forms of localized corrosion. In aggressive chloride environments weldments are generally the area of concern with regard to localized corrosion. Temperature-time-sensitization diagrams are presented that demonstrate the resistance of 1925 hMo weldments to intergranular attack. Immersion tests in 10% ferric chloride substantiate that autogenous tube welds, also have excellent pitting resistance. Various filler metals are compared both electrochemically and in immersion tests. These comparisons reveal that an overalloyed filler metal is required to achieve pitting and crevice corrosion resistance equal or better than that of the base metal. Alloy 625 (UNS NO6625) has been selected. Constant extension rate tests in boiling 62% calcium chloride reveal that 1925 hMo weldments are immune to stress corrosion cracking in this environment which virtually guarantees absence of SCC in seawater regardless of temperature as well as in most commercial chemical environments
-
Directory of Open Access Journals (Sweden)
Nandi Sudarshana
2015-06-01
Full Text Available Factor and multiple regression analysis were used to extract the morphometric variables that contributed to feeding success in three small freshwater fishes. Of the first two factors, factor 1, showed high loading of gut weight (GW, length of the upper (UJ, and lower jaws (LJ in mola, Amblypharyngodon mola (Hamilton, and GW and vertical mouth opening (VMO in punti, Puntius ticto (Hamilton. In darikana, Esomus danricus (Hamilton, GW, horizontal mouth opening (HMO, and VMO were highly loaded on factor 2. Gut length (GL was closely associated withGWof all three species. Subsequently, variables with high loading on factors 1 or 2 were subjected to multiple regression analysis to observe their effect on feeding success, consideringGWas the dependent variable and the extracted variables as the independent variable. In A. mola, HMO and GL influenced GW, whereas in P. ticto, only GL determined GW in the fish. In E. danricus, GL, VMO, and HMO exerted a low effect on GW. Exceptionally, the present study suggested that feeding success in small fishes is largely determined by UJ, LJ, and GL or mouth openings.
-
Financial risk sharing with providers in health maintenance organizations, 1999.
Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael
2002-01-01
The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs?
-
Alkali-Resistant Mechanism of a Hollandite DeNOx Catalyst.
Hu, Pingping; Huang, Zhiwei; Gu, Xiao; Xu, Fei; Gao, Jiayi; Wang, Yue; Chen, Yaxin; Tang, Xingfu
2015-06-02
A thorough understanding of the deactivation mechanism by alkalis is of great importance for rationally designing improved alkali-resistant deNOx catalysts, but a traditional ion-exchange mechanism cannot often accurately describe the nature of the deactivation, thus hampering the development of superior catalysts. Here, we establish a new exchange-coordination mechanism on the basis of the exhaustive study on the strong alkali resistance of a hollandite manganese oxide (HMO) catalyst. A combination of isothermal adsorption measurements of ammonia with X-ray absorption near-edge structure spectra and X-ray photoelectron spectra reveals that alkali metal ions first react with protons from Brønsted acid sites of HMO via the ion exchange. Synchrotron X-ray diffraction patterns and extended X-ray absorption fine structure spectra coupled with theoretical calculations demonstrate that the exchanged alkali metal ions are subsequently stabilized at size-suitable cavities in the HMO pores via a coordination model with an energy savings. This exchange-coordination mechanism not only gives a wholly convincing explanation for the intrinsic nature of the deactivation of the reported catalysts by alkalis but also provides a strategy for rationally designing improved alkali-resistant deNOx catalysts in general.
-
Energy Technology Data Exchange (ETDEWEB)
Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K. [Muenchen Univ. (Germany). Inst. fuer Radiologische Diagnostik; Koenig, A.; Endres, S. [Muenchen Univ. (Germany). Medizinische Klinik Innenstadt
2000-06-01
-Informationssystem entwickelt, das alle Abteilungen der Klinik mit Befund- und Bildinformationen aus der Radiologie versorgt. Aus dem Informationssystem sind darueber hinaus auch andere klinische Informationen wie Labordaten und EKG-Untersuchungen abrufbar. Ergebnisse: Nach einem einjaehrigen Betrieb hat sich das Informationssystem im klinischen Arbeitsablauf bewaehrt und dient den ueberweisenden Abteilungen als primaere Informationsquelle sowohl fuer radiologische Befunde und Bilder als auch fuer klinische Daten wie Laborparameter. Schlussfolgerungen: Vorteile aus der Digitalisierung ergeben sich unter anderem aus der Reduktion der Filmkosten, besonders aber aus der Optimierung der Arbeitsablaeufe durch die digitale Verfuegbarkeit der Bilddaten zu jeder Zeit an jedem Ort. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Klein, M. [Fraunhofer-Inst. fuer Molekularbiologie und Angewandte Oekologie, Schmallenberg-Grafschaft (Germany); Herrmann, M. [Umweltbundesamt, Berlin (Germany)
2004-07-01
Methods. Based on already in-use versions of the leaching model PELMO, an advanced version (MC-PELMO 3.0) was developed with a specific focus on estimating groundwater contamination under storage sites at wood preserving facilities in Germany. The model processes twenty-two different leaching scenarios that were derived from twelve characteristic soil profiles representing pedological regions in Germany along with recorded meteorological data from nine weather stations. These data are related to geographic distribution of industrial wood preserving activity. The model calculates statistic probabilities of concentrations of wood preservatives in seepage water beneath timber storage sites of regions to be selected by the user. Results and Discussion. The reports provided by MC-PELMO 3.0 include mean average concentrations, 55 to 99 percentiles, and single maximum concentrations for each of the scenarios. The results can be related to the total area of Germany, its forest area or to the density of preservation activity in various regions. Beside concentrations of the parent compounds, those of degradation products may be calculated for the seepage water. Conclusion. The described model is a particularly useful tool for comparative assertion of various wood preservative products under aspects of the exposure of groundwater resources. Comparative assertion is a new element within EU-chemicals policy, for the first time materialized in the biocidal products directive 98/8/EC. Furthermore, the results of model calculations identify vulnerable regions in Germany for which appropriate risk management measures have to be taken in order to protect groundwater from contamination. (orig.) [German] Methoden. Basierend auf bestehenden Versionen des Versickerungsmodells PELMO wurde eine Version speziell fuer die Abschaetzung des Versickerungsverhaltens von Holzschutzmitteln unter Lagerplaetzen von Holz-Impraegnierbetrieben in Deutschland entwickelt. Das stochastische Modell
-
Profil des examens radiographiques spéciaux conventionnels dans ...
African Journals Online (AJOL)
But : Montrer l'apport des examens spéciaux dans la démarche diagnostique Méthodologie : Il s'agit d'une étude rétrospective qui a porté sur les résultats de 249 examens spéciaux colligés dans le service de radiologie du CHU- Tokoin de Lomé du 1er mars 2003 au 1er mars 2004. Résultats : L'âge de nos patients varie ...
-
Sedoanalgesia in interventional radiology; Analgosedierung in der interventionellen Radiologie
Energy Technology Data Exchange (ETDEWEB)
Linsenmaier, U.; Pfeifer, K.J.; Reiser, M. [Klinikum der Universitaet Muenchen, Muenchen (Germany). Inst. fuer Klinische Radiologie; Wagner, P. [Klinikum der Universitaet Muenchen, Muenchen (Germany). Inst. fuer Anaesthesiologie und Intensivmedizin; Ambulantes Operationszentrum, Muenchen Pasing (Germany)
2002-02-01
Purpose: Development of a save and effective protocol for analgosedation of patients undergoing painful interventional procedures. Material and Methods: In a prospective trial a consecutive series of 72 adult patients underwent analgosedation during painful interventions. A radiologist performed the analgosedation, the patients received a combination of a shortly effective piperidine derivative (Alfentanil [Rapifen {sup trademark} ]; 7.5-15 {mu}g/kg body weight) and Benzodiazepine (midazolam [Dormicum {sup trademark} ]; 20 {mu}g/kg body weight). After pre-procedure oxygenation patients were continuously monitored. Pain and discomfort were scored using an established visual-analog pain score (0-10). A control group (n=24) had received midazolam, pentazocine or fentanyl according to the study protocol. Results: All procedures could be carried out by an interventional radiologist and a nurse and/or technologist only. In 69/72 cases adequate analgosedation could be achieved. Injection of alfentanil was titrated, with a rapid onset and short acting effect of the analgesia. Patients reported an average pain score of 2.6 vs. 4.5 in the control group. Over 55% experienced no or mild pain (score 0-3), in the control group only 8% reached this level. Conclusion: A combination of shortly effective alfentanil and midazolam allows interventional radiologists to perform major procedures alone under effective analgosedation. This medication scheme is superior to the medication upon demand. (orig.) [German] Ziel: Die Entwicklung eines einfach zu handhabenden Protokolls fuer Radiologen zur Analgosedierung bei schmerzhaften interventionellen Eingriffen. Methoden: Prospektiv wurden 72 konsekutive Patienten zusammengefasst, bei denen schmerzhafte interventionelle Eingriffe geplant waren. Die Anlagosedierung erfolgte mit einer Kombinationsmedikation aus kurzwirksamem Piperidinderivat (Alfentanil [Rapifen {sup trademark} ]; 7,5-15 {mu}g/kg KG) und Benzodiazepin (Midazolam [Dormicum {sup trademark} ]; 20 {mu}g/kg KG). Nach praeinterventioneller Oxygenierung wurde ein kontinuierliches Monitoring durchgefuehrt. Das subjektive Schmerzempfinden der Patienten wurde mit einem visuellen Analogscore (0-10) erfasst. Die Kontrollgruppe (n=24) hatte nach Bedarf Midazolam, Pentazocin (Fortral {sup trademark}) oder Fentanylcitrat (Fentanyl {sup trademark}) erhalten. Ergebnisse: Analgosedierung war in allen Faellen jeweils von einem Radiologen und einer Assistenzperson durchfuehrbar gewesen, in 69/72 Faellen wurde eine ausreichende Analgesie erreicht. Die Gabe von Alfentanil (Rapifen {sup trademark}) wurde titriert (0,4-2,5 mg). Das maximale Schmerzempfinden (0-10) der Patienten betrug durchschnittlich 2,6, in der Kontrollgruppe 4.5. Ueber 55% der Patienten gaben keine oder nur geringe Schmerzen (score 0-3) an, in der Kontrollgruppe waren dies lediglich 8%. Schlussfolgerungen: Der kombinierte Einsatz von kurzwirksamem Alfentanil und Midazolam ermoeglicht interventionellen Radiologen eine effektive Analgosedierung von Patienten bei schmerzhaften interventionellen Eingriffen. Diese Form der Analgosedierung ist der Medikation bei Bedarf deutlich ueberlegen. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Maeurer, J. [Radiologische Praxis am Prinzregentenplatz, Muenchen (Germany)
2001-09-01
Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.) [German] Zielsetzung. Vorstellung der Wertigkeit bildgebender Verfahren fuer die diagnostische und interventionelle Radiologie des Temporomandibulargelenks (TMG). Material und Methodik. Die moderne Radiologie des TMG basiert auf dem Einsatz der konventionellen Roentgendiagnostik, der Computertomographie (CT) und der Magnetresonanztomographie (MRT), sowie interventioneller Verfahren wie der Biopsie, vaskulaerer Embolisationsverfahren und tumorablativer Verfahren. Ergebnisse. Als Basisdiagnostik dient die konventionelle Diagnostik in offener und geschlossener Mundposition der Erfassung von Funktionsstoerungen sowie ossaerer Destruktionen. Die CT erweitert das diagnostische Spektrum und verbessert die Differenzialdiagnostik fuer ossifizierende Prozesse. Der Einsatz der MRT erlaubt die Erfassung der Weichteilinfiltration sowie der Gelenkstrukturen. Vaskulaere interventionelle Verfahren dienen der praetherapeutischen Okklusion bzw. der palliativen Tumortherapie in Form der okklusiven Embolisation, der Chemoembolisation, oder auch der Tumorablation. (orig.)
-
Pricing of surgeries for colon cancer: patient severity and market factors.
Dor, Avi; Koroukian, Siran; Xu, Fang; Stulberg, Jonah; Delaney, Conor; Cooper, Gregory
2012-12-01
This study examined effects of health maintenance organization (HMO) penetration, hospital competition, and patient severity on the uptake of laparoscopic colectomy and its price relative to open surgery for colon cancer. The MarketScan Database (data from 2002-2007) was used to identify admissions for privately insured colorectal cancer patients undergoing laparoscopic or open partial colectomy (n = 1035 and n = 6389, respectively). Patient and health plan characteristics were retrieved from these data; HMO market penetration rates and an index of hospital market concentration, the Herfindahl-Hirschman index (HHI), were derived from national databases. Logistic and logarithmic regressions were used to examine the odds of having laparoscopic colectomy, effect of covariates on colectomy prices, and the differential price of laparoscopy. Adoption of laparoscopy was highly sensitive to market forces, with a 10% increase in HMO penetration leading to a 10.9% increase in the likelihood of undergoing laparoscopic colectomy (adjusted odds ratio = 1.109; 95% confidence interval [CI] = 1.062, 1.158) and a 10% increase in HHI resulting in 6.6% lower likelihood (adjusted odds ratio = 0.936; 95% CI = 0.880, 0.996). Price models indicated that the price of laparoscopy was 7.6% lower than that of open surgery (transformed coefficient = 0.927; 95% CI = 0.895, 0.960). A 10% increase in HMO penetration was associated with 1.6% lower price (transformed coefficient = 0.985; 95% CI = 0.977, 0.992), whereas a 10% increase in HHI was associated with 1.6% higher price (transformed coefficient = 1.016; 95% CI = 1.006, 1.027; P prices. Moreover, laparoscopic surgery may result in cost savings, while market pressures contribute to its adoption. Copyright © 2012 American Cancer Society.
-
An opportunity for HMOs to use marketing to increase enrollee satisfaction.
Dwore, R B; Murray, B P; Parsons, R P; Gustafson, G
2001-01-01
To identify the combination of marketing components (i.e., service, price, access, and promotion) of commercial health maintenance organizations (HMOs) that are related to overall enrollee satisfaction. The researchers focus on factors that commercial HMOs control directly--specifically, health care organization and financing. Descriptive (mail order). This study uses national data provided by a major health benefits consulting firm, which collected data from a 1997 calendar year mail survey of HMO administrators. The administrators responded to an extensive survey, which tapped selected HMO marketing-mix components and the percentage of surveyed members who indicated satisfaction with their HMOs. To test hypotheses, researchers treated marketing-mix components as independent variables and enrollee satisfaction as the dependent variable. This study found statistically significant relationships between overall satisfaction and HMO providers' quality; access, particularly to specialists and out-of-network providers; waiting times for physician services; customer service; and disease prevention/health promotion programs. The researchers did not find significant relationships between overall satisfaction and accreditation by the National Committee for Quality Assurance (NCQA), the presence of physician gatekeepers, numbers of providers, or financial indicators. The relationship between overall satisfaction and utilization was mixed. This study's findings are largely consistent with the literature, consumer- and professional-group position papers, and the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. HMOs can use marketing as a way to address problems and pursue opportunities identified by enrollees. As these findings demonstrate, certain features of HMO design are more appealing to patients. By focusing on these preferences, HMOs can adopt a responsive market orientation that gives rise to more effective marketing mixes
-
International Nuclear Information System (INIS)
Ohashi, K.; Ougiyanagi, J.; Choi, S.Y.; Ito, H.; Imura, H.
2001-01-01
The cloud point extraction behaviour, specification, and determination of traces of iron(III) with 8-quinolinol derivatives (HA), such as 8-quinolinol (HQ), 2-methyl-8-quinolinol (HMQ), and 2-methyl-5-octyl-oxy-methyl-8-quinolinol (HMO 8 Q) were investigated. Above pH 4.0, more than 95% of iron(III) was extracted with 5.00 x 10 -2 M HQ, HMQ, and HMO 8 Q in 4 (v/v)% Triton X-100. The proposed method was applied to the determination of iron(III) in the Riverine Water Reference (JAC 0031 and JAC 0032) by graphite furnace atomic absorption spectrometry. The results agreed well with the certified values within 2% of the RSD. (authors)
-
Contribution to the study of molybdic medium and of rare earth molybdates in solution
International Nuclear Information System (INIS)
Bouih, A.
1989-01-01
On one hand,a potentiometric study of molybdic medium is done, and on the other hand, trivalent Europium behaviour in this medium is investigated The using of potentiometric data resulting from the molybdic medium study has permited to determine, with the help of a calculation program based on the electroneutrality equations and on the mass conservation, the equilibrium constants corresponding to the polymerization of molybdic acid. The behaviour of trivalent Europium in molybdic medium has been investigated using solvent extraction and potentiometry methods. Both methods have permited to identify two complexes: EuHMo7O24(2-); EuHMo7O24(2-) and to calculate their equilibrium constants. 11 figs., 12 tabs., 29 refs.(author)
-
How should HMOs measure their efforts and accomplishments?
Probst, F R
1988-03-01
Accounting procedures among prepaid healthcare plans vary considerably, so much so that the accounting profession is considering what should be appropriate practice. Some standardarization is needed because of wide variations in measuring performance. This can be an obstacle in discussions of whether HMOs are more efficient than other delivery systems and what type of HMO is most successful. Healthcare expenses can be recognized at the time of payment, at the time they are reported to the plan, at the time services are provided, or in anticipation of future services. The accounting profession has identified four HMO models to determine whether organizational structure should affect financial reporting. The models, which differ in the relationship between the HMO and enrolled members and physicians, are staff model, group model, individual practice association, and network model. The accountants reject recognizing expense at the time of payment because it does not conform to generally accepted accounting principles. They suggest two alternatives: recognizing expense when the service is provided, or recognizing as expense, on the date of initial service, the expected cost of all anticipated services required by the diagnosis. The former approach appears preferable because of its consistency with the way healthcare services are delivered and the logic of accounting theory.
-
Energy Technology Data Exchange (ETDEWEB)
Yu, Qianqian, E-mail: qianqianyu09@gmail.com; Sasaki, Keiko; Hirajima, Tsuyoshi
2013-11-15
Highlights: • Biogenic birnessite was used to synthesize microtube-type Li{sup +} ion sieve. • The biomineral facilitates LMO formation at a lower temperature. • HMO-MT with high Li{sup +} uptake capacity was obtained. • Temperature effects on properties of HMO-MTs were studied. -- Abstract: Microbial transformations, a primary pathway for the Mn oxides formation in nature, provide potential for material-oriented researchers to fabricate new materials. Using Mn oxidizing fungus Paraconiothyrium sp. WL-2 as a bio-oxidizer as well as a bio-template, a special lithium ion sieve with microtube morphology was prepared through a solid-state transformation. Varying the calcination temperature from 300 to 700 °C was found to influence sample properties and consequently, the adsorption of Li{sup +}. Lithium manganese oxide microtube (LMO-MTs) calcined at different temperatures as well as their delithiated products (HMO-MTs) were characterized by X-ray diffraction (XRD), X-ray absorption fine structure (XAFS) spectroscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Calcination temperatures affect not only the content but also the crystal structure of LMO spinel, which is important in Li{sup +} adsorption. The optimized sample was obtained after calcination at 500 °C for 4 h, which shows higher Li{sup +} adsorption capacity than particulate materials.
-
Directory of Open Access Journals (Sweden)
Ezgi Özcan
2018-05-01
Full Text Available Human milk contains a high concentration of indigestible oligosaccharides, which likely mediated the coevolution of the nursing infant with its gut microbiome. Specifically, Bifidobacterium longum subsp. infantis (B. infantis often colonizes the infant gut and utilizes these human milk oligosaccharides (HMOs to enrich their abundance. In this study, the physiology and mechanisms underlying B. infantis utilization of two HMO isomers lacto-N-tetraose (LNT and lacto-N-neotetraose (LNnT was investigated in addition to their carbohydrate constituents. Both LNT and LNnT utilization induced a significant shift in the ratio of secreted acetate to lactate (1.7–2.0 in contrast to the catabolism of their component carbohydrates (~1.5. Inefficient metabolism of LNnT prompts B. infantis to shunt carbon toward formic acid and ethanol secretion. The global transcriptome presents genomic features differentially expressed to catabolize these two HMO species that vary by a single glycosidic linkage. Furthermore, a measure of strain-level variation exists between B. infantis isolates. Regardless of strain, inefficient HMO metabolism induces the metabolic shift toward formic acid and ethanol production. Furthermore, bifidobacterial metabolites reduced LPS-induced inflammation in a cell culture model. Thus, differential metabolism of milk glycans potentially drives the emergent physiology of host-microbial interactions to impact infant health.
-
Bio-templated synthesis of lithium manganese oxide microtubes and their application in Li+ recovery
International Nuclear Information System (INIS)
Yu, Qianqian; Sasaki, Keiko; Hirajima, Tsuyoshi
2013-01-01
Highlights: • Biogenic birnessite was used to synthesize microtube-type Li + ion sieve. • The biomineral facilitates LMO formation at a lower temperature. • HMO-MT with high Li + uptake capacity was obtained. • Temperature effects on properties of HMO-MTs were studied. -- Abstract: Microbial transformations, a primary pathway for the Mn oxides formation in nature, provide potential for material-oriented researchers to fabricate new materials. Using Mn oxidizing fungus Paraconiothyrium sp. WL-2 as a bio-oxidizer as well as a bio-template, a special lithium ion sieve with microtube morphology was prepared through a solid-state transformation. Varying the calcination temperature from 300 to 700 °C was found to influence sample properties and consequently, the adsorption of Li + . Lithium manganese oxide microtube (LMO-MTs) calcined at different temperatures as well as their delithiated products (HMO-MTs) were characterized by X-ray diffraction (XRD), X-ray absorption fine structure (XAFS) spectroscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Calcination temperatures affect not only the content but also the crystal structure of LMO spinel, which is important in Li + adsorption. The optimized sample was obtained after calcination at 500 °C for 4 h, which shows higher Li + adsorption capacity than particulate materials
-
Albrecht, Simone; Schols, Henk A; van den Heuvel, Ellen G H M; Voragen, Alphons G J; Gruppen, Harry
2011-11-29
The characterization of oligosaccharides in the feces of breast-fed babies is a valuable tool for monitoring the gastrointestinal fate of human milk oligosaccharides (HMOs). In the present study we monitored fecal oligosaccharide profiles together with the HMO-profiles of the respective breast milks up to six months postpartum, by means of capillary electrophoresis-laser induced fluorescence detection and mass spectrometry. Eleven mother/child pairs were included. Mother's secretor- and Lewis-type included all combinations [Le(a-b+), Le(a+b-), Le(a-b-)]. The fecal HMO-profiles in the first few months of life are either predominantly composed of neutral or acidic HMOs and are possibly effected by the HMO-fingerprint in the respective breast milk. Independent of the initial presence of acidic or neutral fecal HMOs, a gradual change to blood-group specific oligosaccharides was observed. Their presence pointed to a gastrointestinal degradation of the feeding-related HMOs, followed by conjugation with blood group specific antigenic determinants present in the gastrointestinal mucus layer. Eleven of these 'hybrid'-oligosaccharides were annotated in this study. When solid food was introduced, no HMOs and their degradation- and metabolization products were recovered in the fecal samples. Copyright © 2011 Elsevier Ltd. All rights reserved.
-
Siebel, Martin
2003-01-01
Die kohärente Teilchenproduktion in hadronischen Z-Zerfällen mit drei Jets im Endzustand wird anhand von mit dem DELPHI-Experiment in den Jahren 1992-1995 aufgenommenen Daten untersucht. Die unter großem Winkel zur Ereignisebene gemessene Multiplizität ist in guter Übereinstimmung mit einer Vorhersage in führender Ordnung. Es wird gezeigt, dass zur Beschreibung der Daten ein negativer Interferenzterm notwendig ist. Ein Skalieren der Impulsverteilungen der unter großem Winkel produzierten Teilchen wird für Impulse unter ca. 1GeV beobachtet, wodurch die lokale Parton-Hadron Dualitätshypothese (LPHD) bestätigt wird. Es wird eine gute Beschreibung der in Dreijetereignissen gemessenen Gesamtmultiplizität durch eine MLLA-Vorhersage beobachtet. Eine Parameteranpassung der Vorhersage an die Daten ergibt das Farbfaktorverhältnis CA/CF = 2.261 ± 0.014(stat.) ± 0.036(syst.) ± 0.052(theor.) ± 0.041(clus.), welches die bislang präziseste Messung dieses Wertes darstellt. Das Verhältnis der Gluon- zur Quar...
-
Conceito de amor: comparação entre estudantes brasileiros e alemães
Directory of Open Access Journals (Sweden)
Ulrike Schröder
2002-12-01
Full Text Available Das Phänomen Liebe nicht - wie im Alltagsgebrauch - als substantielle Entität, sondern als kommunikativ erzeugte Lebenswirklichkeit zu begteifen, ist Ziel der Untersuchung gewesen. Zu diesem Zweck wurde eine vergleichende Fallstudie zum Liebeskonzept brasilianischer und deutscher Studenten durchgeführt. Theoretische Grundlage der Untersuchung bildete ein im weitesten Sinne konstruktivistisches Verständnis von Kommunikation als wirklichkeitserzeugendem Verhaltensbereich. In einer theoretischen Einführung wurde der Wirklichkeitsbereich Liebe unter Einbeziehung des jeweiligen historisch-kulturellen Hintergrundes fokussiert. Die methodische Vorgehensweise bei der Durchführung der Studie war schließlich überwiegend qualitativ angelegt, um das für den Einzelnen tatsächlich relevante Begriffsinventar ermitteln zu können. In der Auswertung sind dann die Unterschiede im Hinblick auf die Internalisierung eines Liebesideals, die Strukturen der Beziehungswirklichkeit, ihre sprachliche Handhabung, die Verhaltenskoordination, die Funktion von Beziehungen sowie die Folgen für die Kommunikationspraxis herausgestellt worden. Es zeigte sich, dass Liebesbeziehungen unter deutschen Studenten stark vom romantischen Liebesideal geprägt sind, unter brasilianischen Studenten dagegen am ehesten dem passionierten Liebesiedel entsprechen.
-
''Leave me alone lesions'' of the bone. Part 1
International Nuclear Information System (INIS)
Hamers, S.; Freyschmidt, J.
2002-01-01
''Leave me alone lesions'' are found in such a wide variety of diseases that the survey is published in two parts, in order to be able to devote appropriate space to the description of the various lesions. This part 1 discusses the ''leave me alone lesions'' involved in juvenile bone cysts, metaphyseal cortical irregularities, fibrous metaphyseal defect (FMD), calcifying osteochondroma, osteomas and lipomas. Part 2 will be published in the next following issue of Radiologie up2date, (No.3/2002). (orig./CB) [de
-
Energy Technology Data Exchange (ETDEWEB)
Meier, N. [Krombach Armaturen, Kreuztal (Germany)
2000-03-01
Over many years, zero-leakage butterfly valves have eminently proven their capabilities in a large range of elevated-temperature and elevated-pressure processes. This article examines the basic design differences between various butterfly valves. These differences are, among other factors, important indicators of the suitability of the various valve types for their use in industry. (orig.) [German] Dichtschliessende Absperrklappen haben sich ueber Jahre in vielen Prozessen, die unter hoeherem Druck und hoeherer Temperatur ablaufen, bestens bewaehrt. Der Beitrag zeigt die grundsaetzlichen konstruktiven Unterschiede dichtschliessender Absperrklappen. Diese Unterschiede sind unter anderem Indikatoren fuer die Prozesstauglichkeit von Absperrklappen in der Industrie. (orig.)
-
Metabolism of Sialic Acid by Bifidobacterium breve UCC2003
Egan, Muireann; O'Connell Motherway, Mary; Ventura, Marco
2014-01-01
Bifidobacteria constitute a specific group of commensal bacteria that inhabit the gastrointestinal tracts of humans and other mammals. Bifidobacterium breve UCC2003 has previously been shown to utilize several plant-derived carbohydrates that include cellodextrins, starch, and galactan. In the present study, we investigated the ability of this strain to utilize the mucin- and human milk oligosaccharide (HMO)-derived carbohydrate sialic acid. Using a combination of transcriptomic and functional genomic approaches, we identified a gene cluster dedicated to the uptake and metabolism of sialic acid. Furthermore, we demonstrate that B. breve UCC2003 can cross feed on sialic acid derived from the metabolism of 3′-sialyllactose, an abundant HMO, by another infant gut bifidobacterial strain, Bifidobacterium bifidum PRL2010. PMID:24814790
-
Radio-toxicological analysis of urine; Analyses radiotoxicologiques urinaires
Energy Technology Data Exchange (ETDEWEB)
Jeanmaire, L.; Jammet, H. [Commissariat a l' energie atomique et aux energies alternatives - CEA (France)
1959-07-01
The article is divided into two parts: general and technical. In the general part, a study of the behaviour of radioisotopes in the organism shows the hazards of internal contamination. In addition, the principle of the different methods for the estimation of this contamination is indicated. The second part, which is purely technical, describes some of the methods for urine analysis used in the S.H.A.R.P. radiotoxicology laboratory at the Saclay Nuclear Research Centre. The techniques relate to {sup 239}Pu, {sup 226}Ra, {sup 90}Sr, natural Th, natural U and {sup 233}U. Reprint of a paper published in Annales de Radiologie, Vol. 2, no. 9-10, p. 703-722, 1959 [French] L'article est divise en deux parties: generalites et techniques. Dans les generalites, l'etude du comportement des radioelements dans l'organisme met en evidence les dangers de la contamination interne. De plus le principe des differents moyens permettant d'apprecier cette contamination est indique. La seconde partie, purement technique, expose un certain nombre de methodes d'analyse urinaire utilisees au laboratoire de radiotoxicologie du S.H.A.R.P. au Centre d'Etudes nucleaires de Saclay. Les techniques concernent {sup 239}Pu, {sup 226}Ra, {sup 90}Sr, Th naturel, U naturel et {sup 233}U. Reproduction d'un article publie dans les Annales de Radiologie, Vol. 2, no. 9-10, p. 703-722, 1959.
-
Directory of Open Access Journals (Sweden)
BENYAHIA T. M.
2002-07-01
Full Text Available Après avoir souligné, d’une manière concrète, les difficultés de la dissection et le repérage par les méthodes classiques, nous avons essayé dans ce travail d’aborder l’apport de la macroscopie indirecte de l’animal grâce à la radiologie (échographie, tomoscanner, lavement baryté afin de vérifier les donnés anatomiques sur l’écrevisse à pattes rouges, complété par des techniques microscopiques. Dans notre travail, l’adaptation pour l’écrevisse de techniques nouvelles de radiologie (tomoscanner et échographie complétées par les études d’histologie (colorations et immunohistochimie ont permis de se rendre compte des possibilités qu’elles offrent pour l’exploration dynamique et le repérage précis des organes et pour le diagnostic de maladies histopathologiques et ceci sans porter atteinte à l’animal. Le but de cette approche est de mettre au point des moyens d’investigation sur l’animal vivant pour mieux cerner les éventuels états pathologiques touchant surtout ses organes profonds et contribuer ainsi à préserver cette espèce menacée par la pollution des milieux astacicoles et par la sécheresse persistante que connaît le Maroc ces dernières années.
-
2013-08-19
... Organization (HMO) Benefit--Prime Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and... Enrollment Fee Exemption for Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services [[Page 50360
-
रत्नागिरी के कालबादेवी खाडी की ख्ननिज सम्पदा पर मान्सून का प्रभाव
Digital Repository Service at National Institute of Oceanography (India)
Valsangkar, A.B.; Fernandes, D.
¡ & em`X ‘mZgyZ H$s n[aU{V Ho$ ~mX Im‹S>r ‘| VoµO ~hmd (currents) H$s ewê$AmV hmoZm BgH$m H$maU hmo gH$Vm h¡ & à‘wI eãX: aËZm{Jar I{ZO, VbN>Q>, Bë‘oZmBQ>, ‘¡¾oQ>mBQ>, n`m©daU n[aM` 1-12 ^maV Ho$ n{ü‘ VQ> na H$m|H$U àXoe H$s aoV Bë‘oZmBQ> Am¡a ‘¡¾o...$m Cn`moJ H$aHo$ ^mar I{ZO gm‘J«r H$s à{VeV ‘mÌm {ZYm©[aV H$s JB© & `hm± gZ² 2006 Ho$ OZdar (g§H«$‘U H$mb), ‘B© (nyd© ‘mZgyZ) Am¡a AŠQy>~a (‘mZgyZ Ho$ ~mX) Ho$ Xm¡amZ {bE JE I{ZO Ho$ Z‘yZm| H$mo VwbZmË‘H$ AÜ``Z ‘§o em{‘b {H$`m h¡ & n[aUm‘ ‘¡¾oQ>mBQ> H...
-
Chung, Sukyung; Lesser, Lenard I; Lauderdale, Diane S; Johns, Nicole E; Palaniappan, Latha P; Luft, Harold S
2015-01-01
Under the Affordable Care Act (ACA), Medicare coverage expanded in 2011 to fully cover annual preventive care visits. We assessed the impact of coverage expansion, using 2007-13 data from primary care patients of Medicare-eligible age at the Palo Alto Medical Foundation (204,388 patient-years), which serves people in four counties near San Francisco, California. We compared trends in preventive visits and recommended preventive services among Medicare fee-for-service and Medicare health maintenance organization (HMO) patients as well as non-Medicare patients ages 65-75 who were covered by private fee-for-service and private HMO plans. Among Medicare fee-for-service patients, the annual use of preventive visits rose from 1.4 percent before the implementation of the ACA to 27.5 percent afterward. This increase was significantly larger than was seen for patients in the other insurance groups. Nevertheless, rates of annual preventive care visit use among Medicare fee-for-service patients remained 10-20 percentage points lower than was the case for people with private coverage (43-44 percent) or those in a Medicare HMO (53 percent). ACA policy changes led to increased preventive service use by Medicare fee-for-service beneficiaries, which suggests that Medicare coverage expansion is an effective way to increase seniors' use of preventive services. Project HOPE—The People-to-People Health Foundation, Inc.
-
Fabrication and characterization of special microstructured fibers
Kobelke, J.; Schuster, K.; Schwuchow, A.; Litzkendorf, D.; Spittel, R.; Kirchhof, J.; Bartelt, H.
2011-05-01
Microstructured optical fibers (MOFs) as a novel type of light guiding media typically combine structural elements with very different chemical and optical behavior, e.g. silica - air, silica - high refractive index glasses. The applicative potential is very manifold: devices for telecommunication, nonlinear optics, sensing devices, fiber based gas lasers, etc. We report about preparation and characterization of selected total internal reflection (TIR) guiding MOFs: Air Clad Fiber, Suspended Core Fiber and heavy metal oxide (HMO) glass core MOFs. We fabricated Air Clad Fibers with extreme air fraction. The bridge width of about 0.13 μm corresponds to a numerical aperture (NA) of about 0.6. Suspended core fibers for evanescent sensing were prepared by pressurized drawing of arrangements of three and four capillaries. By inflating the cavities the NA was increased up to 0.68. Material combined MOFs were prepared for nonlinear application (e.g. supercontinuum generation) with lanthanum aluminum silicate glass core. Thermochemical and optical behaviors of high nonlinear core glass candidates were investigated for alumina concentration up to 20 mol% and lanthanum oxide concentration up to 24 mol% in silica matrix. The manufactured HMO glass core MOF with a La2O3 concentration of 10 mol% shows a similar background loss level like the unstructured HMO glass fiber about 1 dB/m.
-
Exposure Buildup Factors for Heavy Metal Oxide Glass: A Radiation Shield
DEFF Research Database (Denmark)
Manonara, S. R.; Hanagodimath, S. M.; Gerward, Leif
2011-01-01
Gamma ray exposure buildup factors for three Heavy Metal Oxide (HMO) glass systems, viz. PbO-Bi2O3-B2O3, PbO-B2O3, and Bi2O3-B2O3 glasses are presented. The computations were done by interpolation method using the Geometric Progression fitting formula and ANSI/ANS-6.4.3 library for the energy ran...... of graphs. Buildup factors of these HMO glasses cannot be found in any standard database, but they are useful for practical calculations in gamma ray shield designs, and they also, help to determine and control the thickness of the shielding material used.......Gamma ray exposure buildup factors for three Heavy Metal Oxide (HMO) glass systems, viz. PbO-Bi2O3-B2O3, PbO-B2O3, and Bi2O3-B2O3 glasses are presented. The computations were done by interpolation method using the Geometric Progression fitting formula and ANSI/ANS-6.4.3 library for the energy range...... from 0.015 to 15 MeV, up to penetration depths of 40 mfp (mean free path). The buildup factors have been studied as functions of incident photon energy and penetration depth. The variations in the buildup factor, for all the glass systems, in different energy regions; have been presented in the form...
-
International Nuclear Information System (INIS)
Alberts, W.G.; Dietze, G.; Hohlfeld, K.
1995-01-01
The development of quantities and units in the field of radiation protection dosimetry is demonstrated by some examples. This development is strongly connected with work performed at the PTR/PTB and the work of the ''Normenausschuss Radiologie (NAR) im DIN''. In the following the new radiation protection operational quantities are described which have been recommended by the international commissions ICRU and ICRP for use in area and individual monitoring of external radiation. It is aimed to introduce these quantities in Germany in 1995 - also in legal metrology. (orig.) [de
-
Incidental findings in musculoskeletal radiology; Zufallsbefunde in der muskuloskeletalen Radiologie
Energy Technology Data Exchange (ETDEWEB)
Wuennemann, F.; Rehnitz, C.; Weber, M.A. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)
2017-04-15
Increasing numbers of conventional X-rays, computed tomography and magnetic resonance imaging in the inpatient, outpatient and scientific routine leads to an increasing number of incidental findings. The correct interpretation of these incidental findings with respect to the relevance and the evaluation concerning further work-up is an important task of radiologists. Description of common incidental findings in musculoskeletal imaging and their clinical classification. A PubMed literature search was performed using the following terms: incidental findings, population-based imaging, musculoskeletal imaging, non-ossifying fibroma, enchondroma, osteodystrophia deformans, chondrosarcoma, fibrous dysplasia, simple bone cyst, unicameral bone cyst, solitary bone cyst, aneurysmal bone cyst, vertebral hemangioma, bone island, osteopoikilosis, Tarlov cyst and diffuse idiopathic skeletal hyperostosis (DISH). Incidental findings are observed in up to 40% of imaging procedures. In up to 6% these incidental findings involve the skeletal system. Common incidental findings are discussed and their clinical relevance is explained. (orig.) [German] Mit steigender Menge an konventionellen Roentgen- sowie CT- und MRT-Bildern im stationaeren, ambulanten und wissenschaftlichen Alltag steigt unweigerlich auch die Zahl der Zufallsbefunde. Die korrekte Einordnung bzgl. deren Relevanz, ob eine weitere Abklaerung notwendig ist oder nicht, stellt eine wichtige Aufgabe des Radiologen dar. Vorstellung haeufiger Zufallsbefunde des muskuloskeletalen Systems und deren klinische Einordnung. Pubmed-Literaturrecherche zu den Stichworten ''incidental findings'', ''population-based imaging'', ''musculoskeletal imaging'', ''non-ossifying fibroma'', ''enchondroma'', ''osteodysthrophia deformans'', ''chondrosarcoma'', ''fibrous dysplasia'', ''simple bone cyst'', ''unicameral bone cyst'', ''solitary bone cyst'', ''aneurysmal bone cyst'', ''vertebral hemangioma'', ''bone island'', ''osteopoikilosis'', ''Tarlov cyst'', ''diffuse idiopathic skeletal hyperostosis'' (DISH). Bei bis zu 40 % der Schnittbildgebungen finden sich Zufallsbefunde. Etwa 6 % der Zufallsbefunde entfallen dabei auf das Skelett. Haeufige Zufallsbefunde und deren klinische Relevanz werden dargestellt. (orig.)
-
Directory of Open Access Journals (Sweden)
Beer AM
2014-01-01
Full Text Available Unter den bei Wechseljahresbeschwerden eingesetzten Phytotherapeutika ist die Traubensilberkerze (Cimicifuga racemosa, Actaea racemosa am besten dokumentiert. Die Monographie des Herbal Medicinal Product Committee der Europäischen Arzneimittelbehörde bestätigt das positive Nutzen-Risiko-Profil von Cimicifugaracemosa-(CR- Arzneimitteln. Voraussetzung ist deren Herstellung unter GMP-Bedingungen mit nachweislicher pharmazeutischer Qualität. In einer aktualisierten Metaanalyse unter Berücksichtigung aller geeigneten randomisierten kontrollierten Studien (RCTs zeigt CR eine signifikant bessere Wirksamkeit bei der Besserung klimakterischer Beschwerden im Vergleich zu Placebo. Ein aktueller Review zur Wirksamkeit und Sicherheit von CR bei Wechseljahresbeschwerden differenziert erstmalig zwischen Extrakten, deren Qualität (nachgewiesen durch den Arzneimittelstatus und Indikation und wird somit den Besonderheiten der Phytotherapie gerecht. Hierbei erwiesen sich alle in klinischen Studien untersuchten CR-Extrakte als sicher und gut verträglich. Jedoch konnten nur qualitativ hochwertige, offiziell geprüfte, zugelassene CR-Arzneimittel ihre Wirksamkeit und somit ein positives Nutzen-Risiko-Profil nachweisen. Konsistent konfirmatorische Evidenz mit Oxford-Evidenzlevel 1 und höchstem Empfehlungsgrad A erbringt hierbei nur der isopropanolische Cimicifuga-racemosa-Spezialextrakt (iCR, der in vielen Studien an 11.000 Patientinnen untersucht wurde.
-
Energy Technology Data Exchange (ETDEWEB)
Riedel, G. [Institut fuer Korrosionsschutz GmbH, Dresden (Germany); Stenner, F.; Brill, U. [Krupp-VDM GmbH, Werdohl (Germany)
2001-07-01
High alloyed superaustenitic steels and NiCrMo alloys are recommended in consequence of the results of extensive laboratory corrosion experiments under the strong corrosive conditions with up to 360 g chloride content at temperatures up to 85 C. Because results of laboratory corrosion tests are only of limited relevance to the behaviour in practice, field tests were carried out with immersion of welded materials and of heat exchanger tubes under operating conditions of an evaporation plant for waste water from flue gas desulphurization of a coal-fired power plant. Different kinds of high alloy superaustenitic steels and NiCrMo alloys were studied as TIG-welded specimens in immersion tests. (orig.) [German] Hochlegierte Sonderedelstaehle und NiCrMo-Legierungen empfehlen sich aufgrund der Ergebnisse umfassender Laboruntersuchungen unter den stark korrosiven Bedingungen fuer Eindampfanlagen fuer Abwasser aus der Nassreinigung von Rauchgasen von Grossfeuerungsanlagen mit bis zu 360 g/l Chloridgehalt und Temperaturen bis zu 85 C. Weil aber Ergebnisse von Laborpruefungen nur begrenzte Aussagefaehigkeit fuer das Verhalten unter Praxisbedingungen haben, wurden Feldversuche mit der Auslagerung geschweisster Werkstoffe und von Waermetauscherrohren unter Betriebsbedingungen einer Eindampfanlage fuer Abwasser aus der Rauchgasentschwefelung eines kohlebefeuerten Kraftwerks durchgefuehrt. (orig.)
-
Screening natural libraries of human milk oligosaccharides against lectins using CaR-ESI-MS.
El-Hawiet, Amr; Chen, Yajie; Shams-Ud-Doha, Km; Kitova, Elena N; Kitov, Pavel I; Bode, Lars; Hage, Naim; Falcone, Franco H; Klassen, John S
2018-01-15
Human milk oligosaccharides (HMOs) afford many health benefits to breast-fed infants, such as protection against infection and regulation of the immune system, through the formation of non-covalent interactions with protein receptors. However, the molecular details of these interactions are poorly understood. Here, we describe the application of catch-and-release electrospray ionization mass spectrometry (CaR-ESI-MS) for screening natural libraries of HMOs against lectins. The HMOs in the libraries were first identified based on molecular weights (MWs), ion mobility separation arrival times (IMS-ATs) and collision-induced dissociation (CID) fingerprints of their deprotonated anions. The libraries were then screened against lectins and the ligands identified from the MWs, IMS-ATs and CID fingerprints of HMOs released from the lectin in the gas phase. To demonstrate the assay, four fractions, extracted from pooled human milk and containing ≥35 different HMOs, were screened against a C-terminal fragment of human galectin-3 (hGal-3C), for which the HMOs specificities have been previously investigated, and a fragment of the blood group antigen-binding adhesin (BabA) from Helicobacter pylori, for which the HMO specificities have not been previously established. The structures of twenty-one ligands, corresponding to both neutral and acidic HMOs, of hGal-3C were identified; all twenty-one were previously shown to be ligands for this lectin. The presence of HMO ligands at six other MWs was also ascertained. Application of the assay to BabA revealed nineteen specific HMO structures that are recognized by the protein and HMO ligands at two other MWs. Notably, it was found that BabA exhibits broad specificity for HMOs, and recognizes both neutral HMOs, including non-fucosylated ones, and acidic HMOs. The results of competitive binding experiments indicate that HMOs can interact with BabA at previously unknown binding sites. The affinities of eight purified HMOs for BabA were
-
Meehan, Courtney L; McGuire, Mark A; Foster, James; Sellen, Daniel W; Kamau-Mbuthia, Elizabeth W; Kamundia, Egidioh W; Mbugua, Samwel; Moore, Sophie E; Prentice, Andrew M; Kvist, Linda J; Otoo, Gloria E; Brooker, Sarah L; Price, William J; Shafii, Bahman; Placek, Caitlyn; Lackey, Kimberly A; Robertson, Bianca; Ruíz, Lorena; Pareja, Rossina G; Bode, Lars
2017-01-01
Background: Human milk is a complex fluid comprised of myriad substances, with one of the most abundant substances being a group of complex carbohydrates referred to as human milk oligosaccharides (HMOs). There has been some evidence that HMO profiles differ in populations, but few studies have rigorously explored this variability. Objectives: We tested the hypothesis that HMO profiles differ in diverse populations of healthy women. Next, we examined relations between HMO and maternal anthropometric and reproductive indexes and indirectly examined whether differences were likely related to genetic or environmental variations. Design: In this cross-sectional, observational study, milk was collected from a total of 410 healthy, breastfeeding women in 11 international cohorts and analyzed for HMOs by using high-performance liquid chromatography. Results: There was an effect of the cohort (P 4 times higher in milk collected in Sweden than in milk collected in rural Gambia (mean ± SEM: 473 ± 55 compared with 103 ± 16 nmol/mL, respectively; P < 0.05), and disialyllacto-N-tetraose (DSLNT) concentrations ranged from 216 ± 14 nmol/mL (in Sweden) to 870 ± 68 nmol/mL (in rural Gambia) (P < 0.05). Maternal age, time postpartum, weight, and body mass index were all correlated with several HMOs, and multiple differences in HMOs [e.g., lacto-N-neotetrose and DSLNT] were shown between ethnically similar (and likely genetically similar) populations who were living in different locations, which suggests that the environment may play a role in regulating the synthesis of HMOs. Conclusions: The results of this study support our hypothesis that normal HMO concentrations and profiles vary geographically, even in healthy women. Targeted genomic analyses are required to determine whether these differences are due at least in part to genetic variation. A careful examination of sociocultural, behavioral, and environmental factors is needed to determine their roles in this regard. This
-
Zwischen Commonsense und Wissenschaft Mathematik in der Erziehungsphilosophie A. N. Whiteheads
Sölch, Dennis
Obwohl Whitehead heute wie selbstverständlich als Philosoph rezipiert wird, so hat er seine wissenschaftliche Laufbahn doch als Mathematiker begonnen. Lange Zeit war er gemeinsam mit Bertrand Russell als Autor der Principia Mathematica unter Mathematikern und mathematischen Logikern deutlich besser bekannt als unter Philosophen. Doch selbst von denjenigen, die sich mit Whiteheads Überlegungen zur Metaphysik, zur Wissenschaftsgeschichte und zur Theologie befassen, werden seine Schriften zur Philosophie von Erziehung und Bildung häufig kaum beachtet. So entgeht es leicht, dass Whitehead nicht nur ein auf theoretischem Gebiet brillanter Mathematiker war, sondern sein theoretisches Fachwissen im Hinblick auf pädagogische und didaktische Relevanz fortwährend reflektiert hat.
-
Preferred Provider Organization (PPO) Plans
... Find & compare doctors, hospitals, & other providers Preferred Provider Organization (PPO) Plans How PPO Plans Work A Medicare ... extra for these benefits. Related Resources Health Maintenance Organization (HMO) Private Fee-for-Service (PFFS) Special Needs ...
-
Metabolism of sialic acid by Bifidobacterium breve UCC2003.
Egan, Muireann; O'Connell Motherway, Mary; Ventura, Marco; van Sinderen, Douwe
2014-07-01
Bifidobacteria constitute a specific group of commensal bacteria that inhabit the gastrointestinal tracts of humans and other mammals. Bifidobacterium breve UCC2003 has previously been shown to utilize several plant-derived carbohydrates that include cellodextrins, starch, and galactan. In the present study, we investigated the ability of this strain to utilize the mucin- and human milk oligosaccharide (HMO)-derived carbohydrate sialic acid. Using a combination of transcriptomic and functional genomic approaches, we identified a gene cluster dedicated to the uptake and metabolism of sialic acid. Furthermore, we demonstrate that B. breve UCC2003 can cross feed on sialic acid derived from the metabolism of 3'-sialyllactose, an abundant HMO, by another infant gut bifidobacterial strain, Bifidobacterium bifidum PRL2010. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
-
Directory of Open Access Journals (Sweden)
Steven P. Wallace
2001-07-01
Full Text Available Objetivos. Este estudio usa tres dimensiones de acceso a los servicios médicos que contribuyen a una distribución social equitativa: (disponibilidad, accesibilidad y aceptabilidad para examinar la equidad de dos sistemas médicos en los Estados Unidos de América (EE. UU.: el sistema tradicional de indemnización, en el que se paga una "cuota por servicio" o "pago por acto" (PPA y el nuevo sistema de organizaciones de servicios médicos prepagados (health maintenance organizations: HMO. Se compara la equidad entre tres grupos de adultos mayores: euroamericanos (el grupo mayoritario y latinoamericanos y afroamericanos (las minorías. Métodos. Los datos provienen de una encuesta nacional representativa que incluye un total de 858 latinoamericanos, 970 afroamericanos y 8 622 euroamericanos de la tercera edad (65 años o más de áreas urbanas. Para comparar los grupos se usan la ji² y la regresión logística. Resultados. Los datos indican que las personas de la tercera edad pertenecientes a grupos minoritarios, caracterizadas por tener los recursos económicos más bajos y mayores necesidades de servicios médicos, se benefician más en el sistema de HMO porque este les proporciona mayor disponibilidad y acceso a los servicios médicos en comparación con el sistema de PPA. Esta mejora se debe a que el sistema de HMO reduce las barreras económicas para los pacientes. Sin embargo, los latinoamericanos afiliados a HMO en EE. UU. manifiestan una menor satisfacción con sus médicos de cabecera. Conclusiones. El sistema de HMO incrementa el acceso a la atención médica pero no necesariamente mejora la calidad de la relación entre paciente y médico para las personas de la tercera edad de EE. UU. pertenecientes a grupos minoritarios. Este estudio demuestra que es posible evaluar la equidad de los servicios médicos durante un proceso de reforma y, que para asegurarse de su validez, se deben incluir poblaciones vulnerables y diferentes
-
2010-10-01
... section 1876 of the Act and subpart L of this part. Demonstration project means a demonstration project... illness. (2) Are such that the time required to reach the HMO's or CMP's providers or suppliers (or...
-
Indian Academy of Sciences (India)
of quantitative molecular orbital theory is the Huckel MO (HMO) method. Application of the ... description ofthe non-ideal behaviour of ionic solution is the well-known Debye-Huckel theory. Many students react with .... symposium was planned'.
-
Management information systems: their role in the marketing activities of HMOs.
Aronow, D B
1988-01-01
HMOs are particularly dependent on their information resources in providing cost-effective, high quality, accessible care. Understanding the role of MIS in HMO marketing activities may guide administrators in evaluating information systems applications within their organizations.
-
42 CFR 417.101 - Health benefits plan: Basic health services.
2010-10-01
...; and (8) Preventive health services, which must be made available to members and must include at least... HMO is required only to make a good-faith effort to provide or arrange for the provision of the...
-
Energy Technology Data Exchange (ETDEWEB)
Huebner, J
1996-07-01
der Abstroemwinkelverteilung zusammengestellt und mit den Messungen verglichen. Dabei ergab sich eine grosse Streubreite der Korrelationen, die auf eine unterschiedliche Bewertung der Spaltweite und der aerodynamischen Belastung zurueckzufuehren ist. Die haeufig anzutreffende Trennung in einen reinen Spaltverlust und einen von der Spaltstroemung unbeeinflussten Sekundaerverlust erscheint physikalisch nicht sinnvoll. Unter Beruecksichtigung der experimentellen Ergebnisse wurden verbesserte Spaltverlust- und Abstroemwinkelkorrelationen erarbeitet. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Palzer, Andreas
2016-07-01
With the aim of reducing greenhouse gas emissions, comprehensive climate protection measures have already been adopted both nationally and internationally. This raises the question of how economically and ecologically useful system infrastructure looks, which at the same time ensures the supply reliability of all consumers. The regenerative energy model (REMod) presented in this book has been developed to provide answers. The sectors electricity, heat, transport and industry are considered for the first time simultaneous in an energy system model. In particular, in order to satisfy the criterion of reliability of supply, the model calculates the energy flows in hourly resolution for the period from today (2015) to 2050. The system is optimized with regard to minimum overall costs and under the boundary condition that a maximum set quantity of permitted greenhouse gas emissions is not exceed. On the example of Germany (REMod-D), the results show that, in particular, the interaction of the sectors can lead to strong differences in the design of the system infrastructure. [German] Mit dem Ziel den Ausstoss der Treibhausgase zu reduzieren, wurden bereits national wie international umfangreiche Klimaschutzmassnahmen verabschiedet. Hieraus ergibt sich die Frage wie eine oekonomisch und oekologisch sinnvolle Systeminfrastruktur aussieht, die gleichzeitig die Versorgungssicherheit aller Verbraucher gewaehrleistet. Das in diesem Buch vorgestellte Regenerative Energien Modell (REMod) wurde entwickelt um hierauf Antworten zu liefern. Beruecksichtigt werden erstmalig in einem Energiesystemmodell die Sektoren Strom, Waerme, Verkehr und Industrie gleichzeitig. Insbesondere um dem Kriterium der Versorgungssicherheit gerecht zu werden, berechnet das Modell die Energiefluesse in stuendlicher Aufloesung fuer den Zeitraum von heute (2015) bis 2050. Optimiert wird das System hinsichtlich minimaler Gesamtkosten und unter der Randbedingung, dass eine maximal vorgegebene Menge erlaubter
-
Gaskins, Matthew; Dittmann, Martin; Eisert, Lisa; Werner, Ricardo Niklas; Dressler, Corinna; Löser, Christoph; Nast, Alexander
2018-03-01
Laut einer Befragung im Jahre 2012 war der Umgang mit Antithrombotika bei dermatochirurgischen Eingriffen in Deutschland sehr heterogen. 2014 wurde erstmals eine evidenzbasierte Leitlinie zu diesem Thema veröffentlicht. Es wurde eine anonyme Befragung derselben Stichprobe zum Umgang mit Antithrombotika sowie zu Kenntnissen der Leitlinie durchgeführt. Die Ergebnisse wurden als relative Häufigkeiten berichtet und denen aus 2012 gegenübergestellt. 208 Antwortbögen wurden ausgewertet (Rücklaufquote: 36,6 %). Die große Mehrheit der Dermatologen erklärte, kleinere Eingriffe unter Fortführung der Therapie mit Phenprocoumon, niedrig dosierter Acetylsalicylsäure (≤ 100 mg) und Clopidogrel sowie mit direkten oralen Antikoagulanzien durchzuführen. Bei größeren Eingriffen war der Umgang hingegen weiterhin heterogen, insbesondere unter niedergelassenen Dermatologen. Der Anteil der Dermatologen, die Phenprocoumon, Acetylsalicylsäure und Clopidogrel leitlinienkonform verwendeten, hat sich insgesamt vergrößert. Führten 2012 beispielsweise 53,8 % der Klinikärzte bzw. 36,3 % der niedergelassenen Dermatologen eine große Exzision unter Fortführung der Therapie mit niedrig dosierter Acetylsalicylsäure durch, taten dies 2017 90,2 % bzw. 57,8 % (Phenprocoumon: 33,8 % bzw. 11,9 % auf 63,9 % bzw. 29,9 %; Clopidogrel: 36,9 % bzw. 23,2 % auf 63,9 % bzw. 30,6 %). Unter den Klinikärzten war ein hoher Anteil mit der Leitlinie vertraut und fand diese hilfreich. Eine Zunahme des leitlinienkonformen Verhaltens war bei allen Eingriffen zu verzeichnen. Bei größeren Eingriffen zeigte sich trotz deutlicher Verbesserung die Notwendigkeit verstärkter Anstrengungen zur Leitlinienumsetzung bzw. zur Identifizierung von Implementierungsbarrieren. © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
-
Managed care market share and cesarean section rates in the United States: is there a link?
Hueston, W J; Sutton, A
2000-11-01
After peaking during the early 1980s, cesarean section rates in the United States have been falling for the last decade. At the same time, managed care enrollment has increased dramatically. This study examines whether managed care penetration in local markets is associated with lower cesarean section rates in those geographic area. A cross-sectional comparison of cesarean section rates and health maintenance organization (HMO) market penetration in 61 selected metropolitan areas in the United States was conducted. National birth certificate data for 1996 were used to calculate crude and race-adjusted cesarean section rates for residents in each area. No relationship between overall cesarean section rates in the metropolitan areas and managed care penetration was observed. Subanalyses of racial groups demonstrated the existence of a weak association between managed care penetration and cesarean section rates for white women (21.2% for the highest quartile of HMO penetration, compared with 19.1% for the lowest quartile; P = .03), but not for African-Americans or other minorities. Managed care penetration in a market may have an association with cesarean section rates for white women, but the strength of this relationship is small. Even if managed care delivery systems reduce cesarean section rates in their own populations, this change is likely to have only a small impact on overall cesarean rates. HMO penetration is unlikely to influence national cesarean section rates, nor does it appear to explain state variations in these rates.
-
Energy Technology Data Exchange (ETDEWEB)
Huettenrauch, Jens; Zoellner, Sylvana; Mueller-Syring, Gert [DBI Gastechnologisches Institut gGmbH, Freiberg (Germany); and others
2015-07-01
One of the main challenges in the energy transition is to integrate the increasing based on volatile renewable energy generated power in market and network. Based on actual distribution networks in Emsland in the study presented below was investigated, what contribution an intelligent coupling of electricity and gas distribution networks by means of power to gas (PtG) systems can do to solve this challenge. The investigations have shown, among other things, that the network expansion costs in particular can be significantly reduced by the coupling when otherwise an oversizing would be done by discrete power grid expansion measures. [German] Eine der wesentlichen Herausforderung bei der Energiewende besteht darin, die zunehmend auf volatilen erneuerbaren Energien basierende Stromerzeugung in Markt und Netz zu integrieren. Anhand realer Verteilungsnetze im Emsland wurde in der im Folgenden vorgestellten Studie untersucht, welchen Beitrag eine intelligente Kopplung von Strom- und Gasverteilungsnetzen mittels Power-to-Gas (PtG)-Anlagen zur Loesung dieser Herausforderung leisten kann. Die Untersuchungen haben unter anderem gezeigt, dass durch die Kopplung die Netzausbaukosten insbesondere dann signifikant reduziert werden koennen, wenn andernfalls eine Ueberdimensionierung durch diskrete Stromnetzausbaumassnahmen erfolgen wuerde.
-
42 CFR 417.126 - Recordkeeping and reporting requirements.
2010-10-01
... generally accepted accounting principles, and must include appropriate opinions and notes. (4) Upon written... in accordance with generally accepted accounting principles, and must include appropriate opinions... sound operation. (6) Other matters that CMS may require. (b) Significant business transactions. Each HMO...
-
The impact of the fee-for-service reimbursement system on the ...
African Journals Online (AJOL)
three medical aid schemes in which providers are paid on a fee-far-service basis. ... The majority of health care providers in the private sector in. South Mrica are ... hospital, which bills the HMO for all services and accommo- dation expenses.
-
Glossary of Managed Care Definitions
... or treatment provided to a plan member. Coverage : decision making process that identifies what services or products are ... themselves and pay a monthly premium for it. Mental health care : medical ... abuse. Mixed model or network HMO : a managed care plan that ...
-
Genetic screening of EXT1 and EXT2 in Cypriot families with ...
Indian Academy of Sciences (India)
RESEARCH NOTE. Genetic screening of EXT1 and EXT2 in Cypriot families with hereditary .... on samples from the HMO patient's parents in an attempt to establish .... Intragenic deletions involving single or multiple EXT1 or. EXT2 exons are ...
-
Produktionslogistik mit ERP-Systemen
Bauer, Jürgen
Im Folgenden werden die Teilprozesse der Produktionslogistik bei Eigenfertigung unter Einsatz des ERP-Systems SAP R/3 beschrieben. Dabei wird die häufigste Fertigungsart, die kundenanonyme Losfertigung, zugrundegelegt.
-
Identification of a new mutation in an Iranian family with hereditary multiple osteochondromas
Directory of Open Access Journals (Sweden)
Akbaroghli S
2016-12-01
Full Text Available Susan Akbaroghli,1,* Maryam Balali,2,* Behnam Kamalidehghan,3,4 Siamak Saber,4 Omid Aryani,5 Goh Yong Meng,6 Massoud Houshmand4 1Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, 2ENT and Head & Neck Research Center and Department, Iran University of Medical Sciences (IUMS, 3Medical Genetics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, 4Medical Genetics Department, National Institute for Genetic Engineering and Biotechnology, 5Department of Neuroscience, Iran Medical University, Tehran, Iran; 6Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia (UPM, Serdang, Malaysia *These authors contributed equally to this work Background: Hereditary multiple osteochondromas (HMO, previously named hereditary multiple exostoses (HME, is an autosomal dominant skeletal disorder characterized by the growth of multiple osteochondromas and is associated with bony deformity, skeletal growth reduction, nerve compression, restriction of joint motion, and premature osteoarthrosis. HMO is genetically heterogeneous, localized on at least three chromosomal loci including 8q24.1 (EXT1, 11p11-p13 (EXT2, and 19p (EXT3. The median age of diagnosis is 3 years; almost all affected individuals are diagnosed by age 12. The risk for malignant degeneration to osteochondrosarcoma increases with age, although the lifetime risk of malignant degeneration is low (~1%.Methods and results: This study was performed on an Iranian family with nine affected individuals from three consecutive generations. Here, the proband was an affected woman who received genetic counseling prior to pregnancy. All exons of the three genes were examined in the proband using polymerase chain reaction and sequencing methods (the last member of this family is a male with severe deformities and lesions, especially around his large joints. Exon 4 of EXT1 (c.1235 G>A was changed in affected
-
Nutzerorientiertes Management von materiellen und immateriellen Informationsobjekten
Hübsch, Chris
2001-01-01
Schaffung einer stabilen, erweiterbaren und skalierbaren Infrastruktur für die Bereitstellung von Diensten im Umfeld von Bibliotheken und ähnlichen wissensanbietenden Einrichtungen unter Verwendung von XML-RPC und Python.
-
Directory of Open Access Journals (Sweden)
Stephen Chan Teck Leong
2012-01-01
Full Text Available Aspects of the incidence and spread of the citrus disease huanglongbing (HLB in relation to the vector Diaphorina citri population fluctuation were studied from January 1999 to December 2001 seasons in a 0.8 ha citrus orchard at Jemukan (1° 33′N, 110° 41′E, Southwest Sarawak in Malaysia. In relation to insecticide and horticultural mineral oils (HMOs use, levels of HLB infection rose quite rapidly over the next 3 years in the unsprayed control and less rapidly in the other treatments such as imidacloprid, nC24HMO, and triazophos/cypermethrin/chlorpyrifos. Levels of HLB as determined by Polymerase Chain Reaction (PCR were 42.2%, 9.4%, 11.4%, and 22.7%, respectively. The effects of nC24HMO and conventional pesticides on the citrus psyllid population and parasitoids in citrus orchard were also determined.
-
The impact of non-IPA HMOs on the number of hospitals and hospital capacity.
Chernew, M
1995-01-01
Concentration in the hospital market could limit the success of health care reform strategies that rely on managed care to constrain costs. Hospital market capacity also is important because capacity affects both costs and the degree of price competition. Because managed care plans, particularly non-individual practice association (non-IPA) model HMOs, practice a less hospital-intensive style of care, consolidation and downsizing in the hospital market potentially will accompany managed care growth, influencing the long-run effectiveness of managed care cost-containment strategies. Using Standard Metropolitan Statistical Area (SMSA) data from 1982 and 1987, a 10-percentage point increase in non-IPA HMO market share is estimated to reduce the number of hospitals by about 4%, causing an approximate 5% reduction in the number of hospital beds. No statistically significant relationship is found between non-IPA HMO penetration rates and hospital occupancy rates.
-
Energy Technology Data Exchange (ETDEWEB)
Becker, Benjamin V. [Institut fuer Radiobiologie der Bundeswehr, Muenchen (Germany); Ulm Univ. (Germany); Lissek, Friedrich; Waldeck, Stephan [Bundeswehrzentralkrankenhaus Koblenz (Germany). Klinik fuer Radiologie und Neuroradiologie
2017-07-01
Interventional radiology and neuroradiology covers a variety of diagnostic and therapeutic methods. A minimal invasive percutaneous access under imaging guidance is common for all these methods. The legal regulations for quality assurance are reviewed, technical possibilities for dose reduction and the importance of modern radiation protection procedures are discussed.
-
The resurgence of selective contracting restrictions.
Marsteller, J A; Bovbjerg, R R; Nichols, L M; Verrilli, D K
1997-10-01
As managed care has spread, so has legislation to force plans to contract with any willing provider (AWP) and give patients freedom of choice (FOC). Managed care organizations' selective networks and provider integration reduce patient access to providers, along with provider access to paying patients, so many providers have lobbied for AWP-FOC laws. In opposition are managed care organizations (MCOs), which want full freedom to contract selectively to control prices and utilization. This article comprehensively describes laws in all fifty-one jurisdictions, classifies their relative strength, and assesses the implications of the laws. Most are relatively weak forms and all are limited in application by ERISA and the federal HMO Act. The article also uses an associative multivariate analysis to relate the selective contracting environments to HMO penetration rates, rural population, physician density, and other variables. States with weak laws also have higher HMO penetration and higher physician density, but smaller rural populations. We conclude that the strongest laws overly restrict the management of care, to the likely detriment of cost control. But where market power is rapidly concentrating, not restricting selective contracting could diminish long-term competition and patient access to care. In the face of uncertainty about the impact of these laws, an intermediate approach may be better than all or nothing. States should consider mandating that plans offer point-of-service options, for a separate premium. This option expands patient choice of plans at the time of enrollment and of providers at the time of care, yet maintains plans' ability to control core providers.
-
Meredith-Dennis, Laura; Xu, Gege; Goonatilleke, Elisha; Lebrilla, Carlito B; Underwood, Mark A; Smilowitz, Jennifer T
2018-02-01
When human milk is unavailable, banked milk is recommended for feeding premature infants. Milk banks use processes to eliminate pathogens; however, variability among methods exists. Research aim: The aim of this study was to compare the macronutrient (protein, carbohydrate, fat, energy), immune-protective protein, and human milk oligosaccharide (HMO) content of human milk from three independent milk banks that use pasteurization (Holder vs. vat techniques) or retort sterilization. Randomly acquired human milk samples from three different milk banks ( n = 3 from each bank) were analyzed for macronutrient concentrations using a Fourier transform mid-infrared spectroscopy human milk analyzer. The concentrations of IgA, IgM, IgG, lactoferrin, lysozyme, α-lactalbumin, α antitrypsin, casein, and HMO were analyzed by mass spectrometry. The concentrations of protein and fat were significantly ( p < .05) less in the retort sterilized compared with the Holder and vat pasteurized samples, respectively. The concentrations of all immune-modulating proteins were significantly ( p < .05) less in the retort sterilized samples compared with vat and/or Holder pasteurized samples. The total HMO concentration and HMOs containing fucose, sialic acid, and nonfucosylated neutral sugars were significantly ( p < .05) less in retort sterilized compared with Holder pasteurized samples. Random milk samples that had undergone retort sterilization had significantly less immune-protective proteins and total and specific HMOs compared with samples that had undergone Holder and vat pasteurization. These data suggest that further analysis of the effect of retort sterilization on human milk components is needed prior to widespread adoption of this process.
-
Energy Technology Data Exchange (ETDEWEB)
Sommer, S.A.; Geissler, R. [Kapp and Geissler Lawyers, Stuttgart (Germany); Stampfl, U.; Radeleff, B.A.; Kauczor, H.U.; Sommer, Christof M. [Univ. Hospital Heidelberg (Germany). Clinic for Diagnostic and Interventional Radiology; Wolf, M.B. [German Cancer Research Center (DKFZ), Heidelberg (Germany). Radiology (E010); Richter, G.M. [Klinikum Stuttgart (Germany). Clinic for Diagnostic and Interventional Radiology; Pereira, P.L. [SLK Kliniken, Heilbronn (Germany). Radiology, Minimally-invasive Therapies and Nuclearmedicine
2016-04-15
On February 26th, 2013 the patient law became effective in Germany. Goal of the lawmakers was a most authoritative case law for liability of malpractice and to improve enforcement of the rights of the patients. The following article contains several examples detailing legal situation. By no means should these discourage those persons who treat patients. Rather should they be sensitized to to various aspects of this increasingly important field of law. To identify relevant sources according to judicial standard research was conducted including first- and second selection. Goal was the identification of jurisdiction, literature and other various analyses that all deal with liability of malpractice and patient law within the field of Interventional Radiology - with particular focus on transarterial chemoembolization of the liver and related procedures. In summary, 89 different sources were included and analyzed. The individual who treats a patient is liable for an error in treatment if it causes injury to life, the body or the patient's health. Independent of the error in treatment the individual providing medical care is liable for mistakes made in the context of obtaining informed consent. Prerequisite is the presence of an error made when obtaining informed consent and its causality for the patient's consent for the treatment. Without an effective consent the treatment is considered illegal whether it was free of treatment error or not. The new patient law does not cause material change of the German liability of malpractice law.
-
Energy Technology Data Exchange (ETDEWEB)
Dresel, S.; Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin der Ludwig-Maximilians-Univ. Muenchen (Germany); Meisenzahl, E. [Psychiatrische Klinik der Ludwig-Maximilians-Univ. Muenchen (Germany); Scherer, J. [Bezirkskrankenhaus Haar (Germany)
2002-09-01
-motorische Nebenwirkungen hervorzurufen. Die Besetzung postsynaptischer Dopamin-D2-Rezeptoren wird als ein wesentlicher Aspekt der antipsychotischen Wirksamkeit der Neuroleptika angesehen. Diese koennen nuklearmedizinisch durch [I-123]IBZM-SPECT dargestellt werden. Fuer das typische Neuroleptikum Haloperidol wurde eine dosisabhaengige, exponentielle Besetzung der Dopamin-D2-Rezeptoren nachgewiesen. Ab einem Schwellenwert des spezifischen Bindungsindex von 0,4 (Norm: >0,95) zeigten mit einer Ausnahme alle untersuchten Patienten extrapyramidal-motorische Nebenwirkungen. Auch unter Therapie mit dem atypischen Neuroleptikum Clozapin ergab sich eine exponentielle Dosis-Wirkungsbeziehung mit jedoch einem deutlich flacheren Kurvenverlauf im Vergleich zu Haloperidol. Extrapyramidalmotorische Nebenwirkungen traten bei diesen Patienten nicht auf. Neuere, als atypisch eingestufte Neuroleptika wie Risperidon und Olanzapin zeigten ebenfalls eine exponenzielle Dosis-Wirkungsbeziehung, wobei deren Kurvenverlaeufe zwischen denen von Haloperidol und Clozapin lagen. Extrapyramidal-motorische Nebenwirkungen traten bei den letzteren Neuroleptika seltener als bei Haloperidol, bei Olanzapin nur bei einem Patienten in unserem eigenen Patientengut auf. Das pharmakologische Profil atypischer Neuroleptika zeichnet sich neben der Bindung an die postsynaptischen Dopamin-D2-Rezeptoren auch durch Bindung an Rezeptoren diverser anderer Neurotransmittersysteme, insbesondere des serotonergen Systems, aus. Somit ist wahrscheinlich, dass die niedrigere Inzidenz fuer extrapyramidal-motorische Nebenwirkungen bei atypischen Neuroleptika durch (orig.)
-
Albrecht, S.A.; Schols, H.A.; Heuvel, van den E.G.H.M.; Voragen, A.G.J.
2011-01-01
The characterization of oligosaccharides in the feces of breast-fed babies is a valuable tool for monitoring the gastrointestinal fate of human milk oligosaccharides (HMOs). In the present study we monitored fecal oligosaccharide profiles together with the HMO-profiles of the respective breast milks
-
Energy Technology Data Exchange (ETDEWEB)
Oestreich, A.E. [Children`s Hospital Medical Center, Cincinnati OH (United States). Dept. of Radiology
1998-04-01
A strategy is proposed for the dedicated interpretation of possible radiographic plain film signs that are suspicious for indicating child abuse. For each sign, the features `PRO` raise the question of abuse, while radiographic or clinical findings `CON` suggest an alternate explanation. Birth trauma, oesteogenesis imperfecta, rescue trauma, and metastatic neuroblastoma are among the many entities cited. A triad of situations may lead a radiologist to look systematically for changes from abuse; a triad of resolutions may result from the search. Periosteal reaction is the major factor in dating of fractures; physiologic periosteal reaction of infancy and periosteal reaction from previous fracture must be considered when so dating fractures. (orig.) [Deutsch] Es wird eine Strategie fuer die genaue Interpretation roentgenologischer Befunde, die auf eine Kindesmisshandlung hindeuten koennen, vorgeschlagen. Fuer jeden Befund werfen die unter `PRO` aufgefuehrten Merkmale die Frage nach einer Kindesmisshandlung auf, waehrend radiologische und klinische Befunde unter `CON` andere Erklaerungen nahelegen. Geburtstrauma, Osteogenesis imperfecta, Rettungstrauma und metastasierendes Neuroblastom sind unter den vielen zitierten Differentialdiagnosen. Drei moegliche Situationen koennen den Radiologen dazu veranlassen, systematisch nach Zeichen einer Kindesmisshandlung zu suchen, 3 moegliche Loesungen koennen aus dieser Suche hervorgehen. Eine Periostreaktion ist ein Kardinalbefund zur Datierung von Frakturen. Physiologische Periostreaktionen im fruehen Kindesalter und Periostreaktionen durch fruehere Frakturen muessen bei einer solchen Datierung von Frakturen mitbedacht werden. (orig.)
-
Study design in clinical radiology; Studiendesign in der klinisch radiologischen Forschung
Energy Technology Data Exchange (ETDEWEB)
Knopp, M.V.; Floemer, F.; Zuna, I.; Kaick, G. van [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg (Germany). Forschungsschwerpunkt Radiologische Diagnostik und Therapie
1998-04-01
Purpose: To review important aspects of study design in clinical radiology and to introduce the reader to the requirements of Good Clinical Practice (GCP). Methods: The European guidelines for GCP, the Declaration of Helsinki, the differentiation into study phases and the authors` own experience in open and sponsored clinical trials are the basis of this analysis. Results: Guideline such as GCP do not limit scientific freedom in research but define high standards for the well-being of patients and volunteers as well as guaranteeing scientific honesty. The benefits of defined data monitoring and the necessity of a prospective statistical concept are frequently underestimated. Conclusion: Correct study design has to be expected in radiology too. High standards guarantee accuracy and honesty of scientific studies. Only this can warrant the value for the patient of radiological diagnostics and therapy. (orig.) [Deutsch] Ziel dieses Artikels ist es, auf wesentliche Aspekte des Studiendesigns in der klinischen Radiologie aufmerksam zu machen und den Leser mit den Anforderungen der `good clinical practice` (GCP) vertraut zumachen. Die Europaeischen Richtlinien zur GCP, die Deklaration von Helsinki, die Einteilung in Studienphasen und eigene Erfahrungen in freien und gesponsorten klinischen Studien sind die Grundlage der Analyse. Richtlinien wie GCP und andere stellen keine Einschraenkung der wissenschaftlichen Freiheit dar, sondern definieren hohe Standards zum Schutz der Patienten und Probanden sowie zur Sicherstellung der wissenschaftlichen Wahrheit. Positive Auswirkungen eines definierten Datenmonitorings sowie die Notwendigkeit einer prospektiven statistischen Konzeption werden haeufig unterschaetzt. Regelrechtes Studiendesign ist auch in der Radiologie zu fordern. Hohe Standards garantieren die Aussagekraft und Wahrheit wissenschaftlicher Untersuchungen. Nur so kann die Wertigkeit radiologischer Diagnostik und Therapie fuer den Patienten sichergestellt werden. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Boehm, H.; Beyermann, G.; Bulling, M.
1996-07-01
Two NaNiCl{sub 2}-battery types including the battery controller and peripheral equipment have been developed for the application in fork lift trucks and driverless transportation. The batteries have been tested and evaluated on bench testing as well as in fork lift trucks and driverless trucks in practical application. The field tests have been performed by the subcontractors Still, Mercedes-Benz and Indumat. All test results have shown that the NaNiCl{sub 2}-battery (ZEBRA-battery) is well suited for the application in industrial traction. A series development together with a cost reduction programme have to be performed ahead of the introduction of the ZEBRA-battery into the market for industrial traction batteries. (orig.) [Deutsch] Im Rahmen des Vorhabens wurden zwei NaNiCl{sub 2}-Batterietypen, eine fuer die Anwendung in Gabelstaplern, die andere fuer den Einsatz in fahrerlosen Transportsystemen (FTS), einschliesslich des Batteriesteuergeraetes und der Batterieperipherie entwickelt. Die Batterien wurden auf Teststaenden im Labor sowie in Gabelstaplern und FTS unter Praxisbedingungen erprobt. Der praktische Einsatz erfolgte bei den Unterauftragnehmern Still, Mercedes-Benz und Indumat. Die Ergebnisse haben gezeigt, dass die NaNiCl{sub 2}-Batterie (ZEBRA-Batterie) fuer die Anwendung in Gabelstaplern und FTS geeignet ist. Insbesondere wurde nachgewiesen, dass die NaNiCl{sub 2}-Batterie im Gegensatz zu anderen Batteriesystemen einen Zweischichtbetrieb von Gabelstaplern ohne Batteriewechsel ermoeglicht. Vor Einfuehrung der ZEBRA-Batterie in den Flurfoerdermarkt muss die Serienentwicklung bei gleichzeitiger Senkung der Herstellkosten durchgefuehrt werden. (orig.)
-
DEFF Research Database (Denmark)
Holck, Jesper; Larsen, Dorte Møller; Michalak, Malwina
2014-01-01
Bifidobacterium strains in single culture fermentations. The trans-sialidase also catalysed the transfer of sialic acid from CGMP to galacto-oligosaccharides (GOS) and to the human milk oligosaccharide (HMO) backbone lacto-N-tetraose (LNT) to produce 3′-sialyl-GOS, including doubly sialylated GOS products, and 3...
-
Balti kirjandusloo katse / Ants Oras
Oras, Ants, 1900-1982
2009-01-01
Arvustus: Grundriss einer Geschichte der baltischen Dichtung / herausgegeben von Arthur Behrsing; unter Mitarbeit von André Favre, Otto Greifenhagen und Arthur Knüpffer. Leipzig : Institut für Auslandskunde, Grenz- und Auslanddeutschtum, 1928
-
Organizing pneumonia: what is it? A conceptual approach and pictorial review.
Baque-Juston, M; Pellegrin, A; Leroy, S; Marquette, C H; Padovani, B
2014-09-01
Organizing pneumonia (formerly named bronchiolitis obliterans with organizing pneumonia or BOOP) is a clinical, radiological and histological entity that is classified as an Interstitial Lung Disease. The understanding of this family of diseases has seen great progress over the past twenty years. CT presentation of organizing pneumonia is polymorphous but a few patterns have been recently recognized as being more specific to this diagnosis. The aim of this work is to summarize new understandings of the clinical and histological presentation of the disease and to review the most relevant CT features. Copyright © 2014 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
-
Quality assurance in radiation therapy for ensuring the radiation protection of the patient
International Nuclear Information System (INIS)
Arndt, D.; Eichhorn, H.J.
1987-01-01
This issue contains (1) the full text of two pieces of legislation covering the legal requirements for the execution of radiotherapeutic treatments, which came into effect in March 1986; (2) specimen programmes meant to provide guidance on the legally required establishment of test programmes for the routine inspection of radiotherapy equipment in order to demonstrate that it will perform satisfactorily in service; and (3) five papers that have been presented at a workshop organized by 'Gesellschaft fuer Medizinische Radiologie der DDR', held in Bansin, 16-18 May 1985. They deal with the usefulness of the NSD concept in clinical practice including some recommendations aimed to standardize its handling. (author)
-
Postsurgical telecobalt radiotherapy of mammary carcinomas
International Nuclear Information System (INIS)
Liebl, R.
1980-01-01
The first part of the study is a literature survey. The second part deals with patients and results of radiotherapy of the Klinik and Poliklinik fuer Radiologie der Universitaet Muenchen. The patients with mammary carcinomas, who were treated between 1960 and 1969 were classified according to the TNM classification or they were attributed to stage I or II or III. When the therapy was begun, the mean age of the patients was 55 years, 80% of the patients was between 40 and 60 years old, 45% of the patients were in stage I, 35% in stage II and almost 20% in stage III. (orig./MG) [de
-
[Evolution of the pelvis and hip throughout history: from primates to modern man].
Lapègue, F; Jirari, M; Sethoum, S; Faruch, M; Barcelo, C; Moskovitch, G; Ponsot, A; Rabat, M-C; Labarre, D; Vial, J; Chiavassa, H; Baunin, C; Railhac, J-J; Sans, N
2011-06-01
The evolution to a bipedal mode of locomotion was accompanied by a verticalization of the spine and a modification in the shape of the pelvis: horizontal curvature and sagittal rotation. Phylogenesis meets ontogenesis: flat bones in fetuses similar to the monkey, australopithecus features at birth and "human-like" features by 7 or 8years of age. These anatomical modifications explain the characteristics of human bipedalism: stable, economical, with hip and knee extension in the standing position with little lateral motion. Some pathologies induce a regression to a more archaic mode of bipedal locomotion. Copyright © 2011 Elsevier Masson SAS and Éditions françaises de radiologie. All rights reserved.
-
Pracht, Etienne E; Orban, Barbara L; Comins, Meg M; Large, John T; Asin-Oostburg, Virginia
2011-01-01
Avoidable hospitalizations represent a key indicator for access to, and the quality of, primary care. Therefore, understanding their behavior is essential in terms of management of healthcare resources and costs. This analysis examines the affect of 2 healthcare strategies on the rate of avoidable hospitalization, managed care and the healthcare safety net. The avoidable hospitalizations definition developed by Weissman et al. (1992) was used to identify relevant inpatient episodes. A 2-stage simultaneous equations multivariate regression model with instrumental variables was used to estimate the relative influence of HMO penetration and the composition of local hospital markets on the rate of avoidable hospitalizations. Control variables in the model include healthcare supply and demand, demographic, socioeconomic, and health status characteristics. Increased market presence of public hospitals significantly reduced avoidable hospitalizations. HMO penetration did not influence the rate of avoidable hospitalizations. The results suggest that public investments in healthcare facilities and infrastructure are more effective in reducing avoidable hospitalizations. © 2011 National Association for Healthcare Quality.
-
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false End of CMS's liability for payment: Disenrollment... Enrollment, Entitlement, and Disenrollment under Medicare Contract § 417.464 End of CMS's liability for... disenrollment: General rule. (1) CMS's liability for monthly capitation payments to the HMO or CMP generally...
-
Autran, Chloe A.; Schoterman, Margriet H.C.; Jantscher-Krenn, Evelyn; Kamerling, Johannis P.; Bode, Lars
2016-01-01
Necrotising enterocolitis (NEC) is one of the most frequent and fatal intestinal disorders in preterm infants and has very limited treatment options. Breast-fed infants are at a 6-10-fold lower NEC risk than formula-fed infants, and we have previously shown that human milk oligosaccharides (HMO)
-
The upwelling record in the sediments of the westen continental margin of India
Digital Repository Service at National Institute of Oceanography (India)
Naidu, P.D.; PrakashBabu, C.; Rao, Ch.M.
substanzers in marinen sedimentes unter oxygierenden and reduzierenden Bediggungen. Dissertation, University of Kiel, 175 pp. MOLLER G. and M. GASTNER (1971) The 'Karbonbate Bombe' a simple device for the determination of the carbonate content in sediments...
-
Einige Beobachtungen an Anemonenfischen in der Karibischen See
Albrecht, H.
1977-01-01
Unter Anemonenfischen verstehen wir hauptsächlich Arten der indopazifischen Gattung Amphiprion (Riffbarsche, Pomacentridae), die in Seeanemonen leben. Mariscal (1966) und neuerdings Allen (1975) haben die vielen Untersuchungen dieser Beziehung zusammengefasst. Aus der Literatur sind andere
-
Der gläserne Aschenbecher - oder - Zur Verallgemeinerung des Eulerschen Polyedersatzes
Gallin, P
2009-01-01
Eine Diskussion unter Mathematikern im Lehrerzimmer einer Kantonsschule führt zusammen mit Beiträgen der Schülerinnen und Schüler unversehens zu topologischen Einsichten, die normalerweise im Gymnasium nicht zur Sprache kommen.
-
Kahan, Natan R; Silverman, Barbara; Liphshitz, Irena; Waitman, Dan-Andrei; Ben-Zion, Itzhak; Ponizovsky, Alexander M; Weizman, Abraham; Grinshpoon, Alexander
2018-03-01
An association between bipolar disorder (BD) and cancer risk has been reported. The purpose of this study was to investigate this association through linkage analysis of a national HMO database and a national cancer registry. All members of the Leumit Health Services (LHS) HMO of Israel from 2000 to 2012 were included. Members with a recorded diagnosis of BD and a record of at least one written or dispensed prescription for pharmacotherapy for treatment of BD were classified as patients with BD. We linked the LHS population with the Israel National Cancer Registry database to capture all cases of cancer reported. Standardized incidence ratios (SIRs) for cancer in the BD population as compared with non-BD LHS members were calculated. A total of 870 323 LHS members were included in the analysis; 3304 of whom met the criteria for inclusion in the BD arm. We identified 24 515 and 110 cancer cases among members without BD and with BD, respectively. Persons with BD were no more likely than other HMO members to be diagnosed with cancer during the follow-up period [SIR, males=0.91, 95% confidence interval (CI): 0.66-1.22; SIR, females=1.15, 95% CI: 0.89-1.47]. Sensitivity analysis using different criteria for positive BD classification (lithium treatment alone or registered physician diagnosis) had no effect on the estimate of cancer risk. A nonstatistically significant association between breast cancer and BD among women was observed (SIR=1.24, 95% CI: 0.79-1.86). These findings do not corroborate previously reported associations between BD and elevated cancer risk.
-
Pursel, Kevin J; Jacobson, Martin; Stephenson, Kathy
2012-07-01
The purpose of this study is to describe a reimbursement model that was developed by one Health Maintenance Organization (HMO) to transition from fee-for-service to add a combination of pay for performance and reporting model of reimbursement for chiropractic care. The previous incentive program used by the HMO provided best-practice education and additional reimbursement incentives for achieving the National Committee for Quality Assurance Back Pain Recognition Program (NCQA-BPRP) recognition status. However, this model had not leveled costs between doctors of chiropractic (DCs). Therefore, the HMO management aimed to develop a reimbursement model to incentivize providers to embrace existing best-practice models and report existing quality metrics. The development goals included the following: it should (1) be as financially predictable as the previous system, (2) cost no more on a per-member basis, (3) meet the coverage needs of its members, and (4) be able to be operationalized. The model should also reward DCs who embraced best practices with compensation, not simply tied to providing more procedures, the new program needed to (1) cause little or no disruption in current billing, (2) be grounded achievable and defined expectations for improvement in quality, and (3) be voluntary, without being unduly punitive, should the DC choose not to participate in the program. The generated model was named the Comprehensive Chiropractic Quality Reimbursement Methodology (CCQRM; pronounced "Quorum"). In this hybrid model, additional reimbursement, beyond pay-for-procedures will be based on unique payment interpretations reporting selected, existing Physician Quality Reporting System (PQRS) codes, meaningful use of electronic health records, and achieving NCQA-BPRP recognition. This model aims to compensate providers using pay-for-performance, pay-for-quality reporting, pay-for-procedure methods. The CCQRM reimbursement model was developed to address the current needs of one
-
Handling stress may confound murine gut microbiota studies
Directory of Open Access Journals (Sweden)
Cary R. Allen-Blevins
2017-01-01
Full Text Available Background Accumulating evidence indicates interactions between human milk composition, particularly sugars (human milk oligosaccharides or HMO, the gut microbiota of human infants, and behavioral effects. Some HMO secreted in human milk are unable to be endogenously digested by the human infant but are able to be metabolized by certain species of gut microbiota, including Bifidobacterium longum subsp. infantis (B. infantis, a species sensitive to host stress (Bailey & Coe, 2004. Exposure to gut bacteria like B. infantisduring critical neurodevelopment windows in early life appears to have behavioral consequences; however, environmental, physical, and social stress during this period can also have behavioral and microbial consequences. While rodent models are a useful method for determining causal relationships between HMO, gut microbiota, and behavior, murine studies of gut microbiota usually employ oral gavage, a technique stressful to the mouse. Our aim was to develop a less-invasive technique for HMO administration to remove the potential confound of gavage stress. Under the hypothesis that stress affects gut microbiota, particularly B. infantis, we predicted the pups receiving a prebiotic solution in a less-invasive manner would have the highest amount of Bifidobacteria in their gut. Methods This study was designed to test two methods, active and passive, of solution administration to mice and the effects on their gut microbiome. Neonatal C57BL/6J mice housed in a specific-pathogen free facility received increasing doses of fructooligosaccharide (FOS solution or deionized, distilled water. Gastrointestinal (GI tracts were collected from five dams, six sires, and 41 pups over four time points. Seven fecal pellets from unhandled pups and two pellets from unhandled dams were also collected. Qualitative real-time polymerase chain reaction (qRT-PCR was used to quantify and compare the amount of Bifidobacterium, Bacteroides, Bacteroidetes, and
-
42 CFR 417.572 - Budget and enrollment forecast and interim reports.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Budget and enrollment forecast and interim reports... PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.572 Budget and enrollment forecast and interim reports. (a) Annual submittal. The HMO or CMP must submit an annual operating budget...
-
42 CFR 417.470 - Basis and scope.
2010-10-01
...) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Contract Requirements § 417.470 Basis and scope. (a) Basis. This subpart implements those... section 1876(c), (g), (h), and (i) of the Act that pertain to the contract between CMS and an HMO or CMP...
-
42 CFR 417.122 - Protection of enrollees.
2010-10-01
... insolvency. (iv) Any other arrangements acceptable to CMS. (2) The requirements of this paragraph do not... HMO becomes insolvent. The insolvency protection plan required under § 417.120(a) must provide for... payment has been made. (2) For enrollees who are in an inpatient facility on the date of insolvency, until...
-
Energy Technology Data Exchange (ETDEWEB)
Sachs, W. [Institut fuer Erdoel- und Erdgasforschung, Clausthal-Zellerfeld (Germany)
1998-12-31
Optimisation of gas production necessitates accurate knowledge of gas transport mechanisms. In view of the extreme temperatures, pressures, and permeability conditions of underground gas deposits, linear transfer of existing knowledge will be inappropriate. The author therefore uses a simple capillary bundle model with exemplary pressures, temperatures and permeabilities in order to assess the contribution of transport by diffusion. The diffusion coefficients, which are required for this and so far could not be measured under pressure, were determined by a new experimental method whose results will permit a better interpretation of the concentration dependence of the diffusion coefficient. The velocity of methane inflow and outflow in the water-filled pore space may provide knowledge on problems of gas storage in the pore space. (orig.) [Deutsch] Fuer den Foerderprozess und insbesondere seine Optimierung ist eine genaue Kenntnis der Transportmechanismen wesentlich. Unter den drastischen Bedingungen fuer Temperatur, Druck und Permeabilitaet tiefliegender Gas-Lagerstaetten mag die Uebertragung der bisherigen Vorstellungen ueber den Transport in der Lagerstaette zu einer unvollstaendigen Beschreibung fuehren. Unter Anwendung eines einfachen Kapillarbuendelmodells wird mit Beispielen fuer Druck, Temperatur und Permeabilitaet der moegliche Beitrag des Transports durch Diffusion abgeschaetzt. Zur Bestimmung der hierfuer notwendigen und bisher unter Druckbeaufschlagung nicht gemessenen Diffusionskoeffizienten wurde eine neue experimentelle Methode angewandt, deren Ergebnisse eine weiterfuehrende Interpretation der Konzentrationsabhaengigkeit des Diffusionskoeffizienten ermoeglichen. Auch fuer Fragestellungen der Speicherung von Gas im Porenraum kann die Geschwindigkeit der Ein- und Ausloesung von Methan im wasserhaltigen Porenraum von Interesse sein. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Wildberger, J.E.; Vorwerk, D.; Stargardt, A.; Guenther, R.W. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik; Winograd, R.; Busch, N. [Technische Hochschule Aachen (Germany). Medizinische Klinik 3
1998-10-01
Recurrent variceal bleeding due to liver cirrhosis led to treatment with a transjugular intrahepatic portosystemic shunt (TIPS) in a pregnant woman at 20 weeks` gestation. Fetal radiation exposure was estimated to be less than 10 mSv. The use of a graduated catheter allowed measurement of field size and reliable determination of the patient`s entrance dose. Radiation exposure of an approximated fetal dosage of 5.2 mSv did not justify abortion for medical reasons. Therefore, TIPS procedure is not generally contraindicated during pregnancy itself. TIPS placement may be a therapeutic option related to the severity of the underlying maternal disease, after radiation exposure of the fetus has been estimated. (orig.) [Deutsch] Bei rezidivierender Oesophagusvarizenblutung auf dem Boden einer Leberzirrhose wurde bei bestehender Schwangerschaft der 20. Woche ein transjugulaerer portosystemischer Stent-Shunt (TIPS) neu angelegt. Praeinterventionell wurde die zu erwartende Strahlenexposition fuer den Feten kleiner 10 mSv abgeschaetzt. Der Einsatz eines Messkatheters waehrend des Eingriffs ermoeglichte die genaue Bestimmung der Feldgroesse und somit eine verlaessliche Berechnung der Einfallsdosis. Die applizierte Strahlendosis lag mit 5,2 mSv unter der praeinterventionellen Abschaetzung. Eine Strahlenexposition in diesem Dosisbereich stellt keine Indikation fuer einen medizinisch induzierten Schwangerschaftsabbruch dar. Eine intakte Graviditaet ist keine absolute Kontraindikation zur TIPS-Neuanlage. Diese muss unter Beruecksichtigung der Schwere des muetterlichen Krankheitsbildes und unter Vorausabschaetzung der zu erwartenden Strahlenexposition fuer den Feten als moegliche Therapieoption geprueft werden. (orig.)
-
Grosse Axiallager mit Hybridschmierung - Theoretische und experimentelle Betrachtungen
DEFF Research Database (Denmark)
Santos, Ilmar; Fuerst, Axel
2003-01-01
Der vorliegende Artikel praesentiert die Simulation eines grossen axialen Kippsegmentlagers unter Beruecksichtigung der hybriden Schmierung, d.h. gleichzeitige hydrodynamische und hydrostatische Schmierung. Ein Vergleich mit Messungen zeigt, dass fuer das betrachtete Lager mit 2,2 m Durchmesser die...
-
Begegnungen mit fremden Sprachen
DEFF Research Database (Denmark)
Daryai-Hansen, Petra Gilliyard
Was ist Sprachideologie? Was sind fremde Sprachen? Über welche Sprachen sprechen wir, und wie? Dieses Buch, das sich unter dem theoretisch-methodischen Horizont der komparativen kritischen Diskursanalyse in einem Feld zwischen Soziolinguistik und Bourdieus sprachsoziologischen Arbeiten verortet, ...
-
DEFF Research Database (Denmark)
Winkler, Till J.; Trier, Matthias
2017-01-01
Enterprise Social Networks (ESNs), d. h. Informationssysteme, die die Vernetzung von Mitarbeitern in Unternehmen fördern sollen, sind in verschiedenen Varianten und unter verschiedenen Bezeichnungen (etwa Enterprise Social Media, Corporate Social Software, Social Business oder Enterprise 2...
-
Genetiese parameters van speenkafrf^ eienskappe by ...
African Journals Online (AJOL)
Genetiese en. Omgewingsparameters van 'n VIeisraskudde. Ph.D.-tesis,. Univ. van die Oranje-Vrystaat. VAN MARLE, J., 1964. Untersuchungen tiber Einfltisse von. Umwelt und Erbanlage auf die Gewichtsentwicklung von. Fleischrinden unter extensiven Weidebedingungen der. Versuchstation Armoedsvlakte in Stidafrika.
-
Ungarn seit der Wahl: Demokratie unter Druck
Freyberg-Inan, A.; Varga, M.
2011-01-01
Die Verfasser zeigen, dass die Orban-Regierung legitime Probleme benennt, wie etwa Ungarns extrem niedrige Beschäftigungsrate, die mit zu den großen wirtschaftliche Schwierigkeiten des Landes beiträgt. Doch packt sie die identifizierten Probleme zu oft auf eine Weise an, die ganz nebenbei dem
-
Energy Technology Data Exchange (ETDEWEB)
NONE
1996-12-31
The report describes the activities of the three sections of the key project `Biotechnology`: Biological systems, e.g. environmental biotechnology, enzyme reactions; protein engineering, fermentation problems of secondary metabolites, tetrachloroethylene degradation, stereoselective synthesis; process engineering, i.e. supercritical solvents, enzyme-catalysed reactions, bipolar membrane technology, membrane separation processes, anaerobic processes; information engineering, i.e. morphology recording, process control. Separate abstracts are available in this database for two articles of this report. (SR) [Deutsch] Dargestellt werden die Taetigkeiten der verschiedenen Arbeitsbereiche des Schwerpunktprojektes Biotechnologie. Es handelt sich hierbei um die drei Projektbereiche: Biologische Systeme unter anderem mit den Themen Umweltbiotechnologie, Enzymreaktionen, Protein-Engineering, Fermentationsprobleme bei sekundaeren Metaboliten, Tetrachlorethylen-Abbau, Stereoselektive Synthese; des weiteren der Projektbereich Verfahrenstechnik unter anderem mit den Themen Ueberkritische Loesungsmittel, Enzymkatalysierte Reaktionen, Bipolare Membrantechnik, Membrantrennverfahren, Anaerobprozesse; als letztes der Projektbereich Informationstechnik mit den Themen Morphologieerfassung, Prozessfuehrung. (SR)
-
Strengthening of the brazed joint for single-crystalline molybdenum by using Mo-40%Ru-B alloys
Energy Technology Data Exchange (ETDEWEB)
Hiraoka, Y. [Okayama Univ. of Science (Japan). Department of Applied Physics; Igarashi, T. [Tokyo Tungsten Co. Ltd., Toyama (Japan). Research and Development Division
1998-12-01
In this study, the bend properties of the single-crystalline molybdenum brazed by using Mo-40%Ru alloys containing boron of 1-6 mass%Ru alloy for the improvement of the joint strength was determined. (orig.) [Deutsch] Durchgefuehrt wurde die Herstellung von Verbindungen aus einkristallinem Molybdaen. Hierbei kamen Mo-40%Ru-Legierungen mit 1 bis 6 Gew.-% Bor als Lotmaterialien zum Einsatz. Festigkeit und Duktilitaet der Verbindungen wurden mittels 3-Punkt-Biegepruefung bei Raumtemperatur und unter fluessigem Stickstoff ermittelt. Die Bruchflaechen der Proben wurden mit Hilfe eines Rasterelektronenmikroskopes untersucht. Die Ergebnisse lassen sich wie folgt zusammenfassen: Der optimale Borgehalt bezueglich Festigkeit und Duktilitaet der geloeteten Verbindung liegt bei 2 Gew.-%. Die entsprechende Probe hat bei einem Biegewinkel von 100 bei Raumtemperatur nicht versagt. Auch unter fluessigem Stickstoff zeigte diese Probe eine Festigkeit in der Groessenordnung des einkristallinen Vollmaterials. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Hille, G.; Hoffmann, V.U. [Fraunhofer ISE, Freiburg (Germany); Dienhart, H.; Langniss, O.; Nitsch, J. [DLR, Stuttgart (Germany)
1997-12-01
Experts are unanimous that opening up new markets through innovative technologies will be the successful strategy for reversing the upward trend of unemployment in Germany. This approach puts renewable energy sources into the foreground, as enhanced use of wind power and photovoltaic energy conversion will no doubt create new jobs. These technologies will, however, require favourable regulatory framework conditions in order to become a significant force in combatting unemployment. (orig./CB) [Deutsch] Es gilt unter Experten als sicher, dass eine Umkehr am Arbeitsmarkt nur dadurch zu schaffen ist, dass innovative Technologien genutzt und damit neue Maerkte erschlossen werden. Demnach koennte etwa dem Ausbau der regenerativen Energietraeger Wind und Photovoltaik zur Schaffung zukunftssicherer Arbeitsplaetze eine grosse Bedeutung zukommen. Einen ernstzunehmenden Beitrag im Kampf gegen die Arbeitslosigkeit koennen diese Technologien allerdings nur unter bestimmten Rahmenbedingungen leisten. (orig./RHM)
-
Energy Technology Data Exchange (ETDEWEB)
NONE
1997-12-31
The report describes the activities of the three sections of the key project `Biotechnology`: Biological systems, e.g. environmental biotechnology, enzyme reactions; protein engineering, fermentation problems of secondary metabolites, tetrachloroethylene degradation, stereoselective synthesis; process engineering, i.e. supercritical solvents, enzyme-catalysed reactions, bipolar membrane technology, membrane separation processes, anaerobic processes; information engineering, i.e. morphology recording, process control. Separate abstracts are available in this database for two articles of this report. (SR) [Deutsch] Dargestellt werden die Taetigkeiten der verschiedenen Arbeitsbereiche des Schwerpunktprojektes Biotechnologie. Es handelt sich hierbei um die drei Projektbereiche: Biologische Systeme unter anderem mit den Themen Umweltbiotechnologie, Enzymreaktionen, Protein-Engineering, Fermentationsprobleme bei sekundaeren Metaboliten, Tetrachlorethylen-Abbau, Stereoselektive Synthese; des weiteren der Projektbereich Verfahrenstechnik unter anderem mit den Themen Ueberkritische Loesungsmittel, Enzymkatalysierte Reaktionen, Bipolare Membrantechnik, Membrantrennverfahren, Anaerobprozesse; als letztes der Projektbereich Informationstechnik mit den Themen Morphologieerfassung, Prozessfuehrung. (SR)
-
Mechanik deformierbarer fester Stoffe
Heintze, Joachim
In Bd. I/I haben wir die Mechanik des Massenpunkts und des starren Körpers behandelt; wir wollen nun berücksichtigen, dass sich alle Körper unter dem Einfluss der einwirkenden Kräfte deformieren können.
-
Mertelsmann, Olaf, 1969-
2014-01-01
Arvustus: Rosche, Julia. Zwischen den Fronten. Die Rolle Estlands zwischen dem Hitler-Stalin-Pakt und dem Ende des Zweiten Weltkriegs im internationalen Kontext. Diplomica Verlag. Hamburg 2012. Unter demselben Titel mit identischem Text auch: Grin Verlag. München 2013
-
Energy Technology Data Exchange (ETDEWEB)
Schmidt, F.; Sucic, D.; Wendler, M.
1998-03-01
The goal of this project was the development of a set of tools for the selection of optimal concepts for HVAC-systems in housing buildings. Several factors are considered. They include technical feasibility, costs for investment, maintenance and operation, energy concumption, environmental impacts and user comfort. It is intended with the help of these tools to identify the most important factors which influence energy consumption and to suggest simple and cost effective measures to reduce energy consumption. Measures include improvements of the envelope, changes in the HVAC-system and its operation according to the needs to the inhabitants of the building. This report describes these components of this tool set which were developed in the frame of the project WohnKomfort. It lists data and rules chosen. In addition we report experiences which we gained with an prototypical implementation. This implementation allows load calculations for more than 60.000 different buildings applying EN 802 (only one zone model) as calculation method. It also supports selection of heating systems for such buildings by offering an evaluation according to user specified criteria including cost, environment and comfort. (orig./MM) [Deutsch] Ziel des Vorhabens war die Entwicklung eines Instrumentariums zur Auswahl optimaler Konzepte fuer technische Anlagen in Wohngebaeuden unter Beruecksichtigung der Faktoren technische Machbarkeit, Erstellungs-, Betriebskosten, Energieverbrauch, Umweltbelastung und Nutzerkomfort. Mit Hilfe dieses Instrumentariums soll es moeglich werden, die Haupteinflussfaktoren fuer den Energieverbrauch anzugeben und Vorschlaege fuer einfache und kostenguenstige Massnahmen zu seiner Reduzierung auf der Seite des Gebaeudes (bauliche Massnahmen) und der Anlage (technische Massnahmen, Nutzerverhalten) anzugeben. In diesem Bericht beschreiben wir die im Vorhaben entwickelten Komponenten des Instrumentariums, die zugrundeliegenden Daten und Regeln sowie Erfahrungen, die
-
The battered child syndrome; Die nicht unfallbedingte Verletzung (battered child)
Energy Technology Data Exchange (ETDEWEB)
Sorantin, E.; Lindbichler, F. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Kinderradiologie
2002-03-01
The recognition of a battered child represents a challenge for all groups of adults dealing with children. Radiology plays a special role in this setting. By detection typical injuries, imaging is able to confirm the suspicion of a battered child. Recognition of those injuries on films, taken for other reasons, gives the caretaker an important hint, thus maybe preventing a fatal outcome for the child. One of the most important injury types is represented by the so called ''shakin baby syndrome''. The infant is held by the thorax and shaken. Thus causing a repetitive acceleration-deceleration trauma, which leads to the typical paravertebral rib fractures, intracranial bleeding and eye injuries. After shaking the child is thrown away, with subsequent injuries. The aim of this article is the presentation of an overview regarding the radiology of the battered child. Typical examples will be shown. (orig.) [German] Die Aufdeckung einer Kindesmisshandlung stellt eine grosse Herausforderung fuer alle in der Kinderbetreuung taetigen Berufsgruppen dar. Der Radiologie kommt eine besondere Rolle zu, da sie einerseits durch die Erkennung typischer Verletzungsmuster einen Verdacht bestaetigen, als auch bei ''Zufallsbefunden'' die moeglicherweise fatalen Folgen fuer die betroffenen Kinder verhindern kann. Der typische Verletzungsmechanismus im Rahmen einer Kindesmisshandlung stellt das sog. ''shakin baby syndrome'' dar. Dabei wird der Thorax mit beiden Haenden umfasst und das Kind geschuettelt. Durch dieses repetitive Akzelerations-Dezelerationstrauma entstehen typische Verletzungen mit paravertebralen Rippenfrakturen, ZNS- sowie Retinablutungen. Anschliessend wird das Kind weggeworfen mit entsprechend weiteren Verletzungen. Ziel dieses Artikels ist es, einen Ueberblick ueber die Radiologie der wichtigsten Verletzungen und deren Abklaerung im Rahmen einer Kindesmisshandlung zu geben sowie die Demonstration der Befunde
-
42 CFR 417.538 - Enrollment and marketing costs.
2010-10-01
... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.538 Enrollment and marketing costs. (a) Principle. Costs incurred by an HMO or CMP in performing the enrollment and marketing activities described in subpart k of... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment and marketing costs. 417.538 Section 417...
-
Minott, Jenny
2010-09-01
Key findings. (1) An increase in commercial plan penetration increased the liklihood [sic] that a physician would accept new Medicaid patients, but this did not significantly impact enrollee costs. (2) An increase in Medicaid-dominant HMO market penetration increased the probability that individuals reported using the ED as their primary source of care.
-
Brinks, Jan Herman
1991-01-01
Im Jahre 1945 befand sich die Geschichte Deutschlands, darin besteht Konsens unter Historikern aller Richtungen, an einem ihrer tiefgreifendsten Wendepunkte. Die Ereignissein Hiroshima und in Potsdam im Sommer jenes Jahres, so urteilt Werner Conze, markieren einschneidenste Zäsuren der europdischen,
-
Vorgehensmodelle und Prozesse für die Entwicklung von Produkten und Dienstleistungen
DEFF Research Database (Denmark)
Andreasen, Mogens Myrup
2005-01-01
erreicht werden kan. Prozeduren in der Produktentwicklung basieren normalerweise auf theoretischen Vorgehensmodellen, zu denen sich in der Literatur viele Beispiele finden. Für die praktische Umsetzung dieser Modelle ergeben sich zumeist unter anderem folgende Fragen: Wie aufwändig soll die...
-
Radio-toxicological analysis of urine
International Nuclear Information System (INIS)
Jeanmaire, L.; Jammet, H.
1959-01-01
The article is divided into two parts: general and technical. In the general part, a study of the behaviour of radioisotopes in the organism shows the hazards of internal contamination. In addition, the principle of the different methods for the estimation of this contamination is indicated. The second part, which is purely technical, describes some of the methods for urine analysis used in the S.H.A.R.P. radiotoxicology laboratory at the Saclay Nuclear Research Centre. The techniques relate to 239 Pu, 226 Ra, 90 Sr, natural Th, natural U and 233 U. Reprint of a paper published in Annales de Radiologie, Vol. 2, no. 9-10, p. 703-722, 1959 [fr
-
Imaging features of lower limb malformations above the foot.
Bergère, A; Amzallag-Bellenger, E; Lefebvre, G; Dieux-Coeslier, A; Mezel, A; Herbaux, B; Boutry, N
2015-09-01
Lower limb malformations are generally isolated or sporadic events. However, they are sometimes associated with other anomalies of the bones and/or viscera in patients with constitutional syndromes or disorders of the skeleton. This paper reviews the main imaging features of these abnormalities, which generally exhibit a broad spectrum. This paper focuses on several different bone malformations: proximal focal femoral deficiency, congenital short femur and femoral duplication for the femur, tibial hemimelia (aplasia/hypoplasia of the tibia) and congenital bowing for the tibia, fibular hemimelia (aplasia/hypoplasia) for the fibula, and aplasia, hypoplasia and congenital dislocation for the patella. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
-
Energy Technology Data Exchange (ETDEWEB)
Watzke, E.; Roth, M.; Hoffmeier, C.
2000-07-01
Erhoehung der Bakterienabtoetungsraten wird die erhoehte Temperatur des behandelten Wassers in einem isolierten Sammelbehaelter ueber mehrere Stunden gehalten. Ausserdem wurden Trinkwasserentkeimungsgefaesse (TWEG) aus hoch UV-durchlaessigem Glas entwickelt, die ebenfalls zur Trinkwasserdesinfektion verwendet werden koennen. In einem Folgeprojekt werden mit den TWEA Langzeittests unter praxisrelevanten Anwendungsbedingungen in Entwicklungslaendern durchgefuehrt. (orig.)
-
International Nuclear Information System (INIS)
Druyts, F.; Kursten, B.; Iseghem, P. Van
2004-01-01
The Belgian SAFIR-2 concept foresees the geological disposal of conditioned high-level radioactive waste in stainless steel containers and overpacks placed in a concrete gallery backfilled with Boom clay or a bentonite-type backfill. In addition to earlier in situ experiments, we used a laboratory approach to investigate the corrosion properties of selected stainless steels in Boom clay and bentonite environments. In the SAFIR-2 concept, AISI 316L hMo is the main candidate overpack material. As an alternative, we also investigated the higher alloyed stainless steel UHB 904L. Our study focused on localised corrosion and in particular pitting. We used cyclic potentiodynamic polarisation measurements to determine the pit nucleation potential E NP and the protection potential E PP . The evolution of the corrosion potential with time was determined by monitoring the open circuit potential in synthetic clay-water over extended periods. In this paper we present and discuss some results from our laboratory programme, focusing on long-term interactions between the stainless steel overpack and the backfill materials. We describe in particular the influence of chloride and thio-sulphate ions on the pitting corrosion behaviour. The results show that, under geochemical conditions typical for geological disposal, i.e. [Cl-] ∼ 30 mg/L for a Boom clay backfill and [Cl-] ∼ 90 mg/L for a bentonite backfill, neither AISI 316L hMo nor UHB 904L is expected to present pitting problems. An important factor in the long-term prediction of the corrosion behaviour however, is the robustness of the model for the evolution of the geochemistry of the backfill. Indeed, at chloride levels higher than 1000 mg/L, we predict pitting corrosion for AISI 316L hMo. (authors)
-
Directory of Open Access Journals (Sweden)
Tenhaven, Christoph
2013-02-01
Full Text Available [english] Introduction: Informal and formal lifelong learning is essential at university and in the workplace. Apart from classical learning techniques, Web 2.0 tools can be used. It is controversial whether there is a so-called net generation amongst people under 30.Aims: To test the hypothesis that a net generation among students and young veterinarians exists.Methods: An online survey of students and veterinarians was conducted in the German-speaking countries which was advertised via online media and traditional print media.Results: 1780 people took part in the survey. Students and veterinarians have different usage patterns regarding social networks (91.9% vs. 69% and IM (55.9% vs. 24.5%. All tools were predominantly used passively and in private, to a lesser extent also professionally and for studying.Outlook: The use of Web 2.0 tools is useful, however, teaching information and media skills, preparing codes of conduct for the internet and verification of user generated content is essential.[german] Einleitung: Informelles und formelles lebenslanges Lernen ist im Studium und Beruf essenziell. Dazu können neben der klassischen Fortbildung auch Web 2.0 Tools benutzt werden. Umstritten in der Literatur ist allerdings, ob es unter den „Unter 30 Jährigen“ eine sogenannte Net-Generation gibt. Ziel: Überprüfung der Hypothese, dass eine Net-Generation unter Studierenden und jungen Tierärzten existiert. Methode: Eine Onlineumfrage unter Studierenden und der Tierärzteschaft wurde im deutschsprachigen Raum durchgeführt, die per Onlinemedien und klassischen Printmedien beworben wurde.Ergebnisse: An der Befragung haben 1780 Personen teilgenommen. Es gibt unterschiedliches Nutzungsverhalten von Studierenden und der Tierärzteschaft bei sozialen Netzwerken (91,9% vs. 69% und IMs (55,9% vs. 24,5%. Alle Tools wurden hauptsächlich passiv und privat genutzt, im geringeren Maße auch für den Beruf und das Studium.Ausblick: Der Einsatz von Web 2
-
Energy Technology Data Exchange (ETDEWEB)
Moka, D.; Voth, E.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin
1997-12-01
Aim of this study was to assess the influence of antithyroid drugs (ADT) on the kinetics of {sup 131}I. Therefore, 56 patients with Graves` disease and with shortened effective half-life of {sup 131}I were examined under stationary conditionary conditions. In 38 patients ATD was stopped three days after radioiodine therapy (RIT). The progress of the first RIT and of a second RIT, which still was necessary in 12 patients, was compared to 18 patients receiving ATD continuously. Values of effective half-life for {sup 131}I rose significantly from 3.4 to 5.7 days 2-3 days after stopping ATD. There was an increase of the {sup 131}I-uptake of a second RIT after stopping ATD from 29.0 to 38.4%. In contrast, {sup 131}I-uptake of a second RIT decreased significantly in patients receiving ATD continuously. Effective half-life and uptake of {sup 131}I were affected significantly by ATD. Interrupting ATD after RIT is useful to improve an apparantly insufficient RIT in thyrotoxic patients receiving ATD. (orig.) [Deutsch] Ziel dieser Studie war es, beim M. Basedow die Kinetik von {sup 131}I unter dem Einfluss thyreostatischer Medikation (tM) zu untersuchen. Dazu wurden die 56 Patienten mit immunogener Hyperthyreose M. Basedow (MB) und mit einem erhoehten `turn over` von {sup 131}I unter tM untersucht. Bei 38 Patienten wurde die tM am 3. Tag nach RITh abgesetzt. Der Verlauf der 1. RITh bzw. einer Nachtherapie wurde mit 18 Patienten unter fortlaufender tM verglichen. 2-3 Tage nach Absetzen der tM stieg die effektive Halbwertzeit (HWZ{sub eff.}) von {sup 131}I signifikant von 3,4 auf 5,7 Tage und der {sup 131}I-Uptake bei der Nachtherapie von 29,0 auf 38,4% an, waehrend er unter fortlaufender tM signifikant abfiel. Beide Effekte zeigen, dass tM die {sup 131}I-Kinetik der Schilddruese sehr schnell beeinflussen kann. Gezieltes Absetzen der tM eignet sich deshalb, um bei ausgewaehlten Patienten eine primaer unzureichende RITh noch waehrend des stationaeren Aufenthaltes zu steuern und
-
42 CFR 417.534 - Allowable costs.
2010-10-01
... typical “provider” costs, and costs (such as marketing, enrollment, membership, and operation of the HMO... principles applicable to provider costs, as set forth in § 417.536. (2) The allowability of other costs is determined in accordance with principles set forth in §§ 417.538 through 417.550. (3) Costs for covered...
-
Pricing health care services: applications to the health maintenance organization.
Sweeney, R E; Franklin, S P
1986-01-01
This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.
-
Abnorme uterine Blutungen während hormonaler Kontrazeption
Directory of Open Access Journals (Sweden)
Wunder D
2014-01-01
Full Text Available Blutungsstörungen unter hormonaler Kontrazeption sind einer der häufigsten Gründe für das Absetzen der kontrazeptiven Methode, was unerwünschte Schwangerschaften zur Folge haben kann. Es ist wichtig, dass die Patientin zu Beginn der Kontrazeption über die Möglichkeit des Auftretens von Blutungsstörungen aufgeklärt wird und dass der kontrazeptive Schutz (sofern die korrekte Einnahme bzw. die korrekte Lage gegeben sind durch die Blutungsstörungen nicht beeinträchtigt wird. Bei (persistierenden abnormen Blutungen, eventuell assoziiert mit zusätzlichen Symptomen, muss die Möglichkeit einer Schwangerschaft, einer Zervizitis sowie einer zervikalen/endometrialen/uterinen Pathologie in Betracht gezogen und durch entsprechende klinische Untersuchungen bzw. weitere Zusatzuntersuchungen ausgeschlossen werden. Zur Therapie von reinen Blutungsstörungen unter Kontrazeption stehen verschiedene Möglichkeiten zur Verfügung, je nach Art der hormonalen Kontrazeption.
-
Energy Technology Data Exchange (ETDEWEB)
Hoppe, D.
2000-11-01
A two-phase medium consisting of a fluid containing gas is transported in a turbo-pump via an impeller. The interaction between the gaseous phase and the impeller is to be examined by tomography with gamma rays. Reconstruction of the image of the object is to be made by way of filtered inverse projection. The methodology of using this principle in the given system (geometry and measuring conditions) is explained. (orig./CB) [German] Ein zweiphasiges, aus einer gashaltigen Fluessigkeit bestehendes Medium wird in einer Axialpumpe von einem propellerartigen Laufrad senkrecht zur Drehachse dieses Laufrades transportiert. Die Wechselwirkung zwischen der Gasphase und dem Laufrad soll unter Verwendung von Gamma-Strahlung mittels Tomographie untersucht werden. Dabei ist fuer die Rekonstruktion des Objektbildes das Prinzip der sogenannten gefilterten Rueckprojektion vorgesehen. Die methodischen Grundlagen fuer die Nutzung dieses Prinzips unter von vorgesehenen geometrischen und messtechnischen Bedingungen sind Gegenstand dieser Arbeit. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
NONE
1999-07-01
This year's annual seminar had two main subjects: First, the final colloquium of the CRAY-TECFLAM project in which an industrial code for simulation of combustion processes in furnaces and gas turbines was developed in cooperation with the relevant industry, and secondly, investigations on a TECFLAM standard burner which served to establish a reliable set of state variables by different methods that were applied simultaneously, as well as the validation of the mathematical models. [German] Das alljaehrliche oeffentliche Seminar stand in diesem Jahr unter zwei zentralen Themen: zum einen das Abschlusskolloquium des CRAY-TECFLAM-Projekts, in dem ein Industriecode zur Simulation der Verbrennungsvorgaenge in Feuerungen und Gasturbinen - unter Beteiligung der relevanten Industrie - entwickelt wurde, zum anderen die Untersuchungen am TECFLAM Standardbrenner, mit denen ein verlaesslicher Satz von Zustandsgroessen mit unterschiedlichen, aber simultan angewandten Messmethoden ermittelt wird und die mathematischen Modelle validiert werden. (orig.)
-
Bildanalyse in Medizin und Biologie
Athelogou, Maria; Schönmeyer, Ralf; Schmidt, Günther; Schäpe, Arno; Baatz, Martin; Binnig, Gerd
Heutzutage sind bildgebende Verfahren aus medizinischen Untersuchungen nicht mehr wegzudenken. Diverse Methoden - basierend auf dem Einsatz von Ultraschallwellen, Röntgenstrahlung, Magnetfeldern oder Lichtstrahlen - werden dabei spezifisch eingesetzt und liefern umfangreiches Datenmaterial über den Körper und sein Inneres. Anhand von Mikroskopieaufnahmen aus Biopsien können darüber hinaus Daten über die morphologische Eigenschaften von Körpergeweben gewonnen werden. Aus der Analyse all dieser unterschiedlichen Arten von Informationen und unter Konsultation weiterer klinischer Untersuchungen aus diversen medizinischen Disziplinen kann unter Berücksichtigung von Anamnesedaten ein "Gesamtbild“ des Gesundheitszustands eines Patienten erstellt werden. Durch die Flut der erzeugten Bilddaten kommt der Bildverarbeitung im Allgemeinen und der Bildanalyse im Besonderen eine immer wichtigere Rolle zu. Gerade im Bereich der Diagnoseunterstützung, der Therapieplanung und der bildgeführten Chirurgie bilden sie Schlüsseltechnologien, die den Forschritt nicht nur auf diesen Gebieten maßgeblich vorantreiben.
-
Energy Technology Data Exchange (ETDEWEB)
Willmann, M.
1999-07-01
Two-phase flows were investigated in high-pressure conditions in order to assess the influence of pressure and temperature on spray jet dispersion in so-called airblast sputtering units, whose function is described. The project was to contribute to improved characterisation and better understanding of spray jets. New methods of measurement and calculation were employed that provide more comprehensive and accurate data on two-phase flows. [German] In der vorliegenden Arbeit sollen Zweiphasenstroemungen unter Hochdruckbedingungen untersucht werden, um den Einfluss von Druck und Temperatur auf die Spruehstrahl-Ausbreitung unter Verwendung von sogenannten Airblast-Zerstaeubern aufzuzeigen. Diese Zerstaeuberbauart wird derzeit typischerweise in Gasturbinen eingesetzt, ihre Funktionsweise wird in einem Kapitel der Arbeit dargestellt. Mit der vorliegenden Arbeit wird ein wesentlicher Beitrag zur verbesserten Charakterisierung und zum erweiterten Verstaendnis von Spruehstrahlen, insbesondere unter Einsatz von Airblast-Zerstaeubern geschaffen. Dabei werden sowohl im messtechnischen Bereich wie auch auf numerischer Seite neue Methoden vorgestellt, die eine wesentlich umfassendere und genauere Darstellung von Zweiphasenstroemungen erlauben. Der Einsatz dieser erweiterten Methoden an der Stroemung eines Modellairblastzerstaeubers zeigt wichtige Effekte bei der Tropfenausbreitung und -verdunstung auf. Die Arbeit ist dabei in drei Teilbereiche gegliedert. In einem messtechnisch ausgerichteten Teil werden die neuen, erweiterten Ansaetze zur Auslegung des Phasen-Doppler Verfahrens vorgestellt und damit die Grundlagen zur experimentellen Charakterisierung eines Spruehstrahls geschaffen. In zweiten Teil erfolgt die Darstellung der verwendeten numerischen Methoden. Im dritten Teil werden schliesslich die Resultate experimenteller wie numerischer Untersuchungen parallel eingesetzt, um die physikalischen Phaenomene im Spruehstrahl eines Airblastzerstaeubers darzustellen und damit die
-
Energy Technology Data Exchange (ETDEWEB)
Bresser, G. [Hauptstelle fuer das Grubenrettungswesen DSK, Herne (Germany)
2001-07-01
Mine rescue brigades in Germany use two different types of whole-body cooling systems: The cooling and breathing system of Draegerwerk AG and the Antidust cooling and breathing protective suit of Vorndamme AG. The two systems were investigated at temperatures of 40 - 60 C. The Draegerwerk AG system had to be modified to make it more user-friendly and more ergonomic. The protective suit was tested both underground and above ground in order to obtain data on its maximum time of use and underground characteristics. [German] Im deutschen Steinkohlenbergbau sind zwei Ganzkoerperkuehlsysteme fuer Grubenwehreinsaetze vorhanden: - Das Kuehl- und Atemschutzsystem der Grubenwehr (KAS) der Draegerwerk AG und - der Antidust- Kuehl- und Atemschutzanzug der Vorndamme AG. Fuer die beiden unterschiedlichen Systeme sollten abgesicherte Einsatzdauertabellen fuer den Grubenwehreinsatz erstellt werden. Im Unterschied zum vorangegangenen Vorhaben sollte nun der Schwerpunkt der Untersuchung bei Temperaturen von 40 C bis 60 C liegen. Das Kuehl- und Atemschutzsystem musste modifiziert werden. Das System war so zu vereinfachen, dass jede Grubenwehr - auch ohne besondere Ausbildung und regelmaessiges Training unter Anleitung weniger Spezialisten - die Geraete nutzen kann. Als Ersatz fuer das Atemschutzmodul auf Chemikalsauerstoffbasis sollten vorhandene Drucksauerstoffkreislaufgeraete von Typ Draeger 174 genutzt werden. Um auf einem Rueckentragegestell die moeglichst unveraenderte Technik eines BG 174 und den Waermetauscher (KAS) unterbringen zu koennen, war es notwendig, neue Rueckentragegestelle zu entwickeln. Hierbei sollten ergonomische Gesichtspunkte besser als bisher beruecksichtigt werden. Der Antidust- Kuehl- und Atemschutzanzug war unter und ueber Tage zu erproben, um auch hier eine gesicherte Aussage zur Einsatzdauer und zur Handhabung unter Tage machen zu koennen. (orig.)
-
Neueste Forschung in musiktherapeutischer Diagnostik
DEFF Research Database (Denmark)
Ridder, Hanne Mette Ochsner
2012-01-01
responsivem Verhalten. In der Musiktherapie sind mehrere Assessmentmodelle entwickelt worden, unter anderem der IAP von Kenneth Bruscia, AQR von Karin Schumacher und Claudine Calvet-Kruppa oder das Assessment von Kontaktniveaus bei Anne Steen. Nach dieser Einführung des Assessmentbegriffes werden zusätzlich...
-
Nemški Pavliha im Vergleich zu seiner Vorlage Tyll Eulenspiegels wunderbare und seltsame Historien
Directory of Open Access Journals (Sweden)
Marija Javor Briški
2017-12-01
Full Text Available Unter Berücksichtigung des soziohistorischen Hintergrundes der Zielleser befasst sich der Beitrag auf inhaltlicher, struktureller, medialer und phraseologischer Ebene mit dem Vergleich der slowenischen Übersetzung Nemški Pavliha und seiner wiederentdeckten Vorlage Tyll Eulenspiegels wunderbare und seltsame Historien.
-
Sontag, Ralph
2007-01-01
Modelleisenbahnen können Kinderspielzeug oder anspruchsvolles Hobby sein. Heute fahren viele Bahnen digital und werden mittels Digital Command Control (DCC) gesteuert. Im Vortrag sollen die Grundlagen des Protokolls erläutert und die Grundfunktionen mittels des Decoder Programmers SPROG II unter Linux ausprobiert werden.
-
Energy Technology Data Exchange (ETDEWEB)
Andreae, H. [ed.
1993-12-31
This thesis deals with the distribution and turnover of heavy metals in partial terrestrial ecosystems of the water catchment area of the Soese storage dam in the Western Harz region, a forested area affected by acid deposition. The metals investigated are cadmium, chromium, cobalt, copper, nickel, lead and zinc. The work distinguishes three spatial areas: Regional heavy metal pollution is characterized via the establishment of nine deposition measuring sites (recent pollutant stress) in the field or under spruce stands and via cadastre-oriented surveying of element contents and accumulations in humus ground covers and mineral soils (historical pollutant stress). In-soil heavy metal turnovers are documented in five representative sites via investigation of the soil solution (years of measurement 1989-1991). In three sites, heavy metal turnovers are quantified via flow balances for the terrestrial ecosystem and the soil zone free of roots. (orig.) [Deutsch] Die vorliegende Arbeit befasst sich mit der Verteilung und dem Umsatz von Schwermetallen in terrestrischen Teiloekosystemen des bewaldeten, durch saure Deposition beeinflussten Wassereinzugsgebiets der Soese-Talsperre im Westharz. Untersucht werden die Metalle Cadmium, Chrom, Kobalt, Kupfer, Nickel, Blei und Zink. In der Arbeit werden drei raeumliche Ebenen unterschieden: Die regionale Belastung wird ueber die Einrichtung von neun Depositionsmessstellen [rezente Belastung] im Freiland bzw. unter Fichtenbestaenden sowie ueber eine katasterorientierte Erfassung von Element-Gehalten und -Vorraeten in Humusauflagen und Mineralboeden [historische Belastung] charakterisiert. Die bodeninternen Umsaetze der Schwermetalle werden an fuenf repraesentativen Standorten anhand der Untersuchung der Bodenloesung dokumentiert (Messjahre 1989-1991). An drei Standorten werden die Schwermetall-Umsaetze ueber Flussbilanzen fuer das terrestrische Oekosystem und die undurchwurzelte Bodenzone quantifiziert. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Bauer, C.
2001-07-01
The objective of this study is the development of an algorithm enabling coupling of nonmatching computational grids to carry out calculations of an unsteady flow through a hydraulic axial turbine with reference to interaction between stator and rotor. The algorithm should offer the possibility to operate the computational grids in a fixed position relative to each other as well as in relative movement. Furthermore, the calculation should be feasible with separate grids in parallel and different frames of reference. Employing selected examples this method is investigated in detail the results are compared with performed measurements. The unsteady numerical examination of the coupling process is carried out with different examples; especially the interaction effects between stator, rotor and draft tube of a hydraulic axial turbine are observed. In addition, the effect of tip clearance of the mean flow is described. Extensive model tests using the axial turbine have been performed at the Institute for Fluid Mechanics and Hydraulic Machinery, IHS. Flow time dependent velocities have been measured with a Laser Doppler Velocimeter placed at midspan of the blading. Periodical changes in static pressure have been recorded at different locations near the wall of the turbine casing. These measurements serve as reference for the comparison with results derived from the unsteady calculations. The confrontation of the time-dependent fluctuations of the flow quantities and the calculation of the efficiency of the turbine resulting from the simulation results allow a comparison in absolute terms. (orig.) [German] Fuer die instationaere Berechnung einer hydraulischen Axialturbine unter Beruecksichtigung der Interaktion zwischen Leit- und Laufrad wird ein Algorithmus zum Koppeln von nichtpassenden Berechnungsnetzen entwickelt. Diese Berechnungsnetze sollen zueinander ortsfest sein oder auch eine Relativbewegung zueinander haben koennen. Sie sollen ausserdem und in unterschiedlichen
-
Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs
Eggers, Paul W.; Prihoda, Ronald
1982-01-01
The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre
-
Neues über das Tertiär von Java und die mesozoischen Schichten von West-Borneo
Martin, K.
1888-01-01
Die Monographie, welche unter dem Titel Die Fossilien von Java herausgegeben wird ¹), ist so weit fortgeschritten, dass sich aus den in ihr beschriebenen Gastropoden bereits eine Anzahl von Schlussfolgerungen ableiten lässt, welche für die in Bearbeitung begriffene, geologische Karte von Java von
-
Hans Küng: "Projekt Weltethos "
Altmanninger, Maria
2002-01-01
Bei dieser Arbeit werde ich mich vor Allem auf zwei Werke beziehen: Küng,Hans:Projekt Weltethos.Piper.München 1990. Küng,Hans;Kuschel,Karl-Josef (Hg.):Weltfrieden durch Religionsfrieden.Die unter Punkt Acht aufgeführte Stellungnahme wurde ausschließlich von mir verfasst.
-
Energy Technology Data Exchange (ETDEWEB)
Sterzenbach, D.
1997-11-01
diesem Grund soll das gesamte Verfahren und dessen Einzelschritte unter diesem Gesichtspunkt ueberprueft und gegebenenfalls verbessert werden. Fuer die Probennahme von marinen Schwebstoffen soll ein Verfahren erarbeitet werden, das eine effiziente Abtrennung moeglichst kleiner suspendierter Partikel aus Seewasser ermoeglicht. Mit dem entwickelten Analysenverfahren sollen aktuelle Aspekte der Meereschemie zu Quellen, Transport, Verteilung und Verbleib von chlorierten Kohlenwasserstoffen in der marinen Umwelt behandelt werden. (orig.)
-
Future disposal of sewage sludge in Saxony; Zukuenftige Klaerschlammentsorgung im Freistaat Sachsen
Energy Technology Data Exchange (ETDEWEB)
Kowalski, H.D, [Saechsisches Staatsministerium fuer Umwelt und Landesentwicklung, Dresden (Germany)
1995-11-01
Early in 1994, the Saxonian ministry of environment and regional development (SMU) commissioned an expertise with the preliminary title ``Concept for long-term strategies for sewage sludge disposal from municipal sewage treatment plants in Saxony``. The objective was to develop and evaluate scenarios and submit proposals for securing sewage sludge disposal in the long-term, making use of existing, planned or envisaged plants. The article presents some of the results of this expertise. (orig./SR) [Deutsch] Das Saechsische Staatsministerium fuer Umwelt und Landesentwicklung (SMU) hat Anfang 1994 unter dem Arbeitstitel `Konzeption fuer die Langfriststrategie zur Klaerschlammentsorgung aus kommunalen Abwasserreinigungsanlagen im Freistaat Sachsen` die Ausarbeitung eines Gutachtens veranlasst. Die Zielstellung bestand darin, unter Nutzung vorhandener, bereits geplanter oder neu zu plandender Anlagen Szenarien zu entwickeln und zu bewerten und Vorschlaege fuer Massnahmen zu unterbreiten, welche es ermoeglichen, langfristig eine Entsorgungssicherheit des Klaerschlammes zu gewaehrleisten. Einige Ergebnisse aus diesem Gutachten sollen im Folgenden vorgestellt werden. (orig./SR)
-
Energy Technology Data Exchange (ETDEWEB)
Schumacher, G.; Patzold, V.; Ike, A.; Sekoulov, I. [Technische Univ. Hamburg-Harburg, Hamburg (Germany). Arbeitsbereich Abwasserwirtschaft
1999-07-01
These first investigations have led to results indicating that advanced waste water cleaning with the aid of algae biofilm as a downstream process stage is feasible. The concentration of phosphorus in waste water could be reduced to less than 1 mg per litre. Ammonium, which is toxic to fish, was nitrified, and the overall nitrogen concentration could be cut down. The concentration of bacteria was reduced by means of a close-to-nature process to less than the limiting values set by the European Union directive governing the quality of bathing waters. (orig.) [German] Die Ergebnisse dieser ersten Untersuchungen zeigen, dass eine weitergehende Abwasserreinigung mit Hilfe eines Algenbiofilms als nachgeschaltete Verfahrensstufe moeglich ist. Die Phosphorkonzentration im Abwasser konnte auf unter 1 mg/l reduziert werden. Fischgiftiges Ammonium wurde nitrifiziert und die Gesamtstickstoffkonzentration konnte gesenkt werden. Die Bakterienkonzentration konnte mit Hilfe eines naturnahen Verfahrens bis unter die Grenzwerte der EU-Richtlinie ueber die Qualitaet der Badegewaesser reduziert werden. (orig.)
-
BMI-Referenzwerte für österreichische Knaben und Mädchen
Directory of Open Access Journals (Sweden)
Mayer M
2015-01-01
Full Text Available BMI-Referenzwerte werden empfohlen zur Diagnose von Untergewicht, Übergewicht und Adipositas. Österreichische BMI-Referenzwerte sind bis dato nicht in ausreichender Qualität verfügbar. Deshalb wurden im Rahmen einer Querschnittsstudie 15.000 Kinder und Jugendliche zwischen 4 und 19 Jahren vermessen und abgewogen. Perzentilenkurven für Knaben und Mädchen wurden mit dem GAMLSS-Modell errechnet. Als Grenzwert für die Einteilung in Untergewicht, Normalgewicht, Übergewicht und Adipositas wurden Perzentilenkurven durch die entsprechenden BMI-Punkte mit 18 Jahren erstellt, welche den WHO-Grenzen von Unter-, Normal- und Übergewicht bzw. Adipositas bei Erwachsenen entsprechen. Unter Anwendung dieser neuen Grenzwerte sind rund 18 % der Knaben und 12 % der Mädchen übergewichtig, weitere 5 % der Knaben und 3 % der Mädchen sind adipös. Übergewicht und Adipositas sind somit bei Kindern und Jugendlichen in Österreich ein nicht zu vernachlässigendes Problem.
-
International Nuclear Information System (INIS)
Gumprecht, D.; Haehnel, S.
1995-01-01
The guide explains the medical tasks and activities in the context of the emergency preparedness programmes and provisions established by the Laender. The medical expert for radiation injuries is a particularly important function in the radiologial accident management services. The provisions for medical care have been determined on the basis of knowledge drawn among other sources from the German Nuclear Power Plant Risk Study, Phase B. In addition, the guide's provisions are based on international knowledge about the consequences of enhanced radiation exposure, and the medical tasks and the required organisational infrastructure have been determined accordingly. A further source of reference for planning the activities are the data accumulated during emergency preparedness training activities in the various Laender. (orig./MG). 3 figs., 5 tabs [de
-
Contribution of renal X-ray examinations to the radiation exposure to the population
Energy Technology Data Exchange (ETDEWEB)
Radtke, I [Staedtisches Klinikum Berlin-Buch (German Democratic Republic). Roentgendiagnostisches Zentrum; Angerstein, W [Forschungsinstitut fuer Tuberkulose und Lungenkrankheiten, Berlin (German Democratic Republic); Koenig, W; Menzel, B [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic)
1978-04-02
Measured values of the radiation exposure of patients by urography published in the literature are summarized and critically reviewed. The gonad dose to men, women and children has been determined in 6 series of measurements performed according to the recommendations of the Gesellschaft fuer Medizinische Radiologie. Altogether, the determination of the gonad dose based on 927 individual measurements, 230 of them intravaginally, on 226 patients. The surface dose has been determined from 335 measurements. With exact collimation and shielding values of 250 mR for men and 650 mR for women have been obtained as the most probable ones. For 350,000 urographs equally distributed to both sexes and performed under correct working conditions an average per capita dose of 9.2 mR would result.
-
Pocket atlas of radiographic anatomy. 2. rev. ed.; Taschenatlas der Roentgenanatomie
Energy Technology Data Exchange (ETDEWEB)
Moeller, T.B.; Reif, E. [Caritas-Krankenhaus, Dillingen (Germany)
1998-07-01
This pocket atlas is the second, revised German edition of the pocket atlas of radiographic anatomy. All anatomic structures of clinical relevance are reproduced according to the split page concept, showing the radiographs, the accompanying drawings and the clinical terminology. (orig./CB) [German] Diese 2. ueberarbeitete Auflage des Taschenatlas der Roentgenanatomie und zeichnet sich aus durch folgende Aspekte: - Hoher Informationsgehalt: alle gaengigen Standard- und Spezialeinstellungen der konventionellen Radiologie einschliesslich aller Kontrastmitteluntersuchungen werden beschrieben. - Praezise im Detail: alle klinisch relevanten anatomischen Strukturen werden in einer dem Roentgenbild direkt gegenuebergestellten Zeichnung wiedergegeben und benannt. Der Benennung liegt die klinisch gebraeuchliche Terminologie zugrunde. - Immer griffbereit, handlich und uebersichtlich: das praktische Taschenbuchformat macht es leicht, das Buch immer dabeizuhaben. Der einfache Aufbau erspart muehsames Suchen in Inhalts- oder Sachverzeichnissen. (orig.)
-
2013-02-22
.... In essence, a Cost HMO/CMP or an HCPP that did not meet the minimum MLR requirement on the Part D... MLR provisions. Note that there also are terms defined in other sections of the Part 422 Subpart X and Part 423 Subpart X (for example, ``incurred claims'' is defined in Sec. 422.2420(b) and Sec. 423.2420(b...
-
Schwidtal, Michael
2001-01-01
3. - 5. sept. 2001 toimus Riias sümpoosion "Unter diesem braunen Himmel. Jakob Michael Reinhold Lenz und die deutsche Literatur des Baltikums", 7. - 9. sept. Tartus "Torm ja tung Liivimaal. Mässu mudelid", pühendatud J. M. R. Lenzi ja Kristian Jaak Petersoni loomingule. Ülevaade
-
Über die Datenakzessivität in Printwörterbüchern
African Journals Online (AJOL)
R.B. Ruthven
Alphabets des neuhochdeutschen Schriftsystems ein. Jedes Alphabet lässt sich unter zwei Aspekten betrachten, nämlich dem Verschriftungs- und dem Ord- nungsaspekt. Anders ausgedrückt heißt das: Jedes Alphabet ist bifunktional: Es dient der Verschriftung einer gesprochenen Sprache und hat damit einen Bezug.
-
Energy Technology Data Exchange (ETDEWEB)
Dettmer, S.; Weidemann, J.; Wacker, F. [Hannover Medical School, Hannover (Germany). Inst. for Diagnostic and Interventional Radiology; Fischer, V. [Hannover Medical School, Hannover (Germany). Office for Medical Education
2015-04-15
To survey integrative teaching in radiology at German universities. A questionnaire about radiological education was sent electronically to all 37 chairpersons of university radiology departments in Germany. The questions included the course type, teaching methods, concept, perception, and advantages and disadvantages of integrative teaching. Statistical analysis was performed with nonparametric statistics and chi-square test. The survey was considered representative with a return rate of 68%. Integrative teaching is established at 4/5 of all departments. Integrative teaching is well accepted with an acceptance rate that is significantly higher in so-called 'Modellstudiengaengen' (model courses of study) (100%) compared to conventional courses of study (72%). The advantages of integrative teaching include linking of content (92%) and preparation for interdisciplinary work (76%). The disadvantages include high effort (75%) and time (67%) for organization. Furthermore, there is a risk that basic radiological facts and knowledge cannot be conveyed and that the visibility of radiology as an independent discipline is lost. Conventional radiological teaching has a similarly high acceptance (84%) compared to integrative courses (76%). Integrative teaching has a high acceptance among chairpersons in radiology in Germany despite the greater effort. A good interdisciplinary collaboration is essential for integrative teaching and at the same time this can be conveyed to the students. However, the visibility of radiology as a discipline and the possibility to cover basic radiological content must be ensured. Therefore, both conventional courses and integrative teaching seems reasonable, especially in cross-disciplinary subjects such as radiology.
-
Energy Technology Data Exchange (ETDEWEB)
Kainberger, F.; Kletter, K. [Universitaetsklinik fuer Radiodiagnostik, Medizinische Univ. Wien (Austria)
2007-11-15
Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula. (orig.)
-
Coalification reactions under pressure. Inkohl-ungsreaktionen unter Druck
Energy Technology Data Exchange (ETDEWEB)
Huck, G.; Patteisky, K.
1964-12-15
Studies of the influence of pressure on the coalification reactions in hard coal (temperature ranges from 240 to 350/sup 0/C and pressures ranging from 0.1 to 8000 ata) have shown that coalification reactions in younger coals are impeded by higher mechanical pressures. The relationship of the mutual effect of pressure and temperature on the coalification reactions may be illustrated by graphs, if the parameters are determined, which cause an increase in the reflection index of the vitrinite of 0.89 to 1.0 and liberate 8 liters of gas per kilogram of finely ground coal, at 0.5 mm Hg. The results indicate, contrary to theories often expressed in the literature, that the intensifying influence of pressure on coalification may be excluded if the pressure charge operates through shear- and friction-forces, without temperature changes. The results also show that the use of spores as coalification thermometers is limited. It is shown that at higher pressures spores may be exposed to temperatures above 200/sup 0/C without showing thermal modifications.
-
Der antiskeptische Boden unter dem Gehirn im Tank
Müller, Olaf L.
2001-01-01
Crispin Wright hat die bislang beste Rekonstruktion von Putnams Beweis gegen die skeptische Hypothese vom Gehirn im Tank vorgelegt. Aber selbst in Wrights Fassung hat der Beweis einen Mangel: Er wird mithilfe eines Prädikates wie z.B. "Tiger" geführt und funktioniert nur, wenn man sich darauf verlassen kann, dass es Tiger wirklich gibt. Aber die Skeptikerin bestreitet, über die Existenz von Tigern bescheid zu wissen. Das Problem lässt sich dadurch beheben, dass man den Beweis – statt mit dem ...
-
Mythos Qualifikation – Berufungsverfahren unter der gleichstellungspolitischen Lupe
Directory of Open Access Journals (Sweden)
Eva Blome
2008-11-01
Full Text Available Auf der Grundlage von qualitativen Interviews und einer Vollerhebung aller Verfahrensregelungen liefert die Studie eine umfassende Analyse der Gestaltung von Berufungsverfahren aus gleichstellungspolitischer Perspektive. Aufgrund der ergänzenden konkreten Handlungsempfehlungen zum gleichstellungsorientierten Verfahrensmanagement verhilft die Untersuchung nicht nur zu einer empirisch fundierten Einsicht in die Diskriminierungsmechanismen an deutschen Hochschulen, sondern stellt zudem einen wichtigen Beitrag für die Integration von Gleichstellung in die aktuellen Reformen von Berufungsverfahren dar.
-
Akustische und perzeptive Analysen von Sprache unter Alkoholeinfluss
Baumeister, Barbara Susanne
2015-01-01
In this thesis, several acoustic and perceptive studies on the influence of alcoholic intoxication on speech are presented. The speech samples for the experiments are taken from the Alcohol Language Corpus, a large database containing recordings of 162 (77 female and 85 male) speakers in both sober and intoxicated conditions with various blood alcohol concentrations. An acoustic analysis of recordings of 148 speakers in intoxicated and sober condition reveals a significant increase of the mea...
-
Energy Technology Data Exchange (ETDEWEB)
Hammer, T.; Kishimoto, T.; Birckigt, R.
2000-12-01
Selective catalytic reduction using ammonia based reducing agents is known to reduce the NOx-emissions from Diesel cars. However, it does not work efficiently under cold starting and urban driving conditions, because efficient reduction requires catalyst temperatures above 170 C. Without additional measures, pulsed plasma treatment does not cause reduction but mainly oxidation of nitric oxides preferably emitted as NO. By the combination of pulsed DBD-plasma treatment with selective catalytic reduction efficient NOx-reduction was obtained at catalyst temperatures below 170 C. It could be shown, that this low temperature reduction is a synergistic effect caused by plasma induced oxidation of some fraction of the NO. Based on this knowledge of the reaction mechanism plasma- and SCR-reactors were built, which were tested on a test bench equipped with a modern cars Diesel engine. Under cold starting and urban driving conditions by application of average plasma powers below 300 W the NOx-emissions were reduced for about 60%, the maximum degree of NOx-reduction was 85%. The plasma induced removal of hydrocarbons and particles, as well as the formation of by-products and the influence of hydrocarbons on the plasma induced selective catalytic reduction processes were investigated. No disadvantageous by-products could be found. (orig.) [German] Die selektive katalytische Reduktion mit Ammoniak als Reduktionsmittel ist ein bekanntes Verfahren zur Reduktion der Stickoxidemissionen von Diesel-Pkw, arbeitet aber erst ab Katalysatortemperaturen oberhalb 170 C und ist damit unter Kaltstart- und Stadtverkehrsbedingungen wenig wirksam. Gepulste Plasmen bewirken ohne zusaetzliche Massnahmen keine ausreichende chemische Reduktion sondern ueberwiegend Oxidation der als NO emittierten Stickoxide. Durch Kombination von DBE-Plasmen mit der selektiven katalytischen Reduktion hingegen konnte auch bei Katalysatortemperaturen unter 170 C wirkungsvolle NOx-Reduktion erzielt werden. Es konnte
-
Energy Technology Data Exchange (ETDEWEB)
Renz, U.; Meingast, U.
2001-02-01
Spray/wall-interaction under diesel engine conditions is not yet investigated extensively in detail with high spatial resolution and high time resolution as those experiments require extremely accurate techniques. Numerical modelling to predict fluiddynamic and heat transfer processes are validated mostly under non engine conditions. The processes during spray/wall interaction under internal combustion engine conditions were investigated experimentally in an injection chamber using enhanced laser optical methods. To enable validation and development of numerical spray/wall models the data was collected under well known and reproducible conditions. Microscopic visualisation tools, Phase-Doppler Anemometry (PDA) to measure droplet diameter and velocity as well as fluorescence based film measurement technique and high speed surface thermocouples to determine the wall heat flux were used. The numerical predictions of the spray wall interaction using Computational Fluid Dynamics (CFD) including two spray/wall models from the literature show qualitatively good agreement with the experiments. However, quantitatively some insufficiencies are observed because the models base on experiments under atmospheric conditions disregarding the influences of high pressure and high temperature. Here more detailed investigation is necessary in the future. The present results build up a comprehensive basis to validate future models and their interaction. Progress was done in using measurement techniques to investigate complex mechanisms under challenging conditions. (orig.) [German] Die Spray/Wand Wechselwirkung unter dieselmotorischen Bedingungen ist bisher nicht mit hoher Zeit- und Ortsaufloesung umfassend charakterisiert worden, weil deren Untersuchung hohe Anforderungen an die Messtechniken stellt. Numerische Modelle zur Vorhersage der Stroemungs- und Waermetransportvorgaenge sind nur teilweise unter reale Bedingungen verifiziert worden. Die Vorgaenge beim Auftreffen eines
-
Digital Repository Service at National Institute of Oceanography (India)
Sarkar, A.
$ånm| H$s dOh go `o bha| n¡Xm hmoVr h¢& àemÝV ‘hmgmJa ‘| ¶h ~hþV Am‘ h¢, na ~§Jmb H$s Im‹S>r, {hÝX ‘hmgmJa d Aa~ gmJa ‘| Zht& Bgr{bE em`X ^maVr` ^mfmAm| ‘| BZHo$ {bE {d{eï> Zm‘ Zht h¡& {MÌ 1 g‘wÐ ‘| gwZm‘r H$s bha| {XIm`m gwZm‘r à{H«$`m Am¡a Cg...’w$Q>~m°b H$s naVm| H$s Vah Amng ‘| Ow‹S>r hþB© h¡ `m H$h| {H$ EH$ A§So> H$s Vah go h¡ {Og‘| Xama| hm|&nhbo gyZm‘r H$mo g‘wÐ ‘| CR>Zo dmbo Ádma Ho$ ê$n ‘| ^r {b`m OmVm ahm h¡ bo{H$Z Eogm Zht h¡. XaAgb g‘wÐ ‘| bhao Mm±X gyaO Am¡a J«hm| Ho$ JwéËdmH$f©U Ho$ à...
-
Martin, David C; Berger, Marc L; Anstatt, David T; Wofford, Jonathan; Warfel, DeAnn; Turpin, Robin S; Cannuscio, Carolyn C; Teutsch, Steven M; Mansheim, Bernard J
2004-10-01
The object of this study was to examine the effect of population-based disease management and case management on resource use, self-reported health status, and member satisfaction with and retention in a Medicare Plus Choice health maintenance organization (HMO). Study design consisted of a prospective, randomized controlled open trial of 18 months' duration. Participants were 8504 Medicare beneficiaries aged 65 and older who had been continuously enrolled for at least 12 months in a network model Medicare Plus Choice HMO serving a contiguous nine-county metropolitan area. Members were care managed with an expert clinical information system and frequent telephone contact. Main outcomes included self-reported health status measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), resource use measured by admission rates and bed-days per thousand per year, member satisfaction, and costs measured by paid claims. More favorable outcomes occurred in the intervention group for satisfaction with the health plan (P management and case management led to improved self-reported satisfaction and social function but not to a global net decrease in resource use or improved member retention.
-
Seidl, A.; Colin, N.; Farges, P.; Taubert, F.
2017-01-01
„Was Bertolt Brecht für das deutsche Theater der ersten Hälfte des Jahrhunderts bedeutete, bedeutete Pina Bausch für die zweite Hälfte.“ Rudolf Rach (Verleger, L’Arche Editeur, Paris) Das Tanztheater Wuppertal errang unter seiner Choreographin Pina Bausch Weltruhm. Die Grundannahme ist, dass Bauschs
-
Energy Technology Data Exchange (ETDEWEB)
Engelhart, M.; Dichtl, N. [Technische Univ. Braunschweig (Germany). Inst. fuer Siedlungswasserwirtschaft
1999-07-01
On a semi-technical scale, two process combinations were tested for their suitability for COD elimination and nitrification in combination with an overcongested packed-bed reactor (biofilter). (orig.) [German] Im halbtechnischen Massstab wurden zwei Verfahrenskombinationen unter Einbeziehung eines ueberstauten Festbettreaktors (Biofilter) auf ihre Tauglichkeit zur CSB-Elimination und Nitrifikation untersucht. (orig.)
-
Nelipühad Mozarti ooperitega Berliinis
2002-01-01
Berliini Staatsoper Unter den Lindenil toob 18.-26. maini peadirigent Daniel Barenboimi juhatusel välja kolm Mozarti Lorenzo da Ponte libretole komponeeritud ooperit: "Figaro pulm", "Don Giovanni" ja "Cosi fan tutte". Talvise hooaja lõpetasid märtsis Staatsoperis Albert Lortzingi "Zar und Zimmermann" ja Gioachino Rossini "Sevilla habemeajaja"
-
Energy Technology Data Exchange (ETDEWEB)
Kaesmann, Lukas [University of Luebeck, Department of Radiation Oncology, Luebeck (Germany); Niyazi, Maximilian; Fleischmann, Daniel [LMU Munich, Department of Radiation Oncology, Munich (Germany); German Cancer Consortium (DKTK), partner site Munich, Munich (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); Blanck, Oliver; Baumann, Rene [University Medical Center Schleswig-Holstein, Department of Radiation Oncology, Kiel (Germany); Baues, Christian; Klook, Lisa; Rosenbrock, Johannes; Trommer-Nestler, Maike [University Hospital of Cologne, Department of Radiotherapy, Cologne (Germany); Dobiasch, Sophie [Technische Universitaet Muenchen, Department of Radiation Oncology, Munich (Germany); Eze, Chukwuka [LMU Munich, Department of Radiation Oncology, Munich (Germany); Gauer, Tobias; Goy, Yvonne [University Medical Center Hamburg-Eppendorf, Department of Radiotherapy and Radio-Oncology, Hamburg (Germany); Giordano, Frank A.; Sautter, Lisa [University Medical Center Mannheim, Department of Radiation Oncology, Mannheim (Germany); Hausmann, Jan [University Medical Center Duesseldorf, Department of Radiation Oncology, Duesseldorf (Germany); Henkenberens, Christoph [Hannover Medical School, Department of Radiation and Special Oncology, Hannover (Germany); Kaul, David; Thieme, Alexander H. [Charite School of Medicine and University Hospital, Campus Virchow-Klinikum, Department of Radiation Oncology, Berlin (Germany); Krug, David; Schmitt, Daniela [University Hospital Heidelberg and National Center for Radiation Research in Oncology (NCRO) and Heidelberg Institute for Radiation Oncology (HIRO), Department of Radiation Oncology, Heidelberg (Germany); Maeurer, Matthias [University Medical Center Jena, Department of Radiation Oncology, Jena (Germany); Panje, Cedric M. [Kantonsspital St. Gallen, Department of Radiation Oncology, St. Gallen (Switzerland); Suess, Christoph [University Medical Center Regensburg, Department of Radiation Oncology, Regensburg (Germany); Ziegler, Sonia [University Medical Center Erlangen, Department of Radiation Oncology, Erlangen (Germany); Ebert, Nadja [University Medical Center Dresden, Department of Radiation Oncology, Dresden (Germany); OncoRay - National Center for Radiation Research in Oncology, Dresden (Germany); Medenwald, Daniel [Martin Luther University Halle-Wittenberg, Department of Radiation Oncology, Faculty of Medicine, Halle (Germany); Ostheimer, Christian [Martin Luther University Halle-Wittenberg, Department of Radiation Oncology, Faculty of Medicine, Halle (Germany); Klinik und Poliklinik fuer Strahlentherapie, Universitaetsklinikum Halle (Saale) (Germany); Collaboration: Young DEGRO Trial Group
2018-02-15
. Several potential confounding variables were found and need to be considered for future studies to evaluate GTV changes during definitive radiotherapy with respect to treatment outcome. (orig.) [German] Das Bronchialkarzinom ist die haeufigste Ursache krebsbedingter Mortalitaet weltweit. Das Stadium III des nicht-kleinzelligen Bronchialkarzinoms (NSCLC) praesentiert sich als heterogene Patientengruppe mit Lymphknotenbeteiligung und grossen Tumoren mit Infiltration von Mediastinum, Herz und Wirbelsaeule. Ein interdisziplinaeres Behandlungskonzept mit Strahlentherapie ist Therapiestandard in der Behandlung des Stadium III mit akzeptabler Toxizitaet und verbessertem klinischen Ergebnis hinsichtlich lokaler Kontrolle. Veraenderungen des Tumorvolumens (GTV) unter Strahlentherapie ermoeglichen eine adaptive Bestrahlungsplanung mit Normalgewebeschonung und Dosiseskalation. Durchgefuehrt wurde eine Literaturrecherche zum praediktiven Wert von GTV-Veraenderungen unter Strahlentherapie mit dem Endpunkt ''Gesamtueberleben''. Die Recherche wurde in einem zweistufigen Verfahren unter Verwendung von Medline/Pubmed mit den Stichwoertern ''stage III non-small cell lung cancer'' und ''radiotherapy'' und ''tumour volume'' und ''prognostic factors'' durchgefuehrt. Nach finaler Bewertung blieben 17, 14 und 9 Studien mit 2516, 784 und 639 Patienten zum praediktiven Einfluss von GTV, GTV-Veraenderung und dessen Einfluss auf das Gesamtueberleben uebrig und wurden in den Review aufgenommen. Das initiale GTV war in verschiedenen Studien ein wichtiger prognostischer Faktor fuer das Gesamtueberleben. Zeitpunkt der Evaluation und Einfluss der Histologie muessen jedoch weiter untersucht werden. GTV-Veraenderungen unter Strahlentherapie variieren sehr. Der optimale Zeitpunkt fuer eine Reevaluation des GTVs fuer den praediktiven Wert auf die Prognose ist unklar. Der prognostische Wert von GTV
-
Directory of Open Access Journals (Sweden)
Krämer, Robert
2013-02-01
des hormonrezeptorpen Brustkrebses postmenopausaler Frauen abgelöst. Tamoxifen ist mit einem ca. zweifach erhöhten Risiko für thrombembolische Komplikationen (tiefe Beinvenenthrombose, Lungenembolie assoziiert. Vor dem Hintergrund einer aktuellen und im Februar 2012 im Journal of Plastic and Reconstructive Surgery erschienenen retrospektiven Studie mit Nachweis einer erhöhten Komplikationsrate freier Lappentransplantate zur Brustrekonstruktion unter Tamoxifen-Einnahme haben wir unser Patientenkollektiv nach mikrochirurgischer Brustrekonstruktion retrospektiv auf Minor- und Major-Komplikationen einschließlich thrombembolischer Ereignisse insbesondere vor dem Hintergrund einer perioperativen Tamoxifeneinnahme untersucht. Eingeschlossen wurden insgesamt 29 Patientinnen nach mikrochirurgischer autologer Brustrekonstruktion. Es wurden mikrovaskuläre Lappenkomplikationen und Lappenverluste von Patientinnen ohne und mit Einnahme von Tamoxifen und Aromatasehemmern zum Zeitpunkt der mikrochirurgischen Brustrekonstruktion verglichen. 25 Patientinnen (86,2% erhielten eine DIEP-Lappenplastik und 4 (13,8% eine TRAM-Lappenplastik. Fernerhin verglichen wir die Rate allgemeiner thrombembolischer Ereignisse unter Berücksichtigung sonstiger Nebendiagnosen und Risikofaktoren. Von insgesamt 29 Patientinnen standen zum Zeitpunkt der mikrovaskulären Brustrekonstruktion 3 unter einer Aromatasehemmer-Therapie und 5 unter einer Tamoxifen-Therapie. Insgesamt traten in 11 Fällen (37,9% postoperative Komplikationen auf, in 5 Fällen handelte es sich hierbei um Major-Komplikationen (mit einem Lappenverlust und in um Minorkomplikationen. Unter Tamoxifeneinnahme kam es in einem Fall zu einer Minorkomplikation, und in einem anderen Fall zu einem thrombembolisch bedingten Lappenverlust. Insgesamt kam es postoperativ zu einem thrombembolischen Ereignis in Form einer Lungenembolie ohne Assoziation zur Tamoxifen-Therapie.Die Anzahl thrombembolischer Ereignisse stellten sich mit und ohne
-
Critical factors in recruiting health maintenance organization physicians.
Fisher, N B; Smith, H L; Pasternak, D P
1993-01-01
What factors facilitate successful physician recruiting by health care organizations? Answers surfaced in a study of physician recruiting by a large HMO in the Southwest. Professional networking and word-of-mouth advertising appear to be the prominent means by which physicians learn of attractive staff positions. Successful recruiting also depends on a practice setting that fosters quality care, emphasis on patient care delivery, and collegial interaction.
-
Linking Internet strategy to high-quality, cost-effective managed care.
Beauregard, T R
2000-01-01
This article describes an experimental pilot project incorporating e-commerce and the Internet into the traditional process of health benefit negotiations through the utilization of an HMO Internet auction. The timeline and process of the auction are described, with the final auction taking place during the last week of negotiations. The results reveal an efficient and effective system to augment the traditional benefit negotiation process.
-
Reproductive health care for asylum-seeking women - a challenge for health professionals
Directory of Open Access Journals (Sweden)
Zemp Elisabeth
2010-11-01
Full Text Available Abstract Background Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. Methods A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. Results The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population, due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Conclusion
-
Edwards, Valerie J; Holden, George W; Felitti, Vincent J; Anda, Robert F
2003-08-01
This study examined the prevalence of a history of various combinations of childhood maltreatment types (physical abuse, sexual abuse, and witnessing of maternal battering) among adult members of a health maintenance organization (HMO) and explored the relationship with adult mental health of the combinations of types of childhood maltreatment and emotional abuse in the childhood family environment. A total of 8,667 adult members of an HMO completed measures of childhood exposure to family dysfunction, which included items on physical and sexual abuse, witnessing of maternal battering, and emotional abuse in the childhood family environment. The adults' current mental health was assessed by using the mental health scale of the Medical Outcomes Study 36-item Short-Form Health Survey. The prevalences of sexual abuse, physical abuse, and witnessing of maternal violence were 21.6%, 20.6%, and 14.0%, respectively, when the maltreatment types were considered separately. Among respondents reporting any of the maltreatment types, 34.6% reported more than one type of maltreatment. Lower mean mental health scores were associated with higher numbers of abuse categories (mean=78.5, 75.5, 72.8, and 69.9 for respondents with no, one, two, and three abuse types, respectively). Both an emotionally abusive family environment and the interaction of an emotionally abusive family environment with the various maltreatment types had a significant effect on mental health scores. Childhood physical and sexual abuse, as well as witnessing of maternal battering, were common among the adult members of an HMO in this study. Among those reporting any maltreatment, more than one-third had experienced more than one type of maltreatment. A dose-response relation was found between the number of types of maltreatment reported and mental health scores. In addition, an emotionally abusive family environment accentuated the decrements in mental health scores. Future research examining the effects of
-
Total interaction theory and practice of a new paradigm for the design disciplines
Buurman, Gerhard M
2005-01-01
Interaktivität beschreibt eine dynamische Kooperation von Mensch und Technik und bedingt ein neues Denken unter der Annahme von einem «Leben in Technik». Das Buch führt Wissenschaftler und Menschen aus unterschiedlichen Praxisbereichen zusammen und gibt einen Überblick über das technologische und konzeptionelle Rüstzeug von Gestaltern.
-
Die Inquisition und ihre Wahrnehmung im Alten Reich
Directory of Open Access Journals (Sweden)
Alexandra Kohlhöfer
2013-01-01
Full Text Available Rezension von: Tribunal der Barbaren? Deutschland und die Inquisition in der Frühen Neuzeit, hg. von Albrecht Burckhardt und Gerd Schwerhoff unter Mitwirkung von Dieter R. Bauer (Konflikte und Kultur – Historische Perspektiven 25, Konstanz, München: UVK-Verl.-Ges. 2012, 450 S., ISBN 978-3-86764-371-9
-
Die beiden Azolla-arten des Niederländischen Pleistozäns
Florschütz, F.
1938-01-01
Die erste Mitteilung über die Möglichkeit des Vorkommens fossiler Azolla im niederländischen Boden rührt von J. LORIé her, der im Jahre 1905 bei der Beschreibung von Bohrproben die Entdeckung von Makrosporangien von Azolla filiculoides Lam. in einer dünnen Torfschicht unter Vogelenzang erwähnte
-
Über einige von Edw. Jacobson auf Java gesammelte Trichopteren
Ulmer, Georg
1913-01-01
Seit ich das letzte Verzeichniss der javanischen Triphopteren gab (Notes Leyden Mus. 32. 1910, pp. 64—66) beschrieb Cornelius Betten („Notes on the Trichoptera in the collection of the Indian Museum.” Records of the Indian Museum. Calcutta, Oct. 1909, pp. 231—242 t. 14—18) unter andern indischen
-
Zur Einführung: Die Chamisso-Literatur
Directory of Open Access Journals (Sweden)
Nazli Hodaie
2017-04-01
Die vorliegende ZIF-Ausgabe widmet sich solchen literarischen Schaffensprozessen, die im Folgenden unter „interkultureller Literatur“ zusammengefasst werden. Am Beispiel der so genannten „Chamisso-Autorinnen und -Autoren“ setzen sich die Beiträgerinnen und Beiträger mit interkultureller Literatur im Kontext der Literaturwissenschaft sowie Literaturdidaktik auseinander und diskutieren ihren gesellschaftlichen Stellenwert.
-
Energy Technology Data Exchange (ETDEWEB)
Schueller, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria)
2010-05-15
For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing. The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided. (orig.) [German] Mountainbiking erfreut sich seit mehr als 2 Jahrzehnten sowohl im Breiten- als auch Wettkampfsport einer ungebrochenen Popularitaet. Die assoziierten Risiken werden allerdings nicht mit derselben Aufmerksamkeit beobachtet wie etwa jene des Skisports. Die Verletzungen beim Mountainbiking sind spezifisch und nicht mit den Verletzungen vergleichbar, die bei anderen Radsportarten entstehen. Dies ist z. T. durch die Besonderheiten des Terrains und z. T. durch eine im Vergleich zum Rennradfahren hoehere Risikobereitschaft zu erklaeren. Die Radiologie hat ihren Stellenwert besonders in der Akutdiagnostik. Hier beschaeftigt sie sich v. a. mit muskuloskelettalen Verletzungen und setzt in erster Linie auf die digitale Projektionsradiographie und die MRT. Zur Evaluierung schwerer Verletzungen des Kopfs, der Wirbelsaeule, des Thorax und des Abdomens wird die CT bevorzugt, insbesondere in dezidierten Traumazentren. Damit kann die Radiologie ihren Teil
-
Contribution of renal X-ray examinations to the radiation exposure to the population
International Nuclear Information System (INIS)
Radtke, I.; Koenig, W.; Menzel, B.
1978-01-01
Measured values of the radiation exposure of patients by urography published in the literature are summarized and critically reviewed. The gonad dose to men, women and children has been determined in 6 series of measurements performed according to the recommendations of the Gesellschaft fuer Medizinische Radiologie. Altogether, the determination of the gonad dose based on 927 individual measurements, 230 of them intravaginally, on 226 patients. The surface dose has been determined from 335 measurements. With exact collimation and shielding values of 250 mR for men and 650 mR for women have been obtained as the most probable ones. For 350,000 urographs equally distributed to both sexes and performed under correct working conditions an average per capita dose of 9.2 mR would result. (author)
-
Lauvin, M-A; Martineau, J; Destrieux, C; Andersson, F; Bonnet-Brilhault, F; Gomot, M; El-Hage, W; Cottier, J-P
2012-03-01
Autism is a pervasive disorder of childhood development. Polymorphous clinical profiles combining various degrees of communication and social interaction with restricted and stereotyped behaviour are grouped under the heading of 'autism spectrum disorders' (ASD). Many teams are trying to pick out the underlying cerebral abnormalities in order to understand the neuronal networks involved in relationships with others. Here we review the morphological, spectroscopic and functional abnormalities in the amygdala-hippocampal circuit, the caudate nuclei, the cerebellum, and the frontotemporal regions, which have been described in subjects with ASD. White matter abnormalities have also been described in diffusion tensor imaging, leading to suspected damage to the subjacent neural networks, such as mirror neurones or the social brain. Copyright © 2012 Éditions Françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
-
Energy Technology Data Exchange (ETDEWEB)
Runde, W; Kim, J I
1994-09-15
In order to clarify the chemical behaviour of Americium in saline aqueous systems relevant for final storage this study deals with the chemical reactions of trivalent and pentavalent Americium in NaCl-solutions under the influence of radiolysis from its own alpha radiation. The focus of the study was on investigating the geologically relevant reactions, such as hydrolysis or carbonate- and chloride complexing in solid-liquid equilibriums. Comprehensive measurements on solubility and spectroscopic studies in NaCl-solutions were carried out in a CO{sub 2}-free atmosphere and 10{sup -2} atm CO{sub 2} partial pressure. Identification and characterisation of the AM (III) and AM(V) solid phases were supplemented by structural research with the chemically analogue EU (III) and Np(V) compounds. The alpha-radiation induced radiolysis in saline NaCl solutions and the redox behaviour of Americium which was influenced thereby were spectroscopically quantified. (orig.) [Deutsch] Zur Klaerung des chemischen Verhaltens von Americium in endlagerrelevanten salinen aquatischen Systemen befasst sich die vorliegende Arbeit mit den chemischen Reaktionen des drei- und fuenfwertigen Americiums in NaCl-Loesungen unter dem Einfluss der Radiolyse durch die eigene {alpha}-Strahlung. Der Schwerpunkt dieser Arbeit lag auf der Untersuchung der geologisch relevanten Reaktionen, wie Hydrolyse sowie Carbonat- und Chloridkomplexierung in fest-fluessig Gleichgewichtssystemen. Hierzu wurden umfassende Loeslichkeitsmessungen und spektroskopische Untersuchungen in NaCl-Loesungen, sowohl unter CO{sub 2}-freier Atmosphaere als auch unter 10{sup -2} atm CO{sub 2}-Partialdruck, durchgefuehrt. Die Identifizierung und Charakterisierung der Am(III)- und Am(V)-Festphasen wurde ergaenzt durch strukturelle Untersuchungen mit den chemisch analogen Eu(III)- und Np(V)-Verbindungen. Die von der {alpha}-Strahlung induzierte Radiolyse in salinen NaCl-Loesungen und das dadurch beeinflusste Redoxverhalten von Americium
-
Laterale 10-fach-Biopsie der Prostata liefert bei Karzinomverdacht überlegene Detektionsraten
Directory of Open Access Journals (Sweden)
von Knobloch R
2012-01-01
Full Text Available Einleitung:Die Sextantenbiopsie der Prostata ist für eine verlässliche Karzinomdiagnostik nicht ausreichend. Vielerorts werden bereits bei der Erstbiopsie 12 Stanzen entnommen. In einer großen Serie von 10-fach-Biopsien unter bilateraler lokaler Leitungsanästhesie, wie bereits 2002 publiziert [1], überprüften wir die Qualität unserer Technik als Standard für die Erstbiopsie. Methode:Zwischen April 2005 und Dezember 2007 führten wir bei 736 Männern (Durchschnittsalter 67,5 ± 8,39 Jahre die Erstbiopsie der Prostata durch. Indikation für die Biopsie war entweder ein erhöhter PSA-Wert oder ein auffälliger Tastbefund. Bei allen Männern erfolgte die Biopsie der Prostata unter bilateraler lokaler Leitungsanästhesie. Es wurden nur Proben aus der peripheren Zone der Prostata unter transrektaler Ultraschallkontrolle entnommen. Ergebnisse:Durch die Biopsie wurde in 372 von 736 Fällen (50,5 % ein Karzinom identifiziert. Die Karzinomdetektionsrate war proportional zum PSA-Wert und indirekt proportional zum Organvolumen. Es zeigte sich eine eindeutige Korrelation zwischen der Anzahl positiver Stanzen bei der Biopsie mit dem pathologischen Stadium des Prostatektomiepräparates. 12 Männer (1,6 % mussten wegen akuter Prostatitis und 5 (0,7 % wegen rektaler Blutung wieder ins Krankenhaus eingewiesen werden. Von den 182 Patienten des Untersuchers R. v. K. wurde der durchschnittliche Schmerz der Biopsie mit 1,69 von maximal 10 angegeben. Die Detektions- und Komplikationsraten dieser Biopsietechnik unterschieden sich nicht nach Durchführung von Assistenz- oder Fachärzten. Schlussfolgerung: Die präsentierte Biopsietechnik liefert mit nur 10 Stanzen eine überlegene Detektionsrate und eine geringe Rate an Komplikationen. Sie sollte als Basis für die Definition eines Standards für die Erstbiopsie der Prostata bei Karzinomverdacht dienen.
-
Energy Technology Data Exchange (ETDEWEB)
Pfeiler, C.
1995-02-14
Blasting technique with electric detonators is a standard instrument e.g. for drift heading in underground coal mining. The simultaneous increase of compactness and efficiency of electrical devices especially in underground mining calls for a careful consideration of susceptibility problems. As an interference of an inadmissible high level might cause a hazardous ignition limiting values and technical parameters of interference to electrical blasting circuits are evaluated. The sources of interference are classified into communication and power technique devices. Typical interference field strengths are determined by exemplary measurements and a model of wave propagation in underground galleries. An equivalent circuit of the impedance of typical electro-explosive devices used in German coal mining is evaluated and extended by an electro-thermal part based on the `Rosenthal equation`. By this means it is possible to determine a feasible ignition during a simulation using the calculated bridge wire temperature. (orig.) [Deutsch] Fuer den untertaegigen Steinkohlenbergbau ist die Sprengtechnik sowohl im Bereich der Streckenauffahrung als auch beim Schachtabteufen heute noch ein wichtiges Arbeitsinstrument. Dabei wird ausschliesslich die elektrische Zuendung eingesetzt. Durch den Trend zu kompakteren elektrischen Systemen bei gleichzeitiger Leistungssteigerung in Verbindung mit den geringen raeumlichen Abstaenden unter Tage gewinnen Phaenomene der elektromagnetischen Beeinflussung auch im Steinkohlenbergbau an Bedeutung. Eine unzulaessig hohe Beeinflussung des elektrischen Zuendsystems kann eine unerwuenschte Fruehzuendung verursachen. Dieses Gefahrenpotential erfordert eine gesonderte Untersuchung der Stoerfestigkeit elektrischer Zuendsysteme, zumal die Normen fuer den uebertaegigen Sprengbetrieb unter Tage aufgrund der unterschiedlichen Randbedingungen der Ausbreitung elektromagnetischer Wellen nicht uneingeschraenkt angewendet werden koennen. Die Stoerquellen der
-
Stakeholder Value Matrix - Die VErbindung zwischen Shareholder Value und Stakeholder Value
Frank Figge
2004-01-01
Die Studie zeigt, was unter Stakeholder Value verstanden werden kann, wie Shareholder Value und Stakeholder Value gemessen werden können und welche Verbindung zwischen beiden Konzepten besteht. In dieser Studie wird erstmals die Wertbeitragsanalyse von Stakeholderbeziehungen vorgestellt. Anhand der Stakeholder Value Matrix lässt sich zeigen, welche Stakeholdergruppen zusammen positiv zum Unternehmenswert beitragen.
-
An Anglo-German dialogue the Munich lectures on the history of international relations
Birke, Adolf M; Searle, Alaric
2015-01-01
Die Prinz-Albert-Gesellschaft hat sich zur Aufgabe gemacht, die britisch-deutschen Beziehungen in Wissenschaft, Kultur und Politik zu pflegen. Alljährlich finden unter dieser Prämisse Tagungen statt, deren Beiträge in den Prinz-Albert-Studien veröffentlicht werden und die viele interessante Aspekte der britisch-deutschen Beziehungen verdeutlichen.
-
Zur mediopassiven 2. Und 3. Person dualis im indogermanischen
Directory of Open Access Journals (Sweden)
Bojan Čop
1972-12-01
Full Text Available Bekanntlich gibt es in einigen seltenen idg. Sprachen (im Arischen, Griechischen, Tocharischen auch Personal - suffixe für die 2. u n d 3. P. Du. des Mediopassivs. Von diesen sind die griechischen Ausgänge – 2. und 3. Du primär, 2. Du. sekundär, Du. sekundär sicher junge Neubildungen, s. z. B. Brugmann, Grdr.2 II 3 II, 657, § 602; Schwyzer, Gr. Gr. I 670, 672. Ein voll ausgebildetes System solcher Endungen besitzt das Arische; im Tocharischen kommt nur eine einzige Form mit solcher Endung vor, die die 2. P. Du. Med. lmperativi darstellt. Unter solchen Umständen scheint es schwierig, aus diesem Material wahrscheinliche Schlüsse für da_s Urindogermanische zu machen. Und doch ist gerade die tocharische Form, die uns eine ausserordentlich grosse Hilfe leistet, wenn man sie richtig zu beurteilen vermag. Die tocharische Endung, verbunden mit den arischen, wird unter Einschluss der allgemeinen Tendenzen und Regelungen im System der indogermanischen Personalsuffixe ohne Schwierigkeit die urindogermanische Urform erscheinen lassen.
-
Process-integrated slag treatment; Prozessintegrierte Schlackebehandlung
Energy Technology Data Exchange (ETDEWEB)
Koralewska, R.; Faulstich, M. [Technische Univ., Garching (Germany). Lehrstuhl fuer Wasserguete- und Abfallwirtschaft
1998-09-01
The present study compares two methods of washing waste incineration slag, one with water only, and one which uses additives during wet deslagging. The presented aggregate offers ideal conditions for process-integrated slag treatment. The paper gives a schematic description of the integrated slag washing process. The washing liquid serves to wash out the readily soluble constituents and remove the fines, while the additives are for immobilising heavy metals in the slag material. The study is based on laboratory and semi-technical trials on the wet chemical treatment of grate slag with addition of carbon dioxide and phosphoric acid. [Deutsch] Die dargestellten Untersuchungen beziehen sich auf den Vergleich zwischen einer Waesche der Muellverbrennungsschlacke mit Wasser und unter Zugabe von Additiven im Nassentschlacker. In diesem Aggregat bieten sich optimale Voraussetzungen fuer eine prozessintegrierte Schlackebehandlung. Die Durchfuehrung der integrierten Schlackewaesche wird schematisch gezeigt. Durch die Waschfluessigkeit sollen die leichtloeslichen Bestandteile ausgewaschen und die Feinanteile ausgetragen sowie durch die Additive zusaetzlich die Schwermetalle im Schlackematerial immobilisiert werden. Dazu erfolgten Labor- und halbtechnische Versuche zur nasschemischen Behandlung der Rostschlacken unter Zugabe von Kohlendioxid und Phosphorsaeure. (orig./SR)
-
Energy Technology Data Exchange (ETDEWEB)
Hofmann, H H [SDK Ingenieurunternehmen GmbH, Basel (Switzerland)
1998-11-01
The paper deals with description of structures and the relevant dynamic loads. As to the structures, gas, fluid, or solid structures are to be considered. They determine the characteristic vibrational behaviour of the structures in the interconnected system. The excitation type determines the component that will be induced to change characteristic vibrational behaviour of the structure, depending on the load increasing time and the period of excitation. Three examples are given to illustrate the processes. (Water tank subject to quasi-seismic conditions; pipeline affected by blow-down; shut-off valve for a pipe). (orig./CB) [Deutsch] In diesem Beitrag soll auf die Erfassung der Strukturen und die Erfassung der dynamischen Belastungen eingegangen werden. Zur Erfassung der Strukturen sind `Gas-, Fluid- und Festkoerper-Strukturen` zu beachten. Sie bestimmen das Eigenschwingverhalten im Verbund. Die Erregung bestimmt nun, welcher Bereich aus dem Eigen-Schwingverhalten der Struktur ueber die Lastanstiegs-Zeit und die Zeitdauer der Erregung anregbar ist. Drei Beispiele sollen die Aufgabenstellung erlaeutern (Wasserbehaelter unter erdbebenaehnlichen Bedingungen; Rohrleitung unter `Blow-down-Belastung`; Absperrklappe fuer eine Rohrleitung). (orig./MM)
-
Die Deutsche Statistische Gesellschaft in der Weimarer Republik und während der Nazidiktatur
Wilke, Jürgen
Nach anfänglichen Schwierigkeiten durch den 1. Weltkrieg erlangte die Deutsche Statistische Gesellschaft (DStatG) unter dem renommierten Statistiker und Vorsitzenden der DStatG, Friedrich Zahn, durch eine Vielzahl von Aktivitäten hohes Ansehen. Es gab Bestrebungen, Statistiker aus allen Arbeitsfeldern der Statistik in die DStatG zu integrieren, wobei die "Mathematische Statistik" nur zögerlich akzeptiert wurde (Konjunkturforschung, Zeitreihenanalyse). Nach der Machtübernahme 1933 durch Adolf Hitler geriet die DStatG in das Fahrwasser nationalsozialistischer Ideologie und Politik (Führerprinzip, Gleichschaltung des Vereinswesens). Damit war eine personelle Umstrukturierung in der DStatG verbunden. Politisch Missliebige und rassisch Verfolgte mussten die DStatG verlassen (Bernstein, Freudenberg, Gumbel u.a.). Unter den Statistikern gab es alle Abstufungen im Verhalten zum Regime von Ablehnung und zwangsweiser Anpassung über bereitwilliges Mitläufertum bis zu bewusster Täterschaft. Besonders die Bevölkerungsstatistik wurde durch die NS- Rassenpolitik auf lange Sicht diskreditiert. Im Rahmen von Wirtschaftsplanung und Aufrüstung wurden neue zukunftsträchtige statistische Modelle (Grünig, Bramstedt, Leisse) entwickelt.
-
Energy Technology Data Exchange (ETDEWEB)
John, K.; Purschke, A.; Schuessler, I. [Mannesmann Seiffert GmbH, Berlin (Germany)
1999-07-01
Because of scarcity of space, the last extension stage of the Berlin-Ruhleben sewage treatment plant was executed with vertical-flow final sedimentation tanks with a square surface. The sedimentation efficiency of these tanks in permanent operation is excellent. In the year past, the operation of such a tank at the limits of its capacity was tested under long-term conditions as a master thesis project with a view to further optimization. Subsequently, this Berlin-type tank was developed further into a multi-cell final sedimentation tank, whose effectiveness was verified by means of flow-technical simulation. (orig.) [German] Im KW Berlin-Ruhleben kamen in der letzten Ausbaustufe infolge sehr begrenzter Bauflaeche vertikal durchstroemte Nachklaerbecken mit quadratischer Oberflaeche zum Einsatz. Diese Becken zeigen im Dauerbetrieb eine hervorragende Klaerwirkung, und im vorigen Jahr wurde im Rahmen einer Diplomarbeit zwecks weiterer Optimierung langfristig unter Betriebsbedingungen die Fahrweise eines solchen Beckens an der Auslegungsgrenze getestet. Unter dem Gesichtspunkt der Kostenreduzierung wurde anschliessend der Typ Berliner Becken zum Mehrzellen-Nachklaerbecken weiterentwickelt und seine Wirksamkeit mittels stroemungstechnischer Simulation ueberprueft. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
NONE
2012-07-01
The project aimed at a better understanding of the complex fluid-mechanical processes in the small ducts of bipolar plates. So far, an appropriate technology for in-situ measurement was lacking. The project therefore focused on the further development of microparticle image velocimetry in order to enable analyses of the local velocity distribution of a gas stream in a microduct. Further, measurements were carried out in the microducts of a fuel cell in the more difficult conditions of actual operation. (orig./AKB) [German] Anlass des Forschungsvorhabens war die komplizierten stroemungsmechanischen Zusammenhaenge in den kleinen Kanaelen der Bipolarplatten zu verstehen. Bisher stand keine Messtechnik zur Verfuegung, dies es erlaubt, die stroemungsmechanischen Prozesse in den Mikrokanaelen unter Realbedingungen in situ zu vermessen und mit der instantanen Zellleistung zu korrelieren, Ziel des Projektes war es daher, die Methode der Mikro-Partikel-Image-Velocimetry in der Art weiterzuentwickeln, dass eine Analyse der lokalen Geschwindigkeitsverteilung einer Gasstroemung in einem Mikrokanal ermoeglicht wird. Darueber hinaus wird als zweites Ziel des Projekts eine solche Messung unter den erschwerten Bedingungen einer betriebenen Brennstoffzelle in Mikrokanaelen einer Zelle durchgefuehrt.
-
Directory of Open Access Journals (Sweden)
Kohl, Christian D.
2013-04-01
Full Text Available [english] The management and maintenance of paper-based patient record archives involve high running costs. Therefore, many health care providers choose to digitize their paper records subsequently destroying the originals. By now, this is an established procedure for patient records from routine care.However, at present it is unclear under which circumstances the patient records of patients taking part in clinical trials can be destroyed after digitization. Paper-based original records may only be destroyed if their digital copies are recognized as source documents by both sponsors and authorities. The authors believe that this recognition should be possible, as long as the scanned paper-based records fulfill the requirements for certified copies according to the Note for Guidance (ICH-GCP. This requires that, based on the applied rules, it can be proven at any time that the existing digitization process is clearly regulated, and the resulting quality is regularly controlled and sufficiently high.The objective of this key issues paper is to present the manner in which the existing regulatory guidelines can be implemented to allow the digitized patient records being recognized as source documents.An English version of this article will be published in “Clinical Investigation” (Future Science .[german] Das Verwalten und Vorhalten von Archiven für papierbasierte Patientenakten verursacht hohe laufende Kosten. Viele Gesundheitsversorger sind daher dazu übergegangen, ihre Papierakten in einem Scan-Prozess zu digitalisieren und die Originalakten anschließend zu vernichten. Für die Patientenversorgung hat sich dieses Vorgehen bewährt.Zum gegenwärtigen Zeitpunkt ist jedoch unklar, unter welchen Voraussetzungen Krankenakten von Patienten, die an klinischen Studien teilnehmen, nach dem Digitalisieren vernichtet werden können. Die papierbasierten Originalakten können nur dann vernichtet werden, wenn deren digitale Kopien von Sponsoren und Beh
-
Public–private partnership: how successful is the NHIS – HMO ...
African Journals Online (AJOL)
Collaboration between the National Health Insurance Scheme (NHIS) and Health Maintenance Organizations (HMOs) is a form of public-private partnership in health care delivery in Nigeria. National Health Insurance Schemes' adoption of Health Maintenance Organizations to manage NHIS enrollees is seen as an ...
-
Introduction of an automated medical record at an HMO clinic.
Churgin, P G
1994-01-01
In May 1993, CIGNA Healthcare of Arizona implemented a comprehensive automated medical record system in a pilot project performed at a primary care clinic in Chandler, Arizona. The system, EpicCare, operates in a client-server environment and completely replaces the paper chart in all phases of medical care. After six months of use by 10 medical providers and a 50-member staff, the system has been approved by clinicians, staff, and patients.
-
Vainer Anna; Yaari Einat; Peled Ronit; Wilf-Miron Rachel; Porath Avi; Kokia Ehud
2011-01-01
Abstract Background Populations having lower socioeconomic status, as well as ethnic minorities, have demonstrated lower utilization of preventive screening, including tests for early detection of breast and colorectal cancer. The objective To explore socio-demographic disparities in adherence to screening recommendations for early detection of cancer. Methods The study was conducted by Maccabi Healthcare Services, an Israeli HMO (health plan) providing healthcare services to 1.9 million memb...
-
Energy Technology Data Exchange (ETDEWEB)
Haefner, F.; Belohlavek, K.U.; Behr, A.; Foerster, S.; Pohl, A.
2001-04-01
A method and equipment were developed for measuring the extension of loose zones around worked areas in saline rock and for in situ measurement of very small permeabilities and porosities in these zones. The experiments are based on unsteady borehole logs with flowing gases or liquids with special multiple pack systems that enable measurements from 4 cm to 15 m from the cavern contour. The measurements were evaluated by a specially developed software with automatic parameter identification. Permeabilities were identified between 10{sup 14} m{sup 2} and the detection limit of 10{sup 24} m{sup 2} and effective porosities of less than 0.1% at experimental times of several minutes up to several days. The logs were made in 3 mines in Stassfurt rock salt at depths of 700 and 500 m with different geological and geomechanical boundary conditions, worked in different ways and for different periods of time (between a few days and 37 years). Some of the findings were validated by ultrasonic measurements. [German] Fuer die Ermittlung der Ausdehnung von Auflockerungszonen um bergmaennisch aufgefahrene Strecken/Hohlraeume im Salzgestein und zur In-situ-Bestimmung kleinster Permeabilitaeten und Porositaeten in diesen Bereichen wurde ein Verfahren und eine praktikable Versuchsausruestung entwickelt. Diese eignet sich auch fuer Frac-Untersuchungen. Basis der Versuchsdurchfuehrungen sind instationaere Bohrlochuntersuchungen mit Gasen oder Fluessigkeiten als Stroemungsfluid unter Einsatz spezieller Mehrfachpackersysteme. Damit sind Messungen ab 4 cm Abstand zur Hohlraumkontur bis zu 15 m moeglich. Die Versuchsauswertung erfolgt mittels einer speziell entwickelten Software mit automatischer Parameteridentifikation, die die instationaere Stroemung um die Versuchsbohrung raeumlich vollstaendig beschreibt. Permeabilitaeten wurden je nach Abstand zur Hohlraumkontur zwischen 10{sup -14} m{sup 2} und der Nachweisgrenze 10{sup -24} m{sup 2} und effektive Porositaeten bis <0,1% ermittelt, bei
-
Directory of Open Access Journals (Sweden)
Jokuszies, Andreas
2012-02-01
Full Text Available [english] Background: Anticoagulation is a crucial element in microsurgery. Although various clinical studies and international surveys have revealed that anticoagulation strategies can vary and result in similar outcomes, anticoagulative regimen are far away from standardization. In Germany and german speaking countries standardized anticoagulation protocols concerning free flap surgery do not exist so far. Methods: To evaluate the current practice of clinics in Germany, Austria and Switzerland with specialization in microsurgery we performed a questionnaire surveying the perioperative regimen of anticoagulant and antiplatelet therapy in free flap surgery. The microsurgeons were interrogated on several anticoagulant, rheologic and antiplatelet medications, their dosage and perioperative frequency of application pre-, intra- and postoperative.Results: The questionnaire revealed that the used antithrombotic and perioperative regimens varied from department to department presumably based on the personal experience of the surgeon. Multiple approaches are used with a wide range of anticoagulants used either alone or in combination, with different intervals of application and different dosages. Conclusion: Therefore consensus meetings should be held in future leading to conduct prospective multicenter studies with formulation of standardized anticoagulative and perioperative protocols in microsurgery reducing flap failure to other than pharmacologic reasons.[german] Hintergrund: Die Antikoagulation stellt ein zentrales Element in der Mikrochirurgie dar. Zahlreiche klinische Studien und internationale Erhebungen zu antikoagulatorischen Strategien weisen eine grosse Varianz bei vergleichbaren Resultaten nach, entbehren jedoch einer Standardisierung. Auch in Deutschland und deutschsprachigen Ländern fehlen bislang standardisierte Regime zur Antikoagulation in der Mikrochirurgie.Methodik: Zur Erhebung der antikoagulatorischen Praxis unter
-
Kurzweil, Peter
Brennstoffzellen "verbrennen" einen Brennstoff nicht mit einer Feuererscheinung unter Freisetzung von Wärme. Anders als ihr Name vermuten lässt, wird üblicherweise Wasserstoff wie in einer Batterie durch elektrochemische Vorgänge verstromt statt verbrannt. Brennstoffzellen wandeln die im Brennstoff gespeicherte chemische Energie direkt in Elektrizität — ohne Umweg über Wärme!
-
Energy Technology Data Exchange (ETDEWEB)
Graber, W.K.; Buerki, D. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)
1997-06-01
In the framework of the project `WINDBANK unteres Aaretal` local winds over complex terrain were measured over a 4 month period and a cluster analysis is used to identify 13 different typical wind fields. A subset of representative stations is established to identify the classes for future applications in emergency planning. (author) 4 figs., 3 refs.
-
Directory of Open Access Journals (Sweden)
Henning Radtke
2004-01-01
Full Text Available Rezensierte Werke:William A. Schabas, Der Genozid im Völkerrecht, Hamburg: Hamburger Edition HIS 2003, 792 S., ISBN 3-930908-88-3; Gerhard Werle, Völkerstrafrecht (unter Mitarbeit von Florian Jeßberger, Wulf Burchards, Barbara Lüders, Stephan Meseke, Volker Nerlich, Tübingen: Mohr Siebeck 2003, 553 S., ISBN 3-16-148087-2
-
Entwicklung einer Produktstrategie für einen Veranstaltungskalender Wirtschaftswissenschaften
Steinhagen, Elisabeth
2014-01-01
Diese Arbeit hat das Ziel, am Beispiel des ZBW-Veranstaltungskalenders zu zeigen, dass eine Produktstrategie ein wertvolles Instrument ist, um ein Informationsprodukt erfolgreich zu etablieren bzw. weiterzuentwickeln. Dafür werden in Anlehnung an Methoden der strategischen Unternehmensplanung und des Produktmanagements wichtige Einflussfaktoren für das Produkt ZBWVeranstaltungskalender systematisch identifiziert und mittels IST-Analyse, Zielgruppenanalyse sowie Wettbewerbsanalyse unters...
-
Wang, Hongrui; Liu, Hongwei; Cai, Leixin; Wang, Caixia; Lv, Qiang
2017-07-10
In this study, we extended the replica exchange Monte Carlo (REMC) sampling method to protein-small molecule docking conformational prediction using RosettaLigand. In contrast to the traditional Monte Carlo (MC) and REMC sampling methods, these methods use multi-objective optimization Pareto front information to facilitate the selection of replicas for exchange. The Pareto front information generated to select lower energy conformations as representative conformation structure replicas can facilitate the convergence of the available conformational space, including available near-native structures. Furthermore, our approach directly provides min-min scenario Pareto optimal solutions, as well as a hybrid of the min-min and max-min scenario Pareto optimal solutions with lower energy conformations for use as structure templates in the REMC sampling method. These methods were validated based on a thorough analysis of a benchmark data set containing 16 benchmark test cases. An in-depth comparison between MC, REMC, multi-objective optimization-REMC (MO-REMC), and hybrid MO-REMC (HMO-REMC) sampling methods was performed to illustrate the differences between the four conformational search strategies. Our findings demonstrate that the MO-REMC and HMO-REMC conformational sampling methods are powerful approaches for obtaining protein-small molecule docking conformational predictions based on the binding energy of complexes in RosettaLigand.
-
Prebiotic Oligosaccharides Potentiate Host Protective Responses against L. Monocytogenes Infection
Directory of Open Access Journals (Sweden)
Poyin Chen
2017-12-01
Full Text Available Prebiotic oligosaccharides are used to modulate enteric pathogens and reduce pathogen shedding. The interactions with prebiotics that alter Listeria monocytogenes infection are not yet clearly delineated. L. monocytogenes cellular invasion requires a concerted manipulation of host epithelial cell membrane receptors to initiate internalization and infection often via receptor glycosylation. Bacterial interactions with host glycans are intimately involved in modulating cellular responses through signaling cascades at the membrane and in intracellular compartments. Characterizing the mechanisms underpinning these modulations is essential for predictive use of dietary prebiotics to diminish pathogen association. We demonstrated that human milk oligosaccharide (HMO pretreatment of colonic epithelial cells (Caco-2 led to a 50% decrease in Listeria association, while Biomos pretreatment increased host association by 150%. L. monocytogenes-induced gene expression changes due to oligosaccharide pretreatment revealed global alterations in host signaling pathways that resulted in differential subcellular localization of L. monocytogenes during early infection. Ultimately, HMO pretreatment led to bacterial clearance in Caco-2 cells via induction of the unfolded protein response and eIF2 signaling, while Biomos pretreatment resulted in the induction of host autophagy and L. monocytogenes vacuolar escape earlier in the infection progression. This study demonstrates the capacity of prebiotic oligosaccharides to minimize infection through induction of host-intrinsic protective responses.
-
Davis, Jasmine C. C.; Lewis, Zachery T.; Krishnan, Sridevi; Bernstein, Robin M.; Moore, Sophie E.; Prentice, Andrew M.; Mills, David A.; Lebrilla, Carlito B.; Zivkovic, Angela M.
2017-01-01
Human milk oligosaccharides (HMOs) play an important role in the health of an infant as substrate for beneficial gut bacteria. Little is known about the effects of HMO composition and its changes on the morbidity and growth outcomes of infants living in areas with high infection rates. Mother’s HMO composition and infant gut microbiota from 33 Gambian mother/infant pairs at 4, 16, and 20 weeks postpartum were analyzed for relationships between HMOs, microbiota, and infant morbidity and growth. The data indicate that lacto-N-fucopentaose I was associated with decreased infant morbidity, and 3‧-sialyllactose was found to be a good indicator of infant weight-for-age. Because HMOs, gut microbiota, and infant health are interrelated, the relationship between infant health and their microbiome were analyzed. While bifidobacteria were the dominant genus in the infant gut overall, Dialister and Prevotella were negatively correlated with morbidity, and Bacteroides was increased in infants with abnormal calprotectin. Mothers nursing in the wet season (July to October) produced significantly less oligosaccharides compared to those nursing in the dry season (November to June). These results suggest that specific types and structures of HMOs are sensitive to environmental conditions, protective of morbidity, predictive of growth, and correlated with specific microbiota.
-
Schejter, Eduardo; Bornstein, Jacob; Siegler, Efraim
2013-11-22
The incidence rates for premalignant lesions in Jewish women in Israel are similar to those observed in Western countries, but the incidence of cervical cancer in Israel is low; this discrepancy is not yet clearly understood. Because of the low incidence of cervical cancer in Israel, it was decided to base cervical cancer prevention on opportunistic screening: every woman from the ages of 35-54 years can have a Pap test smear free of charge every 3 years. Over the last decade 12.2% of the women population had an annual Pap test. From 36 to 50% of women who attended the Clalit Health Maintenance Organization (HMO) and the Maccabi HMO, the two largest HMOs in Israel, did so. There were also discrepancies between women of different socio-economic status (SES): Israel Society of Obstetrics and Gynecology recommends continuing cytologic screening in vaccinated women as recommended for the general population. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in Israel" Vaccine Volume 31, Supplement 8, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013. Published by Elsevier Ltd.
-
An evaluation of substance misuse treatment providers used by an employee assistance program.
Miller, N A
1992-05-01
Structural measures of access, continuity, and quality of substance misuse treatment services were compared in 30 fee-for-service (FFS) facilities and nine health maintenance organizations (HMOs). Probit models related effects of the provider system (FFS or HMO) and the system's structural characteristics to 243 employees' access to and outcomes from treatment. Access was decreased in Independent Practice Association (IPA)/network HMOs and in all facilities which did not employ an addictionologist or provide coordinated treatment services. When bivariate correlations were examined, both use of copayments and imposing limits to the levels of treatment covered were negatively related to access, while a facility's provision of ongoing professional development was positively associated with access. These correlations did not remain significant in the multivariate probits. Receiving treatment in a staff model HMO and facing limits to the levels of treatment covered were negatively associated with attaining sufficient progress, while receiving treatment in a facility which provided ongoing professional development was positively related to progress: these effects did not remain significant in multivariate analyses. Implications for employee assistance program (EAP) staff in their role as case managers and for EAP staff and employers in their shared role as purchasers of treatment are discussed.
-
1994-07-15
This final rule implements sections 9312(c)(2), 9312(f), and 9434(b) of Public Law 99-509, section 7 of Public Law 100-93, section 4014 of Public Law 100-203, sections 224 and 411(k)(12) of Public Law 100-360, and section 6411(d)(3) of Public Law 101-239. These provisions broaden the Secretary's authority to impose intermediate sanctions and civil money penalties on health maintenance organizations (HMOs), competitive medical plans, and other prepaid health plans contracting under Medicare or Medicaid that (1) substantially fail to provide an enrolled individual with required medically necessary items and services; (2) engage in certain marketing, enrollment, reporting, or claims payment abuses; or (3) in the case of Medicare risk-contracting plans, employ or contract with, either directly or indirectly, an individual or entity excluded from participation in Medicare. The provisions also condition Federal financial participation in certain State payments on the State's exclusion of certain prohibited entities from participation in HMO contracts and waiver programs. This final rule is intended to significantly enhance the protections for Medicare beneficiaries and Medicaid recipients enrolled in a HMO, competitive medical plan, or other contracting organization under titles XVIII and XIX of the Social Security Act.
-
Energy Technology Data Exchange (ETDEWEB)
Moka, D. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Voth, E. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin
1997-04-01
Aim: A radioiodine therapy (RIT) in thyrotoxic patients receiving antithyroid drugs (ATD) leads in comparison to nonpretreated patients either to higher therapeutic doses or to higher treatment failure rates. Aim of this study was to optimize the effect of RIT in patients pretreated with ATD. Methods: Therefore, the influence of ATD was assessed in 109 patients with shortened effective half-life of {sup 131}I. RIT was performed under stationary conditions. Radioiodine activity of the thyroid gland was stopped three days after RIT. The patients antithyroid medication was stopped three days after RIT. The progress of the first RIT and of a second radioiodine application, which still was necessary in 29 patients, was compared to 32 patients receiving ATD, continuously. Results: Values of effective half-life for {sup 131}I rose significantly from 3.2{+-}0.2 to 5.7{+-}0.2 days (Graves` disease: 3.4 to 5.7 days; toxic goiters` disease: Multifocal autonomy 3.2 to 6.2 days; unifocal autonomy 2.5 auf 5.0 days) 2-3 days after stopping ATD. There was an increase of the {sup 131}I-uptake of a second RIT decreased significantly in patients receiving ATD, continuously. Conclusion: Effective half-life and uptake of {sup 131}I was affected significantly by ATD. The stop taking of ATD after RIT is useful to improve an apparent insufficient RIT in thyrotoxic patients receiving ATD. (orig.) [Deutsch] Ziel: Eine Radioiodtherapie (RITh) unter laufender thyreostatischer Medikation bei hyperthyreoten Patienten fuehrt im Vergleich zu unbehandelten Patienten entweder zu hoeheren Therapiedosen oder zu einem hoeheren Prozentsatz von Therapieversagern. Ziel dieser Studie war es, die RITh unter thyreostatischer Medikation zu optimieren. Methoden: Der Einfluss der thyreostatischen Medikation wurde bei 109 Patienten mit verkuerzter thyreoidaler Halbwertzeit von {sup 131}I untersucht. Bei 77 Patienten wurde die thyreostatische Medikation am 3. Tag nach RITh abgesetzt. Der Verlauf der RITh bzw
-
French days of radiology (J.F.R.) 2005; Journees francaises de radiologie (JFR) 2005
Energy Technology Data Exchange (ETDEWEB)
NONE
2005-07-01
Five parts are presented, the nuclear safety authority informs the radiologists on the evolution of the regulation in radiation protection and its practical application; statements of medical and dental radiodiagnosis equipments; licensing for use of radiodiagnosis installation; to use the diagnosis reference levels in radiology to optimize the practices; radiation protection in interventional radiology. (N.C.)
-
Energy Technology Data Exchange (ETDEWEB)
Hahn, D. (ed.) [Wuerzburg Univ. (Germany). Inst. fuer Roentgendiagnostik
2007-07-01
Cardiovascular system diseases are the most common causes for death besides the progress in medical sciences. The book contains the following contributions within two main chapters: The heart, normal anatomy and important variants, cardiac diseases, thoracic aorta and pulmonal vascular system, abdominal vascular system, peripheric vascular system, veins, supraaortal vascular system, thoracic and abdominal aorta, abdomial vascular system, kidney arteries, mesenterial vascular system, abdominopelvic vascular system, peripheric arteries, hemodialysis shunt, transjugular portosystemic shunt.
-
Energy Technology Data Exchange (ETDEWEB)
Kuefner, M.A. [Dornbirn Hospital (Austria). Dept. of Radiology; Brand, M.; Engert, C.; Uder, M. [Erlangen University Hospital (Germany). Dept. of Radiology; Schwab, S.A. [Radiologis, Oberasbach (Germany)
2015-10-15
Shortly after the discovery of X-rays, their damaging effect on biological tissues was observed. The determination of radiation exposure in diagnostic and interventional radiology is usually based on physical measurements or mathematical algorithms with standardized dose simulations. γ-H2AX immunofluorescence microscopy is a reliable and sensitive method for the quantification of radiation induced DNA double-strand breaks (DSB) in blood lymphocytes. The detectable amount of these DNA damages correlates well with the dose received. However, the biological radiation damage depends not only on dose but also on other individual factors like radiation sensitivity and DNA repair capacity. Iodinated contrast agents can enhance the x-ray induced DNA damage level. After their induction DSB are quickly repaired. A protective effect of antioxidants has been postulated in experimental studies. This review explains the principle of the γ-H2AX technique and provides an overview on studies evaluating DSB in radiologic examinations.
-
Bacteroides in the Infant Gut Consume Milk Oligosaccharides via Mucus-Utilization Pathways
Marcobal, Angela; Barboza, Mariana; Sonnenburg, Erica D.; Pudlo, Nicholas; Martens, Eric C.; Desai, Prerak; Lebrilla, Carlito B.; Weimer, Bart C.; Mills, David A.; German, J. Bruce; Sonnenburg, Justin L.
2011-01-01
Newborns are colonized with an intestinal microbiota shortly after birth but the factors governing the retention and abundance of specific microbial lineages are unknown. Nursing infants consume human milk oligosaccharides (HMOs) that pass undigested to the distal gut where they may be digested by microbes. We determined that the prominent neonate gut residents, Bacteroides thetaiotaomicron and Bacteroides fragilis, induce the same genes during HMO consumption that are used to harvest host mu...
-
Vehicles under electricity. Result booklet; Autos unter Strom. Ergebnisbroschuere
Energy Technology Data Exchange (ETDEWEB)
NONE
2011-09-15
The booklet under consideration reports on the environmental relief of electric-driven vehicles by means of the research project OPTUM 'Potentials of environmental relief of electric driven vehicles - Integrated analysis of vehicle usage and energy economy'. Experts from the Institute for Applied Ecology (Freiburg, Federal Republic of Germany) and the Institute for Social-Ecological Research (Frankfurt (Main), Federal Republic of Germany) are devoted to the following issues: (1) What is the acceptance for electric-driven vehicles?; (2) What is their future market potential?; (3) What are the advantages of electromobility with respect to the climate?; (4) Are their supply shortages concerning major raw materials?.
-
International Nuclear Information System (INIS)
Guionnet, Christophe
2011-01-01
In the events implying radioactive materials, the organization of care in the health facilities requires both the implementation of some skills, which go beyond the usual trade and professional duties of each of the partners, and the identification of the departments and referent staff that are likely to be most affected by these risks. This study, which was conducted within the Radiologie and Medecine Nucleaire Departments of the Centre Hospitalier Universitaire de Nancy, highlights the existence of reference material as means of detecting radiation, the conditions under which they will be developed remain to be defined. Human means can be called for for missions of information, detection, patient screening and decontamination. Volunteering persons, with competences in radiation protection (Personnes Competentes en Radioprotection), and radiographers can lead to the realization of their missions, after an practical training. (author) [fr
-
Spontaneous soft tissue hematomas.
Dohan, A; Darnige, L; Sapoval, M; Pellerin, O
2015-01-01
Spontaneous muscle hematomas are a common and serious complication of anticoagulant treatment. The incidence of this event has increased along with the rise in the number of patients receiving anticoagulants. Radiological management is both diagnostic and interventional. Computed tomography angiography (CTA) is the main tool for the detection of hemorrhage to obtain a positive, topographic diagnosis and determine the severity. Detection of an active leak of contrast material during the arterial or venous phase is an indication for the use of arterial embolization. In addition, the interventional radiological procedure can be planned with CTA. Arterial embolization of the pedicles that are the source of the bleeding is an effective technique. The rate of technical and clinical success is 90% and 86%, respectively. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
-
Temporomandibular Joint: MRT Diagnostics; Temporomandibulargelenk: MRT-Diagnostik
Energy Technology Data Exchange (ETDEWEB)
Kress, B. [Universitaetsklinikum Heidelberg (Germany). Abteilung Neuroradiologie; Universitaetsklinikum Heidelberg (Germany). Neurologische Klinik; Schmitter, M. [Universitaetsklinikum Heidelberg (Germany). Poliklinik fuer zahnaerztliche Prothetik; Universitaetsklinikum Heidelberg (Germany). Abteilung Neuroradiologie
2005-09-01
MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary. (orig.) [German] Magnetresonanztomographie bei Kiefergelenkbeschwerden erfordert neben guter technischer Ausstattung Kenntnisse der Anatomie und Pathologie des Kiefergelenks. Diese Uebersicht stellt neben MRT-Protokollen die Anatomie und die pathologischen Befunde des Kiefergelenks bei geoeffnetem und geschlossenem Mund anhand von Abbildungen und Graphiken systematisch dar. Bildgebende Diagnostik des Kiefergelenks gruendet sich auf eine standardisierte klinische und magnetresonanztomographische Untersuchung und erfordert eine enge interdisziplinaere Kooperation zwischen Zahnmedizin und Radiologie. (orig.)
-
Oman. Quality Culture in Higher Education A Good-Practice Example
Directory of Open Access Journals (Sweden)
Nicola Huson
2015-10-01
Diesem Ansatz folgend liefert die folgende Reflektion zu der Entwicklung einer Lehrendeninitiative an der German University of Technology in Oman ein Good-Practice-Beispiel für die Förderung einer Qualitätskultur innerhalb einer Hochschulinstitution. Diese erfolgt unter Berücksichtigung der soziokulturellen, institutionellen und initiative-bezogenen Rahmenbedingungen und verifiziert das Beispiel innerhalb eines theoretischen Qualitätskulturmodells.
-
Denker, Philipp
2008-01-01
Der vorliegende Beitrag untersucht das Potential und die Bedingungen alternativer Regulierungsformen vor dem Hintergrund von Better Regulation in Deutschland. Nahezu alle EU- und OECD-Staaten betreiben heute umfassende politische Reformprogramme zur Modernisierung der Regulierungsarchitekturen, die unter dem Label Better Regulation subsumiert werden. Die Zielsetzung dieser Programme besteht zum einen in der wirtschaftsfreundlichen Reduktion von Regulierungskosten und zum anderen in der Effekt...
-
Spektroelektrochemie an einzelnen (6,5)-Kohlenstoffnanoröhren
Rühl, Nicolas
2015-01-01
Im Rahmen der vorliegenden Arbeit wurde durch einzelmolekülspektroskopischer bzw. -mikroskopischer Methoden in Kombination mit einer mikrofluischen Zel- le unter Potenzialkontrolle die Elektrochemie von einzelnen einwandigen (6,5)- Kohlenstoffnanoröhren untersucht. Hierfür wurde ein Nahinfrarot-Photolumineszenz- Mikroskop aufgebaut und eine speziell an die experimentellen Vorgaben angepasste elektrochemische Zelle entwickelt, insofern als drei Elektroden (Arbeits-, Gegen- und Referenzelektrod...
-
Energy Technology Data Exchange (ETDEWEB)
Hoefert, M. [CERN, Geneva (Switzerland)
2001-07-01
The conference report presents a brief summary of papers and discussion topics. (orig./CB) [German] Die 21. Jahrestagung der ATSR fand dieses Jahr unter dem Motto 'Strahlenschutz und Kommunikation' im herbstlich sonnigen Aix en Provence statt. Die ATSR ist neben der Franzoesischen Gesellschaft fuer Strahlenschutz (SFR) eine zweite Standesorganisation, in der sich praktisch arbeitende Strahlenschutzverantwortliche in Frankreich organisiert haben. (orig.)
-
Konzeptionelle Entwicklung innovativer Bremssysteme
Schwankl, L.
2017-01-01
Im Rahmen des hier vorgestellten Kooperationsprojekts wurden vorhandene elektromagnetische Bremsen nach konstruktionsmethodischen Gesichtspunkten überarbeitet. Nach einer intensiven Auseinandersetzung mit dem bestehenden System wurde unter Anwendung unterschiedlichster Kreativitätstechniken eine große Anzahl von neuen Lösungsvorschlägen erarbeitet und dokumentiert. Bereits in den frühen Phasen der Produktentwicklung wurden die relevanten, produktbestimmenden Eigenschaften mittels einfacher An...
-
Müller, Bernhard
2016-01-01
Das Fraunhofer-Institut für Werkzeugmaschinen und Umformtechnik IWU ist kompetenter Partner für anwendungsorientierte Forschung im Automobil- und Maschinenbau an den Standorten Chemnitz, Dresden, Zittau unter dem Leitthema „Ressourceneffiziente Produktion“. Die Kernkompetenzen des Instituts in der Werkzeugmaschinenentwicklung, der Umform- und Zerspanungstechnik, der Mechatronik, dem Funktionsleichtbau sowie der Systemtechnologie werden durch den Einsatz generativer Fertigungs-verfahren ergänz...
-
Rohstoffliche und verfahrenstechnische Einflussfaktoren der Pyrolyse biogener Rohstoffe
Reichel, Denise
2017-01-01
Die vorliegende Arbeit beschäftigt sich mit rohstofflichen und verfahrenstechnischen Einflussfaktoren bei der Biomassepyrolyse. Ausgehend von der Entwicklung einer kleintechnischen Festbettpyrolyseapparatur, erfolgten experimentelle Untersuchungen an 26 biogenen Einsatzstoffen unter verschiedenen Prozessbedingungen. Die Apparatur erlaubt eine vollständige Bilanzierung und Gewinnung aller Produkte, zudem können Einflüsse durch sekundäre Reaktionen in der Gasphase minimiert werden. Die Einsa...
-
Energy Technology Data Exchange (ETDEWEB)
Herrmann, A.P. [Universitaet des Saarlandes, Saarbruecken (Germany). Lehrstuhl fuer Prozesstechnik; Janke, H.D. [Gesellschaft fuer Umweltkompatible Prozesstechnik mbH (upt), Saarbruecken (Germany); Chmiel, H. [Gesellschaft fuer Umweltkompatible Prozesstechnik mbH (upt), Saarbruecken (Germany); Universitaet des Saarlandes, Saarbruecken (Germany). Lehrstuhl fuer Prozesstechnik
1999-07-01
Using a continuously operated, two-stage laboratory system (acidification reactor and packed-bed methane reactor) and with brewery waste water as a substrate, systematic studies concerning the influence of COD{sup inflow} on fatty acid formation, COD reduction and biogas formation were carried out. In the upshot, the executed pilot tests permit the conclusion that treatment of a partial stream (COD{sup inflow} {>=} 5000mg/l), though not advantageous in terms of space/time yield, may be more economical on the whole under certain boundary conditions than treatment of the entire stream (COD{sup inflow} 1800-3000 mg/l). (orig.) [German] Mit einer kontinuierlich betriebenen, zweistufigen Laboranlage (Versaeuerungsreaktor und Festbett-Methanreaktor) wurden unter Verwendung von Brauereiabwasser als Substrat systematische Untersuchungen zum Einfluss des CSB{sup ZULAUF} auf die Fettsaeurebildung, CSB-Reduktion und Biogasbildung durchgefuehrt. Aus den durchgefuehrten Modellversuchen laesst sich zusammenfassend ableiten, dass eine Teilstrombehandlung (CSB{sup ZULAUF}{>=}5.000 mg/l) zwar hinsichtlich der Raum/Zeit-Ausbeute keine Vorteile mit sich bringt, aber unter bestimmten Randbedingungen insgesamt wirtschaftlicher als eine Vollstrombehandlung (CSB{sup ZULAUF} 1.800-3.000 mg/l) sein kann. (orig.)
-
Ehin, Kristiina, 1977-
2004-01-01
Sisu: die nachricht von der sanktgeorgsnacht = Jüriöö sõnum ; sie standen unter einem schiefen dach = nad seisid viltuse katuse all ; "der soldat steht auf dem hof ..." = "püssimees seisab õues..." ; "der mond heult..." = "kuu ulub..." ; der frauenräuber = naisteröövija ; "ich schlafe als schlamm im wald..." = "magan mudana metsas..." ; "ruhig erhebt sich der weihrauchdunst..." = "vaikselt tõuseb taevasse..."
-
Hinz, Renate
1999-01-01
Anhand der Reflexion des "Bildungsganges" von Kaspar Hauser untersucht die Autorin vermittels einer biographischen Herangehensweise die These: "Bildungsgänge sind nicht nur in ihrer objektiven Strukturierung, sondern auch als subjektive Entwicklungsaufgaben zu verstehen, die es dem Individuum ermöglichen, selbstverantwortlich und mitgestaltend den eigenen Lebensweg zu bestimmen." Erfahrungsorientierung des Lehrens und Lernens unter Berücksichtigung der je eigenen Lebensgeschichte und also die...
-
Heinrich Heine e Castro Alves: diversidade na convergência
Directory of Open Access Journals (Sweden)
Eloá Heise
1998-11-01
Full Text Available Heinrich Heine und Castro Alves haben Gedichte unter dem gleichen Titel geschrieben: Das Sklavenschiff und O Navio Negreiro. Das bedeutet aber nicht, daß Castro Alves ein Plagiat des Gedichts Heines, des Verfassers der ersten Quelle, begangen hat. Trotz der gleichen Thematik in beiden Fällen kann man durch die Analyse der beiden Gedichte die deutliche Divergenz in der Konvergenz belegen.
-
Informationsdesign von Bildungsportalen : Struktur und Aufbau netzbasierter Bildungsressourcen
Panke, Stefanie
2009-01-01
Sowohl Unternehmen als auch Bildungseinrichtungen, Verlage, politische Organisationen, Verbände, Interessengruppen und Privatpersonen nutzen das Internet, um Informationen zu verbreiten. Die Varianz an Akteuren, Adressaten und Botschaften spiegelt sich wider in einem wachsenden Spektrum an Web-Genres: Suchmaschine, E-Commerce-Auftritt und Online-Zeitung teilen sich die Aufmerksamkeit der Leser unter anderem mit privaten Weblogs und kollaborativen Wissenssammlungen wie der Enzyklopädie Wikiped...
-
Häring, Armando
2014-01-01
"Der Beitrag analysiert den Zusammenhang zwischen Partnermarktoportunitäten aus dem Freundeskreis und der Stabilität von Paarbeziehungen. Unter Verwendung des theoretischen Konzepts der Theorie der Interaktionsgelegenheiten sowie von Annahmen der Austauschtheorie und der Familienökonomie, werden mögliche Zusammenhänge zwischen gemeinsamen Freundeskreisen mit dem Partner, Partnermarktgelegenheiten aus dem Freundeskreis (sex ratio) und der Stabilität von Paarbeziehungen diskutiert. Der Beitrag ...
-
Ulm, Kristin
2008-01-01
In der vorliegenden Arbeit wurden die Ergebnisse von 371 Exhumierungen aus den Jahren 1967 bis 1998 ausgewertet unter der Fragestellung, ob aussagekräftige morphologische Befunde auch noch nach einer längeren Leichenliegezeit erhoben werden und versicherungsmedizinische Fragen hierdurch beantwortet werden können. Die erhobenen morphologischen Befunde sowohl auf mikroskopischer als auch auf makroskopischer Ebene wurden zu einem Erwartungskatalog zusammengefasst und mit den Ergebnissen der...
-
Mocker-Henning, Marina
2016-01-01
In dieser Arbeit werden elektromagnetische Untersuchungen von Fahrzeugantennen für verschiedene Dienste in virtuellen Testfahrten unter Anwendung einer Kombination aus Vollwellen- und Ray Tracing- Methoden simulativ durchgeführt. Es werden verschiedene Vollwellen- Lösungsverfahren und -Lösermethoden vorgestellt und verglichen. Für die Berechnung der Ausbreitung elektromagnetischer Wellen im mobilen Szenario wird ein Ray Tracing Programm entwickelt, das für eine hohe Berechnungsgeschwindigkeit...
-
Mehrfacheffekt-Feuchtluftdestillation bei Umgebungsdruck
Müller-Holst, Hendrik
2007-01-01
Ein neuartiges Verfahren zur Feuchtluftdestillation mittels Verdunstung und Kondensation in einer einzigen Kammer wurde im Rahmen der Arbeit umfassend analysiert. Das Verfahren arbeitet bei Umgebungsdruck; der dadurch bei Temperaturen unter dem Siedepunkt verringerte Stoffübergang wird durch große Austauschflächen mit hoher Packungsdichte kompensiert. Der Transport der im Verdunster beladenen Feuchtluft zum Kondensator erfolgt innerhalb einer optimierten geometrischen Anordnung der Baueinheit...
-
Schauer, Maggie; Elbert, Thomas; Neuner, Frank
2017-01-01
Die Narrative Expositionstherapie (NET) ist ein effizientes Kernelement der Behandlung von Kindern und Erwachsenen, die unter den Folgen von Mehrfach- und Komplextraumatisierung nach Gewalt und Flucht leiden. Die chronologische Erarbeitung einer Narration, der individuellen Lebensgeschichte in der NET ermöglicht Traumaüberlebenden eine Gesamtschau ihres Lebens und so die Integration der Lebenserfahrungen in den biografischen Zusammenhang. Sie aktiviert Ressourcen und erlaubt korrigierende Bez...
-
Energy Technology Data Exchange (ETDEWEB)
Ruehle, T; Schloegl, R [Max-Planck-Gesellschaft, Berlin (Germany). Abt. Anorganische Chemie
1998-12-31
The present project was carried out on the basis of available emission data and the known toxicity of platinum compounds. Its aim was to synthesise manageable amounts of a model substance suitable for toxicological screening. [Deutsch] Unter Augenmerk auf die Emissionsdaten und auf die bekannte Toxizitaet von Platinverbindungen sollte versucht werden, handhabbare Mengen einer Modellsubstanz zu synthetisieren, um so toxikologische Reihenversuche zu ermoeglichen. (orig.)
-
Grünberger, Nina
2014-01-01
Unternehmen sind erfinderisch geworden. In unserer an Output-Steigerung orientierten Marktgesellschaft werden unter dem Schlagwort „Gamification“ bewusst spielerische Elemente in gewöhnliche Arbeitsprozesse implementiert. Dies erfolgt u.a., um die Arbeitsleistung der Mitarbeitenden zu steigern. Kreativ und frei arbeiten, ja, aber nur innerhalb der Vorgaben und analog zur Unternehmensphilosophie? Ergebnisorientierung und Effizienz, ja, und zugleich eine ausgewogene Work-Life-Balance? Der vorli...
-
Wrobel, Denise
2013-01-01
Einleitung: Die vorliegende Studie hatte das Ziel, die Effektivität der spezifischen Immuntherapie unter den imkernden Bienengiftallergikern und ihren Langzeitschutz zu belegen, wobei Sticherfahrungen der weiterimkernden Betroffenen herangezogen wurden, um die Wirksamkeit der Therapie zu bestätigen, sowie Veränderungen auf Verhalten und Psyche darzustellen. Inwiefern Imker eine "natürliche Immunisierung" durchführen und wie wirksam alternative Behandlungen sind, wurde ebenfalls untersucht. ...
-
Kuhlmann, Esther
2008-01-01
Da die Anforderungen an den Schwefelgehalt der fossilen Brennstoffe - nicht zuletzt durch gesetzliche Richtlinien bezüglich der Schadstoffemissionen - im Laufe der Zeit ständig gestiegen sind, sind effektive Entschwefelungsverfahren für fossile Brennstoffe von hohem Interesse. Die derzeitige Entschwefelungstechnologie basiert auf dem HDS-Verfahren, alternative Verfahren sind aber wünschenswert, insbesondere wenn Anwendungen einen Schwefelgehalt von weit unter 10 ppm erforderlich machen. Daher...
-
PMD basierte Fahrspurerkennung und -Verfolgung für Fahrerassistenzsysteme
Gumpp, T.; Schamm, T.; Bergmann, S.; Zöllner, J. M.; Dillmann, R.
In diesem Artikel wird ein System zur Verfolgung von Fahrspuren unter Verwendung von PMD-Kameras vorgestellt. Er gibt einen überblick über die Auswertung der Intensitäts- und Tiefenbilder dieses Sensors in einem System zur fremdlichtunabhängigen Fahrspurverfolgung. Ein Kaiman-Filter wird verwendet, um neben den Fahrspurparametern auch die Position und Orientierung des Fahrzeugs relativ zur Fahrspur zu schätzten.
-
2011-12-01
tnis von NATO und EU- Eine Analyse unter Beriicksichtigung des Lissabonner Reformvertrages (Munich: AVM-Verlag, 2009), 4. Martin Reichard, The EU-NATO...Lockheed Martin Corp., Moorestown, USA. The consortium developed the first multifunctional counter battery radar in the world with a fu lly active phased...significant forces in expeditionary missions. Gustav Lindstrom , Caaudia Major and Christian Mt>lling provide a good review of the historic background, the
-
Determination of kinematic dimensions of guiding mechanisms from measurement
Teichgräber, Carsten
2013-01-01
Führungsgetriebe die durch Servomotoren angetrieben werden, benötigen für definierte Stellungen des Abtriebsglieds eine programmierte Funktion (elektronische Kurvenscheibe). Diese leitet sich aus dem möglicherweise fehlerbehafteten kinematischen Modell des Getriebes ab (inverse Kinematik). Zur Verbesserung der Genauigkeit der Führungsbewegung wird ein Verfahren zur Justierung der Übertragungsfunktion auf Basis des Newton-Verfahrens unter Nutzung der Singulärwertzerlegung vorgestellt. Dabei we...
-
Imagem, texto, sensibilização, criatividade
Directory of Open Access Journals (Sweden)
João Azenha Junior
1997-11-01
Full Text Available Ziel dieses Beitrags ist es, die dynamische Wechselbeziehung zwischen Bild und Text bei der didaktischen Bearbeitung verschiedener Textsorten im Rahmen der Fremdsprachen- bzw. Übersetzungsdidaktik zu untersuchen. Am Beispiel von Textsorten aus dem Bereich der Wissenschaft, Technik, Literatur und Sprachvermittlung wird versucht, erfolgreiche und mißlungene Anwendungen ikonischer Mittel bei der Textproduktion unter die Lupe zu nehmen und didaktische Konsequenzen daraus zu ziehen.
-
The Analysis of Heterogeneous Text Documents with the Help of the Computer Program NUD*IST
Plaß, Christine; Schetsche, Michael
2000-01-01
Anhand eines aktuellen Forschungsprojekts wird der Nutzen des Computerprogramms NUD*IST für die qualitative Dokumentenanalyse erörtert. Unser Projekt untersucht die gesellschaftliche Bewertung von spektakulären Straftaten. Dazu wurden Dokumente aus dem gesamten 20. Jahrhundert erhoben, digitalisiert und unter Einsatz von NUD*IST ausgewertet. Da öffentliche und fachliche Diskurse untersucht werden, ist das Datenmaterial des Projekts außerordentlich heterogen: fachwissenschaftliche Publikatione...
-
Die Auswertung heterogener Textdokumente mit Hilfe des Computerprogramms NUD*IST
Plaß, Christine; Schetsche, Michael
2000-01-01
Anhand eines aktuellen Forschungsprojekts wird der Nutzen des Computerprogramms NUD*IST für die qualitative Dokumentenanalyse erörtert. Unser Projekt untersucht die gesellschaftliche Bewertung von spektakulären Straftaten. Dazu wurden Dokumente aus dem gesamten 20. Jahrhundert erhoben, digitalisiert und unter Einsatz von NUD*IST ausgewertet. Da öffentliche und fachliche Diskurse untersucht werden, ist das Datenmaterial des Projekts außerordentlich heterogen: fachwissenschaftliche Publikatione...
-
M&A-Transaktionen - Fluch oder Segen der Realoptionstheorie?
Franke, Günter; Hopp, Christian
2005-01-01
Technologische und politische Veränderungen sowie komplexere Wertschöpfungsketten haben in den letzten Jahrzehnten zu einer verstärkten Unternehmensexpansion mittels Mergers and Acquisitions geführt. Unter dem Sammelbegriff "Mergers and Acquisitions" werden strategische Entscheidungen eines Unternehmens subsumiert, ein anderes Unternehmen oder einen Geschäftsbereich eines anderen Unternehmens durch Aktientausch oder Barentschädigung zu erwerben oder sich mit einem anderen Unternehmen zusammen...
-
Energy Technology Data Exchange (ETDEWEB)
Ruehle, T.; Schloegl, R. [Max-Planck-Gesellschaft, Berlin (Germany). Abt. Anorganische Chemie
1997-12-31
The present project was carried out on the basis of available emission data and the known toxicity of platinum compounds. Its aim was to synthesise manageable amounts of a model substance suitable for toxicological screening. [Deutsch] Unter Augenmerk auf die Emissionsdaten und auf die bekannte Toxizitaet von Platinverbindungen sollte versucht werden, handhabbare Mengen einer Modellsubstanz zu synthetisieren, um so toxikologische Reihenversuche zu ermoeglichen. (orig.)
-
Olbertz, Franziska
2012-01-01
Die Rolle der Geschwister in der musikalischen Entwicklung sollte anhand empirischer Daten fassbar gemacht und damit eine Forschungslücke der musikalischen Entwicklungspsychologie geschlossen werden. Dazu wurden in der aktuellen Studie zunächst die Formen der musikalischen Beeinflussung unter Geschwistern qualitativ erhoben und kategorisiert. Einfache quantitative Analysen desselben Materials sollten auch Hypothesen über die Bedeutung einiger Variablen ermöglichen, wie z. B. des Altersabstand...
-
Gauermann, Christoph
2013-01-01
Einleitung: Arbeitsbedingte Erkrankungen des Muskel-Skelett-Systems sind unter Physiotherapeuten sehr häufig. Die präventive Forschung hat diese Berufsgruppe bisher kaum untersucht. In diesem Zusammenhang stellt die Veränderung des Arbeitsumfeldes einen vielversprechenden Ansatz für die Verhinderung arbeitsbedingter Erkrankungen dar. Das Ziel dieser Arbeit ist die Erstellung einer Checkliste zur Bewertung des Arbeitsplatzes eines Physiotherapeuten zu erstellen. Material und Methoden: ...
-
Alpha-amino acid derivatives and alpha-fluoro ketones by enantioselective decarboxylation
Baur, Markus A.
2003-01-01
Die Methode der enantioselektiven Decarboxylierung wurde angewendet, um Enantiomeren-angereicherte alpha-Aminosäurederivate und alpha-Fluorketone zu erhalten. Als Substrate wurden 2-N-Acetylamino-2-alkylmalonsäuremonoethylester beziehungsweise beta-Keto-benzylester verwendet. China-Alkaloide und Derivate davon wurden als Katalysatoren eingesetzt. Die besten erhaltenen Ergebnisse waren N-Acetyl-L-phenylalaninethylester mit 70% Enantiomerenüberschuß unter Verwendung der katalytisch aktiven Base...
-
Elementspurenbestimmung in Solarsilicium
Balski, Matthias Michael
2014-01-01
Verunreinigungen von Fremdelementen können den Wirkungsgrad von Solarzellen schon im Spurenbereich beeinträchtigen. Die Kenntnis der Verunreinigungen in Si ist entscheidend für die Produkt- und Produktionskontrolle neuer Solarzellenmaterialien. In dieser Arbeit wurden Analysenmethoden mit unterschiedlichen Messverfahren unter besonderer Berücksichtigung der Ansprüche der Solarindustrie entwickelt, verbessert, charakterisiert und verglichen. Mit der Sektorfeld-Massenspektrometrie (SFMS) mit i...
-
Putz, Matthias
2013-01-01
Produktionstechnik im Wandel, "Treiber" für Energie- und Ressourceneffizienz. Die Produktionstechnik muss sich den Herausforderungen Endlichkeit von fossilen Ressourcen, demografischer Wandel, Klimawandel, steigender Verbrauch an Elektrizität, Globalisierung und Wohlstand, unter dem Ansatz der Machbarkeit der Effizienz, stellen. Mit dem E3-Konzept -effiziente Produktionstechnik, emissionsneutrale, energieautarke Fabrik, Einbindung des Menschen- forscht die FHG an Lösungen für eine ressourcene...
-
Overcoming major bottlenecks in aquaponics - A practical approach
Monsees, Hendrik
2018-01-01
Aquaponik-Systeme stellen an sich einen sehr nachhaltigen, innovativen Ansatz für die zukünftige Lebensmittelproduktion dar. Allerdings hat sich bis heute noch kein flächendeckender, ökonomischer Erfolg eingestellt und wesentliche systemische Engpässe wurden wissenschaftlich nicht untersucht. Daher waren die Hauptziele dieser Dissertation, (I) sichere Nitratkonzentrationen in geschlossenen Kreislaufanlagen (RAS) zu ermitteln, unter denen optimales Wachstum und Tierwohl produzierter Tilapien g...
-
On the phenomenon of electromagnetic hypersensitivity; Das Phaenomen der Elektrosensibilitaet
Energy Technology Data Exchange (ETDEWEB)
David, E.; Reissenweber, J.; Wojtysiak, A.; Pfotenhauer, M. [Witten-Herdecke Univ., Witten (Germany). Inst. fuer Normale und Pathologische Physiologie; Witten-Herdecke Univ., Witten (Germany). Zentrum fuer Elektropathologie
2002-07-01
auch beim Multiple-Chemical-Sensitivity-Syndrom auftreten koennen. Unser Wittener Forschungsansatz beinhaltet unter anderem auch die Untersuchung der psychischen Befindlichkeit von betroffenen Menschen sowie die Analyse der Anfragen an unser Zentrum fuer Elektropathologie. In der vorliegenden Arbeit soll das Phaenomen der Elektrosensibilitaet unter verschiedenen Blickwinkeln beleuchtet werden, darunter auch unter dem Aspekt der Melatoninhypothese. (orig.)
-
Energy Technology Data Exchange (ETDEWEB)
Schloesser, R. [Universitaet Jena, Psychiatrische Klinik (Germany); Universitaet Jena, Psychiatrische Klinik, Jena (Germany); Wagner, G.; Koehler, S.; Sauer, H. [Universitaet Jena, Psychiatrische Klinik (Germany)
2005-02-01
Aside from characteristic psychopathological symptoms, cognitive deficits are a core feature of schizophrenia. These deficits can only be addressed within the context of widespread functional interactions among different brain areas. To examine these interactions, structural equation modeling (SEM) was used for the analysis of fMRI datasets. In a series of studies, both in antipsychotic-treated and drug-free schizophrenic patients, a pattern of enhanced thalamocortical functional connectivity could be observed as an indicator for possible disruptions of frontostriatal thalamocortical circuitry. Moreover, drug-free patients and those receiving typical antipsychotic drugs were characterized by reduced interhemispheric corticocortical connectivity. This difference relative to normal controls was less in patients under atypical antipsychotic drugs. The results could be interpreted as a beneficial effect of atypical antipsychotic drugs on information processing in schizophrenic patients. The present findings are consistent with the model of schizophrenia as a disconnection syndrome and earlier concepts of ''cognitive dysmetria'' in schizophrenia. (orig.) [German] Neben der charakteristischen psychopathologischen Symptomatik stellen kognitive Defizite ein zentrales Merkmal der Schizophrenie dar. Diese Defizite koennen nur im Kontext miteinander interagierender Hirnareale verstanden werden. Zur Untersuchung dieser funktionellen Wechselbeziehungen wurden Strukturgleichungsmodelle (''structural equation modeling'', SEM) zur Auswertung von fMRT-Datensaetzen verwendet. In einer Untersuchungsreihe bei schizophrenen Patienten ergab sich sowohl bei antipsychotisch behandelten als auch bei unbehandelten Patienten ein Muster gesteigerter thalamokortikaler funktioneller Konnektivitaet als Hinweis auf eine moegliche Stoerung fronto-striato-thalamo-kortikaler Regelkreise. Unbehandelte Patienten und Patienten unter typischen Antipsychotika
-
Energy Technology Data Exchange (ETDEWEB)
Backhaus, K. [Univ. GH Kassel (Germany). Inst. fuer Maschinenelemente und Konstruktionstechnik; Hunsicker, W. [Fachhochschule Mannheim (Germany). Inst. fuer Tribologie; Schubert, W. [KS Gleitlager GmbH, St. Leon-Rot (Germany)
2003-07-01
In the frame of this research project a simulation program has been developed in order to investigate suspension pressure build-up in crankshaft axial bearings taking into account mixed friction conditions. The investigated system is performing in a dynamic way taking into account the engine dynamics. Based upon the high engineering state of radial slide bearings, axial bearings as well as conical slide faces with any conical angle can be simulated in the same way. The solid body contact share in the system to be investigated is taken into account by the integral effect of the real microscopic surface structure on microhydrodynamics and contact pressure build-up. The influence of individual parameters, as e.g. macro-geometric bearing surface design can be investigated by means of simulation results. Wavy stopping faces and bearing surfaces with Rayleigh-steps are characterised by high hydrodynamic supporting pressure magnitudes in terms of macrogeometry. Elasto-hydrodynamic investigations at one stop collar and under engine-specific load on stop disks of a base bearing show the influence of structure elasticity and prove the necessity to consider them when the individual systems are analysed. (orig.) [German] Im Rahmen des durchgefuehrten Forschungsvorhabens wurde ein Simulationsprogramm zur Untersuchung des Tragdruckaufbaus in Kurbelwellen-Axiallagern unter Beruecksichtigung von Mischreibungszustaenden entwickelt. Das untersuchte System verhaelt sich dabei unter Beruecksichtigung der Motordynamik dynamisch. Ausgehend von dem hohen Entwicklungsstand von Radialgleitlagern koennen Axiallager sowie kegelfoermige Gleitflaechen mit beliebigen Kegelwinkeln in gleicher Weise simuliert werden. Dem hohen Festkoerperkontaktanteil in dem zu untersuchenden System wird durch die Beruecksichtigung der integralen Wirkung der realen mikroskopischen Oberflaechenstruktur auf Mikrohydrodynamik und Kontaktdruckaufbau Rechnung getragen. Anhand von Simulationsergebnissen kann der
-
Achieving performance breakthroughs in an HMO business process through quality planning.
Hanan, K B
1993-01-01
Kaiser Permanente's Georgia Region commissioned a quality planning team to design a new process to improve payments to its suppliers and vendors. The result of the team's effort was a 73 percent reduction in cycle time. This team's experiences point to the advantages of process redesign as a quality planning model, as well as some general guidelines for its most effective use in teams. If quality planning project teams are carefully configured, sufficiently expert in the existing process, and properly supported by management, organizations can achieve potentially dramatic improvements in process performance using this approach.
-
Employer health insurance offerings and employee enrollment decisions.
Polsky, Daniel; Stein, Rebecca; Nicholson, Sean; Bundorf, M Kate
2005-10-01
To determine how the characteristics of the health benefits offered by employers affect worker insurance coverage decisions. The 1996-1997 and the 1998-1999 rounds of the nationally representative Community Tracking Study Household Survey. We use multinomial logistic regression to analyze the choice between own-employer coverage, alternative source coverage, and no coverage among employees offered health insurance by their employer. The key explanatory variables are the types of health plans offered and the net premium offered. The models include controls for personal, health plan, and job characteristics. When an employer offers only a health maintenance organization married employees are more likely to decline coverage from their employer and take-up another offer (odds ratio (OR)=1.27, phealth plan coverage an employer offers affects whether its employees take-up insurance, but has a smaller effect on overall coverage rates for workers and their families because of the availability of alternative sources of coverage. Relative to offering only a non-HMO plan, employers offering only an HMO may reduce take-up among those with alternative sources of coverage, but increase take-up among those who would otherwise go uninsured. By modeling the possibility of take-up through the health insurance offers from the employer of the spouse, the decline in coverage rates from higher net premiums is less than previous estimates.
-
MALDI Q-TOF CID MS for Diagnostic Ion Screening of Human Milk Oligosaccharide Samples
Directory of Open Access Journals (Sweden)
Marko Jovanović
2014-04-01
Full Text Available Human milk oligosaccharides (HMO represent the bioactive components of human milk, influencing the infant’s gastrointestinal microflora and immune system. Structurally, they represent a highly complex class of analyte, where the main core oligosaccharide structures are built from galactose and N-acetylglucosamine, linked by 1-3 or 1-4 glycosidic linkages and potentially modified with fucose and sialic acid residues. The core structures can be linear or branched. Additional structural complexity in samples can be induced by endogenous exoglycosidase activity or chemical procedures during the sample preparation. Here, we show that using matrix-assisted laser desorption/ionization (MALDI quadrupole-time-of-flight (Q-TOF collision-induced dissociation (CID as a fast screening method, diagnostic structural information about single oligosaccharide components present in a complex mixture can be obtained. According to sequencing data on 14 out of 22 parent ions detected in a single high molecular weight oligosaccharide chromatographic fraction, 20 different oligosaccharide structure types, corresponding to over 30 isomeric oligosaccharide structures and over 100 possible HMO isomers when biosynthetic linkage variations were taken into account, were postulated. For MS/MS data analysis, we used the de novo sequencing approach using diagnostic ion analysis on reduced oligosaccharides by following known biosynthetic rules. Using this approach, de novo characterization has been achieved also for the structures, which could not have been predicted.
-
Ohashi, Akira; Ito, Hiromi; Kanai, Chikako; Imura, Hisanori; Ohashi, Kousaburo
2005-01-30
The cloud point extraction behavior of iron(III) and vanadium(V) using 8-quinolinol derivatives (HA) such as 8-quinolinol (HQ), 2-methyl-8-quinolinol (HMQ), 5-butyloxymethyl-8-quinolinol (HO(4)Q), 5-hexyloxymethyl-8-quinolinol (HO(6)Q), and 2-methyl-5-octyloxymethyl-8-quinolinol (HMO(8)Q) and Triton X-100 solution was investigated. Iron(III) was extracted with HA and 4% (v/v) Triton X-100 in the pH range of 1.70-5.44. Above pH 4.0, more than 95% of iron(III) was extracted with HQ, HMQ, and HMO(8)Q. Vanadium(V) was also extracted with HA and 4% (v/v) Triton X-100 in the pH range of 2.07-5.00, and the extractability increased in the following order of HMQ HQ cloud point extraction was applied to the determination of iron(III) in the riverine water reference by a graphite furnace atomic absorption spectroscopy. When 1.25 x 10(-3)M HMQ and 1% (v/v) Triton X-100 were used, the found values showed a good agreement with the certified ones within the 2% of the R.S.D. Moreover, the effect of an alkyl group on the solubility of 5-alkyloxymethyl-8-quinolinol and 2-methyl-5-alkyloxymethyl-8-quinolinol in 4% (v/v) Triton X-100 at 25 degrees C was also investigated.
-
Atrial therapies reduce atrial arrhythmia burden in defibrillator patients.
Friedman, P A; Dijkman, B; Warman, E N; Xia, H A; Mehra, R; Stanton, M S; Hammill, S C
2001-08-28
Approximately 25% of patients who receive an implantable cardioverter-defibrillator (ICD) to treat ventricular tachyarrhythmias have documented atrial tachyarrhythmias before implantation. This study assessed the ability of device-based prevention and termination therapies to reduce the burden of spontaneous atrial tachyarrhythmias. Patients with a standard indication for the implantation of an ICD and 2 episodes of atrial tachyarrhythmias in the preceding year received a dual-chamber ICD (Medtronic 7250 Jewel AF) that uses pacing and shock therapies for prevention and/or termination of atrial tachyarrhythmias. In a multicenter trial, patients were randomized to 3-month periods with atrial therapies "on" or "off" and subsequently crossed over. Analysis was performed on the 52 of 269 patients who had episodes of atrial tachyarrhythmia and had >/=30 days of follow-up with atrial therapies on and off. The atrial therapies resulted in a reduction of atrial tachyarrhythmia burden from a mean of 58.5 to 7.8 h/mo. A paired analysis (Wilcoxon signed-rank test) showed that the median difference in burden (1.1 h/mo) was highly significant (P=0.007). When the subgroup of 41 patients treated only with atrial pacing therapies was analyzed, the reduction in burden persisted (P=0.01). In this study, patients with a standard ICD indication and atrial tachyarrhythmias had a significant reduction in atrial tachyarrhythmia burden with use of atrial pacing and shock therapies.
-
Digestion of Human Milk Oligosaccharides by Bifidobacterium breve in the Premature Infant.
Underwood, Mark A; Davis, Jasmine C C; Kalanetra, Karen M; Gehlot, Sanjay; Patole, Sanjay; Tancredi, Daniel J; Mills, David A; Lebrilla, Carlito B; Simmer, Karen
2017-10-01
The aim of this study was to measure consumption and absorption of human milk oligosaccharides (HMOs) in a cohort of premature infants treated with probiotic Bifidobacterium breve. Twenty-nine premature infants (median gestational age 28 weeks, range 23-32 weeks) cared for in the neonatal intensive care unit of the King Edward and Princess Margaret Hospital in Perth, Australia, were treated with B breve at a dose of 1.66 billion organisms per day. Samples of feces, urine, and milk were obtained at initiation of the probiotic and again 3 weeks later. 16S ribosomal RNA from the feces was analyzed by next-generation sequencing. Quantitation of HMO content of the milk, urine, and feces was performed using nano-high-performance liquid chromatography-chip/time-of-flight mass spectrometry. There was heterogeneity in colonization with bifidobacteria. "Responders" received milk with higher percentages of fucosylated HMOs and had higher percentages of bifidobacteria and lower percentages of Enterobacteriaceae in their feces than "nonresponders." Several individual HMOs in the milk were associated with changes in fecal bifidobacteria over time. Changes over time in milk, fecal, and urine HMOs suggested heterogeneity among HMO structures in consumption by microbes in the gut lumen and absorption from the intestine. Colonization of the premature infant intestinal tract with probiotic B breve is influenced by prebiotic HMOs. B breve is a selective consumer of HMOs in the premature infant.
-
Peri-Implant Crestal Bone Loss: A Putative Mechanism
Directory of Open Access Journals (Sweden)
Yuko Ujiie
2012-01-01
Full Text Available Purpose. The immunological mechanisms of peri-implant crestal bone loss have, hitherto, not been elucidated. We hypothesized that bacterial products from the microgap cause upregulation of cytokines in otherwise healthy peri-implant cells, which results in osteoclast formation and, ultimately, in bone resorption. Materials and Methods. We used RT-PCR and ELISA to assay mediators of osteoclastogenesis in rat and human macrophages (r-and hMO; bone marrow derived stromal cells (r-and hBMCs; and human gingival fibroblasts (hGF—with or without stimulation by LPS. TRAP positive multinucleate cells were assessed for their resorptive ability. Results. We show that IL-1α, IL-1β, and IL-6 were expressed by all examined cell types, and TNF-α was upregulated in hGF. Secretion of IL-1α and IL-1β proteins was stimulated in hMO by LPS, and IL-6 protein secretion was highly stimulated in hBMCs and hGF. Both LPS and RANKL stimulated macrophages to form osteoclast-like TRAP positive cells, which resorbed calcium phosphate substrates. Conclusion. Taken together, the results of our study support the hypothesis that bacterial endotoxins upregulate enhanced mediators of osteoclastogenesis in resident cells found in the healthy peri-implant compartment and that the local synergistic action of cytokines secreted by such cells results in the genesis of resorptively active osteoclasts.
-
Energy Technology Data Exchange (ETDEWEB)
Hautzel, H.; Mottaghy, F.M.; Schmidt, D.; Mueller, H.-W.; Krause, B. J. [Klinik fuer Nuklearmedizin (KME), Forschungszentrum Juelich (Germany); Nuklearmedizinische Klinik, Heinrich-Heine-Universitaet Duesseldorf (Germany)
2003-10-01
Aim: In cognitive neuroscience regional cerebral blood flow (rCBF) imaging with positron-emission-tomography (PET) is a powerful tool to characterize different aspects of cognitive processes by using different data analysis approaches. By use of an n-back verbal working memory task (varied from 0- to 3-back) we present cognitive subtraction analysis as basic strategy as well as parametric and covariance analyses and discuss the results. Methods: Correlation analyses were performed using the individual performance rate as an external covariate, computing inter-regional correlations, an as network analysis applying structural equation modelling to evaluate the effective connectivity between the involved brain regions. Results: Subtraction analyses revealed a fronto-parietal neuronal network also including the anterior cingulate cortex and the cerebellum. With higher memory load the parametric analysis evidenced linear rCBF increases in prefrontal, pre-motor and inferior parietal areas including the precuneus as well as in the anterior cingulate cortex. The rCBF correlation with the individual performance as external covariate depicted negative correlations in bilateral prefrontal and inferior parietal regions, in the precuneus and the anterior cingulate cortex. The network analysis demonstrated mainly occipito-frontally directed interactions which were predominantly left-hemispheric. Additionally, strong linkages were found between extrastriate and parietal regions as well as within the parietal cortex. Conclusion: The data analysis approaches presented here contribute to an extended and more elaborated understanding of cognitive processes and their different sub-aspects. (orig.) [German] Ziel, Methoden: Im Bereich der neurokognitiven Aktivierungsstudien mit Messung des regionalen zerebralen Blutflusses (rCBF) mit PET koennen durch Anwendung verschiedener Datenanalysestrategien unterschiedliche Aspekte eines kognitiven Prozesses charakterisiert werden. Unter
-
Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D
2015-01-01
Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
-
Evaluation Statistics Computed for the Wave Information Studies (WIS)
2016-07-01
the numerical wave model ( SWAN ) for wave simulation in the Black Sea. Continental Shelf Research 50–51: 80–99. Alves, J.-H. G. M., S...York Harbor Entrance. The time series plots, shown in the left column of Figure 1, compare time series of the modeled ( black line) and observed (red...Hmo on the horizontal axis. Within these plots, the diagonal black line is the best fit line, and the closer a dot lies to the best fit line,
-
Energy Technology Data Exchange (ETDEWEB)
Richter, K. (Herz-Kreislaufklinik, Berlin-Buch (Germany)) (ed.)
1992-01-01
This volume offers a selection of scientific assessments and data contributed by numerous experts that were based on recent experience in various fields, which include in particular: contrast echocardiography, quantitative characterisation of myocardial tissue, filmless cardangiography, quantitative DSA, digitised luminescence radiology of the thorax, on-line computer-aided cardiac evaluations, automatic recognition of image characteristics, ROC analysis, trends in PACS development, contrast media including their influences on microcirculation, recent developments and trends of non-surgical angioplasty, newly devised stents, atherectomy, the use of excimer lasers in coronaries and other vessels and of microcoils in neuroradiology. (MG).
-
Energy Technology Data Exchange (ETDEWEB)
Waldt, Simone; Eiber, Matthias; Woertler, Klaus [Klinikum rechts der Isar der Technischen Univ. Muenchen (TUM), Muenchen (Germany). Inst. fuer Radiologie
2011-07-01
The book on measuring methods and classification in the musculoskeletal radiology covers the following topics: legs; hip joint; knee joint; foot; shoulder joint; elbow joint; wrist joint; spinal column; craniocervical transition region and cervical spine; muscular-skeletal carcinomas; osteoporosis; arthrosis; articular cartilage; hemophilia; rheumatic arthritis; muscular injuries; skeleton age.
-
Social Networks and Cooperative Travel Behaviour
Illenberger, Johannes
2012-01-01
Ein Großteil des Verkehrsaufkommens und der Verkehrsleistung ist allein dem Freizeitverkehr zuzuordnen. Der Forschungsstand in der Modellierung des Freizeitverkehrs ist allerdings weniger fortgeschritten als in der Modellierung des Pendlerverkehrs. Dies ist unter Anderem dadurch zu begründen, dass der Freizeitverkehr eine sehr heterogenes Segment darstellt und die Datengrundlage deutlich geringer ist. Studien zu Freizeitaktivitäten legen nahe, dass Freizeitaktivitäten nicht allein durch den Z...
-
Ernährungszustand bei Patienten mit chronisch entzündlichen Darmerkrankungen
Blunk, Christine
2009-01-01
Zahlreiche internationale Studien konnten den negativen Einfluss einer bestehenden Malnutrition auf den Verlauf einer Erkrankung belegen. Dies gilt insbesondere für Patienten mit chronisch entzündlichen Darmerkrankungen wie Morbus Crohn und Colitis ulcerosa, die wie klinische Studien gezeigt haben besonders häufig unter einer Malnutrition leiden. In der vorliegenden Studie wurde der Ernährungszustand von 127 Patienten mit chronisch entzündlichen Darmerkrankungen anhand verschiedener etabli...
-
Zugck C; Gerhards A; Haass M; Katz N; Kell R; Krüger C; Schellberg D
2001-01-01
Zu den etablierten Prognoseindikatoren bei Patienten mit chronischer Herzinsuffizienz zählen der Herz-Thorax-Quotient in der Röntgen-Thoraxaufnahme (HTQ), die linksventrikuläre Ejektionsfraktion (LVEF) und die maximale Sauerstoffaufnahme unter Belastung (VO2max). Darüber hinaus wird zahlreichen neurohumoralen Parametern eine prognostische Wertigkeit zugeschrieben. An 166 Patienten mit chronischer Herzinsuffizienz (Alter 54 ± 9 Jahre; 70 % dilatative Kardiomyopathie; 30 % KHK; LVEF 21 ± 9 %) ...
-
E-Books in wissenschaftlichen Bibliotheken
Directory of Open Access Journals (Sweden)
Sandra Niemeyer
2014-12-01
Full Text Available Die zweitägige Veranstaltung „E-Books in wissenschaftlichen Bibliotheken, die am 18. und 19. März 2014 im Leibnizhaus in Hannover stattfand, beschäftigte sich mit verschiedenen Aspekten von E-Books. So standen unter anderem Themen wie die Nutzung von E-Books, Erwerbungsmodelle und Lizenzverträge auf dem Programm. Organisiert wurde die Veranstaltung von Technischen Informationsbibliothek (TIB und dem Verein Deutscher Bibliothekare (VDB.
-
Praktische Festigkeitsberechnungen im Maschinenbau
Böge, Gert; Böge, Wolfgang
Ziel aller Festigkeitsberechnungen ist die Ermittlung der vorhandenen Spannung und der Nachweis, dass ein konstruiertes Bauteil mit Sicherheit "hält". Seine geforderte oder erwartete Tragfähigkeit muss unter allen denkbaren Umständen gewährleistet sein, es darf z. B. auch bei Dauerbelastung in der vorgeschriebenen Lebensdauer nicht brechen oder seine Form bleibend so verändern, dass es seine Funktion nicht mehr ausreichend erfüllt.
-
Ein wellenbasiertes stochastisches Modell zur Vorhersage der Erdbebenlast
Bretschneider, Jörg
2007-01-01
Starke Erdbeben stellen weltweit ein hohes Risiko für urbane Zentren dar, dem unter anderem durch Methoden der aseismischen Bauwerksbemessung begegnet wird. Grundlage hierfür bilden Annahmen und Erfahrungswissen über die lokale seismische Bodenbeschleunigung, Grenzen sind hingegen durch die zusätzlichen Kosten gesetzt. Die Schadensbilanz der Starkbeben der letzten Jahre, auch in den Industrieländern, verdeutlicht die Notwendigkeit, die Konzepte und Methoden des erdbebensicheren Bauens weiter ...
-
Das IHS und die Rolle der Forschungsinstitute
Keuschnigg, Christian
2014-01-01
Das Institut für Höhere Studien und wissenschaftliche Forschung (IHS) ist ein unabhängiges Forschungsinstitut und leistet Forschung und Ausbildung auf Spitzenniveau für Politik, Wirtschaft und Gesellschaft. Im Wettbewerb zwischen Universitäten und angewandten Forschungsinstituten ist das IHS einzigartig, weil es unter einem Dach Grundlagenforschung und forschungsnahe Lehre mit angewandter Forschung für die wissenschaftliche Politikberatung verbindet. Mit den drei Disziplinen Ökonomie, Soziolo...
-
Tax Shield, Insolvenz und Zinsschranke
Arnold, Sven; Lahmann, Alexander; Schwetzler, Bernhard
2010-01-01
Dieser Beitrag analysiert den Wertbeitrag fremdfinanzierungsbedingter Steuervorteile (Tax Shield) unter realistischen Bedingungen (keine Negativsteuer; mögliche Insolvenz) für unterschiedliche Finanzierungspolitiken. Zusätzlich wird der Effekt der sogenannten Zinsschranke auf den Wert des Tax Shield ermittelt. Die Bewertung des Tax Shield mit und ohne Zinsschranke findet im einperiodigen Fall auf der Basis von Optionspreismodellen und im mehrperiodigen Fall auf der Basis von Monte Carlo Simul...
-
Gehmacher, Ernst
2003-01-01
'Der Begriff 'Sozialkapital' bezieht sich auf Formen gesellschaftlichen Zusammenhalts, die politischen, sozialen und wirtschaftlichen Nutzen bringen. Unter dem Eindruck, dass sich traditionelle Normen, Vertrauensverhältnisse und Bindungen auflösen und in Zukunft neue soziale Bindungen Bedeutung gewinnen werden, hat die OECD das Programm 'Measuring Social Capital' organisiert: bis 2004 sollen statistische Indikatoren und Survey-Fragen für vergleichende Studien entwickelt werden. Nach einem Übe...
-
Übergewicht und Adipositas, Gesundheit und Krankheit : Diskussionsbeiträge aus philosophischer Sicht
Gottschalk-Mazouz, Niels; Ertelt, Susanne; Radinkovic, Zeljko
2010-01-01
Der vorliegende Band vereint Studien, die im Rahmen des Philosophie-Teilprojekts des Forschungsverbunds "Übergewicht und Adipositas bei Kindern, Jugendlichen und jungen Erwachsenen als systemisches Risiko" entstanden sind. Dieser Verbund wurde vom BMBF von 2006-2009 im Rahmen der sozial-ökologischen Forschung im Themenbereich: Strategien zum Umgang mit systemischen Risiken gefördert. In diesem Verbund wurden unter der Leitung des Risikosoziologen Ortwin Renn die Perspektiven von Epidemiologie...
-
Suchert, Anne
2015-01-01
Diese wissenschaftliche Arbeit beschäftigt sich mit der Eigentümlichkeit der geschriebenen Modesprache. Da die Modesprache offensichtliche sprachliche Auffälligkeiten sowie einen überaus kreativen und erfrischend humorvollen Umgang mit Sprache aufweist, sollte sie unter wissenschaftlichen Aspekten betrachtet werden. Mode ist eine Institution mit der sich die Soziologie seit jeher ausführlich beschäftigt. Somit stellt sie auch einen interessanten Untersuchungsgegenstand für die Soziolinguisti...
-
Nutzung und Akzeptanz von Electronic Commerce : E-Commerce und die Bürger
Schenk, Michael; Wolf, Malthe
2000-01-01
Marktprognosen bescheinigen dem elektronischen Handel eine große Zukunft. Business-Transaktionen verändern sich rapide unter dem Einfluss elektronischer Kommunikationstechnologien. Wenngleich auch erwartet wird, dass sich Business-to-Consumer E-Commerce weltweit als erfolgreicher Vertriebs- und Kommunikationskanal etablieren wird, stößt E-Commerce derzeit noch nicht auf die erhoffte Akzeptanz in breiten Konsumentenschichten. Dies hängt nicht zuletzt mit der Verbreitung des Internet zusammen, ...
-
Mycorrhiza-induced resistance against Thielaviopsis basicola in the ornemental crop Petunia hybrida
Hayek , Soukayna
2012-01-01
Wurzelpathogene zeigen bedeutenden Einfluss auf die Produktion von Zierpflanzen. Vor Allem in erdelosen Produktionssystemen unter Glas verursachen sie erhebliche Verluste und ihre Bekämpfung mit konventionellen Mitteln beinhaltet normalerweise ein hoher Einsatz an Pestiziden. Ein mehr nachhaltiger Gartenbau braucht alternative Methoden, um den Eintrag dieser Chemikalien zu vermeiden. Die Einführung arbuskulärer Mykorrhizapilze (AM Pilze) in das Produktionssystem könnte ein integraler Bestandt...
-
Phan, The Minh
2016-01-01
Elektronische Ventile (IGBT, IGCT, usw.) eines Drei-Punkt-Wechselrichters (3L-NPC-VSI) für Mittelspannungsanwendungen werden üblicherweise auf separaten Kühlkörpern montiert, als Folge entsteht eine schwache thermische Kopplung zwischen den Ventilen. Wie aus der Literatur bekannt ist, kann im normalen Betrieb des Wechselrichters die Wärmeverteilung zwischen den Schaltern mit Hilfe verschiedener Verfahren verbessert werden. Trotzdem ist die Entstehung von lokalen Hotspots unter bestimmten Fehl...
-
Die Geschichte des Marburger Universitätsbundes 1920-1957
Pawelletz, Jörg
2009-01-01
Seit dem Ende des Ersten Weltkrieges gibt es Hochschulfördervereine an deutschen Hochschulen und Universitäten, die sich unter verschiedenen Bezeichnungen ab 1917 bildeten und die bis auf wenige Ausnahmen noch bis heute bestehen. Diese frühen Fördervereine verorten sich im Bereich der privaten Wissenschaftsförderung, welche sich in der zweiten Hälfte des 19. Jahrhunderts ausbildete und zunehmend an Bedeutung gewann. Den Höhepunkt ...
-
Seeking a balanced and sustainable business model for scholarly publishing
Chesler, Adam
2005-01-01
Der Vortrag wurde am 5th Frankfurt Scientific Symposium gehalten (22-23 Oktober 2005). Die Betrachtung des Videos ist (leider) nur mit den Browsern Internet Explorer ab 5.0, Netscape Navigator ab 7.0 oder Internet Explorer ab 5.2.2 für MaC möglich (s. Dokument 1.html). Die gesamten Tagungsbeiträge sind unter http://publikationen.ub.uni-frankfurt.de/volltexte/2005/1992/ abrufbar.
-
Topologieoptimierung im Creo-Umfeld mit ProTopCI
Simmler, Urs
2016-01-01
Wikipedia umschreibt die Topologieoptimierung als ein computerbasiertes Berechnungsverfahren, durch welches eine günstige Grundgestalt (Topologie) für Bauteile unter mechanischer Belastung ermittelt werden kann. Durch die Verwendung von 3D-Druck-Verfahren wird die Gestaltung der Komponenten revolutioniert, weil diese nicht mehr abhängig vom Fertigungsverfahren sind. Dabei werden auch optimale Gitterstrukturen innerhalb der Komponenten immer wichtiger. Diese neuen Herausforderungen können im C...
-
Weigel-Ossiander, Fiona Sarah
2016-01-01
Mit EKG Basics wurde ein detailliertes multimediales Lernprogramm über die Grundlagen der Elektrokardiographie bei Hund und Katze erstellt unter besonderer Berücksichtigung von didaktischen und ergonomischen Gesichtspunkten. Da vielen Veterinärmedizinerinnen/Veterinärmedizinern das Erlernen, Verstehen und Interpretieren der Elektrokardiographie schwer fällt, war das Ziel der vorliegenden Arbeit, sowohl Studierenden der Tiermedizin als auch interessierten Tierärztinnen/Tierärzten die Thema...
-
When size does matter:Dimensional metrology of nanostructured layers and surfaces using x-rays
Wernecke, Jan
2015-01-01
Ein Gebiet der Nanotechnologie ist die dimensionelle Nanometrologie, die sich mit der Messung von Längen in vertikale und laterale Richtung im nm-Bereich befasst. Messungen der Röntgenkleinwinkelstreuung unter streifendem Einfall (GISAXS) sind zerstörungsfrei, bedürfen keiner Probenpräparation, bieten Mittelung über einen makroskopischen Bereich und liefern tiefenaufgelöste Information von vergrabenen Nanostrukturen. In dieser Arbeit sind GISAXS-Messungen an Reflektionsgittern mit Strukturgrö...
-
Energy Technology Data Exchange (ETDEWEB)
Mahler, B; Seiwald, H [Steinbeis-Transferzentrum Energie-, Gebaeude- und Solartechnik; Koch, K P [Rehau AG und Co., Erlangen-Eltersdorf (Germany)
2004-07-01
New office buildings often have concrete core tempering systems for combined heating and cooling. The technology may be applied to well-insulated domestic buildings as well, provided that certain boundary conditions are met. [German] Beim Neubau von Buerogebaeuden findet die Betonkerntemperierung fuer kombinierte Heiz- und Kuehlsysteme immer mehr Verbreitung. Im Zuge des stark reduzierten Heizleistungsbedarfs hochgedaemmter Wohngebaeude bietet sich die Betonkerntemperierung unter bestimmten Voraussetzungen auch hier als Heizsystem an. (orig.)
-
Spremann, Klaus
2007-01-01
Bisher veröffentlicht unter dem Titel: "Modern Finance" Das Buch beinhaltet ebenso einige Portraits: Die didaktische Erfahrung lehrt, dass man sich wissenschaftliche Ergebnisse und Ansätze besser merken kann, wenn eine Assoziation zu jener Person bildlich konkret wird, der wir den betreffenden Denkansatz verdanken. Aus Fragen der Finanzierung und der Investitionsentscheidungen von Unternehmen ist in der Verschmelzung mit der Analyse von Kapitalmärkten ein grosses Gebiet entstanden, da...
-
Boszczyk, Christian
2010-01-01
Nach den Hochrechnungen des Marktforschungsinstituts "iconkids & youth" gaben in 2006 deutsche Teenager in der Alterskategorie von 13 – 19 Jahren insgesamt rund 468 Millionen Euro für Sportartikel aus. Diese imposante Zahl alleine ist Grund genug für einen Absolventen eines Studiums der Wirtschaftswissenschaften, sich mit der Zweierbeziehung "Jugend und Sport" auseinanderzusetzen. Betrachtet man den Jugendmarkt in Deutschland unter ökonomischen Gesichtspunkten, so entpuppt sich diese junge Kä...
-
Reidl, Sebastian
2009-01-01
Multizelluläre Gemeinschaften in Form bakterieller Biofilme stellen aus medizinischer Sicht ein großes klinisches Problem dar. Häufig lassen sich chronische oder rezidivierende Erkrankungen aber auch nosokomiale Infektionen auf die multizelluläre Lebensweise von humanpathogenen Erregern zurückführen. Sowohl fakultativ als auch obligat pathogene Escherichia coli-Stämme besitzen eine Vielzahl unterschiedlicher Faktoren, die die Biofilmbildung beeinflussen. Daran beteiligt sind unter anderem Fla...
-
Einfluss von Thujonen und Omeprazol auf die Aktivität der glatten Muskelzelle im Ileum der Ratte
Huhnstock, Stefan
2010-01-01
Untersucht wurde der Einfluss von Thujonen (α Thujon, αβThujon, natürliches Mischthujon) und Omeprazol auf die Ruheaktivität, den Basaltonus, die pharmakologisch vorstimulierte glatte Muskulatur ,sowie die elektrisch induzierte Kontraktionen und die elektrisch induzierte Relaxation unter nicht-adrenergen nicht-cholinergen Bedingungen an der glatten Muskelzelle im Ileum von Ratten. Auf die Ruheaktivität und den Basaltonus hatten die Substanzen keinen Einfluss. Thujone hatten einen signifikante...
-
Modern oder Postmodern? Traditionalismus, Avantgarde oder Postavangarde?
Directory of Open Access Journals (Sweden)
Kostakeva Maria
2006-01-01
Full Text Available (nemački Mittelpunkt des Aufsatzes sind einige methodologische Probleme bei der Betrachtung der Kunst, bzw. Musik an der Schwelle der zwei Jahrhunderten. Anhang einiger Besonderheiten im Kompositionsverfahren von vier wichtigen Komponisten (György Ligeti, Alfred Schnittke, Helmut Lachenmann, Adriana Hölszky und im Licht der führenden Ideen der modernen Philosophie und Ästhetik wird versucht, die Idiomatik unserer Epoche unter Lupe zu stellen.
-
Energy Technology Data Exchange (ETDEWEB)
Diekmann, J.; Wiehn, G. [Siemens AG Unternehmensbereich KWU, Erlangen (Germany). Bereich Energieerzeugung
1998-09-01
The disposal market for household waste is strongly influenced by the legal framework governing it. A further factor that makes it difficult for the authorities responsible for disposal to decide on residual waste disposal by means of thermal or mechanical-biological treatment plants is the downward pressure on disposal prices from inexpensive, underused landfills. This makes it all the more important for a future-oriented waste management to develop a both economically and ecologically optimised waste disposal concept. In this situation there is much in favour of adopting a concept consisting of a combination of mechanical, mechanical-biological, and thermal treatment which takes due account of waste disposal concepts at the regional and supraregional scale. [Deutsch] Der Entsorgungsmarkt fuer Siedlungsabfaelle wird stark durch die Entwicklung der rechtlichen Rahmenbedingungen beeinflusst. Hinzu kommt, dass der Entscheidungsprozess der oeffentlichen Entsorgungstraeger zur Restabfallentsorgung mittels thermischer oder mechanisch-biologischer Anlagen durch den Druck auf die Entsorgungspreise aufgrund der kostenguenstigen, nicht ausgelasteten Deponien erschwert wird. Umso mehr muss das Ziel einer zukunftsorientierten Abfallwirtschaft sein, unter oekonomischen und oekologischen Gesichtspunkten ein optimiertes Abfallkonzept aufzubauen. Hier kann es sehr hilfreich sein, sich eines Konzeptes, bestehend aus der Kombination von mechanischer, mechanisch-biologischer und thermischer Behandlung unter Beruecksichtigung des regionalen und ueberregionalen Abfallkonzeptes zu bedienen. (orig./SR)
-
ADDRESSING THE DEFICIT: Updating the Budgetary Implications of Selected GAO Work
1996-06-01
DGPS DI DLA DOD DOE DOT DUR EDWAA EM EPA FAIR FAA FAS FDIC FHWA FY GAO GSA HACCP HCFA HHS HMO HUD IDB IFAD INS IRS JCT...Marti, the broadcasts are constantly and effectively jammed , USIA’S research data shows that, mainly as a result of the jamming , the number of Cubans...hours (from 3:30 am to 8:00 am), but Cuban jamming also expanded. In an attempt to overcome jamming , TV Marti has plans to convert from VHF to UHF
-
Is vertical integration adding value to health systems?
Weil, T P
2000-04-01
Vertical integration is a concept used by health systems when attempting to achieve economies of scale, greater coordination of services, and improved market penetration. This article focuses on the actual outcomes of utilizing vertical integration in the health field and then compares these findings with those reported in other industries. This analysis concludes that this organizational model does not work particularly well in the health industry, as illustrated by health alliances' poor fiscal performance when they acquire physician practices or when they start their own HMO plans.
-
Stable and flexible under power; Stabil und flexibel unter Strom
Energy Technology Data Exchange (ETDEWEB)
Irrgang, Reinhard
2011-03-25
If conveyor routes, shelve service devices, hall cranes or other haulage equipment - all this systems want to be supported economically, securely and reliably by energy. Optimized energy chains and gliding connect with innovative details function as probate systems. Also touchless energy- and data transmission technologies open an immense potential. (orig./GL)
-
Electricity trade under financial market supervision; Der Stromhandel unter Finanzmarktaufsicht
Energy Technology Data Exchange (ETDEWEB)
Hagena, Martin
2011-07-01
With the competitive opening of the electricity market at European and national level, the goods electricity became a freely traded commodity. The author of the contribution under consideration describes the legal consequences related to financial market for trading electricity in the context of the current Directive 2004/39/EC now under consideration of the commodity futures trading in its representational scope. The statements clearly indicate that the power market is a goods market with its own laws and not a classical financial market. It considers what characteristics exist in electricity trading and whether and how they are considered for regulatory purposes.
-
Einfluss hochfrequenter Felder des Mobilfunks auf das blutbildende System in vitro
Gläser, Katharina
2017-01-01
Elektromagnetische Felder (EMF) sind in der Umwelt des Menschen allgegenwärtig. Unter Verwendung unterschiedlicher Frequenzen bilden sie die Grundlage zahlreicher Technologien und begegnen uns im Alltag in einer Vielzahl von Anwendungen. Eine sehr wichtige Anwendung von EMF ist die mobile Kommunikation. Die hierfür verwendeten Frequenzen liegen im hochfrequenten Bereich und variieren mit dem Mobilfunkstandard. Weit verbreitet ist die GSM- und UMTS-Modulation der zweiten (2G) und dritten Gener...
-
Untersuchungen zur meiotischen und somatischen Rekombination in Pflanzen
Seeliger, Katharina
2011-01-01
Somatische und meiotische Rekombination sind für den Erhalt von Genomstabilität und -flexibilität verantwortlich. In dieser Arbeit wurde die Beteiligung verschiedener Proteine aus dem pflanzlichen Modellorganismus Arabidopsis thaliana an Rekombinationsprozessen untersucht. Dabei konnte unter anderem in dieser Arbeit über Immunolokalisationsstudien zum ersten Mal für Pflanzen nachgewiesen werden, dass AtBRCA2 als Mediator der AtRAD51- und AtDMC1-vermittelten Rekombination fungiert.
-
Jung, Oliver
2000-01-01
Die nicht-ulzerative Dyspepsie ist eine häufige Ausschlußdiagnose bei Oberbauchbeschwerden ohne objektivierbare organische Läsion. Pathogenetisch werden unter anderem Motilitätsstörungen des Gastrointestinaltraktes beobachtet und angenommen. In einer prospektiven, offenen, kontollierten Studie wurde die Wirkung von Pfefferminzöl, Kümmelöl und Miglyol auf die gastrale und duodenale Motilität an gesunden Probanden untersucht. Als standardisiertes Meßverfahren wurde die antroduode...
-
Modal Testing of the NPSAT1 Engineering Development Unit
2012-07-01
erkläre ich, dass die vorliegende Master Arbeit von mir selbstständig und nur unter Verwendung der angegebenen Quellen und Hilfsmittel angefertigt...logarithmic scale . As 5 Figure 2 shows, natural frequencies are indicated by large values of the first CMIF (peaks), and multiple modes can be detected by...structure’s behavior. Ewins even states, “that no large- scale modal test should be permitted to proceed until some preliminary SDOF analyses have
-
Catalytic Copolymerization of Ethene and Carbon Monoxide on Nickel Complexes.
Domhöver, Bernd; Kläui, Wolfgang; Kremer-Aach, Andreas; Bell, Ralf; Mootz, Dietrich
1998-11-16
Can palladium be replaced by nickel? For the industrial copolymerization of carbon monoxide and ethene a palladium catalyst is used which cannot be recovered-a cheaper procedure would be desirable. The presented complex 1 is the first structurally characterized nickel compound which does not polymerize ethene but a mixture from carbon monoxide and ethene unter mild conditions to give a perfectly alternating polyketone. © 1998 WILEY-VCH Verlag GmbH, Weinheim, Fed. Rep. of Germany.
-
Bánffy-Jósika, Emmerich
2006-01-01
Die Arzneimittelliste im Klinikum der Justus-Liebig-Universiät Gießen wurde erstmals 1974 unter dem Namen Hausliste erstellt, und war aus damaliger Sicht eine wertvolle Arbeitserleichterung, allerdings boten die einfachen Textdokumente aus heutiger Sicht keine optimalen Suchmöglichkeiten. Das Ziel dieser Arbeit lag somit darin, die wertvollen Dokumentinhalte der alten Version der Hausliste optimal nutzbar zu machen, und damit ein modernes Arzneimittelinformationssystem zu etablieren. Dafür wu...
-
Zur Standardisierung der DSH-Prüfungen: Bestandsaufnahme und Perspektiven des Online-Angebotes
Schneider, Agnieszka
2010-01-01
Das Internet ist im 21. Jahrhundert zum wichtigsten Informations- und Kommunikationsmedium geworden und hat auch in der Hochschullandschaft einen festen Platz eingenommen. Das Lernen mit und auf Internetplattformen hat sich im universitären Bereich stark etabliert. Auch die Bedeutung von Online-Prüfungen ist infolge der unter dem Schlagwort "Bologna-Prozess" bekannten Umstrukturierungen stark angestiegen. Da im Bereich der deutschen Sprachprüfung für den Hochschulzugang (DSH) bisher nur wenig...
-
Kombinierte Leber- Dünndarmtransplantation
Thorwarth, Wolf Michael
2002-01-01
Nach Transplantation moduliert die Leber nicht nur die Immunantwort des Empfängers gegenüber ihr selbst, sondern übt auch auf mittransplantierte Organe einen protektiven Effekt aus. Dieses Phänomen wurde in der vorliegenden Arbeit an dem hoch immunogenen Dünndarm untersucht. Diese Studie war dabei nicht nur unter immunologischen Gesichtspunkten von Bedeutung. So stellt die simultane Leber- / Dünndarmtransplantation für Patienten, die an einer Leberzirrhose infolge eines Kurzdarmsyndrom leiden...
-
»Just cut them up like regular children.« : Eraserhead (USA 1977, David Lynch)
Höltgen, Stefan
2010-01-01
Zwischen 1970 und 1977 entsteht in fünfjähriger Dreharbeit mit Unterbrechungen und unter extrem schwierigen Produktionsbedingungen David Lynchs erster Spielfilm "Eraserhead". Vorbereitet wurde er in mehrfacher Hinsicht durch das Frühwerk des noch jungen Regisseurs. Seine kinetische Skulptur "Six Men getting sick", sowie seine Kurzfilme "The Alphabet" und "The Grandmother" verhalfen ihm nicht nur zu Stipendien (etwa der AFI für "The Grandmother"), sondern etablierten auch ein Motivinventar, au...
-
Kahmann, Verena
2008-01-01
Mit Hilfe der IP-Technologie erbrachte Multimedia-Dienste wie IPTV oder Video-on-Demand sind zur Zeit ein gefragtes Thema. Technisch werden solche Dienste unter dem Begriff "Streaming" eingeordnet. Ein Server sendet Mediendaten kontinuierlich an Empfänger, welche die Daten sofort weiterverarbeiten und anzeigen. Über einen Rückkanal hat der Kunde die Möglichkeit der Einflussnahme auf die Wiedergabe. Eine Weiterentwicklung dieser Streaming-Dienste ist die Möglichkeit, gemeinsam mit anderen dens...
-
Schmid, Bianca
2011-01-01
1.1 Hintergrund und Ziele Weltweit sind derzeit 121 Millionen Menschen von Depressionen betroffen. Unter diesem Krankheitsbild versteht man einen Verlust von Interesse oder Freude, depressive Verstimmung, Müdigkeit und Energieverlust, verminderte Denk- und Entscheidungsfähigkeit, Unruhe oder Verlangsamung, aber auch körperliche Symptome wie Schlafstörungen oder Appetitverlust gehören dazu. Je nach Schwere und Ausprägungsgrad der Erkrankung sind die Betroffenen in ihrem Lebensalltag enorm beei...
-
Seismic Pulse Broadening Associated with Fracture Damage Caused by Explosions in Crystalline Rock
1989-08-30
1/ 3 ’)I 3/ 2 -C2(() - 1 +) 3D °2/ 3 D 1 - D 1/ - (I -C, X) 1+ 2/3)-)o _ I C4)L( oj and for loading at constant a3 43 D 02 (D )?/3 31 (28) where S...U3, 103-112. Von Karman, T. (1911). Festigkeitswversuche unter allseiRgim druck , Z. Ver. Dt. Ing., 51, 1749-1757. Wawersik, W.R., and C. Fairhurst
-
Changing life styles - changing competencies : Turkish migrant youth in Europe
Kagitcibasi, Cigdem
2010-01-01
"Dieser Artikel beschäftigt sich mit der Misere der türkischen jugendlichen Migranten in Europa unter dem Gesichtspunkt, dass Migration auch sozialen Wandel darstellt indem sich Lebensstile verändern, die neue Kompetenzen erforderlich machen. Damit jugendliche Migranten einen Gewinn statt einer Last für die Aufnahmegesellschaften darstellen ist eine volle Integration unumgänglich. Diese beinhaltet die Förderung von kognitiven Kompetenzen und der psychosozialen Entwicklung auch im Hinblick auf...
-
Modelle und Methoden für die Bestandsauslegung in Heijunka-nivellierten Supply Chains
Veit, Martin B.
2010-01-01
In dieser Arbeit werden analytische Bestandsmodelle für die Heijunka-Nivellierung unter Berücksichtigung schwankender Nachfrage- und Produktionsprozesse entwickelt. Dies ist in der Praxis von größerer Bedeutung, als die bisherigen wissenschaftlichen Modelle mit dem Ziel einer möglichst gleichmäßigen Produktionssequenz. Es werden Fragestellungen beantwortet, die bei der Auslegung der Nivellierung in der Industrie immer wieder auftreten, wie z.B. die Auslegung bei saisonalem Nachfrageve...
-
Dem Gemeinwohl verpflichtet? Was motiviert die Beschäftigten des öffentlichen Dienstes?
Vogel, Dominik
2011-01-01
Die Arbeit befasst sich theoretisch und empirisch mit der so genannten Public Service Motivation (PSM) und ihrem Zusammenhang zu anderen psychologischen Motivationstheorien. Die Public Service Motivation geht davon aus, dass öffentlich Beschäftigte unter anderem dadurch motiviert sind, dass sie in ihrer Arbeit einen Dienst am Gemeinwohl sehen. Auf Basis einer empirischen Erhebung konnte dieses Konstrukt auch für Beschäftigte in Deutschland nachgewiesen und der Einfluss soziodemographischer Va...
-
Dem Gemeinwohl verpflichtet? - Was motiviert die Beschäftigten des öffentlichen Dienstes?
Vogel, Dominik
2011-01-01
Die Arbeit befasst sich theoretisch und empirisch mit der so genannten Public Service Motivation (PSM) und ihrem Zusammenhang zu anderen psychologischen Motivationstheorien. Die Public Service Motivation geht davon aus, dass öffentlich Beschäftigte unter anderem dadurch motiviert sind, dass sie in ihrer Arbeit einen Dienst am Gemeinwohl sehen. Auf Basis einer empirischen Erhebung konnte dieses Konstrukt auch für Beschäftigte in Deutschland nachgewiesen und der Einfluss soziodemographischer Va...
-
Leibfried, Peter
2013-01-01
Rechtzeitig zu Weihnachten hat das IASB am 18. Dezember 2012 die Ergebnisse seines Agenda-Consultation-Projekts vorgestellt. Für aufmerksame Beobachter waren die Resultate kaum überraschend: Angestrebt werden unter anderem eine "period of calm to let the dust settle" anstatt neuer Regelungen, eine stärker prinzipienorientierte Ausrichtung auf das Rahmenkonzept und eine frühzeitigere Abstimmung mit den Betroffenen mit Blick auf Kosten-Nutzen-Überlegungen. Das 40-seitige Dokument ist die erste ...
-
Context effects in attitude measurement
Schwarz, Norbert
1993-01-01
Der vorliegende Beitrag entwickelt ein Modell der kognitiven Prozesse, die den Kontexteffekten bei der Einstellungsmessung zugrunde liegen. Das Modell erlaubt die folgenden Aussagen bzw. Prognosen: (1) die Bedingungen unter denen Kontexteffekte wahrscheinlich entstehen; (2) ihre Richtung (z.B. Assimilation oder Kontrast); (3) ihre Größe; (4) ihre Generalisierung über verwandte items und (5) ihre Abhängigkeit von der Art der Datenerhebung. Die Literatur der experimentellen Forschung zu diesem ...
-
Aspekte zur Tempelarchitektur in Myanmar : eine Beurteilung des räumlichen Aufbaus
Thaw, Tar Aung
2012-01-01
Das hohe Wirtschaftswachstum vieler asiatischer Länder findet seine Entsprechung in der gebauten Umwelt. Allerdings werden viele Gebäude in diesen Ländern unter Missachtung der kulturellen Wahrzeichen und des traditionellem Soziallebens gebaut. Das eigene traditionelle Erbe sollte besser verstanden und integriert werden in die sich entwickelten Wertesysteme. Traditionelle Werte können dabei einen festen Halt bieten und Identität stiften oder den Entwicklungsprozess und die Akzeptanz der damit...
-
Energy Technology Data Exchange (ETDEWEB)
Tanaka, T.; Kimura, C. [Ochanomizu Univ., Tokyo (Japan); Takatori, K. [Landwirtschaftliche und Technische Univ. Tokyo (Japan)
2002-09-01
Fungi in buildings are closely connected with allergic diseases and deterioration of the building substance. They affect humans and the environment. Countermeasures require an analysis of the conditions which favour the spread of fungi. [German] Pilze in Wohnungen sind u.a. eng verbunden mit allergischen Krankheiten und der Verschlechterung der Gebaeudesubstanz. Sie schaden dem Menschen und verseuchen die Umwelt. Um Gegenmassnahmen ergreifen zu koennen, ist es wichtig, herauszufinden, unter welchen Bedingungen sich Pilze vermehren. (orig.)