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81.
One way hospitals complicate themselves is by increasing the participation of clinical professionals and middle managers in making strategic decisions. Using a survey methodology this article investigates the relationships between the participation of clinical professionals (MDs and RNs) and middle managers with hospital costs, as well as the possible moderating effect of strategic complexity. 相似文献
82.
83.
RY Calne S Thiru P McMaster GN Craddock DJ White DJ Evans DC Dunn BD Pentlow K Rolles 《Canadian Metallurgical Quarterly》1998,9(9):1751-1756
A psychrotrophic yeast, Rhodotorula glutinis KUJ 2731, isolated from soil, effectively produced an extracellular endo-beta-glucanase (EC 3.2.1.4). The enzyme was monomeric, and the molecular mass was about 40,000 Da. The N-terminal amino acid sequence was H-Ser-Leu-Pro- Lys-Leu-Gly-Gly-Val-Asp-Leu-Ala-Gly-Leu-Asp-Ile-Gly-Lys-Asp-Lys-Asn-. alpha-Helix content was calculated to be about 32.6%. The isoelectric point was 8.57. The activation energy was 20.9 kJ/mol, which was much smaller than that of mesophilic enzymes. The enzyme was active at temperatures from 0 to 70 degrees C, with a highest initial velocity at 50 degrees C similar to other psychrotrophic enzymes. The enzyme was inhibited by Hg2+. The enzyme catalyzed hydrolysis of carboxymethyl cellulose with an apparent K(m) of 1.1% and Vmax of 556 mumol/min/mg. Products from the enzymatic hydrolysis of carboxymethyl cellulose by the enzyme were glucose, cellobiose, and cellotriose. The enzyme also catalyzed the transglycosylation of p-nitrophenyl-beta-cellotrioside to cellotetraose. 相似文献
84.
R Kneen NG Pham T Solomon TM Tran TT Nguyen BL Tran J Wain NP Day TH Tran CM Parry NJ White 《Canadian Metallurgical Quarterly》1998,27(4):845-850
PURPOSE: To review the University of Florida experience in treating ependymomas, analyze prognostic factors, and provide treatment recommendations. METHODS AND MATERIALS: Forty-one patients with ependymoma and no metastases outside the central nervous system received postoperative radiotherapy with curative intent between 1966 and 1989. Ten patients had supratentorial lesions, 22 had infratentorial lesions, and 9 had spinal cord lesions. All patients had surgery (stereotactic biopsy, subtotal resection, or gross total resection). Most patients with high-grade lesions received radiotherapy to the craniospinal axis. Low-grade intracranial lesions received more limited treatment. Spinal cord lesions were treated using either partial spine or whole spine fields. RESULTS: Of 32 intracranial tumors, 21 recurred, all at the primary site; no spinal cord tumors recurred. Overall 10-year survival rates were 51% (absolute) and 46% (relapse-free); by tumor site: spinal cord, 100%; infratentorial, 45%; supratentorial, 20% (p = 0.002). On multivariate analysis, tumor site was the only factor that influenced absolute survival (p = 0.0004); other factors evaluated included grade, gender, age, duration of symptoms, resection extent, primary tumor dose, treatment field extent, surgery-to-radiotherapy interval, and days under radiotherapy treatment. CONCLUSIONS: Patients with supratentorial or infratentorial tumors receive irradiation, regardless of grade. Craniospinal-axis fields are used when spinal seeding is radiographically or pathologically evident. Spinal cord tumors are treated using localized fields to the primary site if not completely resected. Failure to control disease at the primary site remains the main impediment to cure. 相似文献
85.
VL Beggs SB Willis EL Maislen TM Stokes D White M Sanford A Becker S Barber PC Pawlow C Downs 《Canadian Metallurgical Quarterly》1998,12(4):72-86
Short hospitalizations for patients undergoing coronary artery bypass grafting (CABG) require continuous nursing evaluation of patients' discharge education. Six institutions collaborated in surveying 300 postoperative patients with CABG to identify learning priorities and patients' perceptions of the effectiveness of discharge education. Data analysis from the self-administered questionnaire demonstrated consistent patient priorities across institutions. Differences in teaching methods and content did not affect perceived preparedness or importance scores. Regional experience demonstrates that variable teaching efforts meet patients' priorities and provide high overall patient preparedness for discharge. Patients with the shortest hospitalizations had higher preparedness scores. 相似文献
86.
The discriminative stimulus effects of the imidazopyridine hypnotic zolpidem and the classic benzodiazepine hypnotic triazolam were examined in seven healthy volunteers using a three-response drug discrimination procedure and a within-subject design. During an initial sampling phase, the training drug conditions (placebo, 20 mg/70 kg zolpidem, and 0.5 mg/70 kg triazolam) were identified to subjects by letter codes before oral drug administration. During a subsequent training phase, subjects earned money for correct drug identifications made 3.75 h after drug administration. Five out of seven subjects acquired the three-response discrimination. Analyses of standardized and unstructured self-report questionnaires revealed that zolpidem and triazolam produced different profiles of effects; zolpidem was associated with a number of negative somatic symptoms including nausea, blurred vision, visual images/hallucinations, and heavy limbs, whereas triazolam was associated with greater sedative effects. These results demonstrate a distinct profile of discriminative stimulus and subjective effects for zolpidem, relative to triazolam, which is consistent with its somewhat distinct pharmacological profile, and provide evidence for the sensitivity of the three-response drug discrimination procedure for detecting between-drug differences. 相似文献
87.
A hyperdynamic circulatory state with elevated cardiac output, decreased peripheral vascular resistance, and sodium retention occurs in patients with portal cirrhosis. Surgical portal-systemic shunts and transjugular intrahepatic portal-systemic shunts (TIPS) have been shown to worsen the high-output state in these patients. However, clinical evidence of high-output congestive heart failure has been reported only rarely to complicate cirrhosis. We describe a patient who developed high-output congestive heart failure with markedly elevated filling pressures after TIPS and had complete resolution of heart failure after liver transplantation. 相似文献
88.
Dave McKenney Tony White 《Soft Computing - A Fusion of Foundations, Methodologies and Applications》2012,16(2):247-259
This paper investigates the speed improvements available when using a graphics processing unit (GPU) for evaluation of individuals
in a genetic programming (GP) environment. An existing GP system is modified to enable parallel evaluation of individuals
on a GPU device. Several issues related to implementing GP on GPU are discussed, including how to perform tree-based GP on
a device without recursion support, as well as the effect that proper memory layout can have on speed increases when using
CUDA-enabled nVidia GPU devices. The specific GP implementation is designed to evolve stock trading strategies using technical
analysis indicators. The second goal of this research is to investigate the possible improvement in performance when training
individuals on a larger number of stocks and training days. This increased training size (nearly 100,000 training points)
is enabled due to the speedups realized by GPU evaluation. Several different scenarios were used to test various speed optimizations
of GP evaluation on the GPU device, with a peak speedup factor of over 600 (when compared to sequential evaluation on a 2.4 GHz
CPU). Also, it is found that increasing the number of stocks and the length of the training period can result in higher out-of-training
testing profitability. 相似文献
89.
R. Sam Williams Steve Lacher Corey Halpin Christopher White 《Materials and Structures》1988,21(4):313-320
RILEM Bulletin
Fourth International Conference on Durability of Building Materials and Components 相似文献90.
P. S. Sklad C. J. McHargue C. W. White G. C. Farlow 《Journal of Materials Science》1992,27(21):5895-5904
Single crystals of -Al2O3 were implanted with iron ions at room temperature to fluences ranging from 4×1016 Fe cm–2 to 1×1017 Fe cm–2. The microstructure and composition in the implanted region were examined using analytical electron microscopy techniques. Special emphasis was placed on monitoring the microstructural changes which take place during post-implantation annealing. Clusters of metallic -Fe were identified in the specimen after implantation to a dose of 1×1017 Fe cm–2. Analytical electron microscopy of implanted specimens annealed in oxygen revealed the redistribution of the implanted iron and the formation of surface precipitates of -Fe2O3, subsurface precipitates of various forms of spinel, and, in some cases, subsurface precipitates of iron, depending on the annealing temperature. Examination of implanted specimens annealed under reducing conditions revealed the presence of precipitates of -Fe. 相似文献