Does the Electronic Medical Record (EMR) Adoption Matter? Exploring Patterns of EMR Implementation and its Impact on Hospital Performance

We aimed to explore the patterns of electronic medical records (EMR) adoption and its effects on hospital performance. We analyzed hospital-level panel data from 2008 to 2013 using Bayesian regression and the Naïve Bayes model. Our research analysis revealed 38 different adoption patterns for 1,919 hospitals that completed EMR implementation (having all of the four components) and 42 different investment patterns for 1,341 hospitals that could not complete the EMR implementation. We examined the hospitals’ EMR adoption patterns that were not completed; but predicted as completed using the Naïve Bayes model. Our results revealed that the hospitals that completed EMR adoption showed higher performance in terms of patient recommendation and net patient revenue than those that did not complete EMR adoption. More importantly, most of hospitals that observed as “not completed” but predicted as “completed” showed lower performance in terms of patient recommendation as well as net patient revenue

CONDOR: Long endurance high altitude vehicle, volume 5

The results of a design study resulting in the proposed CONDOR aircraft are presented. The basic requirements are for the aircraft to maintain continuous altitude at or above 45,000 feet for at least a 3-day mission, be able to comfortably support a two-man crew during this period with their field of vision not obstructed to a significant degree, carry a payload of 200 pounds, and provide a power supply to the payload of 2000 watts. The take-off and landing distances must be below 5000. feet, and time to reach cruise altitude must not exceed 3 hours. The subjects discussed are configuration selection, structural analysis, stability and control, crew and payload accomodations, and economic estimates

A Study on the Manufacturing of Large Size Hollow Shape Parts for Prototype-Car Using Rapid Prototyping Technology and Vacuum Molding

Rapid Prototyping(RP) techniques have revolutionized traditional manufacturing methods. These techniques allow the user to fabricate a part directly from a conceptual model before investing in production tooling and help develop new models with significant short time. This paper suggests the new process to manufacture large size hollow shape parts for prototype-car using Rapid Prototyping technology and Vacuum Molding with the reduction of delivery time. In addition, this paper introduces the dividing and combining method to make large size RP master model in spite of the limit of the build chamber dimensions of commercialized RP systems and post-processing method to achieve sufficient surface quality.Mechanical Engineerin

(1,2-Dicarba-closo-dodeca­boran­yl)trimethyl­methanaminium iodide

The title compound, [1-(CH3)3NCH2-1,2-C2B10H11]+·I− or C6H22B10N+·I−, was obtained by the reaction of (1,2-dicarba-closo-dodeca­boran­yl)dimethyl­methanamine with methyl iodide. The asymmetric unit contains two iodide anions and two (o-carboran­yl)tetra­methyl­ammonium cations. The bond lengths and angles in the carborane cage are within normal ranges, but the N—Cmethyl­ene—Ccage angle is very large [120.2 (2)°] because of repulsion between the carborane and tetra­methyl­ammonium units. In the crystal, ions are linked through C—H⋯I hydrogen bonds

Cultural Practices to Reduce Cd Content in Edible Parts of Staple Crops in Korea

Objectives of this study were to determine the uptake and translocation of Cd in rice plant from soil with applying the water management and soil ameliorators and to investigate the correlations among heavy metal contents in the brown rice, soil pH and chemical species of Cd existing in soil by sequential extracting method with paddy soil contaminated with Cd near abandoned mine. To identify the effect of soil ameliorators on Cd uptake in rice plants, compost and lime were treated. Plants were grown with irrigation water concentrated by 0.01mg kg^ of cadmium in two soil types (sandy loam and clay loam) with treatments of intermittent irrigation and continuous submersion conditions. Compared to intermittent irrigation plots, average Eh value in the continuous submersion plots was low at 136.7mV whereas pH value was high at 0.3. Eh value was decreased in the treatment of soil ameliorator while pH value was increased by 0.2～0.3. Cd content of leaves and brown rice had significantly positive correlation with Eh value in soils while was negatively correlated with soil pH. At the harvest stage, Cd content in the leaves and brown rice was decreased in the continuous submersion plots by 30% relative to the intermittent irrigation plots. In case of soil ameliorator applied plots, Cd content of leaves and brown rice was lower by 35% than that of N, P, K fertilizer plots, respectively. Compared to the soil types, Cd content of leaves and brown rice in sandy loam soil was lower by 64 and 37% than that in clay loam soil, respectively. Order of reduction to Cd uptake was the compost and lime mixture plot>silicate plot>lime plot. However, the effect of Cd uptake reduction by soil ameliorator was decreased in the N, P, K+compost and N, P, K+phosphate plots. Cd uptake reduction by water management and soil ameliorator was more effective in the sandy loam soil than that in the clay loam soil.Special Revie

Maysin and Its Flavonoid Derivative from Centipedegrass Attenuates Amyloid Plaques by Inducting Humoral Immune Response with Th2 Skewed Cytokine Response in the Tg (APPswe, PS1dE9) Alzheimer\u27s Mouse Model

Alzheimer\u27s disease (AD) is a slow, progressive neurodegenerative disease and the most common type of dementia in the elderly. The etiology of AD and its underlying mechanism are still not clear. In a previous study, we found that an ethyl acetate extract of Centipedegrass (CG) (i.e., EA-CG) contained 4 types of Maysin derivatives, including Luteolin, Isoorientin, Rhamnosylisoorientin, and Derhamnosylmaysin, and showed protective effects against Amyloid beta (Aβ) by inhibiting oligomeric Aβ in cellular and in vitro models. Here, we examined the preventative effects of EA-CG treatment on the Aβ burden in the Tg (Mo/Hu APPswe PS1dE9) AD mouse model. We have investigated the EA-CG efficacy as novel anti-AD likely preventing amyloid plaques using immunofluorescence staining to visually analyze Aβ40/42 and fibril formation with Thioflavin-S or 6E10 which are the profile of immunoreactivity against epitope Aβ1-16 or neuritic plaque, the quantitation of humoral immune response against Aβ, and the inflammatory cytokine responses (Th1 and Th2) using ELISA and QRT-PCR. To minimize the toxicity of the extracted CG, we addressed the liver toxicity in response to the CG extract treatment in Tg mice using relevant markers, such as aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) measurements in serum. The EA-CG extract significantly reduced the Aβ burden, the concentration of soluble Aβ40/42 protein, and fibril formation in the hippocampus and cortex of the Tg mice treated with EA-CG (50 mg/kg BW/day) for 6 months compared with the Tg mice treated with a normal diet. Additionally, the profile of anti-inflammatory cytokines revealed that the levels of Th2 (interleukin-4 (IL-4) and interleukin-10 (IL-10)) cytokines are more significantly increased than Th1 (interferon-γ (IFN-γ), interleukin-2(IL-2)) in the sera. These results suggest that the EA-CG fraction induces IL-4/IL-10-dependent anti-inflammatory cytokines (Th2) rather than pro-inflammatory cytokines (Th1), which are driven by IL-2/IFN-γ. With regard to the immune response, EA-CG induced an immunoglobulin IgG and IgM response against the EA-CG treatment in the Tg mice. Furthermore, EA-CG significantly ameliorated the level of soluble Aβ42 and Aβ40. Similarly, we observed that the fibril formation was also decreased by EA-CG treatment in the hippocampus and cortex after quantitative analysis with Thioflavin-S staining in the Tg brain tissues. Taken together, our findings suggested that Maysin and its derivative flavonoid compounds in the EA-CG fraction might be beneficial therapeutic treatments or alternative preventative measures to adjuvant for boosting humoral and cellular include immune response and anti-inflammation which may lead to amyloid plaque accumulation in Alzheimer\u27s patients\u27 brains

KIOM-79, an Inhibitor of AGEs–Protein Cross-linking, Prevents Progression of Nephropathy in Zucker Diabetic Fatty Rats

Advanced glycation end products (AGEs) have been implicated in the development of diabetic complications, including diabetic nephropathy. KIOM-79, an 80% ethanolic extract obtained from parched Puerariae Radix, gingered Magnolia Cortex, Glycyrrhiza Radix and Euphorbia Radix, was investigated for its effects on the development of renal disease in Zucker diabetic fatty rats, an animal model of type 2 diabetes. In vitro inhibitory effect of KIOM-79 on AGEs cross-linking was examined by enzyme-linked immunosorbent assay (ELISA). KIOM-79 (50 mg/kg/day) was given to Zucker diabetic fatty rats for 13 weeks. Body and kidney weight, blood glucose, glycated hemoglobin, urinary albumin and creatinine excretions were monitored. Kidney histopathology, collagen accumulation, fibrinogen and transforming growth factor-beta 1 (TGF-β1) expression were also examined. KIOM-79 reduced blood glucose, kidney weight, histologic renal damage and albuminuria in Zucker diabetic fatty rats. KIOM-79 prevented glomerulosclerosis, tubular degeneration, collagen deposition and podocyte apoptosis. In the renal cortex, TGF-β1, fibronectin mRNA and protein were significantly reduced by KIOM-79 treatment. KIOM-79 reduces AGEs accumulation in vivo, AGE–protein cross-linking and protein oxidation. KIOM-79 could be beneficial in preventing the progression of diabetic glomerularsclerosis in type 2 diabetic rats by attenuating AGEs deposition in the glomeruli

Prevalence and predictors of heated tobacco products use among male ever smokers: results from a Korean longitudinal study

Background This study examined sociodemographic and tobacco-related factors of heated tobacco products (HTPs) use among adult ever smokers in South Korea where the sales of HTPs have been rapidly increasing since their launch in June 2017. Methods Before the launch of HTPs in Korea, participants comprised male ever smokers (234 current smokers and 37 quitters) who participated in the Korea National Health and Nutrition Examination Survey from 2015 to 2017 through one-to-one interview survey and agreed to participate in the follow-up surveys through telephone in December 2017. Data were analyzed using logistic regression, to explore sociodemographic and smoking behavior-related factors of HTPs use. Results Overall, 10.7% (29/271) of participants responded to using HTPs and 8.1% (22/271) were current HTPs users at the time of the follow-up survey. Multivariate analysis showed that HTPs use is associated with middle age (36 to 49 years old) (aOR = 3.72, CI = 1.16–12.0) (vs. ≥ 50 years), higher income (4Q vs 1Q: aOR = 2.71, CI = 1.16–6.34), and higher educational level (college or higher: aOR = 2.40, CI = 0.87–6.60). Also, vaping experience at baseline was highly associated with HTPs use (aOR = 3.11, CI = 1.22–7.93 for the former experience; aOR = 9.14, CI = 2.34–35.6 for current). However, smoking amount and level of motivation for smoking cessation were not found to be predictors of future HTPs use when limited to current smokers at baseline. Conclusions The results showed that vaping experience regardless of current smoking behavior and higher socioeconomic status were found to be associated with subsequent HTPs use among ever smokers. Further studies are required to explore whether this association is causal.This work was supported by the Korea Centers for Disease Control and Prevention (grant numbers 2017-E34011–00). The funding bodies had no role in the design of the study, data collection, analysis and interpretation of data, and writing of the manuscript

Active wave-guiding of piezoelectric phononic crystals

By numerical simulations, we show that active wave-guiding can be realized in a stop band frequency range of a phononic crystal (PC) if piezoelectric inclusions in the PC are electrically controlled. The advantages of the wave-guiding are that no permanent geometry or material change is needed and that somewhat arbitrarily shaped waveguides can be formed actively in PC structures. The analysis with supercells consisting of piezoelectrically coupled and decoupled inclusions shows that symmetric wave modes confined within the waveguide formed by decoupled inclusions are most responsible for wave transmission. (C) 2011 American Institute of Physics. [doi:10.1063/1.3630231clos

Venous Hemangioma of Parapharyngeal Space with Calcification

A hemangioma of the parapharyngeal space (PPS) is an extremely rare tumor and is responsible for 0.5-1% of all tumors occurring in the PPS. We report a case of PPS venous hemangioma in a 49-year-old woman presenting with diffuse swelling in the submandibular region. A preoperative computed tomography (CT) scan showed a cystic mass with multiple calcifications in the PPS. The calcific nodules were round and about 2 mm in diameter. The hemangioma was completely resected via a transcervical approach. During surgery, we found several calcific nodules, which represented phleoboliths or areas of thrombosis with dystrophic calcification. Despite its rarity, a venous hemangioma of the PPS should be considered in a differential diagnosis when a cystic mass with calcification is found by CT scan. To our knowledge, this is the first reported case of a PPS venous hemangioma; we describe its pathognomonic findings on imaging