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Multiple Events (multiple + event)
Selected AbstractsProcess of Care Events in Transplantation: Effects on the Cost of HospitalizationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2010N. N. Egorova Deviations in the processes of healthcare delivery that affect patient outcomes are recognized to have an impact on the cost of hospitalization. Whether deviations that do not affect patient outcome affects cost has not been studied. We have analyzed process of care (POC) events that were reported in a large transplantation service (n = 3,012) in 2005, delineating whether or not there was a health consequence of the event and assessing the impact on hospital resource utilization. Propensity score matching was used to adjust for patient differences. The rate of POC events varied by transplanted organ: from 10.8 per 1000 patient days (kidney) to 17.3 (liver). The probability of a POC event increased with severity of illness. The majority (81.5%) of the POC events had no apparent effect on patients' health (63.6% no effect and 17.9% unknown). POC events were associated with longer length of stay (LOS) and higher costs independent of whether there was a patient health impact. Multiple events during the same hospitalization were associated with the highest impact on LOS and cost. POC events in transplantation occur frequently, more often in sicker patients and, although the majority of POC events do not harm the patient, their effect on resource utilization is significant. [source] Violence from young women involuntarily admitted for severe drug abuseACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007T. Palmstierna Objective:, To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse. Method:, All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates. Results:, Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found. Conclusion:, In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics. [source] Damage-based design with no repairs for multiple events and its sensitivity to seismicity modelEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 3 2007S. Das Abstract Conventional design methodology for the earthquake-resistant structures is based on the concept of ensuring ,no collapse' during the most severe earthquake event. This methodology does not envisage the possibility of continuous damage accumulation during several not-so-severe earthquake events, as may be the case in the areas of moderate to high seismicity, particularly when it is economically infeasible to carry out repairs after damaging events. As a result, the structure may collapse or may necessitate large scale repairs much before the design life of the structure is over. This study considers the use of design force ratio (DFR) spectrum for taking an informed decision on the extent to which yield strength levels should be raised to avoid such a scenario. DFR spectrum gives the ratios by which the yield strength levels of single-degree-of-freedom oscillators of different initial periods should be increased in order to limit the total damage caused by all earthquake events during the lifetime to a specified level. The DFR spectra are compared for three different seismicity models in case of elasto-plastic oscillators: one corresponding to the exponential distribution for return periods of large events and the other two corresponding to the lognormal and Weibull distributions. It is shown through numerical study for a hypothetical seismic region that the use of simple exponential model may be acceptable only for small values of the seismic gap length. For moderately large to large seismic gap lengths, it may be conservative to use the lognormal model, while the Weibull model may be assumed for very large seismic gap lengths. Copyright © 2006 John Wiley & Sons, Ltd. [source] Whole ecosystem metabolic pulses following precipitation eventsFUNCTIONAL ECOLOGY, Issue 5 2008G. D. Jenerette Summary 1Ecosystem respiration varies substantially at short temporal intervals and identifying the role of coupled temperature- and precipitation-induced changes has been an ongoing challenge. To address this challenge we applied a metabolic ecological theory to identify pulses in ecosystem respiration following rain events. Using this metabolic framework, precipitation-induced pulses were described as a reduction in metabolic activation energy after individual precipitation events. 2We used this approach to estimate the responses of 237 individual events recorded over 2 years at four eddy-covariance sites in southern AZ, USA. The sites varied in both community type (woody and grass dominated) and landscape position (riparian and upland). We used a nonlinear inversion procedure to identify both the parameters for the pre-event temperature sensitivity and the predicted response of the temperature sensitivity to precipitation. By examining multiple events we evaluated the consistency of pulses between sites and discriminated between hypotheses regarding landscape position, event distributions, and pre-event ecosystem metabolism rates. 3Over the 5-day post-event period across all sites the mean precipitation effect was attributed to 6·1 g CO2 m,2 of carbon release, which represented a 21% increase in respiration over the pre-event steady state trajectory of carbon loss. Differences in vegetation community were associated with differences in the integrated magnitude of pulse responses, while differences in topographic position were associated with the initial peak pulse rate. In conjunction with the differences between sites, the individual total pulse response was positively related to the drying time interval and metabolic rates prior to the event. The quantitative theory presented provides an approach for understanding ecosystem pulse dynamics and helps characterized the dependence of ecosystem metabolism on both temperature and precipitation. [source] 2-D/3-D multiply transmitted, converted and reflected arrivals in complex layered media with the modified shortest path methodGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 1 2009Chao-Ying Bai SUMMARY Grid-cell based schemes for tracing seismic arrivals, such as the finite difference eikonal equation solver or the shortest path method (SPM), are conventionally confined to locating first arrivals only. However, later arrivals are numerous and sometimes of greater amplitude than the first arrivals, making them valuable information, with the potential to be used for precise earthquake location, high-resolution seismic tomography, real-time automatic onset picking and identification of multiple events on seismic exploration data. The purpose of this study is to introduce a modified SPM (MSPM) for tracking multiple arrivals comprising any kind of combination of transmissions, conversions and reflections in complex 2-D/3-D layered media. A practical approach known as the multistage scheme is incorporated into the MSPM to propagate seismic wave fronts from one interface (or subsurface structure for 3-D application) to the next. By treating each layer that the wave front enters as an independent computational domain, one obtains a transmitted and/or converted branch of later arrivals by reinitializing it in the adjacent layer, and a reflected and/or converted branch of later arrivals by reinitializing it in the incident layer. A simple local grid refinement scheme at the layer interface is used to maintain the same accuracy as in the one-stage MSPM application in tracing first arrivals. Benchmark tests against the multistage fast marching method are undertaken to assess the solution accuracy and the computational efficiency. Several examples are presented that demonstrate the viability of the multistage MSPM in highly complex layered media. Even in the presence of velocity variations, such as the Marmousi model, or interfaces exhibiting a relatively high curvature, later arrivals composed of any combination of the transmitted, converted and reflected events are tracked accurately. This is because the multistage MSPM retains the desirable properties of a single-stage MSPM: high computational efficiency and a high accuracy compared with the multistage FMM scheme. [source] The role of reflection in the library and information sector: a systematic reviewHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2007Maria J Grant Objectives:,To systematically review published literature on the role of reflection in the library and information science sector. To identify examples of good practice and to investigate the reported contribution, if any, of reflection by library and information workers as part of their professional practice. Methods:,Free text searches (reflective or reflection* or reflexion*) were conducted for English language papers on the Library and Information Science Abstracts (lisa) bibliographic database in two phases; in March 2004 for literature dating from 1969 to 2003 and between 2004 and 2006 in January 2006. Thirteen papers met the inclusion criteria and were coded and analysed using thematic analysis. Results:,Two categories of reflection exist: analytical and non-analytical. These focus on events in the recent and distant past. Non-analytical reflective accounts generally adopt a retrospective tone in reporting on multiple events over a number of decades. In contrast, analytical accounts of reflection focused on single events and attempt to understand the relationship between past experiences and how this might impact on future practice. Conclusion:,From the examples of reflective practice identified, greatest personal and professional benefit is reported when time is given to considering the implications of past events on future practice, that is, analytical reflection. [source] Meteorological conditions associated with sea surges in Venice: a 40 year climatologyINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 7 2002Isabel F. Trigo Abstract The frequency of sea surges in Venice has increased during the 20th century, and the trend has been particularly pronounced in the last four decades. However, the time series of independent surge events (i.e. events separated by at least 1 week) has remained nearly stationary during that period. This suggests that, although the sea level rise (due to global warming and human activity in the region) is leading to more multiple events, the frequency of meteorological conditions that trigger independent events seems to be nearly balancing the effects of sea level change. Such meteorological conditions are identified by compositing sea level pressure (SLP) and 995 hPa wind during and before independent sea surge events in Venice. The composite analysis shows that these correspond to storms orographically induced over the western Mediterranean basin, when an Atlantic synoptic system is perturbed by the Pyrenees and/or the Alps. It is, however, the persistence, intensity and relative position of such storms to the Adriatic Sea that contribute to the optimum conditions for the occurrence of floodings in its northern embayment. It is shown that the synoptic picture is translated into persistent low SLP over the Venice region, negative north,south SLP gradient over the Adriatic, and south-southeasterly to southeasterly wind over the central and northern parts of the sea. During the 40 year period under analysis, the persistence and intensity of the most adverse scenarios for the occurrence of sea surges in Venice have been generally decreasing; significant trends have been found in the tails of the distributions of Venice SLP, SLP north,south gradient, and of surface wind over the northern Adriatic. It is the balance between these trends and the continuing sea level rise that may account for the near-stationarity of independent sea surge events during the last four decades. Copyright © 2002 Royal Meteorological Society [source] Real-time monitoring of the membrane-binding and insertion properties of the cholesterol-dependent cytolysin anthrolysin O from Bacillus anthracis,JOURNAL OF MOLECULAR RECOGNITION, Issue 4 2006Simon Cocklin Abstract Bacillus anthracis has recently been shown to secrete a potently hemolytic/cytolytic protein that has been designated anthrolysin O (ALO). In this work, we initiated a study of this potential anthrax virulence factor in an effort to understand the membrane,binding properties of this protein. Recombinant anthrolysin O (rALO35,512) and two N-terminally truncated versions of ALO (rALO390,512 and rALO403,512) from B. anthracis were overproduced in Escherichia coli and purified to homogeneity. The role of cholesterol in the cytolytic activity of ALO was probed in cellular cholesterol depletion assays using mouse and human macrophage-like lines, and also Drosophila Schneider 2 cells. Challenging the macrophage cells with rALO35,512, but not rALO390,512 or rALO403,512, resulted in cell death by lysis, with this cytolysis being abolished by depletion of the membrane cholesterol. Drosophila cells, which contain ergosterol as their major membrane sterol, were resistant to rALO-mediated cytolysis. In order to determine the molecular mechanism of this resistance, the interaction of rALO with model membranes comprised of POPC alone, or with a variety of structurally similar sterols including ergosterol, was probed using Biacore. Both rALO35,512 and rALO403,512 demonstrated robust binding to model membranes composed of POPC and cholesterol, with amount of protein bound proportional to the cholesterol content. Ergosterol supported greatly reduced binding of both rALO35,512 and rALO403,512, whereas other sterols tested did not support binding. The rALO403,512,membrane interaction demonstrated an equilibrium dissociation constant (KD) in the low nanomolar range, whereas rALO35,512 exhibited complex kinetics likely due to the multiple events involved in pore formation. These results establish the pivotal role of cholesterol in the action of rALO. The biosensor method developed to measure ALO recognition of cholesterol in a membrane environment could be extended to provide a platform for the screening of inhibitors of other membrane-binding proteins and peptides. Copyright© 2006 John Wiley & Sons, Ltd. [source] Precursors of cardiorespiratory events in infants detected by home memory monitor,PEDIATRIC PULMONOLOGY, Issue 1 2008Carl E. Hunt MD Abstract In 1,079 infants monitored for >700,000 hr at home for apnea or bradycardia, we found an association between infants having multiple events exceeding conventional or a priori defined more extreme thresholds and less favorable developmental outcome at 1 year of age than infants with few or no events. If it is necessary to prevent such events to minimize risk for developmental morbidity, there is reason to determine whether there are disturbances in advance of the apnea or bradycardia that herald their onset. In the 85 infants with at least 1 extreme event and 1 conventional event, we hypothesized that apnea and bradycardia do not occur de novo but rather are preceded by cardiorespiratory and hemoglobin O2 saturation changes. We compared recorded time intervals preceding these events, and we analyzed three preceding time intervals for each conventional and extreme event, and each non-event recording: Time-2 hr: up to 2 hr before; Time-1 hr: up to 1 hr before; and Time-75 sec: the 75 sec immediately preceding each event. O2 saturation progressively decreased preceding both conventional and extreme events, and progressive increases occurred in heart and breathing rate variability. Duration of respiratory pauses and of periodic breathing progressively increased preceding conventional events, respiratory rate variability increased immediately preceding conventional events and at 1 hr preceding extreme events, and O2 saturation decreased immediately preceding both conventional and extreme events. Thus, conventional and extreme events do not occur de novo but rather are preceded by autonomic instability of the cardiorespiratory system. Pediatr Pulmonol. 2008; 43:87,98. © 2007 Wiley-Liss, Inc. [source] Gender and relationships: Influences on agentic and communal behaviorsPERSONAL RELATIONSHIPS, Issue 1 2004Eun Jung Suh The present research examined the moderating influence of situations involving friends and romantic partners on gender differences in interpersonal behaviors reflecting agency and communion. Behavior was studied in three situations varying in social role and dyadic gender composition: same-sex friendships, opposite-sex friendships, and romantic relationships. To obtain multiple events representing each relationship situation, participants recorded information about their interpersonal interactions during a 20-day period using an event-contingent recording procedure. Results indicated gender differences consistent with gender stereotypes when men and women were interacting with same-sex friends; men with men were more dominant and women with women were more agreeable. In interactions with romantic partners, gender differences in communal behavior were opposite to gender stereotypes; women were less agreeable and more quarrelsome than men with their romantic partners. Results are considered in reference to developmental socialization theory, social role theory, and studies of gender differences in marital relationships. [source] A New Divergent Type of Eukaryotic Methionine Adenosyltransferase is Present in Multiple Distantly Related Secondary Algal LineagesTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 5 2008GABINO F. SANCHEZ-PEREZ ABSTRACT. S -adenosylmethionine is one of the most important metabolites in living cells and is synthesized in a single reaction catalyzed by methionine adenosyltransferase (MAT). At the sequence and structural level, this enzyme is one of the most conserved proteins known. Here we show that some representatives of three distantly related eukaryotic lineages,dinoflagellates, haptophytes, and euglenids,possess a highly divergent type of MAT, which we call MATX. Even though MATX contains all the sites known to be involved in catalysis and the association of monomers, it also has four insertions throughout the protein that are not observed in other MAT homologs. The phylogenetic distribution and affinities of MATX suggest that it originated in a single eukaryotic lineage and was spread via multiple events of eukaryote-to-eukaryote lateral gene transfer. We suggest a tentative model in which the origin of MATX is connected with the progression of secondary endosymbiosis. [source] | ||||||||||||||||