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Improving patient satisfaction through improved telephone triage in a primary care practice

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Family Medicine and Community Health 2019年第4期7卷 59-63页

作者： Rebecca Vitale Samantha smith benjamin R Doolittle Department of Internal Medicine Brigham and Women's HospitalBostonMassachusettsUSA Department of Orthopedics Yale University School of MedicineNew HavenConnecticutUSA Department of Internal Medicine and Pediatrics Yale University School of MedicineNew HavenConnecticutUSA

Objective The objective of this study was to improve the telephone communication experience for patients in a primary care *** An exploratory survey was conducted that revealed suboptimal patient satisfaction with clinic access due to the telephone triage *** interventions were designed:a monthly quality meeting was established among clinic staff,all phone interactions were recorded in the electronic medical record(EMR)and clinic appointments were made available several months in advance.A follow-up survey was conducted to evaluate these *** The study was conducted in a multispecialty,urban-based,resident-faculty practice from November 2016 to November *** Subjects were recruited in a convenience sample from the waiting room.200 subjects participated in the initial survey and 215 in the second *** After the interventions,patients felt that their questions were answered more frequently than before(p<0.01).They also felt that appointments were easier to make(p=0.03).A similar number of patients reported seeking emergency care because they were unable to reach a provider(33.8%vs 31.9%,p=0.68).The percentage of patients who received a call back within 24 hours increased,but it was not statistically significant(38.6%vs 44%,p=0.13).Conclusion Improving telephone triage through implementing a monthly quality improvement meeting,optimising use of the EMR and opening schedules several months in advance resulted in several improvements in the patient experience,but did not change use of emergency *** interventions,including increased resource allocation,are needed to optimise patient experience.

关键词： patient telephone seeking

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政党与政权的生命

开放时代 2008年第3期 89-109页

作者： benjamin smith 严小青(译) 王正绪(译) 美国佛罗里达大学政治学系不详

本文提出了一套关于一党制下的政权巩固理论,并试图利用该理论来解释一党制国家政权寿命长短不一的原因。文章作者认为,在政党建设过程中,政治精英们思忖如何建立强有力的政治支柱时,不得不考虑的两个因素就是反对派势力的强弱和寻租的... 详细信息

本文提出了一套关于一党制下的政权巩固理论,并试图利用该理论来解释一党制国家政权寿命长短不一的原因。文章作者认为,在政党建设过程中,政治精英们思忖如何建立强有力的政治支柱时,不得不考虑的两个因素就是反对派势力的强弱和寻租的难易程度。如果反对派势力越弱小,且寻租越容易,那么政权建设的成本就越低,但同时这又将不利于建立一个强大的政党联盟或政党组织,并最终导致一党制政权脆弱而不堪一击,一遇危机就陷入分崩离析的境地。相反,如果执政精英起初就面临强大的反对势力并且寻租的可能性很小,那么他们就会给潜在的盟友提供话语权和决策权,从而推动政党建设。事实也证明诸如此类的执政党在危机来临的时候有更强的柔韧性和生命力。为了证实该理论,作者以几内亚比绍和坦桑尼亚,印尼和菲律宾这两对国家为例进行了详细的阐述。

关键词：政权巩固政党建设生命政治精英几内亚比绍一党制国家政权难易程度

Integrating Biodegradable 3-Dimensional-Printing into Tracheal Reconstruction

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Open Journal of Regenerative Medicine 2015年第3期4卷 27-33页

作者： Todd A. Goldstein Lee P. smith benjamin D. smith Daniel A. Grande David Zeltsman Orthopedic Research Laboratory Feinstein Institute of Medical Research Manhasset USA Hofstra North Shore-LIJ School of Medicine Hempstead USA Division of Pediatric Otolaryngology Steven and Alexandra Cohen Children’s Medical Center New Hyde Park USA Department of Orthopedic Surgery North Shore-LIJ Manhasset USA Department of Cardiovascular and Thoracic Surgery Long Island Jewish Medical Center New Hyde Park USA

Background: Currently, there is no set standard treatment for long-segment tracheomalacia and stenosis. In this study we set out to explore the potential to create a tissue engineered, biodegradable and three-dimensionally (3D) printed tracheal ring as a first step towards bioengineering a long segment tracheal replacement. Method of Approach: A 3D-Computer aided design (CAD) model was produced with multiple channels to allow for cellular growth while mimicking the native anatomy. The design was optimized to allow for printability, cellular expansion, and integration and 3D printed using a modified commercial 3D printer. Results: The cells grown in the scaffold demonstrated a similar proliferation trend compared to control. Chondrocytes within the 3D printed ring retained their phenotypic properties and did not infer any significant change in flexibility, contour and strength to the scaffold. Conclusion: The combination of living cells and a 3D modeled patient specific graft may address some of the unmet clinical needs in the field of tracheal reconstruction. This proof of concept study represents a first step towards producing a 3D printed and tissue engineered long segment tracheal replacement graft for airway surgery.

关键词： Trachea Tissue Engineering 3D Printing Three Dimensional Printing Bioengineering

Optical imaging technology in colonoscopy:Is there a role for photometric stereo?

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World Journal of Gastrointestinal Endoscopy 2020年第5期12卷 138-148页

作者： benjamin M Shandro Khemraj Emrith Gregory Slabaugh Andrew Poullis Melvyn L smith Department of Gastroenterology St George's University Hospitals NHS Foundation TrustLondon SW170QTUnited Kingdom Centre for Machine Vision University of the West of EnglandBristol BS161QYUnited Kingdom Department of Computer Science CityUniversity of LondonLondon EC1V 0HBUnited Kingdom

Colonoscopy screening for the detection and removal of colonic adenomas is central to efforts to reduce the morbidity and mortality of colorectal ***,up to a third of adenomas may be missed at colonoscopy,and the majority of post-colonoscopy colorectal cancers are thought to arise from *** have three-dimensional surface topographic features that differentiate them from adjacent normal ***,these topographic features are not enhanced by white light colonoscopy,and the endoscopist must infer these from two-dimensional *** may contribute to the number of missed lesions.A variety of optical imaging technologies have been developed commercially to enhance surface ***,existing techniques enhance surface topography indirectly,and in two dimensions,and the evidence does not wholly support their use in routine clinical *** this narrative review,co-authored by gastroenterologists and engineers,we summarise the evidence for the impact of established optical imaging technologies on adenoma detection rate,and review the development of photometric stereo(PS)for *** is a machine vision technique able to capture a dense array of surface normals to render three-dimensional reconstructions of surface *** imaging technique has several potential clinical applications in colonoscopy,including adenoma detection,polyp classification,and facilitating polypectomy,an inherently three-dimensional ***,the development of PS for colonoscopy is at an early *** consider the progress that has been made with PS to date and identify the obstacles that need to be overcome prior to clinical application.

关键词： Photometric stereo Colonoscopy Colonic polyps Adenomas Image enhancement Machine vision

Forecasting tropical cyclone tornadoes and impacts:Report from IWTC-X

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Tropical Cyclone Research and Review 2023年第2期12卷 123-135页

作者： Dereka Carroll-smith benjamin W.Green Roger Edwards Lanqiang Bai A.J.Litta Xianxiang Huang Lauren Pattie Scott Overpeck Eugene W.McCaul Jr University of Maryland College ParkMDUSA Jackson State University JacksonUSA Cooperative Institute for Research in Environmental Sciences University of ColoradoBoulderUSA NOAA Global Systems Laboratory BoulderUSA NOAA/NWS/Storm Prediction Center NormanUSA Foshan Tornado Research Center China Meteorological Administration Tornado Key LaboratoryGuangzhouChina Weathernews Inc. ChibaJapan Environmental Prediction Services Australian Bureau of MeteorologyBrisbaneAustralia NOAA/NWS/Weather Forecast Office AlbuquerqueUSA Science and Technology Institute Universities Space Research AssociationHuntsvilleUSA

This report synthesizes global tropical cyclone(TC)tornado research and operational practices to *** are one of the secondary(and lesser researched)hazards contributing to the devastation TCs leave in their *** gale-force winds and storm surge produce the majority of damage and fatalities globally,TC tornadoes also pose a fatal threat,complicating evacuation plans and protective actions as the storm moves *** studies characterize TC-spawned tornadoes as usually weak and short-lived,primarily originating from miniature supercells in the outer *** tornadic features pose challenges to forecasting and radar ***,TC tornadoes can pose a threat to communities 12 h prior to and beyond 48 h after a TC makes ***,both basic and operational,has increased globally over the last few years in efforts to move from a climatological to ingredientsbased approach to detect and forecast TC *** the United States has led the charge,given the increased exposure to tornadoes year round,other nations such as China,Japan,and Australia have increased their efforts to record and detect TC *** these advancements,more work needs to be done globally to understand the TC environment conducive for tornadic *** for future forecasting and research for TC tornadoes include i)develop a comprehensive global tornado database to improve research and forecasting efforts;ii)apply innovative technology to detect tornadoes;and iii)conduct field campaigns to thoroughly sample TC tornado environments,particularly along coastlines.

关键词： Tropical cyclone Tornado Typhoon Forecasting

Evaluating the Technical and Economic Feasibility of Adding a Power Recovery System to the Steam Condenser of a Lignite Coal-Fired Power Plant

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Journal of Power and Energy Engineering 2022年第11期10卷 16-34页

作者： Joshua Wilmer Wayne Seames Dimitri Bazile Kay Lee smith benjamin Koster Grady Mauch Lucas Weimer Department of Chemical Engineering University of North Dakota Grand Forks ND USA

Steam is the typical working fluid to drive turbo-generators in coal-fired power plants. It is an effective working fluid, but some of its energy is extracted in an unusable form when condensed. A Power Recovery Cycle (PRC) using a more volatile Secondary Working Fluid (SWF) added to the steam cycle could improve energy efficiency. PRCs have been applied to the flue gas and for combined cycle systems but not to traditional plant steam cycles. This paper details an analysis of adding a steam cycle PRC to a 500 MW lignite coal-fired power plant. A validated model of the plant was developed and PRCs using the three most attractive SWFs, benzene, methanol and hydrazine, were then added to the model. Adding a benzene, methanol, or hydrazine steam cycle PRC will produce an additional 59, 34, and 49 MW, respectively. An AACE Class 4 factored broad capital cost estimate and comparable operating costs and revenue estimates were developed to evaluate PRC feasibility. The benzene, methanol, and hydrazine processes had 2019 Net Present Values (NPVs) @12% of -$32, -$59, and +$35 million ± 40%, respectively. Thus, a PRC may be profitable at current or modest increases to U.S. Upper Midwest electricity prices of around $0.0667/kWh.

关键词： Lignite Coal Heat Recovery Power Plant Organic Rankine Cycle Bottoming Cycle

Isolated Lumbar Extension Resistance Training Is Effective at Improving Extension Power and Disability in Subjects with Diagnosed Lumbar Multifidus Dysfunction

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Open Journal of Therapy and Rehabilitation 2024年第3期12卷 245-255页

作者： William Roger Peters James Thomas Ernest smith Mario Guiseppe Zotti Adam Leslie Lincoln benjamin James Enser Faculty of Medicine & Health Sciences Bond University Queensland Australia Back Neck Clinic Bundall Queensland Australia Kieser Australia Bundall Queensland Australia

Background: Lumbar multifidus dysfunction is a prevalent cause of disability in individuals with lower back pain. Previous research highlights the benefits of isolated lumbar extension training for non-specific lower back pain, however, studies examining its efficacy in lumbar multifidus dysfunction are lacking. Objective: To evaluate the effectiveness of isolated lumbar extension resistance training on disability and strength in individuals with lumbar multifidus dysfunction. Methods: Subjects underwent a physiotherapy led structured rehabilitation program incorporating isolated lumbar extension. Sessions were conducted twice weekly targeting momentary muscular failure with time under load 90 - 120 seconds and progressions aimed at 5 - 10 lbs increments. Outcomes were assessed using the Oswestry Disability Index and lumbar extension strength testing at baseline and after 12 weeks, with statistical analysis using t-test and chi-squared 2 × 2. Results: Forty-five subjects (24 male, 21 female) with a median age of 48 completed the intervention. Improvements were noted in Oswestry Disability Index scores (median pre: 24, post: 15) and maximal lumbar extension strength (median pre: 122 lb, post: 186 lb), with p ≤ 0.05. Overall, 89% showed improvement in disability scores, 67% moved to a better disability category, and 51% saw at least a 50% increase in strength. No significant gender differences were observed. Conclusions: Isolated lumbar extension resistance training is effective at improving extension power and disability in subjects with lumbar multifidus dysfunction.

关键词： Low Back Pain Multifidus Muscle Strength Rehabilitation Resistance Training

Neighborhood Effects on Hispanic Young Adult Outcomes

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Psychology Research 2016年第9期6卷 516-529页

作者： benjamin D. smith Jacquelyn D. Wiersma-Mosley, Lindsay S. Ham Zola K. Moon Arizona State University Tempe USA University of Arkansas Fayetteville USA

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危险废弃物及其对评估的影响问题新探

经济资料译丛 2012年第2期 13-19页

作者： benjamin J.smith 王琦纪益成厦门大学评估研究中心 361005

尽管在现实生活中，危险废弃物或污染影响了不动产的市场价值，但关于一项现存的判例的评论指出：当基于税收目的时，法院在衡量其对价值的影响程度方面，仍存在一定困难。这个困难反映了一项隐含的公共政策——污染者不应该获得奖励。... 详细信息

尽管在现实生活中，危险废弃物或污染影响了不动产的市场价值，但关于一项现存的判例的评论指出：当基于税收目的时，法院在衡量其对价值的影响程度方面，仍存在一定困难。这个困难反映了一项隐含的公共政策——污染者不应该获得奖励。公共政策认为，如果允许污染者的应税市场价值因污染而得到一定的扣除，财政负担就会转移给其他无辜的纳税人，这从道义上讲是不道德的。

关键词：废弃物危险评估市场价值公共政策现实生活税收目的财政负担