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Primary care clinicians’ strategies to overcome financial barriers to specialty health care for uninsured patients

Family Medicine and Community Health 2015年第3期3卷 18-24页

作者： james j.werner Kitty K.Corbett Department of Family Medicine and Community Health Mandel School of Applied Social SciencesCase Western Reserve University11000 Cedar AvenueSuite 402ClevelandOH 44106USA School of Public Health and Health Systems University of Waterloo200 University Avenue WestWaterlooOntarioN2L 3G1Canada

Objective:This study describes strategies used by federally qualified health centers(FQHCs)to assist medically uninsured patients in obtaining specialty health care ***:Qualitative methods were used to study strategies for obtaining specialty health care for uninsured *** were gathered from 10 primary care clinicians at three FQHC clinics by means of 10 semistructured interviews,23 brief interviews,and 45 h of direct *** captured additional data by studying cases of referred uninsured ***:The following six strategies were identified:(1)quid pro quo-a specialist accept-ing the clinic’s medically uninsured patients was rewarded with referrals of the clinic’s insured patients;(2)over referral-clinicians referred insured patients whose needs could have been met at the FQHC;(3)brief hospitalization-when a specialist could not be obtained,high-risk patients were briefly hospitalized;(4)case building-diagnostic tests were conducted at the FQHC to justify a referral;(5)direct communication-communication between clinicians and specialists was neces-sary when requesting a referral;(6)specialty clinics-in return for conducting a specialty clinic at the FQHC,the specialist received all referrals of insured ***:Uninsured FQHC patients encountered difficulties accessing specialty health care,and in response,clinicians developed a range of innovative strategies.

关键词： Health services accessibility barriers to health care medically uninsured health care inequities access to specialty care qualitative methods

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An analytical model to estimate the time delay to reach spontaneous ignition considering heat loss in oil reservoirs

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Petroleum Science 2024年第4期21卷 2469-2474页

作者： james j.Sheng Er-Long Yang College of Petroleum Engineering Northeast Petroleum University

During air injection into an oil reservoir, an oxidation reaction generates some heat to raise the reservoir temperature. When the reservoir temperature reaches an ignition temperature, spontaneous ignition occurs. There is a time delay from the injection to ignition. There are mixed results regarding the feasibility of spontaneous ignition in real-field projects and in laboratory experiments. No analytical model is available in the literature to estimate the oxidation time required to reach spontaneous ignition with heat *** paper discusses the feasibility of spontaneous ignition from theoretical points and experimental and field project observations. An analytical model considering heat loss is proposed. Analytical models with and without heat loss investigate the factors that affect spontaneous ignition. Based on the discussion and investigations, we find that it is more difficult for spontaneous ignition to occur in laboratory experiments than in oil reservoirs; spontaneous ignition is strongly affected by the initial reservoir temperature, oil activity, and heat loss; spontaneous ignition is only possible when the initial reservoir temperature is high, the oil oxidation rate is high, and the heat loss is low.

关键词： Spontaneous ignition Time delay Air injection Heat loss Low temperature oxidation Combustion

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Insm1:orchestrating cellular mimicry in the thymus medulla

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Cellular & Molecular Immunology 2024年第4期21卷 414-416页

作者： K.D.james j.E.Cowan UCL Institute of Immunity and Transplantation The Pears BuildingRowland Hill StreetLondonNW32PPUK

The thymus is the primary production site for a functional and self-tolerant T-cell *** establishment of immune tolerance is mediated by the generation and presentation of tissue-restricted self-antigens(TRAs)by medullary thymic epithelial cells(mTECs),which screen T-cell receptors for self-reactivity to eliminate autoreactive T *** studies have extended our understanding of mTEC heterogeneity by examining the mechanisms by which mTECs mimic the peripheral self[1].

关键词： medullary eliminate restricted

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What diameter?What height?Influence of measures of average tree size on area-based allometric volume relationships

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Forest Ecosystems 2024年第1期11卷 100-109页

作者： Yilin Wang john A.Kershaw Mark j.Ducey Yuan Sun james B.McCarter Integrated Forest Mensuration and Systems Analysis Laboratory Faculty of Forestry and Environmental ManagementUniversity of New BrunswickFrederictonNBCanada Department of Natural Resources and the Environment University of New HampshireDurhamNHUSA College of Forestry Nanjing Forestry UniversityNanjing210037China Scientific Programmer RayonierYuleeFLUSA

Volume is an important attribute used in many forest management *** from 83 fixed-area plots located in central New Brunswick,Canada,are used to examine how different measures of stand-level diameter and height influence volume prediction using a stand-level variant of Honer's(1967)volume *** density was included in the models(Volume=f(Diameter,Height,Density))choice of diameter measure was more important than choice of height *** density was not included(Volume=f(Diameter,Height)),the opposite was *** models with density included,moment-based estimators of stand diameter and height performed better than all other *** models without density,largest tree estimators of stand diameter and height performed better than other *** overall best equation used quadratic mean diameter,Lorey's height,and density(root mean square error=5.26 m^3·ha^(-1);1.9%relative error).The best equation without density used mean diameter of the largest trees needed to calculate a stand density index of 400 and the mean height of the tallest 400 trees per ha(root mean square error=32.08 m^(3)·ha^(-1);11.8%relative error).The results of this study have some important implications for height subsampling and LiDAR-derived forest inventory analyses.

关键词： Allometric relationships Stand structure Volume estimation Stand-level attributes

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Leaching of rare Earth elements from an Illinois basin coal source

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journal of Rare Earths 2019年第3期37卷 312-321页

作者： X.Yang j.werner R.Q.Honaker Department of Mining Engineering University of Kentucky

The existence of rare earth elements(REEs) in coal sources at elevated concentrations has been the focus of several studies over the past decade. However, limited research has been conducted on methods to recover and refine the REEs. This paper reports the results of a detailed study into the potential of selectively recovering REEs in an Illinois basin coal source by leaching. Leaching characteristics are obtained for several segments obtained from a core sample as well as three different reject materials collected at a coal processing plant. Using a 1.2 mol/L sulfuric acid solution at 75 ℃,over 60% REE recovery is achieved from the direct floor and an inner parting material as well as the coal-rich core segments that are pretreated by low-temperature plasma oxidation to obtain access to the microdispersed mineral matter. In the leachable parting material, fluorapatite is detected by XRD analysis,which is one of the more soluble phosphate minerals with a documented association with REEs. For the three plant reject samples, the leaching recovery values obtained for the heavy REEs are higher than those obtained for the light REEs under the standard leaching conditions and when 0.1 mol/L(NH_4)_2SO_4 was used to extract REEs by an ion exchange mechanism. Thermal activation by roasting or chemical activation by pretreatment using 8 mol/L NaOH solution increases the total REE recovery with significantly higher gains obtained for the light REEs. Leaching kinetics are relatively fast within the first 2 h and then slow to provide relatively low overall recovery values under the standard test conditions for the coarse and fine reject samples. However, significantly higher recovery values are realized when treating mixed-phase(middling) particles existing within the coarse reject material.

关键词： Leaching Coal Thermal activation Chemical activation Rare earth elements

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Will the traditional horticultural breeding and genetics research be fairly valued in academia?

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Horticulture Research 2015年第1期2卷 71-72页

作者： Zong-Ming(Max)Cheng Dennis j.werner Horticulture Research The Laboratory of Fruit Crop Systems Biology College of HorticultureNanjing Agricultural UniversityNanjing210095Jiangsu ProvinceThe People's Republic of China Department of Plant Sciences University of TennesseeKnoxville37996TNUSA Department of Horticultural Science North Carolina State UniversityBox 7609Raleigh27695-7609NCUSA

I wrote the inaugural Editorial when Horticulture Research was launched in january *** second Editorial was trigged by the manuscript that was submitted to Horticulture Research(HORTRES.2015.49,***/articles/hortres201... 详细信息

关键词： breeding culture submitted

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Outcomes following minimally invasive dorsal cheilectomy for hallux rigidus:A systematic review

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World journal of Orthopedics 2024年第6期15卷 585-592页

作者： Katherine Esser james j Butler Mackenzie Roof Nathaniel P Mercer Michael C Harrington Alan P Samsonov Andrew j Rosenbaum john G Kennedy Department of Orthopaedic Surgery University of Toledo Medical Center University of Toledo College of Medicine and Life SciencesToledoOH 43614United States Department of Orthopedic Surgery NYU Langone HealthNew YorkNY 10002United States Department of Orthopedic Surgery Albany Medical CenterAlbanyNY 12208United States

BACKGROUND Cheilectomy of the 1^(st)metatarsophalangeal joint(MTPj)is one of the most common procedures for the management of hallux ***,there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy(MIDC)for the management of hallux *** To evaluate outcomes following MIDC for the management of hallux *** During November 2023,the PubMed,EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux *** Six studies were *** total,348 patients(370 feet)underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9±16.5 *** distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows:Ⅰ(58 patients,27.1%),Ⅱ(112 patients,52.3%),Ⅲ(44 patients,20.6%).Three studies performed an additional 1^(st)MTPj arthroscopy and debridement following *** intra-articular bone debris was observed in 100%of patients in 1 *** weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9±3.2 to a postoperative score of *** complication rate was 8.4%,the most common of which was persistent joint pain and ***-two failures(8.7%)were ***-three secondary procedures(8.9%)were performed at a weighted mean time of 8.6±3.2 months following the index *** This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up.A moderate reoperation rate at short-term follow-up was *** marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.

关键词： Minimally invasive dorsal cheilectomy Hallux rigidus The first metatarsophalangeal joint Cheilectomy Minimally invasive surgery

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质子磁荷半径:新疑难?

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Science Bulletin 2024年第4期69卷 419-421页

作者：林勇辉 Hans-werner Hammer Ulf-G.Meiûner Helmholtz Institut für Strahlen-und Kernphysik and Bethe Center for Theoretical Physics Universität BonnBonn D-53115Germany Technische Universität Darmstadt Department of PhysicsInstitut für KernphysikDarmstadt 64289Germany ExtreMe Matter Institute EMMI and Helmholtz Forschungsakademie Hessen für FAIR GSI Helmholtzzentrum für Schwerionenforschung GmbHDarmstadt 64291Germany Institute for Advanced Simulation and Institut für Kernphysik Forschungszentrum JülichJülich D-52425Germany Tbilisi State University Tbilisi 0186Georgia

The electric radius,rE,and the magnetic radius,rM,of the proton are fundamental quantities of low-energy QCD,as they are a measure of the probe-dependent size of the proton.

关键词： radius quantities fundamental

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The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[^(18)F]fluoro-D-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology:A single centre retrospective study

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Asian journal of Urology 2024年第1期11卷 33-41页

作者： Anthony Franklin Troy Gianduzzo Boon Kua David Wong Louise McEwan james Walters Rachel Esler Matthew j.Roberts Geoff Coughlina john W.Yaxley Department of Urology The Wesley HospitalBrisbaneQLDAustralia Wesley Medical Research BrisbaneQLDAustralia School of Medicine The University of QueenslandBrisbaneQLDAustralia Department of Radiology Wesley Medical ImagingBrisbaneQLDAustralia Department of Urology Royal Brisbane and Women's HospitalBrisbaneQLDAustralia

Objective:To review the risk of prostate cancer(PCa)in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography(18F-FDG PET/CT)ordered at Department of Urology,The Wesley Hospital,Brisbane,QLD,Australia for non-PCa related ***:Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for 18F-FDG PET/CT for non-prostate related conditions was *** were classified as benign,indeterminate,or malignant depending of the results of prostate-specific antigen(PSA),PSA velocity,biopsy histopathology,and three-Tesla(3 T)multiparametric MRI(mpMRI)Prostate Imaging Reporting and Data System score,or gallium-68-prostate-specific membrane antigen(68Ga-PSMA)PET/CT ***:Three percent(273/9122)of men demonstrated 18F-FDG avidity within the ***-five percent(231/273)were further investigated,including with PSA tests(227/231,98.3%),3 T mpMRI(68/231,29.4%),68Ga-PSMA PET/CT(33/231,14.3%),and prostate biopsy(57/231,24.7%).Results were considered benign in 130/231(56.3%),indeterminate in 31/231(13.4%),and malignant in 70/231(30.3%).PCa was identified in 51/57(89.5%)of the men who proceeded to biopsy,including 26/27(96.3%)men with Prostate Imaging Reporting and Data System scores 4-5 mpMRI and six men with a positive 68Ga-PSMA PET/*** most common Gleason score on biopsy was greater than or equal to 4+5(14/51,27.5%).68Ga-PSMA PET/CT was concordant with the 18F-FDG findings in 26/33(78.8%).All 13 men with a positive concordant 18F-FDG,3 T mpMRI,and 68Ga-PSMA PET/CT had PCa on *** was no statistically significant difference in the 18F-FDG maximum standardized uptake value between the benign or malignant groups(5.7 vs.6.1;p=0.580).Conclusion:In this study,after an incidental finding of an avid intraprostatic lesion on 18F-FDG PET/CT,70 of the 231 cases(30.3%;0.8%of the entire cohort)had results c

关键词： Prostatecancer Positionemission tomography Multiparametric magneticresonance imaging Prostatebiopsy

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Ranking environmental and edaphic attributes driving soil microbial community structure and activity with special attention to spatial and temporal scales

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mLife 2024年第1期3卷 21-41页

作者： Vadakattu V.S.R.Gupta james M.Tiedje CSIRO Agriculture&Food UrrbraeSouth AustraliaAustralia Centre for Microbial Ecology Michigan State UniversityEast LansingMichiganUSA

The incredibly complex soil microbial communities at small scales make their analysis and identification of reasons for the observed structures *** community structure is mainly a result of the inoculum(dispersal),the selective advantages of those organisms under the habitat-based environmental attributes,and the ability of those colonizers to sustain themselves over *** soil is protective,and its microbial inhabitants have long adapted to varied soil conditions,significant portions of the soil microbial community structure are likely ***,a substantial portion of the community will not correlate to often measured soil *** suggest that the drivers be ranked on the basis of their importance to the fundamental needs of the microbes:(i)those that supply energy,i.e.,organic carbon and electron acceptors;(i)environmental effectors or stressors,i.e.,pH,salt,drought,and toxic chemicals;(ii)macro-organism associations,i.e.,plants and their seasonality,animals and their fecal matter,and soil fauna;and(iv)nutrients,in order,N,P,and probably of lesser importance,other micronutrients,and *** relevance of drivers also varies with spatial and time scales,for example,aggregate to field to regional,and persistent to dynamic populations to transcripts,and with the extent of phylogenetic difference,hence phenotypic differences in organismal *** present a summary matrix to provide guidance on which drivers are important for particular studies,with special emphasis on a wide range of spatial and temporal scales,and illustrate this with genomic and population(rRNA gene)data from selected studies.

关键词： abundance community structure diversity functional microbiome microorganisms

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