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  • 2005-2009  (4)
  • 1980-1984  (2)
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  • 1
    Keywords: Aufsatzsammlung
    Type of Medium: Book
    Pages: III S., S. 803 - 1140 , Ill., graph. Darst
    Series Statement: Deep sea research 53.2006,8/10
    Language: English
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  • 2
    Type of Medium: Book
    Pages: S. 2399 - 2534 , Ill., graph. Darst.
    Series Statement: Deep-sea research 55.2008,22/23
    Language: English
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  • 3
    In: Marine ecology progress series, Oldendorf/Luhe : Inter-Research, 1979, 382(2009), Seite 1-21, 1616-1599
    In: volume:382
    In: year:2009
    In: pages:1-21
    Description / Table of Contents: Deep-sea whale falls create sulfidic habitats supporting chemoautotrophic communities, but microbial processes underlying the formation of such habitats remain poorly evaluated. Microbial degradation processes (sulfate reduction, methanogenesis) and biogeochemical gradients were studied in a whale-fall habitat created by a 30 t whale carcass deployed at 1675 m depth for 6 to 7 yr on the California margin. A variety of measurements were conducted including photomosaicking, microsensor measurements, radiotracer incubations and geochemical analyses. Sediments were studied at different distances (0 to 9 m) from the whale fall. Highest microbial activities and steepest vertical geochemical gradients were found within 0.5 m of the whale fall, revealing ex situ sulfate reduction and in vitro methanogenesis rates of up to 717 and 99 mmol m-2 d-1, respectively. In sediments containing whale biomass, methanogenesis was equivalent to 20 to 30% of sulfate reduction. During in vitro sediment studies, sulfide and methane were produced within days to weeks after addition of whale biomass, indicating that chemosynthesis is promoted at early stages of the whale fall. Total sulfide production from sediments within 0.5 m of the whale fall was 2.1 ± 3 and 1.5 ± 2.1 mol d-1 in Years 6 and 7, respectively, of which ~200 mmol d-1 were available as free sulfide. Sulfate reduction in bones was much lower, accounting for a total availability of ~10 mmol sulfide d1. Over periods of at least 7 yr, whale falls can create sulfidic conditions similar to other chemosynthetic habitats such as cold seeps and hydrothermal vents.
    Type of Medium: Online Resource
    Pages: Ill., graph. Darst
    ISSN: 1616-1599
    Language: English
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  • 4
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc
    Journal of cardiac surgery 20 (2005), S. 0 
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background: While potential benefits of robotic technology include decreased morbidity and improved recovery, some have suggested a prohibitively high cost. This study was undertaken to compare actual hospital costs of robotically assisted cardiac procedures with conventional techniques. Methods: We conducted a retrospective review of clinical and financial data of 20 patients who underwent atrial septal defect (ASD) closure and 20 patients who underwent mitral valve repair (MVr) using either robotic techniques or a conventional approach with a sternotomy. Total hospital cost (actual resource consumption) was subdivided into operative and postoperative costs. Results: Robotic technology did not significantly increase total hospital cost for ASD closure or MVr (p = 0.518 and p = 0.539). However, when including the initial capital investment for the robot through amortization of institutional costs, total hospital cost was increased by $3,773 for robotic ASD closure and $3,444 for robotic MVr (p = 0.021 and p = 0.004). The major driver of cost for robotic cases (operating room time) decreased over time. Conclusions: Robotic technology did not significantly increase hospital cost. While the absolute cost for robotic surgery was higher than conventional techniques after taking into account the institutional cost of the robot, the major driver of cost for robotic procedures will likely continue to decrease, as the surgical team becomes increasingly familiar with robotic technology. Furthermore, other benefits, such as improvement in postoperative quality of life and more expeditious return to work may make a robotic approach cost-effective. Thus, it is possible that the benefits of robotic surgery may justify investment in this technology.
    Type of Medium: Electronic Resource
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  • 5
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of community health 6 (1980), S. 6-17 
    ISSN: 1573-3610
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 1975, the Johns Hopkins Medical house staff was reorganized into four Firms. Each Firm provides inpatient and outpatient care to a group of patients. Two of the goals of the reorganization were to improve accessibility and continuity of care. This study, based on a before and after research design utilizing routinely collected data, sought to determine whether these goals had been attained. Accessibility was assessed by observing changes in waiting time for appointments, broken appointments, and number of patients seen before their scheduled appointments. The results showed that mean waiting time for a Medical Clinic appointment fell from 15 days to 1 day (p〈0.01); broken appointments for new patients fell from 54% to 34% (p〈0.01); no significant changes occurred in broken appointments for old clinic patients (34% vs 32%); and patients seen before their scheduled appointments increased from 30% to 38% (p〈0.001). Continuity was assessed by observing changes in use of emergency and walk-in clinic services, the proportion of Medical Clinic patients lost to follow-up care, the proportion of hospital readmissions returning to the same nursing unit, and the proportion of patients discharged from the hospital who returned to the Medical Clinic. The results showed that use of emergency and walk-in clinic services fell slightly, from 24% of all visits before to 22% of all visits after the Firm System (p〈0.001); no change occurred in the proportion of patients lost to Medical Clinic follow-up (21% before and after the Firm System); the proportion of hospital readmissions returning to the same nursing unit increased from 35% to 73% (p〈0.005); and the proportion of patients discharged from the hospital who returned to the Medical Clinic increased from 21% to 35% (p〈0.001). These data suggest that implementing the Firm System led to improvement in several selected aspects of accessibility and continuity of care but that further improvements could be made.
    Type of Medium: Electronic Resource
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