Foodborne pathogens such as Clostridium perfringens can cause diverse illnesses and seriously threaten to human health, yet far less attention has been given to detecting these pathogenic bacteria. Herein, two morphologies of nanoceria were synthesized via adjusting the concentration of NaOH, and CeO₂ nanorod has been utilized as sensing material to achieve sensitive and selective detection of C. perfringens DNA sequence due to its strong adsorption ability towards DNA compared to nanoparticle. The DNA probe was tightly immobilized on CeO₂/chitosan modified electrode surface via metal coordination, and the DNA surface density was 2.51 × 10−10 mol/cm². Under optimal experimental conditions, the electrochemical impedance biosensor displays favorable selectivity toward target DNA in comparison with base-mismatched and non-complementary DNA. The dynamic linear range of the proposed biosensor for detecting oligonucleotide sequence of Clostridium perfringens was from 1.0 × 10−14 to 1.0 × 10−7 mol/L. The detection limit was 7.06 × 10−15 mol/L. In comparison, differential pulse voltammetry (DPV) method quantified the target DNA with a detection limit of 1.95 × 10−15 mol/L. Moreover, the DNA biosensor could detect C. perfringens extracted DNA in dairy products and provided a potential application in food quality control.

Catalysts are urgently needed to remove the residual CO in hydrogen feeds through selective oxidation for large-scale applications of hydrogen proton exchange membrane fuel cells. We herein propose a new methodology that anchors high concentration oxygen vacancies at interface by designing a CeO2-x/Cu hybrid catalyst with enhanced preferential CO oxidation activity. This hybrid catalyst, with more than 6.1% oxygen vacancies fixed at the favorable interfacial sites, displays nearly 100% CO conversion efficiency in H2-rich streams over a broad temperature window from 120 to 210 °C, strikingly 5-fold wider than that of conventional CeO2/Cu (i.e., CeO2 supported on Cu) catalyst. Moreover, the catalyst exhibits a highest cycling stability ever reported, showing no deterioration after five cycling tests, and a super long-time stability beyond 100 h in the simulated operation environment that involves CO2 and H2O. On the basis of an arsenal of characterization techniques, we clearly show that the anchored oxygen vacancies are generated as a consequence of electron donation from metal copper atoms to CeO2 acceptor and the subsequent reverse spillover of oxygen induced by electron transfer in well controlled nanoheterojunction. The anchored oxygen vacancies play a bridging role in electron capture or transfer and drive molecule oxygen into active oxygen species to interact with the CO molecules adsorbed at interfaces, thus leading to an excellent preferential CO oxidation performance. This study opens a window to design a vast number of high-performance metal-oxide hybrid catalysts via the concept of anchoring oxygen vacancies at interfaces.

Plasma-sprayed hydroxyapatite (HA) coating, applied to metal substrates, can induce a direct chemical bond with bone and hence achieve a biological fixation of the implant. However, the poor bonding strength between the HA coating and the substrate has been a concern for the orthopedists. In a previous study, the zirconia-reinforced hydroxyapatite composite coatings (HA/ZrO(2)) could significantly improve the mechanical strength before and after soaking in simulated body fluid. This study aims to investigate the biological responses of osteoblasts on plasma-sprayed HA/ZrO(2) coating. The osteoblasts derived from neonatal rat calvarial were cultured in Dulbecco's modified Eagle medium (DMEM) with fetal bovine serum (FBS) on the surface of plasma-sprayed HA coating, HA/ZrO(2) coating, and ZrO(2) coating, respectively. The biological responses were investigated by the cell growth (1, 3, 5, and 10 days) and the cell morphology under scanning electron microscopy (SEM) (3, 6, 12, 24 and 48 h). Examination by SEM revealed that osteoblasts on HA coatings exhibit less spreading during the medium phase (6 and 12 h), while, better morphologies were observed at the latter phases (24 and 48 h). This should be derived by the dissolution of HA coating in the culture medium. On HA/ZrO(2) coating, the cells showed the poor morphologies at the latter phases (24 and 48 h). This could be explained by the no apatite formed at the surface HA/ZrO(2) coating after soaking in simulated body fluid. The lower contents of ZrO(2) coating in HA coating and the addition of other solid solution (ZrO(2)-MgO, CaO-ZrO(2), ZrO(2)-CeO(2)) in HA coating are the two possible methods to improve the cytocompatibility of HA/ZrO(2) coating.

Free-standing CeO(2) nanorods with different morphology grew directly on Ti substrates via an electrochemical assembly process, and their absorption edges show a remarkable red-shift to the visible region. Moreover, photoelectrochemical cell (PEC) measurements demonstrate these CeO(2) nanorods exhibit a photovoltaic response under visible light illumination (λ≥ 390 nm).

Modern Healthcare's first comprehensive report on CEO pay at the top for-profit healthcare providers and insurers shows pay and stock performance aren't always linked. One exception is Norman Payson, left, who was tapped in 1998 to help turn around then-faltering Oxford Health Plans. He pulled in total direct compensation of $76 million last year, including $73 million in exercised stock options.

CEOs now recognize that the business expertise of board members is a valuable resource that needs to be tapped. So, in an effort to develop the best possible response to an increasingly complex business environment, a growing number of CEOs are asking their boards to play a key role in strategic planning. And when the strategic plan is a joint effort, the CEO is less likely to be blamed if the plan fails. The strategic planning process is not always a smooth operation, say executives. Corporate and individual hospital boards have different perspectives and are not always on the same wavelength, which may leave the CEO caught in the middle. At the community level, developing a shared vision with the trustees is a time-consuming task. And in those communities where physicians are viewed as competitors, the CEO may find it tough to convince trustees that physicians must be part of an integrated plan.

The intent of this study was to assess disaster preparedness in community hospitals across New York.

Descriptive and analytical cross-sectional survey study. The survey instrument consisted of 35 questions that examined six elements of disaster preparedness: disaster plan development, onsite surge capacity, available materials and resources, disaster education and training, disaster preparedness funding levels, and perception of disaster preparedness.

Community hospitals in New York.

Contact information was obtained for 207 of 208 community hospitals. Email invitations to participate in the survey were sent to hospital CEOs and disaster preparedness coordinators. Completed surveys were received from 80 hospitals.

Hospital responses to questions related to the six elements of disaster preparedness.

Most (87.5 percent) hospitals had experienced a disaster event during the past 5 years (2012-2016). Eighty percent had disaster plans that addressed all of six major types of disasters. Only 17.5 percent believed their disaster plans were "very sufficient" and did not require any revisions. Nearly three-quarters (73.3 percent) of hospitals could continue operations for less than a week without external resources. Less than half (49.4 percent) reported being satisfied or very satisfied with the level of funding that they received from the Hospital Preparedness Program. Most (88.8 percent) respondents felt that barriers to disaster preparedness exist for their organizations.

The results demonstrate the current level of disaster preparedness among New York hospitals. The study's approach is discussed as a model that will enable hospitals to identify focus areas for improvement and opportunities for legislation and advocacy.

BACKGROUND

Prior literature provides only a descriptive view of the types and numbers of capital expenditures made by hospitals.

OBJECTIVE

This study conducted an empirical analysis to assess simultaneously what market, organizational, and financial factors relate to the number of capital projects as well as the specific types: medical equipment, expansion, and maintenance projects.

METHODS

Sampling California hospital capital expenditure data from 2002 to 2007, this study aggregated the number of capital projects by each type of capital investment decision: medical equipment, expansion, and maintenance/renovation per hospital. Using ordinary least squares regression, this study evaluated the association of these factors with these types of capital investment projects.

RESULTS

This study found that hospitals capturing a greater share of the market, maintaining high levels of liquidity, and operating with more than 350 beds invested in a greater number of capital projects per hospital as well as medical equipment and expansionary projects per hospital.

CONCLUSIONS

Within the state of California, the demand for health care services within a hospital market as well as cash and investment reserves were key drivers in the hospital CEOs and boards' decision to increase their capital purchases. The types of purchases included capital outlays related to medical equipment, such as CT scanners, MRIs, and surgical systems, and revenue-generating expansionary projects, such as new bed towers, hospitals wings, operating and emergency rooms, and replacement hospitals from 2002 to 2007.

Institutional and market changes seem to force hospitals across the Western world to revitalize their corporate strategies towards more cost efficiency on the one hand, and more flexibility towards customer demands on the other hand. Hospitals, however, apparently differ in the extent to which they are able to implement such strategies effectively. This paper explores whether these different levels of effectiveness depend on how hospitals' top managers' use of the available management information systems (MIS). Based on data obtained from the 218 CEOs of public hospitals in Spain, we analyze how CEOs' professional and educational backgrounds affect their use of MIS, and how the use of the MIS subsequently supports or inhibits the implementation of these strategic goals. The results indicate that CEOs with a predominant clinical background focus more on non-financial information for decision-making and prefer an interactive style of using MIS, which together support flexibility strategies. CEOs with a predominant administrative background seem more effective in establishing cost-reduction strategies, through their larger inclination to emphasize financial information in combination with a diagnostic use of the MIS. Implications for the strategic management of hospitals are outlined.

Anyone who has signed up for cell phone service, attempted to claim a rebate, or navigated a call center has probably suffered from a company's apparent indifference to what should be its first concern: the customer experiences that culminate in either satisfaction or disappointment and defection. Customer experience is the subjective response customers have to direct or indirect contact with a company. It encompasses every aspect of an offering: customer care, advertising, packaging, features, ease of use, reliability. Customer experience is shaped by customers' expectations, which largely reflect previous experiences. Few CEOs would argue against the significance of customer experience or against measuring and analyzing it. But many don't appreciate how those activities differ from CRM or just how illuminating the data can be. For instance, the majority of the companies in a recent survey believed they have been providing "superior" experiences to customers, but most customers disagreed. The authors describe a customer experience management (CEM) process that involves three kinds of monitoring: past patterns (evaluating completed transactions), present patterns (tracking current relationships), and potential patterns (conducting inquiries in the hope of unveiling future opportunities). Data are collected at or about touch points through such methods as surveys, interviews, focus groups, and online forums. Companies need to involve every function in the effort, not just a single customer-facing group. The authors go on to illustrate how a cross-functional CEM system is created. With such a system, companies can discover which customers are prospects for growth and which require immediate intervention.

OBJECTIVE

To determine the issues important to stakeholders in today's academic surgery departments, to query key stakeholders about possible solutions, and to investigate the correlation of organizational alignment among department stakeholders with department performance.

METHODS

Between July 2003 and October 2005, the author designed, piloted and carried out a study in which he interviewed key stakeholders-deans, chief executive officers/chief financial officers (CEOs/CFOs) of hospitals and health system practice plans, surgery department chairs, and surgery department members-from 12 randomly selected academic surgery departments. Important issues and solutions were identified and comparisons among stakeholder groups performed. Alignment was evaluated both among and within groups and organizations.

RESULTS

Stakeholders (11 deans, 9 CEO/CFOs, 12 department chairs, 10 department faculty members) identified 12 issues and offered potential solutions and responses important to today's academic surgery department. One issue identified was promotion and tenure; nearly all stakeholders stated that its current form needed to be changed. Alignment analysis was incomplete because of inconsistent outcomes reporting.

CONCLUSIONS

The uniformity of issues facing academic surgery departments and the similarity of the solutions proposed to address these issues (both study findings) suggest a need to change the paradigm and think "outside the box." The study findings suggest that academic surgery departments, under strong leaders, must establish a unified culture, define a compelling vision, articulate a clear mission, and develop fully accepted values to be successful. The study findings could be useful in designing and developing academic surgery departments in today's health care environment.

The most complex aspect of the future for health care managers is the intensity of change in the environment in which they work/The CEO's role today and in the future is examined.

We describe a Yb-fiber-based laser comb, with a focus on the relationship between the net-cavity dispersion and frequency noise on the comb. While tuning the net-cavity dispersion from anomalous to normal, we measure the relative intensity noise, offset frequency (f(CEO)) linewidth, and the resulting frequency noise spectrum on the f(CEO). We find that the laser operating at zero net-cavity dispersion has many advantages, including an approximately 100× reduction in free-running f(CEO) linewidth and frequency noise power spectral density when compared to the normal-dispersion regime. At the zero-dispersion point, we demonstrate a phase-locked f(CEO) beat with low residual noise.

OBJECTIVE

To report investigations in a case series of patients diagnosed with idiopathic multifocal choroiditis (MFC) in order to determine whether or not a new clinical phenotype could be identified and to determine the long-term visual prognosis.

METHODS

Twenty-eight patients were identified from the clinic database of approximately 1200 and subsequently reviewed. After ocular examination, which included fluorescein angiography, 20 of these patients were determined to have idiopathic MFC. Visual outcome, patient demographics, presenting symptoms, the distribution of inflammatory cells, the pattern of chorioretinal lesions and the development of peripapillary atrophy, choroidal new vessels or cystoid macular oedema were compared.

RESULTS

The range of follow up was 1-27 years (mean 10 years). A Kaplan-Meier plot showed that approximately 60% of patients maintained their best-corrected visual acuity for 10 years after diagnosis. Poor vision at final review was associated with eyes having choroidal new vessels or cystoid macular oedema. Oral steroids were used to treat 11 patients, of which 10 responded with a visual improvement. The one non-responsive patient had foveal ischaemia angiographically. Generally the idiopathic phenotype was variable and only four patients showed some overlap with known subgroups of MFC. Unusual vascular features were observed in two patients.

CONCLUSIONS

No specific phenotype was seen to emerge from this cohort of patients diagnosed with idiopathic MFC, although most were significantly different from the retinal white dot syndromes currently described. The visual prognosis was relatively good and most cases responded to oral steroids.

A case of an intraocular cilium noted in the anterior chamber after routine small incision phacoemulsification is described. The cilium was noted on the third postoperative day. It initially protruded internally from the paracentesis site and subsequently pierced the peripheral iris to migrate through to the posterior chamber to finally re-emerge through the pupil and come to rest in the inferior angle. No adverse effects have been noted and the patient's visual acuity was stable at 6/5 after 6 months of follow up.

The objective of this work was to verify the incidence of dental caries by means of the CPO-D, CPO-S, ceo-d and ceo-s indexes in patients with Down syndrome regularly enrolled in a preventive program. Twenty four Down syndrome patients of both sexes age range of one to 48 years were examined. The prevalence (initial experimental situation) and incidence (final experimental situation) of dental caries were verified using of the initial and final CPO-D, CPO-S, ceo-d and ceo-s indexes of the participants. From 24 individual examined, 10 (42.0%) were free of caries. The prevalence of dental caries showed values of CPO-D= 2.33; CPO-S= 3.60; ceo-d= 1.75 e ceo-s= 2.80; while the incidence of caries showed values of 2.33; 3.80; 1.10 e 1.90, respectively. Down syndrome individuals evaluated in this study presented low level of caries and small incidence of new lesions, emphasizing the importance of the maintenance of these patients at preventive programs.

A periodic electrostatic embedding scheme is presented that uses the periodic fast multipole method. The convergence of properties with increasing cluster size is examined for cluster models of calcium fluoride. Properties investigated are the electron density, the density of states, the electronic excitation of color centers, and energies of defect formation. The embedded cluster method is applied to CeO(2) and oxygen vacancies in bulk CeO(2) as well as on its (111) surface. Employing the PBE0 functional, vacancy formation energies of 3.0 and 3.3 eV have been obtained for the bulk and the (111) surface, respectively. Formation of subsurface defects requires 3.33 eV (singlet open shell). The localization of the electrons left behind on defect formation in Ce 4f states is discussed. Occupied Ce 4f states are well localized on nearest Ce atoms for surface and subsurface vacancies. Localization apart from the vacancy was obtained for bulk. The total CPU time spent on the embedding part did not exceed 30 s on a single CPU even if 8000 basis functions of the cluster are involved.

The authors (a) investigated trait homogeneity in organizations by examining within-organization similarity among members' personality traits and personal values and (b) tested the relationship between the top leaders' personal characteristics and organizational profiles of personality and values. Results replicate and extend B. Schneider, D. B. Smith, S. Taylor, and J. Fleenor's (1998) hypothesis of the homogeneity of personality in organizations. Using data from CEOs and 467 employee participants from 32 organizations, the authors found evidence of within-organization homogeneity of both personality and values. Results also suggest initial empirical support for assumptions presented by E. Schein (1992) and B. Schneider (1987) about leader-follower congruence. Some implications regarding leadership and organizational behavior are discussed.

Follicular fluid meiosis-activating sterol (FF-MAS) is regarded as an important compound relevant to meiotic resumption in mammalian oocytes. The objective of this study was to investigate the influence of FF-MAS on germinal vesicle breakdown (GVBD) and first polar body (PBI) extrusion with regard to culture conditions, state of the oocyte and mouse strain. Denuded oocytes (DO) and cumulus-enclosed oocytes (CEO) were retrieved from PMSG-primed Quackenbush or C57BL/6J x DBA/2 (C57) mice and cultured for 20 h in alpha-MEM medium under the following conditions: (i) 250 micromol/l dibutyryl cAMP (dbcAMP) +/- EGF, 1 ng/ml or FF-MAS, 20 micromol/l; (ii) 4 mmol/l hypoxanthine (HX) +/- EGF or FF-MAS; (iii) HX + EGF + FF-MAS; and (iv) HX + FF-MAS 5 h priming and subsequent culture with HX + EGF. Oocyte GVBD and PBI emission were recorded and stained with Hoechst 33342. Very limited meiotic inhibition was observed in Quackenbush mice in comparison with C57 mice. FF-MAS promoted maturation in C57 DO and CEO and Quackenbush DO. In Quackenbush DO and CEO and C57 DO a significant increase in atypical PBI extrusion occurred, but not in C57 CEO as well as in EGF-treated Quackenbush CEO primed or co-cultured with FF-MAS. These results support a meiosis resumption function for FF-MAS and suggest that in its presence, the quality of the MII oocytes retrieved appears to be influenced by the strain of the mice, the state of the oocyte and the presence or absence of growth factors in the culture medium.

Synthesis of a novel thermally stable mesoporous ceria-titania phase using a neutral templating route is reported. The as-made inorganic-template hybrid mesostructured matrix showed a broad low-angle XRD peak characteristic of mesoporous materials. Careful thermal treatment of the matrix allowed the subsequent densification (of the pore walls) of the inorganic component and removal of the organic component so that a high-quality mesoporous ceria-titania was formed as observed by TEM analysis. The calcined material showed the formation of fluorite type structure of CeO(2) but no crystalline titania phase was observed. The mesoporous structure remained even after high-temperature treatment. The material had high surface area after calcination up to the temperature of 973 K, with well-dispersed ceria and titania components and negligible bulk oxide formation (from XRD, UV-vis, and XPS analysis). These novel mesoporous ceria-titania materials showed high performance for the removal of volatile organic compound (toluene). The toluene removal performance was further enhanced for Pt impregnated mesoporous ceria-titania.

Keeping the intact germinal vesicle (GV) is essential for maintaining the capacity of mammals including human. It is maintained by very complex procedures along with folliculogenesis and is a critical step for getting competent oocyte. So far, a few mechanisms involved in folliculogenesis are known but GV arrest mechanisms are largely unrevealed. Cyclic AMP, a adenosine derived substance, have been used as inhibitor of germinal vesicle breakdown as a putative oocyte maturation inhibitor. In this study, we examined the potency of adenosine as GV maintainer and a possible signaling mediator for that. A1, A2b, and A3 were detected in cumulus cells of cumulus enclosed-oocyte (CEO). Intact of germinal vesicle was not kept like in follicle but the spontaneous maturation was inhibited by exogenous adenosine. It is inhibited with concentration dependent manners. Intracellular calcium level of cumulus was extensively increased after adenosine treatment. Based on these results it is suggested that one of the pathway for GV arrest by adenosine and its receptors is calcium mediated signaling pathway in CEO.

With steadily rising revenue and large numbers of clinical trials utilizing novel treatment strategies, the field of neuro-oncology is at the core of the growing cancer therapy industry. In June 2012, the Weill Cornell Brain and Tumor Center hosted the first Brain Tumor Biotech Summit as a forum for fostering and encouraging collaboration between researches and investors to accelerate novel treatments for brain cancer. This event brought together neuro-oncologists, neurosurgeons, academicians, entrepreneurs, non-profits, CEOs and investors in an attempt to bring innovative treatments and concepts to the fore. Specific subjects presented at the meeting included new surgical devices and delivery techniques, targeted therapeutics, immunotherapy, and stem cell biology. The mission of the summit was to provide opportunities for researchers in neuro-oncology to directly interact with leaders from the investment community with insight into the commercial aspects of our work. Our shared goal is to shorten the time for basic science ideas to be translated into the clinical setting. The following serves as a progress report on the biotech industry in neuro-oncology, as presented at the Brain Tumor Biotech Summit.

BACKGROUND

Corneal ulcer caused by Aureobasidium pullulans is considered to be a rare entity. So far very few reports have appeared in the world literature and the authors' hospital is the first to report from Nepal. Although A. pullulans is regarded as a contaminant, it should be considered as a pathogen if isolated from corneal ulcer specimen with clinical signs of infection and with growth of the organism on two or more culture media or growth in one medium with consistent direct microscopy findings or growth of the same organism on repeated corneal scrapings. In the present study, a series of proven cases of A. pullulans corneal ulcers at a tertiary eye care centre of Eastern Nepal is reported.

METHODS

A retrospective analysis of stored data of microbiological and clinical cases of corneal ulcer was carried out. All consecutive patients (447 patients) with presumed microbial keratitis from 1 August 1998 to 31 July 2001 were evaluated with regards to clinical details, microbiological examination and management.

RESULTS

Of 200 fungal organisms isolated from the cultures, 25 were identified as A. pullulans. These ulcers showed negligible improvement to topical natamycin and required either topical fluconazole or topical itraconazole in all along with systemic intravenous fluconazole in eight patients. Of 25 eyes, 22 responded well to antifungal therapy and 2 required therapeutic penetrating keratoplasty. One patient was lost to follow up for 3 months and revealed phthisis bulbi on subsequent examination.

CONCLUSIONS

Aureobasidium pullulans corneal infection should be considered as a cause of keratomycosis.