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This study is an initial effort to examine the dynamics of efficiency and productivity in Greek public hospitals during the first phase of the crisis 2009-2012. Data were collected by the Ministry of Health after several quality controls ensuring comparability and validity of hospital inputs and outputs. Productivity is estimated using the Malmquist Indicator, decomposing the estimated values into efficiency and technological change.
Hospital efficiency and productivity growth are calculated by bootstrapping the non-parametric Malmquist analysis. The advantage of this method is the estimation efficiency and productivity through the corresponding confidence intervals. Additionally, a Random-effects Tobit model is explored to investigate the impact of contextual factors on the magnitude of efficiency.
Findings reveal substantial variations in hospital productivity over the period from 2009 to 2012. The economic crisis of 2009 had a negative impact in productivity. The average Malmquist Productivity Indicator (MPI) score is 0.72 with unity signifying stable production. Approximately 91% of the hospitals score lower than unity. Substantial increase is observed between 2010 and 2011, as indicated by the average MPI score which fluctuates to 1.52. Moreover, technology change scored more than unity in more than 75% of hospitals. The last period (2011-2012) has shown stabilization in the expansionary process of productivity. The main factors contributing to overall productivity gains are increases in occupancy rates, type and size of the hospital.
This paper attempts to offer insights in efficiency and productivity growth for public hospitals in Greece. The results suggest that the average hospital experienced substantial productivity growth between 2009 and 2012 as indicated by variations in MPI. Almost all of the productivity increase was due to technology change which could be explained by the concurrent managerial and financing healthcare reforms. Hospitals operating under decreasing returns to scale could achieve higher efficiency rates by reducing their capacity. However, certain social objectives should also be considered. Emphasis perhaps should be placed in utilizing and advancing managerial and organizational reforms, so that the benefits of technological improvements will have a continuing positive impact in the future.
Electronic supplementary material
The online version of this article (doi:10.1186/s12962-017-0068-5) contains supplementary material, which is available to authorized users.
Efficiency, Hospitals, Productivity, Malmquist, Tobit, Greece, Crisis
Efficiency and productivity assessment of public hospitals in Greece during the crisis period 2009-2012
P. Xenos,1 J. Yfantopoulos,corresponding author2 M. Nektarios,1 N. Polyzos,3 P. Tinios,1 and A. Constantopoulos2
Overt and subclinical hypothyroid states have been depicted as risk factors for a more prominent level of coronary calcification. The utilization of coronary atherectomy with percutaneous coronary intervention (PCI) is on the ascent over the past few years as lesions that are more complex are now attempted with a percutaneous approach. However, the real-world data on hypothyroid status influencing PCI with coronary atherectomy outcomes is very limited. Therefore, we proposed to investigate the outcomes of percutaneous coronary intervention with coronary atherectomy in hypothyroid patients using the largest inpatient database in the United States (US), the National Inpatient Sample (NIS). To minimize the selection bias, we surveyed and compared the outcomes in both the unmatched and propensity-score matched euthyroid and hypothyroid cohorts. Concisely, this propensity-matched analysis, using the largest population-based sample in the US, has established higher cardiovascular comorbidities and worse clinical outcomes of PCI with coronary atherectomy owing to clinical hypothyroidism.
hypothyroidism, percutaneous coronary intervention, coronary atherectomy, calcified lesions, coronary atherosclerosis, all-cause mortality, outcomes, hospitalization cost, cardiovascular complications, pci
Impact of Hypothyroidism on Outcomes of Percutaneous Coronary Intervention with Coronary Atherectomy for Calcified Coronary Lesions: A Propensity-matched Analysis
Rupak Desai,corresponding author1 Hemant Goyal,2 Gautam Kumar,3 and Rajesh Sachdeva4
Control and manipulation of synthesis parameters of thin film coatings is of critical concern in determination of material properties and performance. Structural and morphological properties of rf-sputtered WC-Co thin films deposited under varying deposition parameters namely, substrate temperature and rf power are presented in this data article. The surface morphology, crystallite size and nature were acquired using x-ray photoelectron spectroscopy (XPS) and Grazing Incidence X-ray absorption spectroscopy (GI-XAS). Furthermore, Synchrotron findings are correlated with complimentary data acquired from Scanning electron microscopy (SEM), Raman spectroscopy and surface profilometry to predict and point out optimum synthesis parameters for best properties of the film.
WC-Co thin films, X-ray photoelectron spectroscopy (XPS), Grazing incidence X-ray absorption spectroscopy (GI-XAS), Synchrotron radiation, SEM
Structural and morphological dataset for rf-sputtered WC-Co thin films using synchrotron radiation methods
R.R. Phiri,a O.P. Oladijo,a,b,∗ H. Nakajima,c A. Rattanachata,c and E.T. Akinlabib