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Over the past decade, many health care systems across the Global North have implemented elements of market mechanisms while also dealing with the consequences of the financial crisis. Although effects of these two developments have been researched separately, their combined impact on the governance of health care organizations has received less attention. The aim of this study is to understand how health care reforms and the financial crisis together shaped new roles and interactions within health care. The Netherlands – where dynamics between health care organizations and their financial stakeholders (i.e., banks and health insurers) were particularly impacted – provides an illustrative case. Through semi-structured interviews, additional document analysis and insights from institutional change theory, we show how banks intensified relationship management, increased demands on loan applications and shifted financial risks onto health care organizations, while health insurers tightened up their monitoring and accountability practices towards health care organizations. In return, health care organizations were urged to rearrange their operations and become more risk-minded. They became increasingly dependent on banks and health insurers for their existence. Moreover, with this study, we show how institutional arenas come about through both the long-term efforts of institutional agents and unpredictable implications of economic and societal crises. [ABSTRACT FROM AUTHOR]

Understanding the spatial variability of reservoir properties in tight gas sandstones can significantly reduce uncertainties in reservoir characterization. This study focuses on two outcrops of Upper Carboniferous (Westphalian D) fluvial sandstones in the southern part of the Lower Saxony Basin, NW Germany, which are analogues for tight, gas-producing reservoir rocks at fields in the north of the basin. Large-scale differences in reservoir quality occur between the two outcrops which are separated by a distance of approximately 15 km and by 600 m of stratigraphy. Smaller-scale heterogeneities in the form of channel geometries occur within individual fluvial cycles, as evidenced in a 30 m (high) by 150 m (long) porosity-permeability profile at one of the outcrops studied. In the Woitzel quarry, lower Westphalian D deposits consist of fining-upwards cycles of channel and bar sandstones with intercalated floodplain sediments and coal seams. In abandoned quarries at the Hüggel location, upper Westphalian D strata are composed of grey and red coloured sandstones which suggest deposition in a fluvial - alluvial plain environment under increasingly arid conditions. Reservoir quality is higher in the upper Westphalian D sandstones at Hüggel (permeability: up to 1 mD; mean porosity: 19%) than in the lower Westphalian D sandstones at Woitzel (permeability: <0.1 mD; mean porosity: 15%). Due to the high degree of compaction of the upper and lower Westphalian D deposits (intergranular volumes of 21.9% and 19.4% respectively) and the high proportions of pseudomatrix, porosity in these sandstones is mainly secondary with up to 80% microporosity. Reservoir quality is in general higher in the upper Westphalian D sandstones where kaolinite is present. In contrast, intense illitization has degraded the reservoir quality of the lower Westphalian D sandstones. A positive correlation between permeability and grain size is exhibited by the kaolinite-bearing upper Westphalian D sandstones. No such correlation is evident in the illite-bearing lower Westphalian D sandstones, unless samples with permeabilities of <0.01 mD are excluded from the correlation. However, such a low permeability cut-off is not related to sorting, grain size or authigenic quartz cementation. At a small scale, permeability varies laterally by two orders of magnitude from 0.001 mD to 0.1 mD in a single, approximately 3 m thick tight sandstone bed over a distance of 150 m. Repeated, centimetre-scaled fining-upwards grading and bed-internal erosion contribute to lateral variations in reservoir flow characteristics. Integrated studies of the depositional environment, diagenesis and sedimentary geometries of the deposited units are a key to the understanding of heterogeneities in tight fluvial sandstones and thus to the successful development of Upper Carboniferous reservoirs in the Lower Saxony Basin and elsewhere. [ABSTRACT FROM AUTHOR]

Through analysing the correspondence between key refugee camp commanders based at Amsterdam's Lloyd Hotel and different authorities involved in Dutch refugee matters, this paper examines how "the Dutch state" responded to German-Jewish refugees fleeing Nazi Germany in the prelude to World War II. Using a largely Foucauldian approach to discipline, power, security and governmentality to examine the bio-, macroand micro-politics behind the management of these refugees and their lived spaces, we seek to illustrate how the Lloyd Hotel formed part of a quasi-carceral spatial regime implemented to segregate and contain those with an unclear legal status at a time of political confusion. The article also seeks to show how the involvement of different authorities at different scales brought serious implications for the status, spatial regimentation, mobilities and future of the refugees. [ABSTRACT FROM AUTHOR]

The article presents a study which describes the dynamic Neural Network Ozone Retrieval System (NNORSY)-based ozone profile climatology. The study compares output ozone profiles, correlative measurements and lidar stations in an effort to explore the geophysical soundness of the climatology. It also illustrates the ozone profile measurement data sets and the NNORSY processing scheme.

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Peripheral blood lymphocytes from patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS). Reiter's disease, osteoarthritis. and from healthy volunteers were investigated for interferon-γ (IFN-γ) production after mitogen activation. Phytohaemagglutinin stimulation revealed an impaired IFN-γ production in RA, SLE, and PSS but normal levels in Reiter's disease and osteoarthritis. In RA this deficiency was also seen after pokeweed mitogen. OKT3, and concanavalin A activation. No major differences were found in interleukin 2 (IL-2) production and cell proliferation. The IL-2 receptor expression was reduced on stimulated RA lymphocytes. The deficient IFN-γ production was compensated in RA by co-stimulation of PHA or OKT3 with phorbol myristic acetate (PMA). In addition, the combination of the calcium ionophore A 25187 and PMA induced a strong IFN-γ secretion in all patient groups and in the controls [ABSTRACT FROM AUTHOR]

In this long term retrospective study of radiation synovectomy with Yttrium-90 (Y90), we evaluated the results of 164 applications in 82 patients with RA, OA with synovitis, ankylosing spondylitis and psoriatic arthritis. Radiation synovectomy with Y90 has an overall success rate of approximately 50% and is therefore an effective alternative to surgical synovectomy in chronic synovitis which fails to respond to conservative treatment. Elbow and knee responded significantly better than shoulder and ankle joints. Patients with radiological stages from 0 to 2 showed a significantly better success rate than those with stage 3 changes. In responders, repeat therapy for recurrence of symptoms or treatment of a symptomatic corresponding symmetrical joint is advisable. Repeat therapy in a previous non-responder is associated with an unacceptably high failure rate. Therefore, when a joint fails to respond after 6 months, arthroscopy should be performed to evaluate further treatment procedures. A successful result was found in only 11 of 25 joints treated with arthroscopic synovectomy followed by radiation synovectomy within 2 weeks, indicating no benefit of this combination. [ABSTRACT FROM PUBLISHER]

Serum immunoreactive cationic trypsinogen (ICT) response to bolus injection of secretin (1 Clinical Units/ kg of body weight) has been evaluated in 123 normal controls and related to sex, age, smoking habit, and alcohol and coffee consumption. A 100% increase of serum immunoreactive cationic trypsinogen levels after secretin has been considered as a positive response (R+). When the population was considered as a whole, 55% of subjects proved to be R+ and the remaining were R-. In the R+ group the serum immunoreactive cationic trypsinogen response was appreciated as early as 5 min after secretin and even after 2 min in the few cases in which it was evaluated. It is suggested that this direct leakage of the proenzyme from the pancreas may be due to an increased sensitivity of the pancreas to secretin. Coffee consumption and age of subjects did not affect the test. Male sex, smoking habit, and alcohol intake were associated with a significantly higher percentage of R+. Therefore, we suggest that alcohol and smoking might result in the development of biochemical abnormalities in pancreatic function before the appearance of clinical evidence of pancreatic disease. [ABSTRACT FROM AUTHOR]

Marked lymphocytosis occurs after exercise. In a study of healthy volunteers this was dominated by one population lacking T cell and B cell determinants and another expressing the Leu 2a phenotype (cytotoxic/suppressor). Lymphocytes from two individuals were characterised further and a near five-fold increase in cells expressing antigens associated with natural killer (NK) cells (Leu 7 and Leu II) was noted. In addition, these emergent lymphocytes, unlike most T cells, lacked acid alpha-naphthyl esterase activity. In functional studies, exercise led to significantly greater NK activity but. in spite of altering the distribution of lymphocyte subpopulations. there was no detectable change in the proliferative response to the T cell mitogen. concanavalin A, over a wide range of cell concentration, mitogen dose and time. The numbers of low density macrophages and dendritic cells increased concomitantly with the increase in total lymphocytes. We conclude that exercise increases the proportion of circulating NK cells and cells expressing the Leu 2a phenotype. [ABSTRACT FROM AUTHOR]

Differential scanning calorimetry and thermogravimetric analysis curves were obtained for cotton cellulose in the presence of both flame-retarding and nonflame-retarding compounds and evaluated quantitatively for ΔH, activation energy, total weight loss, and char remaining after pyrolysis. Twenty-three compounds were tested and were found to fall roughly into three groups: (I) those which do not undergo decomposition in the temperature interval in which cellulose decomposes (200-400°C); (II) those which decompose appreciably during or preceding this temperature range; and (III) those which do not interact in any way with cellulose. It was found that, with increasing molar add-on, heat liberated from cellulose decreased for group I, increased for group II, and was not a function of molar add-on for III.A study of the kinetics of decomposition for these systems indicates that, while the majority of reactions proceeded as a pseudo first-order process, there are several exceptions to the trend. As would be expected for a first-order process, activation energy was found to decrease with increasing flame retardancy.Further, it has been observed that the addition to cellulose of any of the compounds from the first two groups lowers the onset temperature of decomposition and the temperature at which the first major weight loss begins. This temperature decrease approaches some type of limiting value for all the compounds, and varies from compound to compound. In addition, a large increase in remaining char results from a very small add-on, and this, too, tends to approach a limiting value as add-on increases. [ABSTRACT FROM PUBLISHER]