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The in-situ X-ray diffraction approach is employed to explain the various reaction pathways of the Ba[CO.sub.3]-Ce[O.sub.2]-[In.sub.2][O.sub.3] and Ce[O.sub.2]-[In.sub.2][O.sub.3] systems. The formation and the properties of these structures are also analyzed.

Supplemental Digital Content is available in the text Objectives: To determine whether racial/ethnic disparities in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among universally insured older adult (≥65 years) emergency general surgery patients; vary by diagnostic category; and can be explained by variations in geography, teaching status, age-cohort, and a hospital's percentage of minority patients. Summary of Background Data: As the US population ages and discussions surrounding the optimal method of insurance provision increasingly enter into national debate, longer-term outcomes are of paramount concern. It remains unclear the extent to which insurance changes disparities throughout patients' postacute recovery period among older adults. Methods: Survival analysis of 2008 to 2014 Medicare data using risk-adjusted Cox proportional-hazards models. Results: A total of 6,779,649 older adults were included, of whom 82.8% identified as non-Hispanic white (NHW), 9.2% non-Hispanic black (NHB), 5.6% Hispanic, and 1.5% non-Hispanic Asian (NHA). Relative to NHW patients, each group of minority patients was significantly less likely to die [30-day NHB vs NHW hazard ratio (95% confidence interval): 0.88 (0.86–0.89)]. Differences became less apparent as outcomes approached 180 days [180-day NHB vs NHW: 1.00 (0.98–1.02)]. For major morbidity and unplanned readmission, differences among NHW, Hispanic, and NHA patients were comparable. NHB patients did consistently worse. Efforts to explain the occurrence found similar trends across diagnostic categories, but significant differences in disparities attributable to geography and the other included factors that combined accounted for up to 50% of readmission differences between racial/ethnic groups. Conclusion: The study found an inversion of racial/ethnic mortality differences and mitigation of non-NHB morbidity/readmission differences among universally insured older adults that decreased with time. Persistent disparities among nonagenarian patients and hospitals managing a regionally large share of minority patients warrant particular concern. [ABSTRACT FROM AUTHOR]

Objectives: Following calls from the National Institutes of Health and American College of Surgeons for "urgently needed" research, the objectives of the present study were to (1) ascertain whether differences in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among adult (18-64 yr) and older adult (≥65 yr) emergency general surgery (EGS) patients; (2) vary by diagnostic category; and (3) are explained by variations in insurance, income, teaching status, hospital EGS volume, and a hospital's proportion of minority patients. Background: Racial/ethnic disparities have been described in in-hospital and 30-day settings. How longer-term outcomes compare--a critical consideration for the lived experience of patients--has, however, only been limitedly considered. Methods: Survival analysis of 2007 to 2011 California State Inpatient Database using Cox proportional hazards models. Results: A total of 737,092 adults and 552,845 older adults were included. In both cohorts, significant differences in 30/90/180-day mortality, major morbidity, and unplanned readmissions were found, pointing to persistently worse outcomes between non-Hispanic Black and White patients [180-d readmission hazard ratio (95% confidence interval):1.04 (1.03-1.06)] and paradoxically better outcomes among Hispanic adults [0.85 (0.84-0.86)] that were not encountered among Hispanic older adults [1.06 (1.04-1.07)]. Stratified results demonstrated robust morbidity and readmission trends between non-Hispanic Black and White patients for the majority of diagnostic categories, whereas variations in insurance/income/teaching status/EGS volume/proportion of minority patients all significantly altered the effect--combined accounting for up to 80% of risk-adjusted differences between racial/ethnic groups. Conclusions: Racial/ethnic disparities exist in longer-term outcomes of EGS patients and are, in part, determined by differences in factors associated with emergency care. Efforts such as these are needed to understand the interplay of influences--both in-hospital and during the equally critical, postacute phase--that underlie disparities' occurrence among surgical patients. [ABSTRACT FROM AUTHOR]

Objective: To examine differences in patient outcomes across Traumatic Brain Injury Model Systems (TBIMS) rehabilitation centers and factors that influence these differences using hierarchical linear modeling (HLM). Setting: Sixteen TBIMS centers. Participants: A total of2056 individuals 16years or older with moderate to severe traumatic brain injury (TBI) who received inpatient rehabilitation. Design: Multicenter observational cohort study using HLM to analyze prospectively collected data. Main Outcome Measures: Functional Independence Measure and Disability Rating Scale total scores at discharge and 1 year post-TBI. Results: Duration of posttraumatic amnesia (PTA) demonstrated a significant inverse relationship with functional outcomes. However, the magnitude of this relationship (change in functional status for each additional day in PTA) varied among centers. Functional status at discharge from rehabilitation and at 1 year post-TBI could be predicted using the slope and intercept of each TBIMS center for the duration ofPTA, by comparing it against the average slope and intercept. Conclusions: HLM demonstrated center effect due to variability in the relationship between PTA and functional outcomes of patients. This variability is not accounted for in traditional linear regression modeling. Future studies examining variations in patient outcomes between centers should utilize HLM to measure the impact of additional factors that influence patient rehabilitation functional outcomes. [ABSTRACT FROM AUTHOR]

Objective To compare patient functional outcomes across Traumatic Brain Injury Model Systems (TBIMS) rehabilitation centers using an enhanced statistical model and to determine factors that influence those outcomes. Design Multicenter observational cohort study. Setting TBIMS centers. Participants Patients with traumatic brain injury (TBI) admitted to 19 TBIMS rehabilitation centers from 2003–2012 (N=5505). Interventions Not applicable. Main Outcome Measures Functional outcomes of patients with TBI. Results Individuals with lower functional status at the time of admission, longer duration of posttraumatic amnesia, and higher burden of medical comorbidities continued to have worse functional outcomes at discharge from inpatient rehabilitation and at the 1-year follow-up, whereas those who were employed at the time of injury had better outcomes at both time periods. Risk-adjusted patient functional outcomes for patients in most TBIMS centers were consistent with previous research. However, there were wide performance differences for a few centers even after using more recently collected data, improving on the regression models by adding predictors known to influence functional outcomes, and using bootstrapping to eliminate confounds. Conclusions Specific patient, injury, and clinical factors are associated with differences in functional outcomes within and across TBIMS rehabilitation centers. However, these factors did not explain all the variance in patient outcomes, suggesting a role of some other predictors that remain unknown. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a significant public health problem in the US. Specific preexisting medical illnesses delay recovery after TBI and increase mortality or risk of repeat TBI. This study examined the impact of preexisting illness and substance use on patient rehabilitation outcomes following TBI. The Functional Independence Measure total score and Disability Rating Scale score measured functional outcomes at discharge from inpatient rehabilitation, while the Trail Making Test A and B and Total Trials 1-5 of the California Verbal Learning Test-II measured neuropsychological outcomes in 128 TBI survivors with moderate or severe TBI. Results showed that the presence of a heart condition or diabetes/high blood sugar was associated with lower functional outcomes by discharge. A history of a heart condition, stroke, or respiratory condition prior to TBI was associated with reduced cognitive flexibility. Those with preexisting diabetes/high blood sugar demonstrated poorer visual attention, visuomotor processing speed, and ability to learn and recall verbal information. Those with pre-TBI cancer also had greater auditory-verbal memory deficits. The findings showed that specific preexisting medical conditions are independently associated with lower functional and cognitive outcomes for patients with TBI. By screening patients for preexisting medical conditions, multidisciplinary TBI rehabilitation teams can identify patients who require more aggressive treatments or greater length of stay. [ABSTRACT FROM AUTHOR]

Intermediate temperature solid-oxide fuel cells (IT-SOFCs) ), as one of the energy conversion devices, have attracted worldwide interest for their great fuel efficiency, low air pollution, much reduced cost and excellent longtime stability. In the intermediate temperature range (500–700 °C), SOFCs based on proton conducting electrolytes (PSOFCs) display unique advantages over those based on oxygen ion conducting electrolytes. A key obstacle to the practical operation of past P-SOFCs is the poor stability of the traditionally used composite cathode materials in the steam-containing atmosphere and their low contribution to proton conduction. Here we report the identification of a new Ruddlesden–Popper-type oxide Sr3Fe2O7−δ that meets the requirements for much improved long-term stability and shows a superior single-cell performance. With a Sr3Fe2O7−δ-5 wt% BaZr0.3Ce0.5Y0.2O3−δ cathode, the P-SOFC exhibits high power densities (683 and 583 mW cm−2 at 700 °C and 650 °C, respectively) when operated with humidified hydrogen as the fuel and air as the cathode gas. More importantly, no decay in discharging was observed within a 100 hour test. [ABSTRACT FROM AUTHOR]

A proton-conducting solid oxide electrolysis cell using an Y-doped BaZrO3 electrolyte film, which has been demonstrated to be chemically stable, was successfully fabricated for the first time and showed a promising electrolysis performance. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To measure patient functional outcomes across rehabilitation centers. SETTING: Traumatic Brain Injury Model System (TBIMS) centers. PARTICIPANTS: Patients with traumatic brain injury (TBI) admitted to 21 TBIMS rehabilitation centers (N = 6975, during 1999-2008). DESIGN: Retrospective analysis of prospectively collected data. MAIN MEASURES: Center-specific functional outcomes of TBI patients using Functional Independence Measure, Disability Rating Scale, and Glasgow Outcome Scale-Extended. RESULTS: There were large differences in patient characteristics across centers (demographics, TBI severity, and functional deficits at admission to rehabilitation). However, even after taking those factors into account, there were significant differences in functional outcomes of patients treated at different TBIMS centers. CONCLUSION: There are significant differences in functional outcomes of TBI patients across rehabilitation centers. [ABSTRACT FROM AUTHOR]

We report the formation, structures, temperature- dependent phase transitions, and high-temperature reactivity o f the potential proton and oxide ion conductors BaCe1-xMxO3 (M3+ = In3+, La3+). The present in situ diffraction studies show oxidative platinum uptake at temperatures as low as 950 °C into BaCeO3, forming the cubic Ba2CePtO6 double perovskite. The transient B-site double perovskite expels platinum at around 1200-1250 °C. Platinum oxidation via BaCeO3 is investigated by in situ powder X-ray and neutron diffraction experiments in various atmospheres. Doped BaCe1-xMxO3 phases show the formation o f Ba2CePtO6 without incorporating the M3+ dopant Oxidative platinum uptake is also observed during the synthesis o f BaCeO3 on platinum metal. We report the reaction pathway for the low-temperature oxidative formation o f Ba2CePtO6 and the subsequent liberation o f platinum for the barium cerate system. The findings are supported by ambient-temperature X-ray diffraction, in situ powder X-ray, and powder neutron diffraction as well as XPS. [ABSTRACT FROM AUTHOR]