Resistance to care

Resisting care is defined as any patient behavior which prevents or interferes with the care provider performing or assisting with ADLs for the patient, including bathing, eating, toileting, dressing and grooming. Significant consequences of resisting care include malnutrition, skin breakdown, dehydration, constipation and weight loss. Creativity, flexibility and patience are key components of any intervention. Due to the lability of the person with cognitive impairment, a plan that works perfectly one day may never work again.     

Actions of cisplatin on the electrophysiological properties of cultured dorsal root ganglion neurones from neonatal rats

In this study we have employed the whole cell patch clamp technique to investigate the effects of an anti-cancer drug cisplatin on basic electrophysiological properties of cultured dorsal root ganglion neurones from neonatal rats. The results show that within the clinical concentration range, cisplatin (0.1 to 10 microM) caused a decrease in input conductance, and complex changes in resting membrane potential in these cultured sensory neurones. The dominant effects of cisplatin on input conductance may be due to inhibition of leak conductances. Transplatin (5 microM) was significantly less effective than cisplatin at reducing input conductance which suggests a degree of stereoselectivity. Cisplatin (1 to 5 microM) transiently increased excitability of the cultured neurones as reflected by a reduction in the threshold for activation of action potentials by 8 mV. The rise time, peak amplitude and duration of action potentials were not changed by acute application of 5 microM cisplatin. Long term treatment of neurones with cisplatin (5 microM), for up to 1 week reduced the viability of the cultures, and attenuated neurone excitability, although input conductance of the cells was significantly increased to 322 +/- 49 M omega (n = 9) compared with controls of 210 +/- 20 M omega (n = 30; P < 0.05). Acute and chronic treatment of cultured neurones with cisplatin therefore produced contrasting actions.     

Tumor necrosis factor-alpha-induced apoptosis in a human keratinocyte cell line (HaCaT) is counteracted by transforming growth factor-alpha

Pulmonary surfactant is a complex mixture of lipids and proteins that functions to keep alveoli from collapsing at the end of expiration. Dipalmitoylphosphatidylcholine has been identified as the most important component for lowering surface tension at the air-liquid interface. Hydrophobic surfactant apoproteins, SP-B and SP-C, play essential roles in the biophysical functions of the surfactant phospholipids. Hydrophilic surfactant apoproteins (SP-A and SP-D) that are members of C-type lectin superfamily, interact with phospholipids and glycolipids and modulate host defense functions in the lung. SP-A also plays an important role in regulating phospholipid homeostasis in the alveolar spaces. Recent advances in genetics and molecular biology have clarified the structure-function relationship of surfactant apoproteins.     

The Effects of Scaling and Bias Configuration on Operating-Voltage Constraints in SiGe HBTs for Mixed-Signal Circuits

This paper presents a comprehensive picture of operating-voltage constraints in SiGe heterojunction bipolar transistors, addressing breakdown-related issues as they relate to technology generation, bias configuration, and operating-current density. New definitions for breakdown voltage, adopted from standard measurements, are presented. Practical design implications and physical origins of breakdown are explored using calibrated 2-D simulations and quasi-3-D compact models. Device-level analysis of ac instabilities and power performance, which is relevant to mixed-signal circuit design, is presented, and implications of the relaxed voltage constraints for common-base operation are explored.     

Developing competency-based methods for near-real-time air combat problem solving assessment

Air combat scenarios present unique problems where the solution is not obvious. An advanced networked simulation environment can be used to train high-level cognitive air combat skills such as problem solving. A problem in the development of principled and construct oriented assessment is related to determining the level of specificity of the assessment. We present a detailed discussion of the definition of critical competencies associated with combat mission problem solving performance, and we describe our approach to develop and implement an embedded performance assessment system that maps outcomes to these competencies. Finally, we discuss the implications for our approach for comprehensive assessment and discuss our goals for an evaluation of the competency-based approach to assessment.     

GaAs/AlGaAs grating surface-emitting diode lasers on Si substrates

A monolithic grating surface-emitting, GaAs/AlGaAs, separate-confinement-heterostructure, single-quantum-well diode laser has been fabricated on a Si substrate using a single-step metalorganic chemical vapour deposition process. An output power of 30 mW has been obtained under pulsed operation with a peak emission wavelength of 885 nm.<>     

Effects of benfluorex metabolites on membrane fluidity and insulin-related processes

Hepatocyte growth factor (HGF) is a potent mitogen for the maturation of hepatocytes in vitro which plays a role in liver regeneration in vivo. In addition, transforming growth factor-beta 1 (TGF-beta 1) is also a potent regulator of liver regeneration. In attempting to clarify the mechanisms related to liver regeneration after partial hepatectomy, we investigated the expression of HGF and TGF-beta 1 in rats with liver cirrhosis (LC). A rat model of LC was prepared using carbon tetrachloride (CCl4). The expression of HGF mRNA in both the LC and control groups showed a similar time-course with the highest expression seen at 18h after a 70% hepatectomy. The expression of TGF-beta 1 mRNA peaked at 18h after partial hepatectomy in the LC group and at 48h in the control group. The 5-bromo-2'-deoxyuridine (BrdU) labeling index for the LC group at 24, 48, and 72 h after partial hepatectomy was 9.2%, 5.9%, and 1.8%, while for the control group it was 7.0%, 11.7%, and 6.8%, respectively. The BrdU labeling index in the LC group was thus suppressed earlier than that in the control group. We therefore postulate that regeneration of the remnant liver in the presence of LC accelerates immediately after partial hepatectomy, but the extent of regeneration is insufficient because of an early cessation due to an early expression of TGF-beta 1.