Costs incurred by outpatient surgical centers in managing postoperative nausea and vomiting

STUDY OBJECTIVE: To estimate the financial costs incurred by outpatient surgical centers in managing postoperative nausea and vomiting (PONV). DESIGN: Prospective, observational study. SETTING: 6 hospital-based outpatient surgery centers. PATIENTS: 211 adult patients undergoing outpatient surgery for laparoscopy, dilatation and curettage, knee arthroscopy, or hernia repair. MEASUREMENTS AND MAIN RESULTS: Of the 211 patients studied, 34 experienced PONV in the recovery room. For those patients experiencing PONV, personnel, supply, and drug costs for management of this condition averaged $14.94 per patient. In addition, PONV increased the centers' operating costs by delaying patient discharge by an average of 24 minutes. A minimum estimate of this cost, based on nurses' wage rates, was $7.12. This estimate is appropriate only for short-run considerations in outpatient surgery centers that operate at low capacity. An appropriate valuation for long-run considerations and for centers operating near capacity is based on the revenue that centers lose as a result of extended stays. Lost revenue was estimated to be $415 per patient experiencing PONV. CONCLUSIONS: PONV substantially increases the costs incurred by outpatient surgical centers.     

Caspase-independent cell death induced by anti-CD2 or staurosporine in activated human peripheral T lymphocytes

We examined the effects of the cell-permeable, broad spectrum peptide caspase inhibitors, benzyloxycarbonyl-Val-Ala-Asp(OMe)-fluoromethyl ketone (Z-VAD.fmk), and BOC-Asp(OMe)-fluoromethyl ketone (BOC-D.fmk), on apoptosis induced by anti-CD2, anti-Fas, and the protein kinase inhibitor staurosporine in activated human peripheral T lymphocytes. We monitored ultrastructural, flow cytometric, and biochemical apoptotic changes, including externalization of phosphatidylserine, cleavage of poly(ADP-ribose) polymerase (PARP) and lamins, activation of caspase-3 and caspase-7, decrease in mitochondrial membrane potential, and DNA fragmentation. Z-VAD.fmk and BOC-D.fmk completely inhibited all the biochemical and ultrastructural changes of apoptosis in anti-Fas-treated cells. In marked contrast, neither Z-VAD.fmk nor BOC-D.fmk inhibited CD2- or staurosporine-mediated cell shrinkage, dilatation of the endoplasmic reticulum (seen in anti-CD2-treated cells), externalization of phosphatidylserine, and loss of mitochondrial membrane potential that accompanied cell death. However, these inhibitors did inhibit the cleavage of PARP and lamins and the formation of hypodiploid cells, and partially inhibited chromatin condensation. These results demonstrate that in activated T cells, anti-CD2 and staurosporine induce a caspase-independent cell death pathway that exhibits prominent cytoplasmic features of apoptosis. However, caspase activation is required for the proteolytic degradation of nuclear substrates such as PARP and lamins together with the DNA fragmentation and extreme chromatin condensation that occur in apoptotic cells.     

Left ventricular malposition of a transvenous cardioverter defibrillator lead: a 3-year follow-up

A case of left ventricular malposition of a transvenous implantable cardioverter defibrillator lead through an atrial septal defect is presented. The patient has been continually anticoagulated with warfarin. A 3-year follow-up has thus far been uneventful.     

On the physical mechanism of the NROM memory erase

The purpose of this paper is to investigate the physical mechanism of NROM memory erase. Three conduction mechanisms potentially responsible of NROM erase will be analyzed (tunneling and emission of electrons through both bottom and top oxide, tunneling and injection of holes over the bottom oxide barrier) by means of standard two-dimensional simulations and ad-hoc models reproducing hole and electron transport mechanisms across the oxide not included in standard device simulators. Hot-hole injection will be identified as the actual conduction mechanism of NROM erase, and two compact models capable to describe the main characteristics of NROM erase current will be developed.     

Die bei beginnender Fleischf?ulnis auftretenden chemischen und physiko-chemischen Ver?nderungen

Ohne Zusammenfassung     

具有远程服务设施的染色机控制系统

由于生态和经济上的原因，通过新型机器控制器对染色过程进行精确的控制是必须的。除了复杂的算法，传感器和传动装置的应用日益增加，这样就需要合格的服务员工，否则就不能做到这一点。远程服务能够帮助解决这个问题．本文介绍了以Then-Dyne控制器和TDS管理器的复合系统为代表的远程控制系统。     

On ACK filtering on a slow reverse channel

Acknowledgement (ACK) filtering has been proposed as a technique to alleviate the congestion at the input of a slow channel located on the reverse path of a TCP connection. Old ACKs waiting at the input of the slow channel are erased when new ACKs are to be queued. In the literature the case of one‐ACK per connection at a time has been studied. In this paper we show that this is too aggressive for short transfers where ACKs arrive in bursts due to the slow start phase, and where the TCP source needs to receive the maximum number of ACKs to increase fast its window. We study first static filtering where a certain ACK queue length is allowed. We show analytically how this length needs to be chosen. We present then some algorithms that adapt the filtering of ACKs as a function of the slow channel utilization rather than the ACK queue length. These algorithms provide a good compromise between reducing the ACK queueing delay and passing a large number of ACKs that guarantee a fast window increase. Copyright © 2003 John Wiley & Sons, Ltd.     

Equilibrium, Games, and Pricing in Transportation and Telecommunication Networks

Network equilibrium models that have traditionally been used for transportation planning have penetrated in recent years to other scientific fields. These models have recently been introduced in the telecommunication networks literature, as well as in the field of game theory. Researchers in the latter fields are not always aware of the very rich literature on equilibrium models outside of their application area. On the other hand, researchers that have used network equilibrium models in transportation may not be aware of new application areas of their tools. The aim of this paper is to present some central research issues and tools in network equilibria and pricing that could bring closer the three mentioned research communities.