CMA-sponsored Task Force on the Allocation of Health Care Resources.

Hurray for the Canadian Medical Association! They have just released Health: A Need for Redirection, the report of a Task Force on the Allocation of Health Care Resources. The task force, headed by Joan Watson, the former hostess of CBC's "Marketplace," included the Honourable Pauline McGibbon, former lieutenant-governor of Ontario, Roy Romanow, former NDP attorney general of Saskatchewan, and two physicians, John O'Brien-Bell and Leon Richard. The purpose of the task force was to examine the allocation of health care resources in the face of an increasing elderly population and the explosion of new technology. The report could help shape the future of the health care system. The report makes it clear that the health system is in crisis and the reform of the health system needs us all, as both active professionals and critical consumers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adaptive control of speed and equivalence ratio dynamics of adiesel driven power-plant

A method of modeling, involving approximation of dead-times, is presented for diesel driven power prime-movers. The resulting predictive adaptive control scheme is compared to a conventional PI scheme on the basis of common disturbances encountered by a practical prime-mover. It is found that the adaptive scheme achieves significant improvement despite the nonlinearities introduced by turbocharger operation. It is observed in general that adaptive schemes, such as the one described, affect the prime-mover dynamics in essentially two ways. First, the engine fuel-flow response is improved by better control of the actuator. Secondly, by indirectly controlling the exhaust energy of the plant, the turbocharger air-dynamics is made faster, leading to better dynamic fuel/air ratio. The overall effect is good response of the prime-mover speed notwithstanding the fact that the diesel prime-mover is a low inertia structure and that the system parameters suffer from various nonlinear variations     

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. The authors classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns?=?10 and 10) and nongeneralized social phobics without APD (n?=?10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with AD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information, but the additional diagnosis of APD may simply identify a severe subgroup of social phobics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of dietary fish oil supplementation on peroxidation of serum lipids in patients with non-insulin dependent diabetes mellitus

Target 17 of the Health Policy for Europe calls for the health-damaging consumption of dependence-producing substances such as alcohol, tobacco and psychoactive substances to be significantly reduced in all Member States between the year 1980 and the year 2000. With regard to alcohol, it is suggested that alcohol consumption be reduced by 25%, with particular attention to reducing harmful use. A question posed by a number of Member States is what is the level of per capita alcohol consumption of lowest risk to physical, psychological and social harm. A working group was convened to consider population levels of alcohol consumption with particular reference to the Member States of the European Region of WHO. A basis for understanding population problem experience can be established through the interaction between individual risk and distribution of consumption levels within the population. The working group concluded that public health policy within the European Region should continue to advise decreases of per capita consumption. Even when taking into account coronary heart disease, it can be concluded at the population level, across all ranges of alcohol consumption found in almost all countries of Europe, that a reduction in consumption is linked to better health. However, public health policy concerning alcohol should not be based solely on mortality. All outcomes of drinking, that is mortality, morbidity, social and criminal consequences, as well as quality of life, should be considered. The existing data relating alcohol consumption to health originates from countries primarily with a cultural experience of consuming alcohol. In those countries, where there is a cultural or religious tradition of not consuming alcohol, there can be no public health grounds for recommending alcohol consumption.     

Measurement of Adhesion Between Carbon Fibers and Bismaleimide Resins

The adhesion between carbon fibers and bismaleimide resins was evaluated using the microbond single fiber pull-out test. A commercially-available, methylene dianiline-based bismaleimide resin and a novel phosphorus-containing bismaleimide were tested with as-received and plasma-treated polyacrylonitrile-based carbon fibers. The surface chemical composition, topography, tensile strength, and surface free energy of the carbon fibers were studied using x-ray photoelectron spectroscopy, scanning electron microscopy, single fiber tensile tests, and dynamic contact angle analysis. The carbon fiber-bismaleimide adhesion improved when the carbon fiber received an oxidative commercial surface treatment or was exposed to an air or ammonia plasma prior to bonding.     

Development of a novel microperfusion chamber for determination of cell membrane transport properties

A novel microperfusion chamber was developed to measure kinetic cell volume changes under various extracellular conditions and to quantitatively determine cell membrane transport properties. This device eliminates modeling ambiguities and limitations inherent in the use of the microdiffusion chamber and the micropipette perfusion technique, both of which have been previously validated and are closely related optical technologies using light microscopy and image analysis. The resultant simplicity should prove to be especially valuable for study of the coupled transport of water and permeating solutes through cell membranes. Using the microperfusion chamber, water and dimethylsulfoxide (DMSO) permeability coefficients of mouse oocytes as well as the water permeability coefficient of golden hamster pancreatic islet cells were determined. In these experiments, the individual cells were held in the chamber and perfused at 22 degrees C with hyperosmotic media, with or without DMSO (1.5 M). The cell volume change was videotaped and quantified by image analysis. Based on the experimental data and irreversible thermodynamics theory for the coupled mass transfer across the cell membrane, the water permeability coefficient of the oocytes was determined to be 0.47 micron. min-1. atm-1 in the absence of DMSO and 0.65 microns. min-1. atm-1 in the presence of DMSO. The DMSO permeability coefficient of the oocyte membrane and associated membrane reflection coefficient to DMSO were determined to be 0.23 and 0.85 micron/s, respectively. These values are consistent with those determined using the micropipette perfusion and microdiffusion chamber techniques. The water permeability coefficient of the golden hamster pancreatic islet cells was determined to be 0.27 microns. min-1. atm-1, which agrees well with a value previously determined using an electronic sizing (Coulter counter) technique. The use of the microperfusion chamber has the following major advantages: 1) This method allows the extracellular condition(s) to be readily changed by perfusing a single cell or group of cells with a prepared medium (cells can be reperfused with a different medium to study the response of the same cell to different osmotic conditions). 2) The short mixing time of cells and perfusion medium allows for accurate control of the extracellular osmolality and ensures accuracy of the corresponding mathematical formulation (modeling). 3) This technique has wide applicability in studying the cell osmotic response and in determining cell membrane transport properties.     

Measuring the ability of residents to manage oncologic problems

BACKGROUND: Administration of angiotensin converting enzyme (ACE) inhibitors to patients with congestive heart failure (CHF) is associated to a decrease in the abnormal vasoconstrictor neurohormonal activity. This contributes to the sustained benefits of these drugs on symptoms and survival of patients with CHF. There is little information, however, regarding the effects of ACE inhibition on vasodilator and natriuretic hormones. AIM: To evaluate the chronic effects of enalapril, in addition to digitalis and diuretics in patients with chronic cardiac failure. PATIENTS AND METHODS: Nine patients with an idiopathic dilated cardiomyopathy (8 male, aged 48 to 76 years old) under treatment with digitalis and diuretics, received enalapril 20 mg bid during eight weeks. Before and after this treatment period resting left ventricular ejection fraction, functional class, plasma levels of atrial natriuretic factor and bradykinins (BK) and urinary excretion of kalikreins (BK) and prostaglandin E2 (PGE2) were measured. RESULTS: After enalapril therapy, there was a significant increase in maximal O2 consumption (14.8 +/- 1.2 to 18.6 +/- 1.5 ml/kg/min, p < 0.05) and radionuclide LV ejection fraction (27.4 +/- 1.1 to 31.4 +/- 0.9% p < 0.05). This was associated with a significant decrease in plasma ANP levels (559 +/- 158 to 178 +/- 54.8 pg/ml) and UK (391 +/- 112 to 243 +/- 92 Cu/24 h). CONCLUSIONS: The decrease in ANP levels, which is a well known marker of prognosis in CHF, could contribute to explain the sustained clinical benefits observed with ACE inhibitors in patients with CHF.     

Antibodies capable of releasing diphtheria toxin in response to the low pH found in endosomes

Diphtheria toxin (DT) undergoes a rapid conformational change in response to the acidity encountered within endosomes. That transition is integral to the passage of its catalytic domain into the cytosol and thus its lethal action. The importance of this translocation mechanism led us to develop several monoclonal antibodies that bind DT at neutral pH but spontaneously release the toxin when critical epitopes denature or unfold upon lowering the pH to 4.5-5.5. Hybridomas were selected using a microtiter plate assay that measured the pH-dependent detachment of antibody from immobilized toxin. The acid-sensitive epitopes involved were on the catalytic, transmembrane, and receptor binding domains of DT. This pH-induced disruption of the binding of toxin to these monoclonal antibodies was analyzed by sedimentation velocity ultracentrifugation. Antibody combining sites were fully occupied at pH 5.5, partially bound at pH 5.0, and totally empty at pH 4.5. It was estimated that the Ka for antibody-toxin binding was approximately 1000-fold lower at pH 5.0 than at neutral pH. This novel acid-triggered release mechanism provides a basis for delivery of antibody-bound toxin into cells accompanied by its immediate dissociation as the complex enters acidic vesicles.     

The dielectric behavior of glassy amorphous polymers at 2.45 GHz

The dielectric behavior of glassy thermoplastic polymer in the microwave frequency range was investigated. Specifically, the relationship between energy absorption and temperature for several thermoplastic systems was examined to test the theoretical basis for heating under microwave irradiation. Irradiation under traveling and standing wave conditions were explored. The heating rate versus temperature data at a frequency of 2.45 GHz yielded a microwave calorimetry procedure for examination of the dielectric and relaxation behaviors. Correlations were drawn between (a) the apparent activation energy and the critical temperature, and (b) the shape of the dielectric spectra at 2.45 GHz and its shape in the kHz region. WLF relationships were examined for glassy thermoplastics to show the difference in changing activation energy with temperature.