Housing Singapore's frail elderly in the next millennium

This paper looks at the design of housing for an ageing population in the coming years, particularly the frail elderly, and at criteria which an architect would need to apply to provide for their social needs and various physical disabilities which may accompany old age. Recent local and overseas initiatives in providing special housing for elderly people are discussed and some proposals are made for more universal solutions, in the form of "lifetime homes".     

The role of nitric oxide in inhibitory neurotransmission in the middle cerebral artery of the sheep

We examined the pregnancy outcome of 112 women classified as minor degrees of glucose intolerance (MDGI) in pregnancy in a screening program based on Carpenter and Coustan's criteria. The MDGI group comprised 49 women with abnormal oral glucose challenge test (OGCT) followed by normal OGTT (group A), and 63 with "borderline" OGTT (1 abnormal value, group B). No treatment was offered to 88 MDGI women, while 26 received dietary advice and metabolic monitoring. A control group was constituted from 112 age- and BMI-matched negative screenees. Similar rates of cesarean sections and macrosomia, but higher rate of large for gestational age (LGA) babies (25.9% vs 14.3%) were found in MDGI, without difference between groups A and B. When comparing treated and untreated MDGI, lower LGA incidence (11.5% vs 30.2%) and no macrosomia were found in the former. In conclusion, untreated MDGI may present excessive fetal growth, which can be normalized by dietary treatment and metabolic monitoring.     

Toxic effects of deoxynivalenol on ribosomes and tissues of the spring wheat cultivars Frontana and Casavant

The toxic effects of the Fusarium graminearum trichothecene toxin deoxynivalenol were determined on ribosomes and leaf tissues of the fusarium head blight-resistant spring wheat cultivar Frontana and the susceptible spring wheat cultivar Casavant. The use of a poly-U-directed 14C-phenylalanine and deoxynivalenol ribosome-binding assays provided evidence of resistance to the protein-synthesis inhibition effects of deoxynivalenol in the head blight-resistant cultivar Frontana. This is probably due to the existence of a mutation in the peptidyl transferase. This cultivar also exhibited resistance to the membrane-damaging properties of this toxin compared to the other cultivar. This report summarizes the evidence for various kinds of "trichothecene tolerance" mechanisms in fusarium head blight-resistant wheat genotypes.     

Intron "sliding" and the diversity of intron positions

Alignments of homologous genes typically reveal a great diversity of intron locations, far more than could fit comfortably in a single gene. Thus, a minority of these intron positions could be inherited from a single ancestral gene, but the larger share must be attributed to subsequent events of intron gain or intron "sliding" (movement from one position to another within a gene). Intron sliding has been argued from cases of discordant introns and from putative spatial clustering of intron positions. A list of 32 cases of discordant introns is presented here. Most of these cases are found to be artefactual. The spatial and phylogenetic distributions of intron positions from five published compilations of gene data, comprising 205 intron positions, have been examined systematically for evidence of intron sliding. The results suggest that sliding, if it occurs at all, has contributed little to the diversity of intron positions.     

Bilateral posteroventral pallidotomy in advanced Parkinson's disease in three patients

In this report, we describe the effect of staged bilateral posteroventral pallidotomy in three patients with advanced Parkinson's disease who were all of the young-onset type. Two patients had developed response fluctuations after the use of levodopa, with severe hypokinesia, painful dystonia, and rigidity in the "off" phase and violent dyskinesias in the "on" phase. One patient, in a continuous hypokinetic rigid state, was totally unresponsive to dopaminergic medication. All were at Hoehn and Yahr stage 5 in the "off" phase before surgery. After surgery, the hypokinetic state was reversed and dyskinesias were abolished in all patients. Hoehn and Yahr stages were 3 in the "off" phase postoperatively. Overall functional improvement was marked and lasting after follow-up for 7, 12, and 13 months, respectively. Complications were visual field deficit and transient central facial paresis, both in the same patient. Bilateral posteroventral pallidotomy can ameliorate response fluctuations, hypokinesia, rigidity, and painful dystonia in advanced Parkinson's disease.     

Wedge resection versus lobectomy for stage I (T1 N0 M0) non-small-cell lung cancer

BACKGROUND: The role of nonanatomic wedge resection in the management of stage I (T1 N0 M0) non-small-cell lung cancer continues to be debated against the present gold standard of care--anatomic lobectomy. METHODS: We analyzed the results of 219 consecutive patients with pathologic stage I (T1 N0 M0) non-small-cell lung cancer who underwent open wedge resection (n = 42), video-assisted wedge resection (n = 60), and lobectomy (n = 117) to assess morbidity, recurrence, and survival differences between these approaches. RESULTS: There were no differences among the three groups with regard to histologic tumor type. Analysis demonstrated the wedge resection groups to be significantly older and to have reduced pulmonary function despite a higher incidence of treatment for chronic obstructive pulmonary disease when compared with patients having lobectomy. The mean hospital stay was significantly less in the wedge resection groups. There were no operative deaths among patients having wedge resection; however, a 3% operative mortality occurred among patients having lobectomy (p = 0.20). Kaplan-Meier survival curves were nearly identical at 1 year (open wedge resection, 94%; video-assisted wedge resection, 95%; lobectomy, 91%). At 5 years survival was 58% for patients having open wedge resection, 65% for those having video-assisted wedge resection, and 70% for those having lobectomy. Log rank testing demonstrated significant differences between the survival curves during the 5-year period of study (p = 0.02). This difference was a result of a significantly greater non-cancer-related death rate by 5 years among patients having wedge resection (38% vs 18% for those having lobectomy; p = 0.014). CONCLUSION: Wedge resection, done by open thoracotomy or video-assisted techniques, appears to be a viable "compromise" surgical treatment of stage I (T1 N0 M0) non-small-cell lung cancer for patients with cardiopulmonary physiologic impairment. Because of the increased risk for local recurrence, anatomic lobectomy remains the surgical treatment of choice for patients with stage I non-small-cell lung cancer who have adequate physiologic reserve.     

Is the Strategic Asset Seeking Investment Proclivity of Chinese MNEs Different to that of Developed Market MNEs? A Comparative Analysis of Location Choice and Orientation

Do emerging market MNEs acquire strategic assets in psychically distant developed markets to augment the firm-specific advantages they lack? This question is central to current conceptual discussion of their FDI strategies. To date, however, empirical testing has focused on emerging market MNE FDI location choices in isolation to indirectly infer facts about strategic asset seeking orientation. There are two weaknesses with this approach. First, comparative analysis with developed market MNEs is limited. Second, the focus on geographical location choices does not account for important direct, firm-level evidence on the strategic assets found in foreign subsidiaries. To address these gaps, we first undertake a comparative location choice study of Chinese MNE and developed market MNE FDI in the US. Second, we test corresponding firm-level US subsidiary data using logit modelling to explore whether there are differences between Chinese and developed market MNEs. Our results indicate similarities, rather than differences, in the strategic asset seeking behavior of Chinese and developed market MNEs. This calls into question whether theoretical extension is necessary to explain the behavior of emerging market MNEs as well as the value of indirect, location choice approaches to the analysis of strategic asset seeking FDI.     

Glutathione levels in antigen-presenting cells modulate Th1 versus Th2 response patterns

Current thinking attributes the balance between T helper 1 (Th1) and Th2 cytokine response patterns in immune responses to the nature of the antigen, the genetic composition of the host, and the cytokines involved in the early interaction between T cells and antigen-presenting cells. Here we introduce glutathione, a tripeptide that regulates intracellular redox and other aspects of cell physiology, as a key regulatory element in this process. By using three different methods to deplete glutathione from T cell receptor transgenic and conventional mice and studying in vivo and/or in vitro responses to three distinct antigens, we show that glutathione levels in antigen-presenting cells determine whether Th1 or Th2 response patterns predominate. These findings present new insights into immune response alterations in HIV and other diseases. Further, they potentially offer an explanation for the well known differences in immune responses in "Th1" and "Th2" mouse strains.     

EXAMINING THE ROLE OF CUTTING FLUIDS IN MACHINING AND EFFORTS TO ADDRESS ASSOCIATED ENVIRONMENTAL/HEALTH CONCERNS

ABSTRACT

Cutting fluids have seen extensive use and have commonly been viewed as a required addition to high productivity and high quality machining operations. Cutting fluid related costs and health concerns associated with exposure to cutting fluid mist and a growing desire to achieve environmental sustainability in manufacturing have caused industry and academia to re-examine the role of these fluids and quantify their benefits. This work summarizes the traditional purposes of cutting fluids and reports on recent analytical and experimental research to critically examine these functions. To minimize or even eliminate the concerns associated with cutting fluid usage, several recent and novel approaches have been proposed and are examined.     

The further development of the active urine collection device: a novel continence management system

Continence difficulties affect the lives of a substantial minority of the population. Women are far more likely than men to be affected by urinary incontinence but the range of management options for them is limited. There has been considerable interest in developing an external urine collection system for women but without success to date. This paper describes the development and preliminary clinical testing of an active urine collection device (AUCD), which could provide a solution for sufferers. The device uses stored vacuum, protected by a high bubble point filter, to remove urine as quickly as it is produced. This allows a small battery-operated pump to provide the required vacuum, enabling the device to be portable. Two different types of non-invasive patient/device interface were developed, and tested by volunteers: urinal and small pad. The slimline urinal was popular with users although liquid noise was a problem. The pad interface was successful on occasions but further work is necessary to produce a reliable pad. This study has successfully demonstrated that a prototype AUCD liquid handling system can remove urine at clinically relevant flowrates. While further development is required, volunteer tests have shown that the AUCD could be a useful advance in continence management.