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61.
The article describes the experience of implementing patient-focused care from a physician's perspective. Pitfalls that guarantee failure are presented, many of which are avoidable with early participation by all parties involved: administrators, nursing staff, physicians, and patients. Contamination of the process with downsizing needs, lack of support for staff in dealing with necessary change, loss of administrative commitment, and withholding of appropriated funds are among the key errors to be avoided.  相似文献   
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Using the fear-potentiated startle paradigm in rats, 4 experiments examined whether the inhibitory effect of a feature is evident after its offset following serial feature-negative discrimination training (A+ and X-->A-). When startle probes were presented shortly after the offset of X on X-->A test trials, the inhibitory properties of X were observed immediately after its offset. Furthermore, trace reinforcement of X (X-->+), but not delay reinforcement (X+), disrupted the ability of X to inhibit fear-potentiated startle on X-->A trials. Trace conditioning to X was also retarded after A+ and X-->A- training. These results suggest that the inhibitory properties of the serially trained feature are present after its offset and raise the possibility that either temporal information regarding nonreinforcement or poststimulus attributes of X acquire inhibitory properties.  相似文献   
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This paper presents a new self-routing packet network called the plane interconnected parallel network (PIPN). In the proposed design, the traffic arriving at the network is shaped and routed through two banyan network based interconnected planes. The interconnections between the planes distribute the incoming load more homogeneously over the network. The throughput of the network under uniform and heterogeneous traffic requirements is studied analytically and by simulation. The results are compared with the results of the baseline network and another banyan network based parallel interconnection network. It is shown that, for the proposed design, a higher degree of heterogeneity results in better performance  相似文献   
65.
This paper presents the design criteria, procedure, and implementation of a soft-switched power-factor-correction (PFC) circuit based on the extended-period quasi-resonant (EPQR) principles. All power electronic devices including switches and diodes in the circuit are fully soft switched. The design method is demonstrated in a prototype circuit. The operating principles are confirmed with computer simulation and experimental results. A comparison of the EP-QR operation and zero-voltage-transition (ZVT) pulse-width modulation (PWM) method  相似文献   
66.
A comprehensive survey of photosensitivity in silica glasses and optical fiber is reviewed. Recent work on understanding the mechanisms contributing to germanium or aluminum doped fiber photosensitivity is discussed within the framework of photoelastic densification models  相似文献   
67.
The three-dimensional structure of glutathione S-transferase from Arabidopsis thaliana has been solved at 2.2 A resolution (Reinemer et al., 1996). The enzyme forms a dimer of two identical subunits. The structure shows a new G-site architecture and a novel and unique dimer interface. Each monomer of the protein forms a separate G-site. Therefore, the requirements on the dimer interface are reduced. As a consequence, the interactions between the monomers are weaker and residues at the dimer interface are more variable. Thus, the dimer interface looses its relevance for a classification of plant glutathione S-transferases and the formation of heterodimers becomes even more difficult to predict.  相似文献   
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Malignant bone pain: pathophysiology and treatment   总被引:1,自引:0,他引:1  
2-acetyl aminofluorene (AAF) reacts in acidic conditions with nitrous fume yielding N-nitroso-AAF (N-NO-AAF), as previously described, that exerts more toxic and mutagenic effects than its parental compound. In this study, the effect of sodium nitrite (NaNO2) on the tumorigenicity of AAF in rats fed with AAF and NaNO2 was observed. Wistar rats were divided into five groups: group I served as control; group II were treated with NaNO2 (0.3%); group III was given 0.02% AAF alone; groups IV and V received both AAF and NaNO2 (0.2 and 0.3% respectively) in their diet for 12 weeks. At the end of the experiment, all rats in groups III, IV and V developed early stage phenomena of hepatocellular carcinoma, including hepatomegaly with variable-sized foci and neoplastic nodules. Severe damage was observed in the rats treated with AAF and NaNO2. Feeding of AAF (0.02%) for 3 months elevated the levels of c-Fos, c-Jun and c-Myc proteins in the rat livers. The AAF-induced c-Jun, c-Fos and c-Myc expressions were significantly magnified (P < 0.001) by NaNO2. These data confirmed that the strengthening of AAF-induced hepatocarcinogenesis by NaNO2 should be associated with its enhancing effect on the AAF-induced increases in the expressions of c-Jun, c-Fos and c-Myc.  相似文献   
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