Breath and blood ethanol following use of a cough-cold preparation

All leaders in health care today are charged with the responsibility of transforming present practices into new and different ones that are needed for the future. The structural side of transforming is ultimately easier than the human side. However, the most frequent failures come from not concentrating sufficiently on the behavioral side of the change. Structural and psychological change must occur simultaneously and embrace each other for best results.     

Structural and electrophysiological analysis of annexin V mutants. Mutagenesis of human annexin V, an in vitro voltage-gated calcium channel, provides information about the structural features of the ion pathway, the voltage sensor and the ion selectivity filter

Annexin V binds to phospholipids in a calcium-dependent manner and exhibits calcium channel activity in vitro. We prepared a variety of mutants yielding information about the structure-function relationship of the ion channel activity. All mutants were characterized by X-ray crystallography, electron microscopy and electrophysiological measurements. Their structures are insignificantly changed whereas their electrophysiological properties are drastically different. Glu95, located in the central hydrophilic pore of the molecule, is crucial for the ion selectivity filter as its exchange leads to reduced calcium and increased sodium conductance. The removal of Glu17, located on the protein surface and far from the ion conduction pathway, leads to the appearance of a second conductance level of 9 pS in addition to the conductance level of about 30 pS in the wild-type molecule. This was also the case for Glu78, which is part of a weak calcium binding site. The exchange of Glu17 and Glu78 produced a mutant retaining only the smaller conductance level. We conclude that these two residues influence the angle between the two halves of the molecule, which determines the diameter of the ion conduction pathway, thereby leading to the occurrence of a second conductance level.     

The formalization and analysis of a communications protocol

The MSMIE protocol [SBC89] allows processors in a distributed system to communicate via shared memory. It was designed to meet the reliability and efficiency needs of applications such as nuclear safety systems. We present a formal model of the MSMIE protocol expressed in the notation CCS. Desirable properties of the protocol are expressed in the modal mu-calculus, an expressive modal logic. We show that the protocol lacks an important liveness property. In actual operation, additional operating constraints are checked to avoid potential problems. We present a modified protocol and show that it possesses the liveness property even without checking operating constraints. We also show how parts of the analysis were automated with the Concurrency Workbench.     

Serum amyloid P component scintigraphy and turnover studies for diagnosis and quantitative monitoring of AA amyloidosis in juvenile rheumatoid arthritis

OBJECTIVE: To evaluate aspects of the natural history of AA amyloidosis complicating juvenile rheumatoid arthritis (JRA), and its response to therapy with chlorambucil. METHODS: Scintigraphy and 7-day turnover studies were performed in JRA patients with histologically proven (n = 35) or clinically suspected (n = 30) AA amyloidosis, following intravenous injection of 123I and 125I-labeled serum amyloid P component (SAP). Prospective monitoring studies were performed over 2-3 years in 20 patients with amyloidosis. All but 2 amyloidosis patients were treated with chlorambucil. RESULTS: Positive scanning results were obtained in all patients in whom imaging was performed within 12 years of positive biopsy findings of amyloid and in 5 patients with clinically suspected amyloidosis. Negative scanning results with normal SAP metabolism, indicating regression of amyloid, were obtained in 4 patients whose amyloidosis had been in full clinical remission for more than 12 years. Prospective monitoring studies in patients whose JRA-associated inflammatory activity was in remission demonstrated regression of amyloid in 8 patients and no substantial changes in 8 others; however, in 4 further patients with active inflammation, there was accumulation of amyloid. There was a very poor correlation between the amount of amyloid present at a particular site and the resultant organ dysfunction. CONCLUSION: Radiolabeled SAP scintigraphy and turnover studies are useful complementary tools in the diagnosis, screening, and quantitative monitoring of type AA amyloidosis in JRA. The amyloid deposits may progress and/or regress at different rates in different anatomic sites over short periods.     

The role of examples and rules in the acquisition of a cognitive skill

In 3 experiments, participants memorized 8 examples, each exemplifying a different rule. Participants were asked to extend these rules to new examples. They practiced applications of the rules to examples over a period of 4 days (Experiment 1) or 5 days (Experiments 2 and 3). Although these rules were bidirectional, an asymmetry gradually built up such that participants became more facile in using the rules in the practiced direction. Participants also showed an advantage when the initial study example was repeated or when test examples were repeated. It is argued that skill acquisition involves development of a complex set of strategies based on use of rules and retrieval of examples. Four overlapping stages of skill acquisition are described.     

Impact and penetration by L/D ≤ 1 projectiles

Calculations of steel target penetration by L/D ≤ 1 tungsten and tungsten alloy projectiles have been extended to L/D = 1/32 over the velocity range 1.5 to 5 km/s. The ratio of crater to projectile diameter tends to 1 as L/D decreases over this entire velocity range. For impact velocities of 1.5 and 3 km/s, penetration depth normalized by projectile length, P/L, increases with decreasing projectile L/D up to a maximum value and then decreases for still lower L/D. Experiments at impact velocities of 2 and 3 km/s confirm these results. For 5 km/s impact velocity, the calculations show P/L increasing with decreasing projectile L/D over the entire range 1/32 ≤ L/D ≤ 1. The projectile L/D for which the maximum P/L occurs appears to depend on the impact velocity. P/L generally scales with impact velocity as P/L v^f(L/D) where f(L/D) ranges from 0 for a long rod to, we believe, 2 in the limit as projectile L/D approaches zero. The calculations show for 1/8 ≤ L/D ≤ 1/2, P/L v^0.9; for L/D = 1/16, P/L v^1.5; and for L/D = 1/32, the new results give P/L v^1.9.     

Guest Editors' Introduction: Machine Ethics

Machine ethics is concerned with how machines behave toward human users and other machines. It aims to create a machine that's guided by an acceptable ethical principle or set of principles in the decisions it makes about possible courses of action it could take. As ethics experts continue to progress toward consensus concerning the right way to behave in ethical dilemmas, the task for those working in machine ethics is to codify these insights. Eight articles in this special issue address the issues.This article is part of a special issue on Machine Ethics.     

Bilateral control of teleoperators with time delay

A control law for teleoperators is presented which overcomes the instability caused by time delay. By using passivity and scattering theory, a criterion is developed which shows why existing bilateral control systems are unstable for certain environments, and why the proposed bilateral control law is stable for any environment and any time delay. The control law has been implemented on a single-axis force-reflecting hand controller, and preliminary results are shown. To keep the presentation clear, a single-degree-of-freedom (DOF) linear time-invariant (LTI) teleoperator system is discussed. Nevertheless, results can be extended, without loss of generality, to an n-DOF nonlinear teleoperation system     

The integrated academic information management system at Columbia-Presbyterian Medical Center.

Over the past seven years, Columbia-Presbyterian Medical Center has been planning and implementing an integrated academic information management system. Accomplishments to date include establishing an institutional information architecture, installing a campus-wide network of workstations, recruiting the staff needed to develop and implement the system, and developing various applications. This paper presents the rationale and steps involved in these accomplishments, as well as data on use of the system so far.