The effects of an outpatient practice guideline at a teaching hospital: a prospective pilot study

BACKGROUND: Platelet-activating factor (PAF) is a bioactive phospholipid which is a potent hypotensive agent. To investigate the role of PAF in renovascular hypertension, we determined the PAF concentration and its production level assessed by the activity of cholinephosphotransferase (CPT) in renal tissue and examined the effect of a PAF antagonist on the mean arterial pressure (MAP) in control and two-kidney with one clipped (2K1C) hypertensive rats. MATERIALS AND METHODS: The concentration of PAF and CPT in the renal medulla and cortex were determined by radioassay. Also, the effect of a PAF antagonist, CV-6209, on MAP was also examined in both 2K1C hypertensive and normal control rats. RESULTS: The PAF concentration and CPT activity were significantly higher in the medulla than in the cortex in both 2K1C hypertensive and normal control rats, and both values in the medulla were also significantly higher in the clipped kidney than in the contralateral unclipped kidney or in control rat kidneys. We also observed a significant negative correlation between the PAF concentration in the medulla, and the medulla weight in the clipped kidney of 2K1C hypertensive rats. Infusion of the PAF antagonist, CV-6209, did not affect MAP in 2K1C hypertensive rats, but was significantly increased (P < 0.05) in control rats. CONCLUSIONS: These findings suggest that PAF, whose production is induced by renal ischemia due to renal artery stenosis, plays an important role in the renomedullary vasodepressor system, but the effect of PAF as a vasodilator in the peripheral vessels is limited in 2K1C hypertension.     

Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups

OBJECTIVES: The National Hospital Discharge Survey (NHDS) was used to evaluate potentially avoidable hospital conditions as an indicator of equity and efficiency in the US health care system. METHODS: With the use of 1990 data from the NHDS, the National Health Interview Survey, and the census, national rates of hospitalization were calculated for avoidable conditions by age, race, median income of zip code, and insurance status. RESULTS: An estimated 3.1 million hospitalizations were for potentially avoidable conditions. This was 12% of all hospitalizations in 1990 (excluding psychiatric admissions, women with deliveries, and newborns). Rates of potentially avoidable hospitalizations were higher for persons living in middle- and low-income areas than for persons living in high-income areas, and were higher among Blacks than among Whites. These class and racial differences were also found among the privately insured. Differences among income and racial groups for persons aged 65 and over were not significant. CONCLUSIONS: Inequalities in potentially avoidable hospitalizations suggest inequity and inefficiency in the health care delivery system. Avoidable hospital conditions are a useful national indicator to monitor access to care.     

Room temperature synthesis of crystalline metal oxides

Crystalline titanium dioxide powders have been synthesized as either rutile or anatase from aqueous solutions at low temperatures (T≤100°C) and atmospheric pressure. First, a sol is prepared by the hydrolysis of a titanium alkoxide in an acidic solution. The sol is subsequently heated at different rates to produce the different crystalline phases of titanium dioxide. Powder characterization was carried out using X-ray diffraction, scanning electron microscopy and high resolution transmission electron microscopy. In general, the precipitate size was observed to be between 50 and 100 nm. Possible mechanisms involved in determining the crystal variants are discussed. This revised version was published online in November 2006 with corrections to the Cover Date.     

Advanced concepts in electric vehicle design

In 1994, the Eco-Vehicle Project was begun to develop an electric vehicle (EV) using a ground-up design approach that incorporates unique designs specific to an EV. The Eco-Vehicle will be a high-performance, but ultrasmall, battery-powered vehicle. New designs for the Eco-Vehicle include an in-wheel motor drive system, a hollow load floor which will house the batteries, and a new battery management system. The Eco-Vehicle may also utilize other advanced concepts suitable especially for EVs, including solar panels for battery charging and intelligent crash avoidance and guidance systems     

Ultrathin oxide-nitride dielectrics for rugged stacked DRAMcapacitors

Ultrathin dielectric materials that provide high capacitance values are needed for 64- and 256-Mb stacked DRAMs. It is shown that capacitance values as high as 12.3 fF/μm² can be obtained with ultrathin nitride-based layers deposited on rugged polysilicon storage electrodes. These films present the reliability and low leakage current levels required for 3.3-V applications. The nitride thickness, however, cannot be scaled much below 6 nm to avoid the oxidation-punchthrough mechanisms that appear when too-thin films are unable to withstand the reoxidation step     

Generalized impedance control of robot for assembly tasks requiringcompliant manipulation

To perform assembly tasks requiring compliant manipulation, the robot must follow a motion trajectory and exert an appropriate force profile while making compliant contact with a dynamic environment. For this purpose, a generalized impedance in the task space consisting of a second-order function relating the motion errors and interaction force errors is introduced such that the contact force can be commanded and controlled. With generalized impedance control, the robot can behave with a desired dynamic characteristic when it interacts with the environment. To ensure the success of the assembly, a strategy during task planning which takes into consideration the interrelation between motion and force trajectories as well as contact compliance is introduced. The generalized impedance control method is applied to the prismatic joint of a selective compliance assembly robot arm (SCARA) robot for inserting a printed circuit board (PCB) into an edge connector socket. Depending on the progress of the parts joining operation, various amount of interaction forces are generated which have to be accommodated. It is demonstrated that an assembly strategy which consists of a sequence of carefully planned target impedance can enable the task to be executed in a desirable manner. The effectiveness of this approach is illustrated through experiments by comparing the results with those obtained using a well-established position control scheme as well as the original impedance control method     

Association of the glycogen synthase locus on 19q13 with NIDDM in Pima Indians

Skeletal muscle glycogen synthase (encoded by GYS1 on chromosome 19q13.3) is the rate-limiting enzyme in insulin-mediated non-oxidative glucose disposal. Our previous studies have demonstrated an impairment of insulin-stimulated GYS1 activities in insulin-resistant Pima Indians, and associations of non-insulin-dependent diabetes mellitus (NIDDM) with the GYS1 locus were reported recently in Finnish and Japanese populations. We have performed linkage and association analyses of GYS1 and seven additional DNA markers on 19q with NIDDM, and with parameters of insulin action in the Pima Indians. We have found a significant association of NIDDM with GYS1 genotypes (p = 0.009), and with common GYS1 alleles (p = 0.022) in the Pima Indians. We have performed a detailed comparative analysis of the GYS1 gene, mRNA, and protein product in insulin-sensitive and insulin-resistant Pima Indians. No mutations in GYS1 coding sequences were detected; nor did we find alterations of GYS1 mRNA expression or of its basal enzymatic activity in insulin-resistant Pima Indians. These results contrasted with a 25% reduction of immunoreactive protein in insulin-resistant subjects as detected by Western blotting with an antibody specific for the C-terminal end of GYS1 (t-test p = 0.024; Wilcoxon's rank-sum test, p = 0.04). Because no mutations were detected in the DNA encoding this epitope, the difference in immunoreactivity may reflect post-translational modification(s) of the protein rather than a difference in the gene itself, or it could have occurred by chance. We conclude that our data do not indicate alterations in the GYS1 gene as the cause for the observed association, and that a different locus near GYS1 may be the contributing genetic element.     

Neurotoxicity following the ingestion of a Chinese medicinal plant, Alocasia macrorrhiza

1. A case of poisoning due to the raw root tuber of a Chinese medicinal plant, Alocasia macrorrhiza is presented. 2. The patient developed neurological (severe pain and numbness in the perioral area and throat) and gastrointestinal (nausea, vomiting, abdominal pain) symptoms immediately after eating the root tuber. 3. A macrorrhiza has properties and morphology very similar to another medical plant. A. odora. The root tuber of the latter is known to contain a neurotoxin sapotoxin.     

Zero-quantised discrete cosine transform prediction technique for video encoding

A new analytical model to eliminate redundant discrete cosine transform (DCT) and quantisation (Q) computations in block-based video encoders is proposed. The dynamic ranges of the quantised DCT coefficients are analysed, then a threshold scheme is derived to determine whether the DCT and Q computations can be skipped without video quality degradation. In addition, fast DCT/inverse DCT (IDCT) algorithms are presented to implement the proposed analytical model. The proposed analytical model is compared with other comparable analytical models reported in the literature. Both the theoretical analysis and experimental results demonstrate that the proposed analytical model can greatly reduce the computational complexity of video encoding without any performance degradation and outperforms other analytical models