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.     

The adsorption and decomposition of carbon dioxide on polycrystalline copper

The interaction of carbon dioxide with polycrystalline copper has been studied by radiolabelling techniques using {14-C} carbon dioxide, and by temperature programmed desorption. It is showninter alia, that: carbon dioxide is weakly adsorbed at the clean surface; that this acts as precursor which, on activation, produces adsorbed carbon monoxide and surface oxygen; and that this oxidised copper surface then adsorbs carbon dioxide more strongly yielding a state which can be hydrogenated first to formate, and thereafter to methanol.     

Synthesis and Evaluation of Osteogenic Oxysterols as Hedgehog Pathway Activators

Oxysterols (OHCs) are metabolic byproducts of cholesterol that are known to function as agonists of the Hedgehog (Hh) signaling pathway. Previously, we reported 23(S)‐hydroxycholesterol [23(S)‐OHC, 4 ] as a potent activator of Hh signaling with the ability to functionally differentiate mouse embryonic fibroblasts to an osteogenic fate. To obtain 23(S)‐OHC in quantities suitable for in vivo evaluation, we developed a revised synthetic route that decreases the number of steps and chromatographic purifications, and which also enhances the stereoselective nature of the synthesis. This new route also allows access to the C21 methyl group of the OHC scaffold, and several new analogues with varying stereochemistry at this location were evaluated for their ability to up‐regulate the Hh pathway.     

驱动WLED不必4V

白光LED（SLED）能为便携式电子产品的显示器提供背光，最常见的是需要4V驱动电压的单个WLED，而单节锂电池平均电压为3.6V，因此在使用单节锂电池驱动WLED的情况下需用升压转换器。探讨WLED的低电流应用与对其正向电压的影响，并介绍TI的新款LED驱动器TPS7510。     

Small-scale experiments of self-sustaining decomposition of NPK fertilizer and application to events aboard the Ostedijk in 2007

Small-scale experiments to investigate the self-sustaining decomposition (SSD) behaviour of NPK 16.16.16 fertilizer have been undertaken. These experiments show that this material will undergo self-sustaining decomposition and are used to give insight into the behaviour of the reaction. A three-step decomposition process is observed leading to a self-sustained reaction reaching temperatures of 200–350 °C. The measured heat of reaction is 0.73–1.8 MJ/kg. Measurements are applied to the events that occurred aboard the ship Ostedijk in 2007 in which a SSD reaction occurred. The mass loss rate from the cargo was calculated to range from 0.5 kg/s on the first day to 12 kg/s on the last day. From this measurement, the maximum fire size was estimated to be in the range 5.8–29 MW.     

Ignition of Combustible Fuel Beds by Hot Particles: An Experimental and Theoretical Study

The process of spotting occurs in wildland fires when fire-lofted embers or hot particles land downwind, leading to ignition of new, discrete fires. This common mechanism of wildland fire propagation can result in rapid spread of the fire, potentially causing property damage and increased risk to life safety of both fire fighters and civilians. Despite the increasing frequency and losses in wildland fires, there has been relatively little research on ignition of fuel beds by embers and hot particles. In this work, an experimental and theoretical study of ignition of homogeneous cellulose fuel beds by hot metal particles is undertaken. This type of well-characterized laboratory fuel provides a more controllable fuel bed than natural fuels, and the use of hot metal particles simplifies interpretation of the experiments by reducing uncertainty due to unknown effects of the ember combustion reaction. Spherical steel particles with diameters in the range from 0.8 mm to 19.1 mm heated to temperatures between 500°C and 1300°C are used in the experiments. A relationship between the size of the particle and temperature required for flaming or smoldering ignition is found. These results are used to assess a simplified analysis based on hot-spot ignition theory to determine the particle size-temperature relationship required for ignition of a cellulose fuel bed.     

Insulin sensitivity in pre-eclampsia

Gastric mucosal damage induced by haemorrhagic shock in the anaesthetized rat has been evaluated by studying changes in capillary-to-lumen clearance of fluorescein isothiocyanate (FITC)-labelled dextran. Haemorrhagic shock (20 min ischaemia + 20 min reperfusion) induced a significant increase in blood-to-lumen permeability to FITC-dextran of different molecular weight (10,000, 40,000 and 70,000) without modifying the macroscopic integrity of the gastric mucosa. The increase in vascular permeability was dependent on the time of administration of the tracer and was correlated with an elevation of the protein content of the gastric lumen. Intravenous administration of the secretagogue pentagastrin (20 or 50 micrograms kg-1 h-1) did not significantly modify the vascular permeability to dextran in control animals or in animals subjected to haemorrhagic shock. When the intraluminal pH was reduced by intragastric administration of acidic saline solution, only pH 1, which itself induced the appearance of macroscopic mucosal lesions, significantly increased vascular permeability to dextran, both in control animals and in animals subjected to haemorrhagic shock. These findings suggest that stress induced by haemorrhagic shock increases vascular gastric permeability to dextran, by an acid-independent mechanism, without affecting the macroscopic integrity of the gastric mucosa.     

Pd Ion-Exchange and Ammonia Etching of a Prussian Blue Analogue to Produce a High-Performance Water-Splitting Catalyst

The authors report an ammonia-assisted in situ cation-exchange method for the synthesis of dodecagon N-doped PdCoNi carbon-based nanosheets (Pd-e-NiCo-PBA-C) and explore the catalytic performance. Pd-e-NiCo-PBA-C exerts extremely low overpotential and Tafel slope for hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) both in acidic and alkaline media, only 47 mV, 55 mV dec⁻¹ (pH = 0, HER) and 147 mV, 67 mV dec⁻¹ (pH = 14, HER), and 309 mV, 67 mV dec⁻¹ (pH = 14, OER), outperforming commercial IrO₂-based and Pt-based catalysts. In addition, after 5000 cycles, the linear sweep voltammetry curve shows a negligible shift, indicating excellent stability performance. To test its overall water-splitting performance, Pd-e-NiCo-PBA-C is applied as both cathode and anode materials. A high current density of 33 mA cm⁻² at a battery voltage of 1.6 V is obtained, with the catalytic activity maintained at 97.3% after over 50 h. To get a further insight into the superior OER and HER performance, theoretical calculations are carried out, the better performance originates from the affinity difference of Pd and Ni atoms for gas atoms, and the replacement of inert atoms can decrease the binding energy and enhance the electrocatalytic activity.     

Dentistry in another EC country: Germany

There are many similarities between dental education and treatment provision in the UK and Germany but also some important differences. V Hadden was interested to learn about the health care system in Germany, especially as the UK may soon follow European practice.     

为电源应用选择正确的IC

引言为了在设计工作中选择正确的IC,必须综合考虑成本、解决方案尺寸、电源、占空比与所需输出功率等许多因素,井根据重要性加以权衡与排序。本文将介绍如图1所示的应用解决方案的基本原理。