Coupler point-paths and line-envelopes of 4-bar linkages in asymptotic configurationsTrajectoires de la bielle d'accouplement et enveloppes de lignes des chaines a quatre barres en configuration asymptotique

This paper describes some of the properties of coupler point-paths and line-envelopes when the instantaneous centre approaches infinity. The degeneration of the cusp circle and inflexion circle leads to interesting properties of the loci of certain points and lines on the moving lamina. Finally, the conditions for the existence of a point of inflexion in a mechanically traced planar line-envelope are established.     

Motivational factors in the violation of a prohibition.

An experiment with 90 college Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nimodipine monotherapy and carbamazepine augmentation in patients with refractory recurrent affective illness

We investigated the expression and function of Fas and Fas ligand (FasL) on peripheral blood lymphocytes (PBLs). The cells were stimulated with various cytokines or 12-0-tetradecanoyl phorbol 13-acetate (PMA) plus ionomycin. About 30% of unstimulated PBLs expressed Fas, and the expression was augmented by interleukin-1beta (IL-1beta), IL-2, tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), or PMA plus ionomycin. Although only minimal FasL expression was detected on unstimulated PBLs, FasL expression was markedly induced by IL-2 or PMA plus ionomycin, suggesting that Fas and FasL were both expressed on IL-2-stimulated or PMA-plus-ionomycin-stimulated PBLs. Although IL-2-stimulated or PMA-plus-ionomycin-stimulated PBLs were positive for both Fas and FasL, no significant increase in apoptosis was demonstrated in these activated PBLs. In addition, treatment of PBLs with IL-2 or PMA plus ionomycin did not change anti-Fas-induced apoptosis, although these activated PBLs expressed Fas strongly when compared with unstimulated PBLs. Only IL-2-stimulated or PMA-plus-ionomycin-stimulated PBLs killed Fas+ target cells efficiently via the interaction of Fas on target cells with FasL of PBLs. Bcl-2 was constitutively expressed on unstimulated PBLs, but its expression was significantly augmented by IL-2 or PMA plus ionomycin. The expression of Bax was clearly induced only on IL-2-stimulated or PMA-plus-ionomycin-stimulated PBLs and that of other Bcl-2 family proteins such as Bcl-x and Bad could not be detected on human PBLs, including IL-2-stimulated or PMA-plus-ionomycin-stimulated PBLs. Our results suggest that PBLs activated by IL-2 or PMA plus ionomycin express both Fas and FasL and that they kill Fas+ target cells by using FasL on the surface. The resistance of these activated PBLs to Fas-mediated apoptosis may be due to the augmented Bcl-2 expression or the presence of Bcl-2:Bax heterodimers on these cells.     

A note on symmetrical self-oscilating coupler curvesBemerkungen über symmetrische selbstoskulierende koppelkurven

Some special symmetrical coupler curves, from hinged planar 4-bar linkages, are presented which not only touch themselves but which osculate with themselves where three double points coalesce. Possible applications in point-guidance are touched on.     

Gabapentin does not alter single-dose lithium pharmacokinetics

We considered the role of monounsaturated and other types of fats on breast carcinogenesis, using data from a case-control study of 2,569 incident, histologically confirmed cases of breast cancer and 2,588 controls from six Italian areas. The multivariate odds ratios, adjusted for age, education, parity, menopausal status plus various sources of energy and types of fats, were 1.10 (95% confidence interval 0.99-1.23) for an increase of 10 g/day of saturated fat intake, 0.99 (0.94-1.04) for an increase of 10 g/day of monounsaturated fats, and 0.91 (0.87-0.96) for an increase of 5 g/day of polyunsaturated fats. The present data confirm that saturated, but not mono- or polyunsaturated fats, are directly, though moderately, related to breast cancer risk.     

Alternative approaches to refractory depression in bipolar illness

Thus, there appears to be a large variety of approaches to refractory bipolar depression. In contrast to several decades ago, wherein augmentation of lithium with antidepressants and neuroleptics was essentially the only treatment mode available, a panoply of treatment options now exist. However, their relative efficacy in different illness subtypes and stages remains to be better delineated, as do their optimal sequencing and use in combination in individual patients. It is the opinion of these authors and many of our colleagues in the field that initial use of several mood stabilizer drugs in combination may have a preferable long-term outcome in some rapid cycling patients, compared with the immediate use of a unimodal antidepressant with an inadequate single mood stabilizer, although this remains to be systematically studied. The use of thyroid augmentation strategies would appear to have merit in relationship to not only the potential treatment of lithium-related hypothyroidism, but also in augmenting antimanic and antidepressant effects. As one moves toward some of the complex combination treatment strategies discussed in this chapter, one has to be particularly careful about drug interactions and their potential for toxicity as well as therapeutic effects. Perhaps a prevailing guideline would be to use these agents more carefully in combination therapy than in monotherapy, with slow upward titration of dose to individual patients' side effects thresholds, even in preference to targeting of conventional blood level windows. In this way, side effects can be avoided during the assessment of complex combination regimens. In addition, one should be aware of potential pharmacokinetic interactions. For example, with the addition of valproate to carbamazenine, one should reduce the dose of carbamazepine, as valproate will not only increase the free fraction of carbamazepine based on displacement of protein binding, but will lead to increased accumulation of carbamazepine-10,11-epoxide. This epoxide is not measured in conventional assays but could contribute to the side effects profile (Ketter and Post, 1994). Similarly, valproate will markedly increase blood levels of lamotrigine; the starting dose of this agent should be substantially lower than conventional dosage when these two drugs are used in combination. We suggest the utility of detailed mapping with a formal system-such as the Life Chart Methodology (LCM) (Leverich and Post, 1996)-of mood fluctuation vs. medications in order to optimize and rationalize complex combination therapy. In this way, not only can the nuances of partial response be better defined, but also basic decisions about the therapeutic index and relative likelihood of response can be more readily assessed. We have discussed the other merits of the life chart method as an important clinical treatment tool as well as a research tool in other venues, but reemphasize its potential great importance in the treatment of refractory cyclic bipolar patients, in whom an initial period of remission of depression may, in many instances, be as likely attributable to the natural course of illness as the current intervention being offered. As such, it behooves the clinician to have a systematic database for the more subtle issues of dose titration and sequential addition of medications in complex combination regimens. In the face of inefficiency to one combination strategy, how one moves to the next strategy remains a highly individualized, clinically-based algorithm. We suggest the potential utility of moving towards a new set of mood stabilizers and then repeating some of the unimodal antidepressant additions and augmentation trials in an attempt to overcome refractory depression. Refractory depression in bipolar patients should be viewed as a medical emergency in light of the high potential for suicide in the illness in general (Chen and Dilsaver, 1996) and in patients who have either sustained or episodic refracto     

Development of boundary curves,time-ratio curves and rocker swing-angle curves

The paper presents a simple analytical method of obtaining the boundary curves, time-ratio curves and rocker swing-angles of a four-bar mechanism. These curves are very helpful in the design of such mechanisms. The results concur with those of Eschenbach [1] who obtained them by a different method.     

Graphical synthesis of a 4-bar mechanismLa synthese graphique d'un mecanisme avec quatre barres

For a mechanism operating at steady state, the synthesis technique for specified coupler point location, velocity and acceleration is developed from the geometric nature of the acceleration pole. Two examples are presented. One example is based on a known site for the acceleration pole and the other depends on locating the pole from a specified acceleration.     

Beyond lithium in the treatment of bipolar illness

Primary non-Hodgkin lymphoma of the stomach is a rare disorder for which clinical management has not yet been settled completely. Faced with the many uncertainties associated with the selection of a treatment for a patient with this disorder, it is difficult to determine the treatment that is optimal for the patient, as well as the prognosis to be expected. The development of a decision-theoretic model of non-Hodgkin lymphoma of the stomach is described. The model aims to assist the clinician in exploring various clinical questions, among others questions concerning prognosis and optimal treatment. Central to the model is a probabilistic network that offers an explicit representation of the uncertainties underlying the decision-making process. The model has been incorporated in a decision-support system. Preliminary evaluation results indicate that the performance of the model in its present form matches the performance of experienced clinicians.