Published reports from France and Norway suggest a frequent incidence of anaphylaxis to rocuronium and have raised concerns about its safety. We hypothesized that the Food and Drug Administration ...Adverse Event Reporting System could be used to confirm whether there has been an unusual incidence of anaphylactic events for rocuronium in the United States (U.S.) and whether the reporting patterns differ within and outside of the U.S.. We queried the Food and Drug Administration Adverse Event Reporting System for 1999 through the first quarter of 2002 for all adverse events for the drugs rocuronium and vecuronium and then searched on the terms considered to represent possible anaphylaxis using proprietary software. We compared the frequency of these terms in data both for rocuronium and vecuronium. We then assessed the occurrence of reports of anaphylaxis-related terms in reports from the U.S. compared with reports originating outside of the U.S.. For rocuronium, the database contained 311 reports, 166 domestic and 145 from foreign sources. Fifty percent of the foreign reports contained an anaphylaxis term versus 20% of the domestic reports (P < 0.001). For vecuronium, the comparable figures were 17% and 19% (not significant) and the total number of reports was 243. The incidence of the reports containing anaphylaxis terms did not differ between vecuronium and rocuronium in the U.S. but were significantly different for foreign reports (P < 0.001). These data confirm that U.S. anesthesia providers have not observed a significant difference in anaphylactic reactions between the two commonly used intermediate-acting muscle relaxants and suggest that frequency of reports of anaphylaxis may be significantly influenced by the area from which the reports originate.
PCB integrated inductors for low power DC/DC converter Ludwig, M.; Duffy, M.; Donnell, T.O. ...
APEC. Seventeenth Annual IEEE Applied Power Electronics Conference and Exposition (Cat. No.02CH37335),
2002, Letnik:
1
Conference Proceeding
This paper discusses the use of PCB integrated inductors for low power DC/DC buck converters. Coreless, magnetic plates and closed core structures are compared in terms of achievable inductance, ...power handling and efficiency in a footprint of 10 /spl times/ 10 mm/sup 2/. Analytic and FEM methods are applied and typical current waveforms encountered in a buck converter are included. The magnetic layers consist of electroplated NiFe, so that the process is fully compatible with standard PCB process. A 4.7 /spl mu/H PCB integrated inductor with DC current handling of up to 500 mA is presented. This inductor is employed in a 1.5 W buck converter using a commercial available IC. The footprint of the entire converter measures 10 /spl times/ 10 mm/sup 2/ and is built on top of the integrated inductor to demonstrate the concept of integrated passives in power electronic circuits to achieve ultra flat and compact converter design.
Disability care coordination organizations (DCCOs) combine attributes of the medical home model and community nursing. Teams of nurses and social workers collaborate with the client to arrange ...disability-competent medical and social services. This article synthesizes observational findings from site visits to approximately half of the DCCOs operating in 2004. DCCOs have 6 core clinical activities: comprehensive assessment; self-directed, person-centered planning; health visit support; centralized medical-social record; community resource engagement; and constant communication. We also identified 3 core business competencies: service coordination, patient education/behavioral modification, and continuous enhancement of disability competency. Each DCCO started as a new company rather than as a product line of an existing business, and each included the target population in the design stage. Most DCCOs contract with state Medicaid agencies under a prepaid capitation arrangement, and some also enroll Medicare beneficiaries. Capitated DCCOs retain cost savings and may be financially stronger than fee-for-service DCCOs. Although studies suggest that DCCOs improve coordination and clinical outcomes while reducing costs, the current evidence has not been peer reviewed.
The use of the modified Newton method for the solution of nonlinear magnetostatic problems arising from the vector potential Finite Element analysis is investigated. In particular the optimum choice ...of the relaxation factor /spl alpha/ is investigated. A new method is developed for determining the relaxation factor which minimizes the energy functional in the direction along the solution update at each nonlinear iteration. This method is based on approximating the functional with a fourth order polynomial. In this way the optimum relaxation factor can be quickly determined with the minimum number of extra function evaluations. This choice of /spl alpha/ is compared to choosing the relaxation factor which minimizes the residual norm at each iteration. The modified Newton methods are compared to the standard Newton-Raphson method for the solution of 2D and 3D problems. For problems involving saturated iron parts convergence rates are greatly improved by use of the modified Newton methods. Of the two methods for choosing the relaxation factor the one which minimizes the functional is shown to be the better. Using the new algorithm to determine this relaxation factor results in substantial reductions in solution times.< >
Prolonged oesophageal acidification may impair lower oesophageal sphincter (LOS) function in reflux disease. The aim of this study was to investigate aspects of altered LOS innervation in a model of ...oeso‐phagitis. Oesophagitis was induced by acid (HCl, 0.15 M) and pepsin (0.1% w/v) infusions in anaesthetized ferrets. LOS muscle strip responses to the following stimuli were measured in vitro from control and acid/pepsin‐treated ferrets: electrical field stimulation (EFS; 1–50 Hz), potassium chloride KCl; 20 m
M), substance P, β‐Ala8‐neurokinin A 4‐10, Sar9, Met (O2)11‐substance P (all 10−10to 10−6 M) and capsaicin (10−8to 10−6 M). LOS relaxation occurred in response to all stimuli except β‐Ala8‐neurokinin A 4‐10, which evoked contraction. In muscle strips from acid/pepsin‐treated animals there were no differences in amplitude or sensitivity of relaxation following EFS, KCl or substance P vs controls. However, the inhibitory response to capsaicin was increased four‐fold (10−8 M; P < 0.05) and an increased sensitivity of the inhibitory response to Sar9, Met(O2)11‐substance P occurred (pD2 = 8.64 ± 0.12acid/pepsin‐treated vs 7.94 ± 0.24 control, P < 0.05). We conclude that in acute oesophagitis, increased sensitivity of capsaicin‐activated inhibitory pathways occurs in which activation of NK‐1 receptors plays an integral role in the ferret LOS.
A unique ion-optical system for the production of high-intensity, short-lived radioactive nuclear beams has been designed, constructed and put into operation at the Nuclear Structure Laboratory at ...the University of Notre Dame as a joint project between the University of Michigan and NSL-UND. The system consists of a matched in-line pair of large-bore (30 cm) 6T superconductive solenoid magnets which act as high-acceptance collectors and magnetic filters of secondary radioactive nuclear beam (RNB) products. The latter are brought to a focus on a secondary target and nuclear reactions using the RNB studied. These are primarily reactions of interest in Big-Bang nucleosynthesis and stellar helium burning and involve the production of /sup 6/He, /sup 7/Be, /sup 8/B and similar beams. A number of unique features were incorporated in the magnet design to permit use as a precise ion-optical device in the RNB mode. To the authors' knowledge this is the only large-scale in-beam ion-optical system to operate primarily in persistent mode. A similar device will also be built at the University of Sao Paulo for RNB research.
One of the most important elements to the rise of Henry George to international prominence in the 1880s was his successful cultivation of a large Irish-American following. This was no small ...accomplishment, given the fact that George was not Irish Catholic, but rather English-American Protestant. Nonetheless, through his early interest in Ireland's troubles, marriage to Irish Catholic Annie McCloskey Fox, friendship with Patrick Ford and Michael Davitt, activism in the Irish Land League, travels through Ireland during the Land War as a correspondent for the Irish World, and linking the struggle of Irish peasants against economic injustice to a similar struggle of American workers, George developed an enormous Irish-American following. This relationship accounted for much of the early sales of "Progress and Poverty" and subsequent lecture opportunities, as well as making him known widely throughout the British Isles. The culmination of this phenomenon was George's sensational run for mayor of New York City in 1886.
The nucleotide sequence of the "high-affinity" L-arabinose transport operon has been determined 3' from the regulatory region and found to contain three open reading frames designated araF, araG and ...araH. The first gene 3' to the regulatory region, araF, encodes the 23-residue signal peptide and the 306-residue mature form of the L-arabinose binding protein (33,200 Mr). The binding protein, which has been described elsewhere, is hydrophilic, soluble and found in the periplasm of Escherichia coli. This gene is followed by an intragenic space of 72 nucleotides, which contains a region of dyad symmetry 23 nucleotides long capable of forming an 11-member stem-loop. The second gene, designated araG, contains an open reading frame capable of encoding an equally hydrophilic protein containing 504 residues (55,000 Mr). Following a 14-nucleotide spacer, which does not appear to have any secondary structure, the third open reading frame, herein designated araH, is capable of encoding a hydrophobic protein containing 329 residues (34,000 Mr) that can only be envisioned as having an integral membrane location. 3' to araH there is a T-rich region containing a 24-nucleotide area of dyad symmetry centered 55 nucleotides from the termination codon. Analysis of the derived primary sequences of the araG and araH products indicates the nature and potential features of these components. The araG protein was found to possess internal homology between its amino and carboxyl-terminal halves, suggesting a common origin. The araG gene product has been shown to be homologous to the rbsA gene product, the hisP product, the ptsB product and the malK product, all of which presumably play similar roles in their respective transport systems. Putative ATP binding sites are observed within the regions of homology. The araH gene product has been shown to be homologous to the rbsC gene product, which is the first observed homology between two purported membrane proteins.
