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I. Food, Film, and a Desire to Nothing but Literature'Office life is a dog's life.' 'Yes, Kafka agreed, 'yet I don't . . . bark at anyone and I don't bite either. As you know-I'm a vegetarian. We only live on our own flesh."1Shortly after his early retirement in 1922 Franz Kafka went to live with his sister Ottla who was renting a summer cottage in the rural community of Plana outside of Prague. There he worked in her vegetable garden, took long walks in the woods with the landlady's dog (Binder 1975, 358)2 and wrote one of his most accomplished and intricately reflexive short stories, "Investigations of a Dog." Completed a few months after A Hunger Artist, Forschungen eines Hundes represents both the final installment and culmination of Kafka's literary exploration of the spiritual and socio-cultural significance of eating and food. Keying in on this largely underappreciated but abiding concern in this paper, I will read this overtly autobiographical tale as an ironic "Bildungsnovella" in which Kafka views the trajectory of his creative development through the prism of his own "alimentary aesthetics."3 I will explore, more specifically, how the strikingly cinematic quality of the central event around which he spins this alimentary parable-about a canine nutritional scientist-is subtly informed by his ambivalence about the emerging cultural phenomenon of early film. Narrated from the perspective of the dog, who traces the vagaries of his obsessive dedication to this arcane field of inquiry back to the crucial but inscrutable-and remarkably "cinematic"-experience that determined the course of his life, the canine protagonist offers a suggestive reflection on his creator s aesthetic breakthrough and subsequent writing in which eating, food, and the largely subliminal "vestigial" effects of cinema are inextricably intertwined.Kafka's prodigious literary accomplishments in the final years of his life are a testament to the power of imagination under the sign of not-eating. As if nourished by his advancing tuberculosis, which ravaged his body as it gradually starved him to death, Kafka wrote in the last two years of his life some of his most acclaimed stories, his third novel, The Castle, as well as his genial pair of hunger parables. It is prophetically ironic that Kafka had actually considered in 1923-while living in Berlin with his young lover, Dora Diamant-immigrating to the land of milk and honey where the two would open a restaurant and begin a new life, far away, as it was, from the dire material conditions and chronic food shortages of the inflation-wracked German capital (Diamant 2003, 49). In devoting himself to the real business of food in this imagined eatery in the promised land, Kafka fantasized achieving with Dora the domestic happiness that always had been denied by the ascetic demands of his literary pursuits, his desire to be "nothing but literature." His literary ambitions, Kafka told Hermann Bauer, his prospective father-in-law, are simply at odds with everything in his life, including his ability to bring home the bread: "My job," he indulges,is unbearable to me because it conflicts with my only desire and my only calling, which is literature. . . . I am nothing but literature and can and want to be nothing else. . . . Everything that is not literature bores me and I hate it, for it disturbs or delays me. . . . I lack all aptitude for family life except, at best, as an observer. (Kafka 1976, 230-31)4Kafka drafted this letter in the summer of 1913 in the heady period of writing and reflection that followed his celebrated creative breakthrough and engagement to Felice Bauer. Similar formulations of this new-found confidence in his ascetic drive are recorded in his diary and letters of August and September, 1913, in which he begins to push his unstinting identification with literature and his hermetic writing process to an extreme. It took several more years for him to understand this "myth of his existence," his "system of obsessions" and "the fundamentalist logic of purity," which in Reiner Stach's words, "would enhance his life on a narcissistic level but consume all of its vitality" (2005, 321ff, 421ff). …

Particulate samples collected from a laboratory ventilation manifold during routine maintenance were analyzed to determine if particulate composition had changed as a result of changes in the laboratory's atmosphere. This ventilation manifold exhausts more than 100 fume hoods. The particulate samples were analyzed using static secondary ion mass spectrometry (SIMS). The negative SIMS spectra showed abundant Cl-, NO3-, and HSO4-, consistent with the use of mineral acids in the laboratory. Cluster anions containing primarily Zn (but also other transition metals) were detected, which signaled corrosion of the manifold's galvanized steel by the volatilized acids. The most abundant ions in the cation SIMS spectra were derived from cyclohexylamine (CHA), which had been used as an antiscaling agent in the facility's boiler. Steam from the boiler, which contained CHA, was used to humidify the building air; this practice stopped in 1997. The abundances of the CHA-derived ions were significantly lower in the samples collected in 2004 and 2006 than in the 1992 samples, indicating that the CHA is being slowly depleted. Changes in the relative abundances suggest exponential depletion from the manifold with rate constants that are on the order of 0.01 to 0.04 month-1.

We undertake Life Cycle Assessment (LCA) of the cumulative energy demand (CED) and global warming potential (GWP) for a portfolio of 10 multi-family residences in the U.S. We argue that prior LCA studies of buildings use an inconsistent boundary for processes to be included in the supply chain: The operational phase includes all energy use in a building, but supply chains for the production of appliances, equipment and consumables associated with activities done in the building are neglected. We correct this by starting the analysis with an explicit definition of a functional unit, providing climate controlled space, and including processes associated with this functional unit. Using a hybrid LCA approach, the CED for low, mid and high-rise multi-family residences is found to increase from 30, 34, to 39 GJ/m 2 , respectively. This increase is due to the need for energy-intensive structural materials such as concrete and steel in taller buildings. With our approach, the share of materials and construction of total life cycle energy doubles to 26%, compared with a 13% share that would be obtained with inconsistent system boundaries used in prior studies. We thus argue that explicit definition of functional unit leads to an increase in the contribution of supply chains to building energy life cycles.

The Micra® Transcatheter Pacing System (TPS; Medtronic Inc., Minneapolis, MN, USA) is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein. In this study, the electrical performance was compared between the TPS and a traditional leaded pacemaker. In addition, the safety profile of the two systems was compared by thorough monitoring for a number of adverse events.The TPS was implanted in the right ventricular apex of 10 Yucatan mini pigs and a Medtronic single-lead pacemaker (SLP) was implanted in the right ventricular apex of another 10 pigs and connected to a traditional pacemaker. The electrical performance of all devices was monitored for 12 weeks. The safety profile of each system was characterized using x-ray, computed tomography, ultrasound, blood work, and necropsy to monitor for a variety of adverse events.At implant the mean pacing thresholds were 0.58 ± 0.17 V @0.24 ms and 0.75 ± 0.29 V @0.21 ms for the TPS and the SLP respectively. After 12 weeks, mean thresholds were 0.94 ± 0.46 V and 1.85 ± 0.75 V (P0.0001). There were two pulmonary emboli that were small and past the tertiary branch, and one occurred in each arm. There were also two infections with one in each arm. There were no dislodgements (macro or micro), tissue injury, tamponade, or valve injury.Overall, despite the 10-fold size reduction of the Micra TPS, it appears to perform similarly and have a similar safety profile to a traditional pacemaker system.

A new approach for quantifying the net environmental impact of a "community" of interrelated products is demonstrated for consumer electronics owned by an average U.S. household over a 15-year period (1992-2007). This consumption-weighted life cycle assessment (LCA) methodology accounts for both product consumption (number of products per household) and impact (cumulative energy demand (MJ) and greenhouse gas emissions (MT CO2 eq) per product), analyzed using a hybrid LCA framework. Despite efficiency improvements in individual devices from 1992 to 2007, the net impact of the entire product community increased, due primarily to increasing ownership and usage. The net energy impact for the product community is significant, nearly 30% of the average gasoline use in a U.S. passenger vehicle in 2007. The analysis points to a large contribution by legacy products (cathode ray tube televisions and desktop computers), due to historically high consumption rates, although impacts are beginning to shift to smaller mobile devices. This method is also applied to evaluate prospective intervention strategies, indicating that environmental impact can be reduced by strategies such as lifespan extension or energy efficiency, but only when applied to all products owned, or by transforming consumption trends toward fewer, highly multifunctional products.

The status and prospects of the development of Japanese nuclear power are controversial and uncertain. Many deem that nuclear power can play key roles in both supplying energy and abating CO2 emissions; however, due to severe nuclear accidents, public acceptance of nuclear power in Japan has not been fully obtained. Moreover, deregulation and liberalization of the electricity market impose pressure on large Japanese electric power companies with regard to both the operation of nuclear power plants and the development of the nuclear fuel cycle. Long-term Japanese CO2 reduction strategies up to 2100 are of environmental concern and are socially demanded under the circumstances described above. Taking these factors into account, we set the following two objectives for this study. One is to estimate lifecycle CO2 (LCCO2) emissions from Japanese nuclear power, and the other is to evaluate CO2 emissions from the Japanese electric power sector in the 21st century by quantifying the relationship between LCCO2 emissions and scenarios for the adoption of nuclear power. In the pursuit of the above objectives, we first create four scenarios of Japanese adoption of nuclear power, that range from nuclear power promotion to phase-out. Next, we formulate four scenarios describing the mix of the total electricity supply in Japan till the year 2100 corresponding to each of these nuclear power scenarios. CO2 emissions from the electric power sector in Japan till the year 2100 are estimated by summing those generated by each respective electric power technology and LCCO2 emission intensity. The LCCO2 emission intensity of nuclear power for both light water reactors (LWR) and fast breeder reactors (FBR) includes the uranium fuel production chain, facility construction/operation/decommission, and spent fuel processing/disposal. From our investigations, we conclude that the promotion of nuclear power is clearly a strong option for reducing CO2 emissions by the electric power sector. The introduction of FBR has the effect of further reducing CO2 emissions in the nuclear power sector. Meeting energy demand and reducing CO2 emissions while phasing out nuclear power appears challenging given its importance in the Japanese energy supply.

The last two decades saw a remarkable dual transition sweep Latin America as authoritarian regimes gave way to (qualified) democratic ones, and governments abandoned state-led development models for more market-friendly, neoliberal ones. In many new democracies, technocrats?that is, highly educated, professionally trained policy makers?served as architects of economic reform projects and rose to power as global economic integration, increasingly complex economic issues, and the bankruptcy of past development models encouraged governments to enhance their technical capacity.1 Although technocrats made their deepest inroads within central banks and executive branch agencies such as finance and trade ministries, technocratic policy making also permeated other public policy realms, including social security, health care, labor relations, and social welfare provision; in some instances, it even made headway at municipal levels of government.2

Rapid economic growth in Asia and the increasing transboundary movement of secondary resources will increasingly require both 3R endeavors (reduce, reuse, recycle) in each country and appropriate control of international material cycles. Recently, managing electrical and electronic waste (E-waste) has become an important target for domestic and international material cycles from the viewpoints of environmental preservation and resource utilization efficiency. To understand the current status of E-waste issues in the context of international material cycles and to discuss the future tasks related to achieving 3R in the region, we organized the National Institute for Environmental Studies (NIES) E-waste Workshop in December 2004. This article reviews past studies on E-waste and briefly describes the topics presented and discussions held at the workshop. The topics at the workshop included E-waste generation, recycling systems, international trade, and environmental impacts. In addition, we discussed various issues such as terminology, current environmental concerns, and possible solutions. Transboundary shipments of E-waste should be conducted taking into consideration the concept of sustainable development. The direction of future research and possible collaborations are also discussed.

Amyotrophic lateral sclerosis (ALS) is characterized by degeneration of motor neurons. We tested the hypothesis that proteomic analysis will identify protein biomarkers that provide insight into disease pathogenesis and are diagnostically useful. To identify ALS specific biomarkers, we compared the proteomic profile of cerebrospinal fluid (CSF) from ALS and control subjects using surface-enhanced laser desorption/ionization-time of flight mass spectrometry (SELDI-TOF-MS). We identified 30 mass ion peaks with statistically significant (p < 0.01) differences between control and ALS subjects. Initial analysis with a rule-learning algorithm yielded biomarker panels with diagnostic predictive value as subsequently assessed using an independent set of coded test subjects. Three biomarkers were identified that are either decreased (transthyretin, cystatin C) or increased (carboxy-terminal fragment of neuroendocrine protein 7B2) in ALS CSF. We validated the SELDI-TOF-MS results for transthyretin and cystatin C by immunoblot and immunohistochemistry using commercially available antibodies. These findings identify a panel of CSF protein biomarkers for ALS.

Objective Cytokine dysregulation contributes to the systemic inflammatory response after cardiopulmonary bypass. Clearance of cytokine binding proteins may be important in the resolution of inflammation. Our aim was to determine whether the cytokine binding protein α 2 -macroglobulin and its soluble receptor were upregulated in endotracheal aspirates from infants and children undergoing cardiopulmonary bypass. Methods Seventy tracheal aspirates were collected before and after cardiopulmonary bypass from 35 infants and children undergoing surgical correction of congenital heart defects. α 2 -Macroglobulin and the soluble α 2 -macroglobulin receptor were identified by Western blot. With the use of multi-analyte cytokine profiling, pro-inflammatory and anti-inflammatory cytokines were quantified, normalized to total protein, and expressed as ratios. Paired t tests and Wilcoxon signed-rank tests were performed between prebypass and postbypass samples. Correlations were examined among α 2 -macroglobulin, soluble α 2 -macroglobulin receptor, cytokine ratios, and the clinical variables of cardiopulmonary bypass, aortic crossclamp, and circulatory arrest times. Results α 2 -Macroglobulin increased by 50% (mean densitometry increase 82,683 ± 184,594, P = .012), and soluble α 2 -macroglobulin receptor increased by 17% (mean densitometry increase 506,148 ± 687,037, P = .0001) after cardiopulmonary bypass. The ratio of interleukin-8/interleukin-4 increased by 136% ( P = .0001), and interleukin-8/interleukin-10 increased by 102% ( P = .001). The increase in soluble α 2 -macroglobulin receptor was positively correlated with the ratios of interleukin-8/interleukin-4 and interleukin-8/interleukin-10. There were no statistically significant positive correlations between the increase in α 2 -macroglobulin or soluble α 2 -macroglobulin receptor and measured clinical variables. Conclusions We report for the first time the upregulation of α 2 -macroglobulin and soluble α 2 -macroglobulin receptor in tracheal aspirates after cardiopulmonary bypass in infants and children. Soluble α 2 -macroglobulin receptor correlates with increased α 2 -macroglobulin and a disproportionate increase in pro-inflammatory to anti-inflammatory cytokine ratios.

This article explores historic carbon dioxide (CO2) emission trends from road and air transportation of the United States and 26 developing and industrializing nations. It is argued that environmental trends in the newest industrializing countries do not follow the more sequential and long-term shifts experienced by the United States. The empirical analysis demonstrates that all rapidly developing countries analyzed exhibit comparable transportation CO2emissions per capita levels at lower levels of income per capita, or sooner, than the United States. For some developing countries (the most rapidly growing), these emissions also grow faster over time. Last, there is clear evidence that emissions from road and air sources are occurring more simultaneously compared to the United States. This pattern of changes is in contrast with the common interpretation of environmental Kuznets curves, which suggest that countries follow similar patterns of environmental impacts over time as they develop economically.

Telework ~or telecommuting! has been proposed as a way of reducing transportation externalities such as congestion and passenger vehicle energy use. While there is contention among sources about the secondary induced transportation effects, many studies have estimated net benefits as a result of transportation reductions. Analyses including effects from shifts in commercial and residential building energy use, however, are not as visible. It is expected that commercial building energy use would decrease, and residential energy would increase as a result of telework adoption. We estimate macrolevel energy effects across these three energy intensive sectors ~transportation, commercial, and residential buildings ! to help characterize the potential of telework as a policy initiative to improve national energy efficiency. For current estimated teleworking populations and practices in the United States and Japan, we estimate national level energy savings of only 0.01-0.4% in the United States and 0.03-0.36% in Japan. In a future scenario with pervasive adoption of teleworking, where 50% of information workers telecommute 4 days per week, United States and Japan national energy savings are estimated at only about 1% in both cases. These energy savings are quite modest compared with currently available policy options to mitigate energy demand. By comparison, an improvement in average vehicle fuel efficiency of 20% would save 5.4% of total United States energy demand, suggesting that the direct benefits of adopting telework are relatively small given the large degree of behavioral and structural change required. Still, presuming that future work practices tend to favor greater adoption, the potential energy savings may merit direction towards environmentally beneficial implementation. If trends in the workplace favor more telework in the future, we suggest that maximizing environmental benefits merits greater attention to how telework is adopted. Obviously the increased number of avoided commutes is a factor, but more importantly, elimination of office space due to virtual offices yields energy savings that rival those from reduced commuting. Future analyses and implementation of telework should thus give greater attention to energy use in buildings and residences.

The rapid transition towards a “digital economy” was enabled by a converging set of innovations. Computing saw the development of the semiconductor transistor, integrated circuit, personal computers (PCs), operating systems, and graphical interfaces. The physical layer of telecommunication was enabled via the emergence of optical fiber and new wireless communication technologies, while networking saw the development of the Internet (essentially packet switching) and the World Wide Web. These advances combined to realize a series of new applications of information and communications technologies (ICTs) such as business software, e-mail, and e-commerce. However, progress seriously stumbled with the collapse of the dot com bubble, which among other things revealed a huge amount of misdirected investment that could have been used more productively. The question of the day is thus how to realize new “killer apps” to stimulate a new round of growth. The use of cell phones for communicating text, pictures, and video is a rapidly expanding area, but it seems unlikely that these applications will have a macroeconomic impact. Entertainment is a key industry whose fortunes are entwined with ICTs. Indeed, the application of ICT to innovating entertainment products is an important driver for the continued growth of the industry. Distribution of music and video via the Web could significantly stimulate demand but also raises the thorny question of how to protect intellectual property rights (IPR) of content providers. Another possible killer apps are interactive video-on-demand and telecalls/teleconferencing. The latter would, among other things, stimulate adoption of telework. The current Internet is capable of handing neither one-way transmissions of high-quality video nor interactive video-on-demand. There are bottlenecks both for the “last mile” connection from Internet service provider (ISP) to the home but also the “first miles” from originating server to ISP. The effective first miles bandwidth has not increased along with improvements in equipment, essentially because demand increases with capacity and thus traffic jams on the net continue. Digital subscriber line (DSL) technologies over telephone wires, and possibly wireless networks, will play important roles in getting over the last mile hurdle. Upgrading the first miles will probably require new networking protocols beyond TCP/IP that support multimedia and also changes in the economic model of information transfer via the Net.

The significance or incidence of heterotopic ossification (HO) associated with artificial disc replacement is not known at this time. This is not actually surprising as total hip arthroplasty has been around a lot longer than the SB Charite™ prosthesis and in total joint replacement the low incidence in early studies is attributable to imprecise diagnostic criteria.

Material and economic flows in a global production chain are analyzed in order to identify shifts in economic structure relevant to environmental issues. Results suggest that the economic and environmental weight of high-tech manufacturing and specialized material sectors will increase significantly relative to extractive and primary commodity sectors, perhaps reaching a similar environmental scale within a few decades. Though further study is needed, the forecasts suggest that a reprioritization of analysis and policy to address these new industries is in order. These results are based on a case study of the global production chain for high-purity silicon and its use in semiconductors, solar cells and optical fiber from primary materials. Forecasts for future material/economic flows are carried out based on the identification of time scales that reveal stable long-term trends. Assuming constant growth over 7–10 year averages reproduces thirty years of historical growth of three global sectors to around 1–2% accuracy. This suggests the constant growth model can be used to forecast with a relatively high degree of confidence.

The scale of environmental impacts associated with the manufacture of microchips is characterized through analysis of material and energy inputs into processes in the production chain. The total weight of secondary fossil fuel and chemical inputs to produce and use a single 2-gram 32MB DRAM chip are estimated at 1600 g and 72 g, respectively. Use of water and elemental gases (mainly N2) in the fabrication stage are 32 000 and 700 g per chip, respectively. The production chain yielding silicon wafers from quartz uses 160 times the energy required for typical silicon, indicating that purification to semiconductor grade materials is energy intensive. Due to its extremely low- entropy, organized structure, the materials intensity of a microchip is orders of magnitude higher than that of "traditional" goods. Future analysis of semiconductor and other low entropy high-tech goods needs to include the use of secondary materials, especially for purification.

The advent of the Internet and e-commerce has brought a new way of marketing and selling many products, including books. The system-wide impacts of this shift in retail methods on cost, energy, and the environment are still unclear. While reductions in inventories and returns provide significant savings, some of the major concerns of e-commerce business models are the energy and packaging materials used by the logistics networks for product fulfillment and delivery. In this paper, we analyze the different logistics networks and assess the energy and cost impacts of different delivery systems in the United States and Japan. In Japan, the results suggest a crossover in energy use according to population density. In the United States, the crossover also exists, based on delivery method and distance to local bookstores. In neither case, however, are the potential spillover energy benefits from e-commerce-based methods considered. The results show notable differences for the two distribution methods, and suggest areas where further energy improvements may be possible.

Successful market reform projects require significant revision of government agencies, institutional arrangements, and policy-making procedures, in part, to provide reformers autonomy from countervailing pressures. This paper examines how such innovations facilitated reforms in Mexico and Argentina. It finds executive leadership helped facilitate institutional change, but that technocrat policymakers played more crucial roles than previously documented. Through rule-changing, instrument-creating, and strategizing behaviors, they helped engineer their own autonomy and gained control of the policy agenda by changing the organization of decision making, and the position they occupied in the bureaucracy. These findings hold across distinct policy arenas and political systems.

This essay explains how the peculiar properties of Mexico9s political system helped shape the approach to the study of Mexican politics. It assesses some of the strengths and limitations of the scholarship this produced, examines the political changes that fueled Mexico9s democratic transition, and assesses their implications both for Mexico9s recent market reforms and the study of Mexican politics in general. It finds that the demise of single-party rule and fundamental changes in patterns of governance have opened new research avenues, and suggests an emerging research agenda in light of these developments. En este ensayo se explica la manera en que las propiedades peculiares del sistema poliitico mexicano ayudaron a configurar el acercamiento al estudio de la poliitica mexicana. Se valoran algunas de las ventajas y las desventajas en este enfoque, se examinan los cambios poliiticos que influyeron en la transicioon democraatica meexicana y se analizan sus implicaciones en las reformas recientes del mercado y estudio de la poliitica mexicana en general. El anaalisis concluye que, debido al cese de influencia del antiguo reegimen del partido oficial y a los cambios fundamentales en los modelos de gobierno, se han abierto nuevas aareas de investigacioon, proponiendo un nuevo programa de investigacioon que tome en cuenta el giro de los nuevos acontecimientos.

This article examines how to facilitate effective organizational change, beyond change readiness. Three organizational levels of change are considered: individual, team and corporate. Combining str...

Carbon capture and storage (CCS) for coal power plants reduces onsite carbon dioxide emissions, but affects other air emissions on and offsite. This research assesses the net societal benefits and costs of Monoethanolamine (MEA) CCS, valuing changes in emissions of CO2, SO2, NOX, NH3 and particulate matter (PM), including those in the supply chain. Geographical variability and stochastic uncertainty for 407 coal power plant locations in the U.S. are analyzed. The results show that the net environmental benefits and costs of MEA CCS depend critically on location. For a few favorable sites of both power plant and upstream processes, CCS realizes a net benefit (benefit-cost ratio >1) if the social cost of carbon exceeds $51/ton. For much of the U.S. however, the social cost of carbon must be much higher to realize net benefits from CCS, up to a maximum of $910/ton. While the social costs of carbon are uncertain, typical estimates are in the range of $32-220 per ton, much lower than the breakeven value for many potential CCS locations. Increased impacts upstream from the power plant can dramatically change the social acceptability of CCS and needs further consideration and analysis.

ER stress has recently been linked to the development of hypertension in male SHR. Little is known regarding ER stress in females, although blood pressure (BP) in female SHR is lower than in age-matched males. This study was designed to test the hypothesis that female SHR have less ER stress than males, and consequently will have a smaller decrease in BP in response to an ER stress inhibitor. 11-week old rats were treated with vehicle or the ER stress inhibitor phenylbutyric acid (PBA) for 2 weeks (100 mg/kg/day via drinking water; N=4) and BP was measured weekly via tail cuff. The ER stress markers glucose-regulated protein (GRP78) and C/EBP homologous protein (CHOP) were measured in the renal cortex via Western blot analysis. Basal expression of CHOP was higher in females when compared to males (female: 2.7±0.4 vs. male: 1.3±0.2, P=0.007) as well as with GRP (female: 1.8±0.2 vs. male: 1.3±0.1, P=0.04), however these differences were abolished after treatment. BP did not change in either sex following PB...

InGaAs strained epitaxial layers on GaAs are of considerable interest in semiconductor devices. An important feature is the critical thickness of the epitaxial layer beyond which relaxation occurs, affecting the device performance. With this in view, a series of such structures have been grown by organometallic vapor phase epitaxy and characterized by ion channeling, high resolution x-ray diffraction and Raman spectroscopy. The results of these three techniques are compared for the samples in this study which are fully strained, nominally and by experimental measurements. Beam steering effect that occurs at low energy channeling is also addressed.

Liquid lung ventilation has been demonstrated to improve cardiorespiratory function after cardiopulmonary bypass. We hypothesized that liquid lung ventilation (LLV) would decrease the pulmonary inflammatory response after cardiopulmonary bypass (CPB).Prospective, randomized, experimental, controlled, nonblinded study.Animal research laboratory at a university setting.A total of 24 neonatal piglets.After intubation with a cuffed endotracheal tube, swine were conventionally ventilated. After surgical cannulation, each piglet was placed on conventional nonpulsatile CPB and cooled to 18 degrees C (64.4 degrees F). Subsequently, the animals were exposed to 90 mins of low-flow CPB (35 mL/kg/min). Animals were rewarmed to 37 degrees C (98.6 degrees F), removed from CPB, and ventilated for 90 min. Ten animals received conventional gas ventilation only (control), seven received initiation of LLV before CPB (prevention), and seven received initiation of LLV during the rewarming phase of CPB (treatment). After the animals were killed, the lungs were removed en bloc. The left lobe was dissected and formalin-fixed at 20 cm H2O overnight, followed by paraffin embedding. Sections were taken from the paraffin-embedded lungs. Neutrophil accumulation and lung injury were assessed by histochemical staining with leukocyte esterase and morphometrics, respectively. One hundred microscopic images were digitized from each tissue sample for lung morphometrics, and neutrophil counts were obtained from every fifth image.Lung tissue sections showed a significantly lower number of neutrophils per alveolar area in the prevention and treatment groups than in the control group (control 681 +/- 65, prevention 380 +/- 49, treatment 412 +/- 101 neutrophils per alveolar area [cells/mm2]; p.05 for both prevention and treatment compared with control). There were no differences in lung injury as assessed with morphometrics or hemodynamic measurements between any of the three groups.The data suggest that LLV reduces the CPB-induced neutrophil sequestration in the pulmonary parenchyma independent of its effects on the circulatory physiology or evidence of early lung injury.

Objectives: A clinical pathway standardizing management for patients with an admission diagnosis of pneumonia was initiated after a previous study found delayed time to initial antibiotic administration, a longer length of stay, and higher mortality rate for the authors patients as compared with those in a “benchmark” hospital. The current study was undertaken to determine whether implementation of the clinical pathway resulted in statistically significant decreases for these measures, both in the initial year following pathway implementation and two years later. Methods: A retrospective chart review was completed for three cohorts of pneumonia patients admitted via the ED: 1) three months immediately prior to pathway implementation, 2) 10-12 months after implementation of the pathway, and 3) 34-36 months after implementation of the pathway. Four standard antibiotic regimens were used following pathway implementation: community-acquired, community-acquired penicillin-allergic, nursing home-acquired, and nursing home-acquired penicillin-allergic. Demographics, medical history, presentation signs and symptoms, process of care, and outcome data were abstracted from each patient's medical record. Results: The mean time to antibiotic administration decreased from 315 minutes prepathway to approximately 175 minutes during the first postpathway period and 171 minutes at three years (ANOVA, p < 0.0001). The percentage of patients who received antibiotics in the ED increased from 58% prepathway to 94% during the first postpathway period and 97% at three years (chi square, p < 0.0001). Length of stay decreased from 9.7 prepathway to 8.9 days during the first postpathway period and 6.4 days at three years (ANOVA, p < 0.0001). There was no significant change of in-hospital mortality (9.6% prepathway to 5.2% and 4.9%) in the two respective periods. Conclusions: This study demonstrates that implementation of a pneumonia clinical pathway for the management of hospitalized patients admitted via the ED decreases the time to initial antibiotic treatment and increases the proportion of patients initially treated with antibiotics in the ED. These effects were evident in the first year following pathway implementation and sustained at the three-year study interval.

The next generation of engineers must be able to design with natural resources that have very different constraints for a wider variety and greater number of end users.

A disconnection transition is a phase transition which accompanies a change in the connectedness of the fermi sea. The existence of such a transition is established in the context of a one-dimensional interacting model. The model considered is an extension of the delta function bose gas in which its fourth order conservation law is added to the original hamiltonian. For low density, the ground state of the model consists of two separated fermi seas and there are two distinct branches of excitations. At a critical density, one branch of excitations disappears, and there is a second order phase transition to a single fermi sea ground state.

Doppler measurements of 51 Pegasi have been made from 1995 October through 1996 August, with a precision of 5 m s-1. We find a period of 4.231 days, a velocity amplitude of 56 ± 1 m s-1, and a velocity curve that is essentially sinusoidal, all in excellent agreement with Mayor & Queloz. The only viable interpretation is a companion having minimum mass, m sin i = 0.45 MJupiter, in a circular orbit of radius of 0.051 AU, with an eccentricity less than 0.01. Alternative explanations involving stellar surface phenomena such as pulsation or spots are ruled out. The lack of tidal spin-up of the star constrains the mass of the companion to be less than 15 MJupiter. If the tidal Q-value is less than ~106 for the planet (close to Jupiter's presumed value), then internal dissipation is adequate to circularize the orbit and synchronize the planet's rotation. After subtracting the best-fit Keplerian velocity curve, the residuals exhibit no apparent variations at a level of 5 m s-1 during 10 months. The absence of further reflex motion along with limits from IR speckle observations rule out additional companions in a large portion of the parameter space of mass and orbital radius, including all masses greater than 1 MJupiter within 2.0 AU.

To establish outcome rates for patients receiving intravenous thrombolysis based on vascular occlusion site.This is a retrospective analysis of 225 patients who had received intravenous-rt-PA for anterior circulation strokes. The occlusion-site was prospectively determined on the admission computed tomographic angiography (CTA) and divided into: large vessel occlusion (LVO) including patients with an internal carotid artery terminus or middle cerebral artery (M1/proximal M2) occlusions and no large vessel occlusion (No-LVO; distal M2/M3/ACA) including patients with either distal or no occlusions. The primary outcome was the modified Rankin score (mRS) at 90-days with a good outcome defined by mRS of 0-2.000.There were 114 (50.7%) patients in the LVO and 111 (49.3%) in the No-LVO group. A good outcome was seen in 28 (24.6%) patients in the LVO and 77 (69.4%) patients in the No-LVO group (OR .14; 95% CI: .08-.26; P.0001). Mortality was observed in 13 (11.7%) patients in the No-LVO group and 48 (42.1%) patients in the LVO group (OR .18; 95% CI: .09-.36; P.0001). Significant hemorrhage was seen in 14 (12.5%) patients in the LVO and 0 (0%) patients in the No-LVO group (P.0001). Older age (OR .96; 95% CI: .93-.98; P = .002) and presence of LVO (OR .29; 95% CI: .12-.68; P = .004) were significant independent predictors of poor outcome.CTA identification of proximal occlusions is associated with significantly poor outcomes in patients receiving intravenous stroke thrombolysis.

The Contura brachytherapy applicator is a silicone balloon with five lumens in which a high-dose-rate brachytherapy source can traverse. Multilumen applicators, like the Contura, are used in accelerated partial breast irradiation (APBI) brachytherapy in instances where asymmetric dose distributions are desired; for example, when the applicator surface-to-skin thickness is small (< 7 mm). In these instances, the air outside the patient and the lung act as a poor scattering medium, scattering less dose back into the breast and affecting the dose distribution. The recent report by Task Group 186 of the American Association of Physicists in Medicine (AAPM) has outlined the importance of moving towards brachytherapy dose calculations using heterogeneity corrections. However, at this time, many commercial treatment planning systems do not correct for tissue heterogeneity, which can result in inaccuracies in the planned dose distribution. To quantify the deviation in the skin dose we utilize the dose modification factor (DMF), defined as the ratio of the dose rate at 1 cm beyond the applicator surface with homogenous medium, to the dose rate at 1 cm with heterogeneous medium. This investigation models the Contura applicator with the Monte Carlo N-Particle code version 5, and determines a DMF through simulation. Taking all geometrical considerations into account, an accurate model of the Contura balloon applicator was created in MCNP and used to run simulations. The dose modification factor was found to be only slightly dependent on whether the dose distribution was symmetric or asymmetric. These results indicate that the dose delivered to part of the PTV may be lower than the planned dose by up to 12%, and that these brachytherapy plans should be viewed with caution. In addition to studying the effects of backscatter, an evaluation was made regarding the capabilities of the Contura device to shape an asymmetric dose distribution. We compared these results to a previous study of a MammoSite ML and a SAVI device and found that the dose shaping capabilities of the Contura were quite similar to that of the MammoSite ML, but markedly inferior to the SAVI. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

The free energy of the supersymmetric t-J model is expressed in terms of finite temperature excitations away from thermodynamic equilibrium. This reveals that the free energy has the form of noninteracting fermions with temperature dependent excitation spectra. We also discuss the ground state and zero temperature excitations.