A study to determine the association between medical decision-making and the performance of an institutional ethics committee

This study developed proxy measures to test the independent effects of medical specialty, institutional ethics committee (IEC) and the interaction between the two, upon a proxy for the dependent variable of the medical decision to withhold/withdraw care for the dying--the resuscitation index (R-index). Five clinical vignettes were constructed and validated to convey the realism and contextual factors implicit in the decision to withhold/withdraw care. A scale was developed to determine the range of contact by an IEC in terms of physician knowledge and use of IEC policy.^ This study was composed of a sample of 215 physicians in a teaching hospital in the Southwest where proxy measures were tested for two competing influences, medical specialty and IEC, which alternately oppose and support the decision to withhold/withdraw care for the dying. A sub-sample of surgeons supported the hypothesis that an IEC is influential in opposing the medical training imperative to prolong life.^ Those surgeons with a low IEC score were 326 percent more likely to continue care than were surgeons with a high IEC score when compared to all other specialties. IEC alone was also found to significantly predict the decision to withhold/withdraw care. Interaction of IEC with the specialty of surgery was found to be the best predictor for a decision to withhold/withdraw care for the dying. ^

A dual resonance, image -guided, volume localization technique for magnetic resonance spectroscopy

An interleaved, dual resonance, volume localization technique for $\sp1$H/$\sp{31}$P magnetic resonance spectroscopy has been designed, implemented on a 2 T imager/spectrometer, and verified with phantom studies.^ Localization techniques, including several single voxel techniques and spectroscopic imaging, were implemented, and studies were performed to compare the efficiency of each sequence of $\sp1$H/$\sp{31}$P spectral acquisitions. The sequence chosen was a hybrid of the stimulated echo single voxel technique and the spectroscopic imaging technique.^ Water suppression during the $\sp1$H spectral acquisitions was accomplished by the use of three narrow bandwidth RF saturation pulses in combination with three spoiler gradients. The spoiler gradient amplitudes were selected on the basis of a numerical solution of the Bloch equations. A post-acquisition water suppression algorithm was used to minimize any residual water signal.^ For interleaved $\sp1$H/$\sp{31}$P acquisitions, a dual resonance RF coil was constructed and interfaced to the existing RF detection system via a custom-designed dual resonance transcoupler and switching system. Programmable attenuators were incorporated to allow for changes in receiver and transmitter attenuation "on the fly".^ To provide the rapidly switched gradient fields required for the $\sp1$H/$\sp{31}$P acquisitions, an actively screened gradient coil system was designed and implemented. With this system, gradient field rise times on the order of 100 $\mu$s were obtained. These rapid switching times were necessary for minimizing intrasequence delays and for improving localization quality and water suppression efficiency.^ The interleaved $\sp1$H/$\sp{31}$P volume localization technique was tested using a two-compartment phantom. Analysis of the data showed that the spectral contamination was less than three percent. One-to-one spatial correspondence of the $\sp1$H and $\sp{31}$P spectra was verified and allowed for direct correlation of the spectral data with a standard magnetic resonance image. ^

Ethics and materials: Some Spanish Cases

The problem is general: modern architects and engineers are trying to understand historic structures using the wrong theoretical frame, the classic (elastic) thery of structures developed in the 19th Century for iron and stell, and in the 20th century for reinforced concrete, disguised with "modern" computer packages, mainly FEM, but also others. Masonry is an essentially different material, and the structural equations must be adapted accordingly. It is not a matter of "taste" or "opinion", and the consequences are before us. Since, say 1920s, historic monuments have suffered the aggression of generations of archietcts and engineers, trying to transform masonry in reinfored concrete or steel. The damage to the monuments and the expense has been, and is, enormous. However, as we have an adequate theory (modern limit analysis of masonry structures, Heyman 1966) which encompasses the "old theory" used successfully by the 18th and 19th Century practical engineers (from Perronet to Sejourné), it is a matter of "Ethics" not to use the wrong approach. It is also "contra natura" to modify the material masonry with indiscriminate injections, stitchings, etc. It is insane to consider, suddenly, that buildings which are Centuries or milennia old, are suddenly in danger of collapse. Maintenance is necessary but not the actual destruction of the constructive essence of the monument. A cocktail of "ignorance, fear and greed" is acting under the best of intentions.

Dual role of HupF in the biosynthesis of [NiFe] hydrogenase in Rhizobium leguminosarum

Background: [NiFe] hydrogenases are enzymes that catalyze the oxidation of hydrogen into protons and electrons, to use H2 as energy source, or the production of hydrogen through proton reduction, as an escape valve for the excess of reduction equivalents in anaerobic metabolism. Biosynthesis of [NiFe] hydrogenases is a complex process that occurs in the cytoplasm, where a number of auxiliary proteins are required to synthesize and insert the metal cofactors into the enzyme structural units. The endosymbiotic bacterium Rhizobium leguminosarum requires the products of eighteen genes (hupSLCDEFGHIJKhypABFCDEX) to synthesize an active hydrogenase. hupF and hupK genes are found only in hydrogenase clusters from bacteria expressing hydrogenase in the presence of oxygen. Results: HupF is a HypC paralogue with a similar predicted structure, except for the C-terminal domain present only in HupF. Deletion of hupF results in the inability to process the hydrogenase large subunit HupL, and also in reduced stability of this subunit when cells are exposed to high oxygen tensions. A ?hupF mutant was fully complemented for hydrogenase activity by a C-terminal deletion derivative under symbiotic, ultra low-oxygen tensions, but only partial complementation was observed in free living cells under higher oxygen tensions (1% or 3%). Co-purification experiments using StrepTag-labelled HupF derivatives and mass spectrometry analysis indicate the existence of a major complex involving HupL and HupF, and a less abundant HupF-HupK complex. Conclusions: The results indicate that HupF has a dual role during hydrogenase biosynthesis: it is required for hydrogenase large subunit processing and it also acts as a chaperone to stabilize HupL when hydrogenase is synthesized in the presence of oxygen.

Opportunities and challenges in the use of inorganic fullerene-like nanoparticles to produce advanced polymer nanocomposites

Polymer/inorganic nanoparticle nanocomposites have garnered considerable academic and industrial interest over recent decades in the development of advanced materials for a wide range of applications. In this respect, the dispersion of so-called inorganic fullerene-like (IF) nanoparticles, e.g., tungsten disulfide (IF-WS2) or molybdenum disulfide (IF-MoS2), into polymeric matrices is emerging as a new strategy. The surprising properties of these layered metal dichalcogenides such as high impact resistance and superior tribological behavior, attributed to their nanoscale size and hollow quasi-spherical shape, open up a wide variety of opportunities for applications of these inorganic compounds. The present work presents a detailed overview on research in the area of IF-based polymer nanocomposites, with special emphasis on the use of IF-WS2 nanoparticles as environmentally friendly reinforcing fillers. The incorporation of IF particles has been shown to be efficient for improving thermal, mechanical and tribological properties of various thermoplastic polymers, such as polypropylene, nylon-6, poly(phenylene sulfide), poly(ether ether ketone), where nanocomposites were fabricated by simple melt-processing routes without the need for modifiers or surfactants. This new family of nanocomposites exhibits similar or enhanced performance when compared with nanocomposites that incorporate carbon nanotubes, carbon nanofibers or nanoclays, but are substantially more cost-effective, efficient and environmentally satisfactory. Most recently, innovative approaches have been described that exploit synergistic effects to produce new materials with enhanced properties, including the combined use of micro- and nanoparticles such as IF-WS2/nucleating agent or IF-WS2/carbon fiber, as well as dual nanoparticle systems such as SWCNT/IF-WS2 where each nanoparticle has different characteristics. The structure–property relationships of these nanocomposites are discussed and potential applications proposed ranging from medicine to the aerospace, automotive and electronics industries.

Water use efficiency and water productivity in the Spanish irrigation district ¿Río Adaja?

A study of the assessment of the irrigation water use has been carried out in the Spanish irrigation District “Río Adaja” that has analyzed the water use efficiency and the water productivity indicators for the main crops for three years: 2010-2011, 2011-2012 and 2012-2013. A soil water balance model was applied taking into ccount climatic data for the nearby weather station and soil properties. Crop water requirements were calculated by the FAO Penman- Monteith with the application of the dual crop coefficient and by considering the readily vailable soil water content (RAW) concept. Likewise, productivity was measured by the indexes: annual relative irrigation supply (ARIS), annual relative water supply (ARWS), relative rainfall supply (RRS), the water productivity (WP), the evapotranspiration water productivity (ETWP), and the irrigation water productivity (IWP. The results show that in most crops deficit irrigation was applied (ARIS<1) in the first two years however, the IWP improved. This was higher in 2010-2011 which corresponded to the highest effective precipitation Pe. In general, the IWP (€.m-3) varied amongcrops but crops such as: onion (4.14, 1.98 and 2.77 respectively for the three years), potato (2.79, 1.69 and 1.62 respectively for the three years), carrot (1.37, 1.70 and 1.80 respectively for the three years) and barley (1.21, 1.16 and 0.68 respectively for the three years) showed the higher values. Thus, it is highlighted the y could be included into the cropping pattern which would maximize the famer’s gross income in the irrigation district.

Long-term potentiation and dual-component quantal signaling in the dentate gyrus

Long-term potentiation (LTP) of excitatory transmission is an important candidate cellular mechanism for the storage of memories in the mammalian brain. The subcellular phenomena that underlie the persistent increase in synaptic strength, however, are incompletely understood. A potentially powerful method to detect a presynaptic increase in glutamate release is to examine the effect of LTP induction on the rate at which the use-dependent blocker MK-801 attenuates successive N-methyl-d-aspartic acid (NMDA) receptor-mediated synaptic signals. This method, however, has given apparently contradictory results when applied in hippocampal CA1. The inconsistency could be explained if NMDA receptors were opened by glutamate not only released from local presynaptic terminals, but also diffusing from synapses on neighboring cells where LTP was not induced. Here we examine the effect of pairing-induced LTP on the MK-801 blocking rate in two afferent inputs to dentate granule cells. LTP in the medial perforant path is associated with a significant increase in the MK-801 blocking rate, implying a presynaptic increase in glutamate release probability. An enhanced MK-801 blocking rate is not seen, however, in the lateral perforant path. This result still could be compatible with a presynaptic contribution to LTP in the lateral perforant path if intersynaptic cross-talk occurred. In support of this hypothesis, we show that NMDA receptors consistently sense more quanta of glutamate than do α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors. In the medial perforant path, in contrast, there is no significant difference in the number of quanta mediated by the two receptors. These results support a presynaptic contribution to LTP and imply that differences in intersynaptic cross-talk can complicate the interpretation of experiments designed to detect changes in transmitter release.

Ethics and access to teaching materials in the medical library: the case of the Pernkopf atlas*

Conflicts can occur between the principle of freedom of information treasured by librarians and ethical standards of scientific research involving the propriety of using data derived from immoral or dishonorable experimentation. A prime example of this conflict was brought to the attention of the medical and library communities in 1995 when articles claiming that the subjects of the illustrations in the classic anatomy atlas, Eduard Pernkopf's Topographische Anatomie des Menschen, were victims of the Nazi holocaust. While few have disputed the accuracy, artistic, or educational value of the Pernkopf atlas, some have argued that the use of such subjects violates standards of medical ethics involving inhuman and degrading treatment of subjects or disrespect of a human corpse. Efforts were made to remove the book from medical libraries. In this article, the history of the Pernkopf atlas and the controversy surrounding it are reviewed. The results of a survey of academic medical libraries concerning their treatment of the Pernkopf atlas are reported, and the ethical implications of these issues as they affect the responsibilities of librarians is discussed.

Estimation of Key Dates and Stages in Rice Crops Using Dual-Polarization SAR Time Series and a Particle Filtering Approach

Information of crop phenology is essential for evaluating crop productivity. In a previous work, we determined phenological stages with remote sensing data using a dynamic system framework and an extended Kalman filter (EKF) approach. In this paper, we demonstrate that the particle filter is a more reliable method to infer any phenological stage compared to the EKF. The improvements achieved with this approach are discussed. In addition, this methodology enables the estimation of key cultivation dates, thus providing a practical product for many applications. The dates of some important stages, as the sowing date and the day when the crop reaches the panicle initiation stage, have been chosen to show the potential of this technique.

El sistema de gobierno dual de Argentina y su origen,

"Memoria presentada ... al II Congreso científico latinoamericano en Montevideo ... [y] en la tercera reunión del Congreso científico latinoamericano verificada en Rio de Janeiro."

Tests of the dual differential radiometer under field conditions /

Issued Aug. 1978.

Conventional and advanced sewer design concepts for dual purpose flood and pollution control : a preliminary case study, Elizabeth, New Jersey /

Mode of access: Internet.

Dual process high-rate filtration of raw sanitary sewage and combined sewer overflows /

Mode of access: Internet.

Christian ethics.

Mode of access: Internet.

Nomination of Amy L. Comstock : hearing before the Committee on Governmental Affairs, United States Senate, One Hundred Sixth Congress, second session, on the nomination of Amy L. Comstock, to be Director of the Office of Government Ethics, May 12, 2000.

Shipping list no.: 2000-0341-P.