Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

Zinc coupling potentiates anti-HIV-1 activity of baicalin

Baicalin (BA) has been shown with anti-HIV-1 activity. Zinc is a nutrient element. The anti-HIV-1 activity of zinc complex of baicalin (BA-Zn) in vitro was studied and compared with the anti-HIV-1 activities between BA and BA-Zn in the present study. Our results suggested that BA-Zn has lower cytotoxicity and higher anti-HIV-1 activity compared with those of BA in vitro. The CC(50)s of BA-Zn and BA were 221.52 and 101.73 muM, respectively. The cytotoxicity of BA-Zn was about 1.2-fold lower than that of BA. The BA and BA-Zn inhibited HIV-1 induced syncytium formation, HIV-1 p24 antigen and HIV-1 RT production. The EC(50)s of BA-Zn on inhibiting HIV-1 induced syncytium formation (29.08 muM) and RT production (31.17 muM) were lower than those of BA (43.27 and 47.34 muM, respectively). BA-Zn was more effective than BA in inhibiting the activities of recombinant RT and HIV-1 entry into host cells. Zinc coupling enhanced the anti-HTV-1 activity of baicalin. (C) 2004 Elsevier Inc. All rights reserved.

Coupling between elytra of some beetles: Mechanism, forces and effect of surface texture

Lightweight materials, structures and coupling mechanisms are very important for realizing advanced flight vehicles. Here, we obtained the geometric structures and morphologies of the elytra of beetles and ascertained its coupling zone by using the histological section technique and SEM. We set up a three-dimensional motion observing system to monitor the opening and closing behaviour of elytra in beetles and to determine the motion mechanism. We constructed a force measuring system to measure the coupling forces between elytra. The results show that elytra open and close by rotating about a single axle, where the coupling forces may be as high as 160 times its own bodyweight, the elytra coupling with the tenon and mortise mechanism, surface texture and opening angle between elytra heavily influence the coupling forces. These results may provide insights into the design mechanism and structure for future vehicles of flight.

Coupling between NMDA receptor and acid-sensing ion channel contributes to ischemic neuronal death

Acid-sensing ion channels (ASICs) composed of ASIC1a subunit exhibit a high Ca2+ permeability and play important roles in synaptic plasticity and acid-induced cell death. Here, we show that ischemia enhances ASIC currents through the phosphorylation at Ser478 and Ser479 of ASIC1a, leading to exacerbated ischemic cell death. The phosphorylation is catalyzed by Ca2+/calmodulin-dependent protein kinase II (CaMKII) activity, as a result of activation of NR2B-containing N-methyl-D-aspartate subtype of glutamate receptors (NMDARs) during ischemia. Furthermore, NR2B-specific antagonist, CaMKII inhibitor, or overexpression of mutated form of ASIC1a with Ser478 or Ser479 replaced by alanine (ASICla-S478A, ASIC1a-S479A) in cultured hippocampal neurons prevented ischemia-induced enhancement of ASIC currents, cytoplasmic Ca2+ elevation, as well as neuronal death. Thus, NMDAR-CaMKII cascade is functionally coupled to ASICs and contributes to acidotoxicity during ischemia. Specific blockade of NMDAR/CaMKII-ASIC coupling may reduce neuronal death after ischemia and other pathological conditions involving excessive glutamate release and acidosis.

Solid-state memories based on ferroelectric tunnel junctions.

Ferroic-order parameters are useful as state variables in non-volatile information storage media because they show a hysteretic dependence on their electric or magnetic field. Coupling ferroics with quantum-mechanical tunnelling allows a simple and fast readout of the stored information through the influence of ferroic orders on the tunnel current. For example, data in magnetic random-access memories are stored in the relative alignment of two ferromagnetic electrodes separated by a non-magnetic tunnel barrier, and data readout is accomplished by a tunnel current measurement. However, such devices based on tunnel magnetoresistance typically exhibit OFF/ON ratios of less than 4, and require high powers for write operations (>1 × 10(6) A cm(-2)). Here, we report non-volatile memories with OFF/ON ratios as high as 100 and write powers as low as ∼1 × 10(4) A cm(-2) at room temperature by storing data in the electric polarization direction of a ferroelectric tunnel barrier. The junctions show large, stable, reproducible and reliable tunnel electroresistance, with resistance switching occurring at the coercive voltage of ferroelectric switching. These ferroelectric devices emerge as an alternative to other resistive memories, and have the advantage of not being based on voltage-induced migration of matter at the nanoscale, but on a purely electronic mechanism.

Switching characteristics of diamond-based m-i-p+ diodes in power electronic applications

Modeling and numerical analysis of diamond m-i-p+ diode have been performed for static and transient analysis using TCAD Sentaurus platform. The simulation results are compared with experimental measurements. Prediction of transient turn-off characteristics of diamond m-i-p+ diode at high temperature is performed for the first time. It was found that unlike conventional Si diode, peak reverse current in diamond m-i-p+ diode reduces with increasing temperature while on-state voltage drop increases. © 2011 IEEE.

Liquid crystal multi-mode lenses and axicons based on electronic phase shift control

We report on the principle of operation, construction and testing of a liquid crystal lens which is controlled by distributing voltages across the control electrodes, which are in turn controlled by adjusting the phase of the applied voltages. As well as (positive and negative) defocus, then lenses can be used to control tip/tilt, astigmatism, and to create variable axicons. © 2007 Optical Society of America.