The Impact of Admissions for the Management of End-stage renal disease on hospital bed occupancy

BACKGROUND:

End-stage renal disease (ESRD) is increasingly prevalent but the inpatient costs associated with this condition are poorly defined due to limitations with data extraction and failure to differentiate between hospitalisation for renal and non-renal disease reasons. The impact of admissions primarily for the management of ESRD on hospital bed utilisation was assessed over a 5-year period in a large teaching hospital.

METHODS:

All admission episodes were reviewed and the ESRD group was identified by a primary International Classification of Diseases code for ESRD or a non-specific primary renal failure code with a secondary code for ESRD. The frequency and duration of hospitalisation and contribution to bed day occupancy of this group with ESRD was determined.

RESULTS:

There were 70,808 patients responsible for a total of 116,915 admissions and 919,212 bed days over the study period. Of these, 988 (1.4%) patients were admitted for the management of ESRD, accounting for 2,387 (2.0%) of admissions and utilisation of 23,011 (2.5%) bed days. After adjustment for age and gender, those admitted for ESRD management were significantly more likely to have a prolonged admission exceeding 30 days (odds ratio 1.46, 95% confidence interval 1.23-1.72, p < 0.001). When the admission was an emergency rather than an elective event, the patient was 4.6 times more likely to be hospitalised for over 30 days.

CONCLUSIONS:

Persons admitted for ESRD management are hospitalised more frequently and for longer than the overall inpatient population, occupying a substantial number of bed days.

China's Labor Question

The Honda workers’ strike in 2010 attracted world wide attention. It was one of thousands of labor disputes that happen every year in China, but it was the first major calling for the right of workers to represent themselves in collective bargaining. The question of representation is therefore the main topic of the book. The various contributors to this volume share the view that the Chinese party-state takes the protest against social inequality seriously. It has enacted many laws aimed at channeling dissatisfaction into safe channels. The implementation of these laws, however, lags behind and these laws do not include the right of freedom of association. Without this right, super-exploitation will persist and the system of labor relations will remain prone to eruptive forms of protest. The first part of the book provides an overview of the economic context of Chinese labor relations, the transformation of class-relations, the evolution of labor law, and government policies intended to set a wage floor. Based on extensive field research, the second part looks at the evolution of labor relations at the industry level. In the third part, the focus shifts to the Corporate Social Responsibility agenda in China. The final part looks at the connection between land reform and social inequality.

El poder colombiano, los piratas del siglo XXI

El galeón español San José, que se hundió en 1708 en la bahía de Cartagena, Colombia, es la nave más pretendida en la actualidad por los cinco mil millones de dólares que alberga. Cuando el expresidente de Colombia Belisario Betancur se enteró de su valor, en 1982, se inició una fiebre de corrupción entre figuras de poder colombiano y los cazatesoros por rescatar el gran botín. En 2013 el presidente de Colombia Juan Manuel Santos sancionó la Ley 1675 con el objetivo de proteger y regular la protección al patrimonio cultural sumergido. Sin embargo, como varias fuentes lo evidencian, esto es solo la luz verde que esperaron los ambiciosos durante décadas para poder obtener beneficios personales con el patrimonio de la Nación.

Final report of the Highway cost allocation study. Letter from the Secretary of Commerce transmitting the Final report of the Highway cost alloction study, pursuant to Section 210 of the Highway revenue act of 1956 (70 Stat. 387) as amended by Section 2 of the act approved August 28, 1958.

Mode of access: Internet.

The application of Raman spectroscopy to the study of the uranyl mineral coconinoite Fe2Al2(UO2)2(PO4)4(SO4)(OH)2•20H2O

Raman spectra of the uranyl containing mineral coconinoite, Fe2Al2(UO2)2(PO4)4(SO4)(OH)2•20H2O, are presented and compared with the mineral’s infrared spectra. Bands connected with (UO2)2+, (PO4)3- , (SO4)2-, (OH)- and H2O stretching and bending vibrations, are assigned. Approximate U-O bond lengths in uranyl, (UO2)2+, and O-H...O hydrogen bond lengths are calculated from the wavenumbers of the U-O stretching vibrations and (OH)- and H2O stretching vibrations, respectively, and compared with published data for similar natural and synthetic compounds.

Reduced electron recombination of dye-sensitized solar cells based on TiO 2 spheres consisting of ultrathin nanosheets with [001] facet exposed

An anatase TiO 2 material with hierarchically structured spheres consisting of ultrathin nanosheets with 100% of the [001] facet exposed was employed to fabricate dye-sensitized solar cells (DSC s). Investigation of the electron transport and back reaction of the DSCs by electrochemical impedance spectroscopy showed that the spheres had a threefold lower electron recombination rate compared to the conventional TiO 2 nanoparticles. In contrast, the effective electron diffusion coefficient, D n, was not sensitive to the variation of the TiO 2 morphology. The TiO 2 spheres showed the same Dn as that of the nanoparticles. The influence of TiCl 4 post-treatment on the conduction band of the TiO 2 spheres and on the kinetics of electron transport and back reactions was also investigated. It was found that the TiCl 4 post-treatment caused a downward shift of the TiO 2 conduction band edge by 30 meV. Meanwhile, a fourfold increase of the effective electron lifetime of the DSC was also observed after TiCl4 treatment. The synergistic effect of the variation of the TiO 2 conduction band and the electron recombination determined the open-circuit voltage of the DSC. © 2012 Wang et al.

Carvedilol induces greater control of β2- than β1-adrenoceptor-mediated inotropic and lusitropic effects by PDE3, while PDE4 has no effect in human failing myocardium

The beta-blockers carvedilol and metoprolol provide important therapeutic strategies for heart failure treatment. Therapy with metoprolol facilitates the control by phosphodiesterase PDE3, but not PDE4, of inotropic effects of catecholamines in human failing ventricle. However, it is not known whether carvedilol has the same effect. We investigated whether the PDE3-selective inhibitor cilostamide (0.3 mu M) or PDE4-selective inhibitor rolipram (1 mu M) modified the positive inotropic and lusitropic effects of catecholamines in ventricular myocardium of heart failure patients treated with carvedilol. Right ventricular trabeculae from explanted hearts of nine carvedilol-treated patients with terminal heart failure were paced to contract at 1 Hz. The effects of (-)-noradrenaline, mediated through beta(1)-adrenoceptors (beta(2)-adrenoceptors blocked with ICI118551), and (-)-adrenaline, mediated through beta(2)-adrenoceptors (beta(1)-adrenoceptors blocked with CGP20712A), were assessed in the absence and presence of the PDE inhibitors. The inotropic potency, estimated from -logEC(50)s, was unchanged for (-)-noradrenaline but decreased 16-fold for (-)-adrenaline in carvedilol-treated compared to non-beta-blocker-treated patients, consistent with the previously reported beta(2)-adrenoceptor-selectivity of carvedilol. Cilostamide caused 2- to 3-fold and 10- to 35-fold potentiations of the inotropic and lusitropic effects of (-)-noradrenaline and (-)-adrenaline, respectively, in trabeculae from carvedilol-treated patients. Rolipram did not affect the inotropic and lusitropic potencies of (-)-noradrenaline or (-)-adrenaline. Treatment of heart failure patients with carvedilol induces PDE3 to selectively control the positive inotropic and lusitropic effects mediated through ventricular beta(2)-adrenoceptors compared to beta(1)-adrenoceptors. The beta(2)-adrenoceptor-selectivity of carvedilol may provide protection against beta(2)-adrenoceptor-mediated ventricular overstimulation in PDE3 inhibitor-treated patients. PDE4 does not control beta(1)- and beta(2)-adrenoceptor-mediated inotropic and lusitropic effects in carvedilol-treated patients.

N-(7-Nitrobenz-2-oxa-1,3-diazol-4-yI)colcemid, a probe for different classes of colchincine-binding site on tubulin

The nature of binding of 7-nitrobenz-2-oxa-1,3-diazol-4-yl-colcemid (NBD-colcemid), an environment-sensitive fluorescent analogue of colchicine, to tubulin was tested. This article reports the first fluorometric study where two types of binding site of colchincine analogue on tubulin were detected. Binding of NBD-colcemid to one of these sites equilibrates slsowly. NBD-colcemid competes with colchicine for this site. Binding of NBD-colcemid to this site also causes inhibition of tubulin self-assembly. In contrast, NBD-colcemid binding to the other site is characterised by rapid equilibration and lack of competition with colchicine. Nevertheless, binding to this site is highly specific for the cholchicine nucleus, as alkyl-NBD analogues have no significant binding activity. Fast-reaction-kinetic studies gave 1.76 × 105 M–1 s–1 for the association and 0.79 s–1 for the dissociation rate constants for the binding of NBD-colcemid to the fast site of tubulin. The association rate constants for the two phases of the slow site are 0.016 × 10–4 M–1 s–1 and 3.5 × 10–4 M–1 respectively. These two sites may be related to the two sites of colchicine reported earlier, with binding characteristics altered by the increased hydrophobic nature of NBD-colcemid.

Synthesis, structure characterization and biological activity of a novel amino acid salt (HAla)(8)(H3O)(10)[PMo12O40](6) center dot 22H(2)O

A novel compound was synthesized and characterized by means of elemental analysis, IR and UV spectra, TG, CV and single crystal X-ray diffraction. The compound crystallized in an orthorhombic space group C222 with a=1. 622 4(3) nm, b=3. 498 4(7) nm, c=1. 301 5(3) nm, V=7. 387 (3) nm(3), Z=6, R-1= 0. 037 3, wR(2)=0. 114 0. The Ala (Ala = alanine) molecules were protonated at the amino nitrogen N (1) and the C (2) of Ala group with the terminal oxygen atom O(15), O(14), O(26) and O(27) of the polyoxometalates participating in the hydrogen bond network. The anti-tumor activity of the title compound was estimated against Hela and Pc-3m cancer cells.