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Origin and destination entropies of U.S. 1965-70 age-sex-specific intercounty migration flows.

"Eight independent pairs of entropy-based rankings of 3,140 U.S. county-level units are obtained. The criteria employed are the homogeneities of the distribution of 1965-70 in- and out-migrants of each county--for eight age-sex-specific groups--over the other 3,139 counties. The most homogeneous counties for males of ages 19-39 in 1970 consistently have major military facilities." The results show that "for those 65 and over, Florida, Arizona and Texas counties have the broadest in-migration, while Northern metropolitan counties have dispersed out-migration. The cross-correlations of entropies--though all strongly positive--are lowest between those 19-39 and those 65 and over, and relatively weak, in general, between those 65 and over and other groups. In all eight demographic groups, destination entropies reach higher values than origin entropies."

Age Factors↗

Synaptic organization of the cerebello-thalamo-cerebral pathway in the cat. III. Cerebellar input to corticofugal neurons destined for different subcortical nuclei in areas 4 and 6.

To analyze the cerebellar effects on corticofugal neurons destined for different subcortical nuclei, intracellular recordings were made from corticofugal neurons in areas 4 and 6 of the cat. Corticonuclear neurons to the red nucleus (RN) and the pontine nucleus (PN), and pyramidal tract neurons (PTNs) with collaterals to these nuclei were identified by their antidromic responses to the stimulation of these nuclei and the pyramid. Three types of RN-projecting neurons (corticorubral neurons (CRNs), corticopontine neurons (CPNs) with a collateral to the RN and PTNs with a collateral to the RN) and two types of PN-projecting neurons (CPNs and PTNs with a collateral to the PN) were differentiated. Furthermore, these corticofugal neurons were classified as fast and slow neurons on the basis of a critical axonal conduction velocity of 20 m/s. About 80% of 98 RN-projecting neurons in area 4 were PTNs, and among the rest, CPNs were more common than CRNs. A similar tendency of the frequency distribution of 37 RN-projecting neurons was also observed in area 6. In area 4, about 70% of 158 PN-projecting neurons were PTNs (80 fast and 30 slow PTNs) and the rest were CPNs, while in area 6, only 35% of 99 PN-projecting neurons were PTNs (10 fast and 25 slow PTNs). Among the CPNs in areas 4 and 6, slow CPNs were more frequently encountered. Cerebellar effects on these identified corticofugal neurons were investigated, using electrical stimulation of the brachium conjunctivum (BC). In both areas 4 and 6, a substantial number of fast conducting CRNs, CPNs and PTNs projecting to the RN or the PN received short-latency (predominantly disynaptic), large-amplitude EPSPs from the BC, and a considerable number of slow conducting neurons to the RN and/or the PN received longer-latency, smaller-amplitude EPSPs from the BC.

Animals↗

Using computer graphics to map origin-destination data describing health care delivery systems.

An interactive graphic computer program, called FLOWMAP, is used to examine the referral patterns of cancer patients in western Washington between 1974 and 1978. FLOWMAP allows one to produce several types of maps from origin-destination data easily and inexpensively. Several maps show some of the significant geographic components of the referral of more than 7000 cancer patients among 13 counties over a 5-year period. It is shown that cancer care has become more decentralized during this period. Nine other possible applications of FLOWMAP to issues of concern regarding the delivery of health care are described. Maps produced by FLOWMAP can be expected to cost 1/30 to 1/50 of the cost of comparable manual methods. An Appendix gives some technical detail regarding the use of FLOWMAP and its data requirements.

Computers↗

Motoneurons destined to die are rescued by blocking N-methyl-D-aspartate receptors by MK-801.

Motoneurons to soleus muscle die if their axons are injured at birth. We tested the possibility that their death may be caused by toxic effects of excitatory transmitters such as glutamate. Animals that had their sciatic nerves crushed at birth were treated either with a blocker of the N-methyl-D-aspartate receptor, dizocilpine maleate (MK-801), or saline. The number of surviving soleus motoneurons and motor units was assessed 60-90 days later. Treatment of rats with MK-801 rescued a large proportion of injured motoneurons destined to die. Moreover, the weight loss of soleus muscles seen after nerve injury at birth was reduced in animals treated with MK-801. These results suggest that motoneurons axotomized at birth are unable to withstand the excitotoxic effects of glutamate and die. Blocking glutamate receptors in conditions where motoneuron loss occurs could be an effective way of rescuing them.

Animals↗

Relationship of initial hematocrit level to discharge destination and resource utilization after ischemic stroke: a pilot study.

OBJECTIVE: To examine the association between initial hematocrit level at the time of ischemic stroke, discharge destination, and resource utilization. DESIGN: Case series. SETTING: University hospital. PARTICIPANTS: A total of 1012 consecutive patients with ischemic stroke admitted to a university health system between August 3, 1995, and June 24, 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Length of stay, hospital cost, and discharge disposition. RESULTS: Of 1012 patients presenting with ischemic stroke, 58% were discharged home, 10% were discharged home with home care services, 15% were discharged to a rehabilitation hospital, 11% were discharged to a skilled or intermediate care facility, and 6% died. After adjusting for age, sex, race, and comorbidities, a significant association (P=.009) existed between discharge outcome and initial hematocrit level. The probability of achieving an equivalent or less favorable outcome increased at both high and low hematocrit levels, with a minimum probability at a hematocrit level of approximately 45%. CONCLUSIONS: An association exists between hematocrit level at the time of ischemic stroke and discharge outcome. Midrange hematocrit levels appear to be associated with discharge to home rather than to an inpatient rehabilitation unit or to a nursing facility. Further study is indicated to examine the relationship among hematocrit level, stroke severity, and outcome.

Aged↗

Protein kinase D regulates the fission of cell surface destined transport carriers from the trans-Golgi network.

When a kinase inactive form of Protein Kinase D (PKD-K618N) was expressed in HeLa cells, it localized to the trans-Golgi network (TGN) and caused extensive tubulation. Cargo that was destined for the plasma membrane was found in PKD-K618N-containing tubes but the tubes did not detach from the TGN. As a result, the transfer of cargo from TGN to the plasma membrane was inhibited. We have also demonstrated the formation and subsequent detachment of cargo-containing tubes from the TGN in cells stably expressing low levels of PKD-K618N. Our results suggest that PKD regulates the fission from the TGN of transport carriers that are en route to the cell surface.

Biological Transport↗

Risk and aetiology of diarrhoea at various tourist destinations.

Almost two of three tourists developed traveller's diarrhoea during 2-week stays at high-risk destinations. Large differences in infection rates between hotels were seen. Patients with milder forms of diarrhoea show a similar chronology to those more severely affected. Although enterotoxigenic Escherichia coil was the most frequent cause, viral pathogens were detected more often than in other studies.

Brazil↗

Membrane biogenesis in embryonal carcinomas: glycoproteins destined for the cell surface are delayed in a pre-Golgi compartment.

Embryonal carcinoma and early embryonic cells assemble a family of unusually large and complex carbohydrates. These glycans are highly branched, repeating copolymers of the sugars galactose and N-acetylglucosamine, referred to as polylactosamines, and are frequently decorated with fucose, sulfate, and sialic acid. We have previously shown that in teratocarcinoma cells these glycans are part of a large spectrum of glycans assembled on mannose cores derived from a common precursor glycan. Metabolic studies revealed a large excess of high-mannose glycans at a time when complex-type glycans cease to accumulate. The present studies demonstrate that these high-Man glycans are not degraded internally or secreted directly but are on glycoproteins destined for the cell surface. These unprocessed glycoproteins replace material lost during the extensive membrane turnover that occurs in these cells. Their export to the cell surface is delayed in a pre-Golgi compartment.

Animals↗

S-R compatibility between response position and destination of apparent motion: evidence of the detection of affordances.

In choice reaction time, stimuli and responses in some combinations (e.g., based on spatial arrangement) are faster than in other combinations. To test whether motion toward a position yields faster responses at that position, a computer-generated square in front of one hand appeared to move either toward that hand or toward the other hand. Compatible responses (e.g., motion toward left hand/left response) were faster than incompatible responses, even when that opposed traditional positional compatibility. In Experiment 2, subjects responded to the same stimuli but with both hands left, right, or on the body midline. Medial responses were the fastest, showing that destination, rather than mere relative position, was a critical variable. It was suggested that spatial compatibility effects are not unique to position but apply to a variety of task situations, describable by J.J. Gibson's theory of affordances, in which he claims that one perceives the actions (e.g., catching) permitted in a situation.

Adult↗

Cerebellar complex spikes encode both destinations and errors in arm movements.

Purkinje cells of the cerebellum discharge complex spikes, named after the complexity of their waveforms, with a frequency of approximately 1 Hz during arm movements. Despite the low frequency of firing, complex spikes have been proposed to contribute to the initiation of arm movements or to the gradual improvement of motor skills. Here we recorded the activity of Purkinje cells from the hemisphere of cerebellar lobules IV-VI while trained monkeys made short-lasting reaching movements (of approximately 200 milliseconds in duration) to touch a visual target that appeared at a random location on a tangent screen. We examined the relationship between complex-spike discharges and the absolute touch position, and between complex-spike discharges and relative errors in touching the screen. We used information theory to show that the complex spikes occurring at the beginning of the reach movement encode the absolute destination of the reach, and the complex spikes occurring at the end of the short-lasting movements encode the relative errors. Thus, complex spikes convey multiple types of information, consistent with the idea that they contribute both to the generation of movements and to the gradual, long-term improvement of these movements.

Action Potentials↗

Sugar feeding and fluid destination control in the phlebotomine sandfly Lutzomyia longipalpis (Diptera: Psychodidae).

Sandfly feeding behaviour and destination of coloured sugar meals in the gut of Lutzomyia longipalpis were investigated with particular attention to the role of the crop. Sandflies were able to ingest sugar from liquid drops, microcapillaries, a slice of pear and even sugar powder. In most cases the flies adopted a 'sugar feeding mode' with raised palps. As the fruit dried, flies of both sexes fed by piercing the tissue with the proboscis. All sugar-fed flies had a full crop plus a small amount of sugary fluid in the thoracic mid-gut, i.e. past the stomodaeal valve. Dissections of flies interrupted during feeding showed that the very first trace of sugar passed through the stomodaeal valve, but that the rest of the meal was diverted into the crop. This suggests that closure of the stomodaeal valve is initiated only after a small volume of sugar solution has passed through it.

Animals↗

Career destinations and views in 1998 of the doctors who qualified in the United Kingdom in 1993.

OBJECTIVE: To report career destinations and views in 1998 of doctors who qualified in the United Kingdom (UK) in 1993. DESIGN: Postal questionnaire survey. SETTING: This study took place in the United Kingdom. SUBJECTS: All doctors who qualified in the UK in 1993. MAIN OUTCOME MEASURES: The percentage of doctors in each branch of medicine five years after qualification, and their views on their training and career opportunities. RESULTS: The NHS and universities in the UK employed 88% of respondents (men 90%, women 86%). UK general practice employed 24% of respondents (men 19%, women 28%). There were significant differences (P < 0.01) between the percentages of men and women working in the surgical specialties (men 28%, women 10%), paediatrics (men 8%, women 15%) and obstetrics and gynaecology (men 5%, women 10%). Respondents not in paid employment comprised 1.4% of men and 6.6% of women. 45% of respondents agreed that their postgraduate training was of a high standard, with 26% disagreeing and 29% unsure. 47% of specialist registrars felt their training was too short and 78% were concerned about the availability of consultant posts on completion. CONCLUSIONS: Although loss of doctors from the British workforce through emigration or unemployment is not increasing, our findings confirm a substantial shift away from careers in general practice. The number of home-trained GPs from this generation of doctors will be inadequate to meet service needs. GPs and hospital specialist doctors expressed concerns about quality of training, lack of careers advice, the shortness of specialist registrar training and availability of consultant posts on completion of training.

Career Choice↗

Chaos in a dynamic model of traffic flows in an origin-destination network.

In this paper we investigate the dynamic behavior of road traffic flows in an area represented by an origin-destination (O-D) network. Probably the most widely used model for estimating the distribution of O-D flows is the gravity model, [J. de D. Ortuzar and L. G. Willumsen, Modelling Transport (Wiley, New York, 1990)] which originated from an analogy with Newton's gravitational law. The conventional gravity model, however, is static. The investigation in this paper is based on a dynamic version of the gravity model proposed by Dendrinos and Sonis by modifying the conventional gravity model [D. S. Dendrinos and M. Sonis, Chaos and Social-Spatial Dynamics (Springer-Verlag, Berlin, 1990)]. The dynamic model describes the variations of O-D flows over discrete-time periods, such as each day, each week, and so on. It is shown that when the dimension of the system is one or two, the O-D flow pattern either approaches an equilibrium or oscillates. When the dimension is higher, the behavior found in the model includes equilibria, oscillations, periodic doubling, and chaos. Chaotic attractors are characterized by (positive) Liapunov exponents and fractal dimensions.(c) 1998 American Institute of Physics.

Journal Article↗

The effect of decreasing length of stay on discharge destination and readmission after coronary bypass operation.

BACKGROUND: Over the decade of the 1990s, hospital stay after operation declined in response to prospective payment and managed care. As a result, complications previously detected and treated in the hospital may have begun to occur after discharge. In addition, discharge to nursing homes and rehabilitation hospitals may have increased. To address these questions, we used a statewide database to look at the use of postacute care and the 30-day readmission and mortality after coronary bypass operation. METHODS: A modification of the Commonwealth of Massachusetts Division of Health Care Finance and Policy discharge data to include a unique patient identifier allowed us to retrospectively track patient destination at discharge and study 30-day readmission to all hospitals in the state. RESULTS: Over the 3-year period after the institution of the unique patient identifier (1993 to 1996), postoperative length of stay after coronary bypass operation decreased from 7.4 to 6 days (19%, P <.0005), but the 30-day readmission rate (17.7%) did not increase. Discharge to rehabilitation hospitals and skilled nursing facilities rose significantly (11.7% to 23.8%), especially in the Medicare population (17.2% to 38.5%). Mortality in the 30 days after discharge remained constant at 0.3%. CONCLUSIONS: A shorter postoperative length of stay did not appear to disadvantage coronary artery bypass patients by increasing their likelihood of readmission or death. Cost savings from reduced length of stay were offset by increased use of postacute services.

Aged↗

Patterns of mRNA expression during early cell growth differ in kidney epithelial cells destined to undergo compensatory hypertrophy versus regenerative hyperplasia.

An increase in cell size and protein content is characteristic of cells undergoing hypertrophy and of replicating cells prior to DNA synthesis. Cell enlargement in the two situations could be regulated by similar early events with an interruption of the cell cycle occurring in hypertrophy, or the two processes could be uncoupled. In vivo models were used to compare hypertrophy induced by unilateral nephrectomy and hyperplasia induced by folic acid injection in rabbit renal cortical cells. Within 48 hr, cell volume increased in both groups but the number of cells in the cell cycle and DNA synthesis was increased only after folic acid. Patterns of mRNA expression of the following three groups of cell cycle-dependent genes were analyzed: (i) protooncogenes (c-fos, c-myc, and c-Ha-ras), (ii) structural protein genes (vimentin and beta-actin), and (iii) transport protein genes (Na+, K+-ATPase, ADP-ATP translocase, and calcyclin). mRNAs for all genes, except calcyclin and c-Ha-ras, were detected in controls. Folic acid generally induced rapid, transient increases in mRNA levels, but after unilateral nephrectomy, expression of most mRNAs showed a gradual, progressive increase. These data indicate that gene expression in the early stages of cell enlargement differs in cells destined to undergo proliferation vs. hypertrophy. The term "sustained message amplification" is proposed to describe the hypertrophied cell.

Animals↗

Generation of a fusion partner to sample the repertoire of splenic B cells destined for apoptosis.

B cells proliferate and diversify in germinal centers in response to antigen. Only a small percentage of these B cells will emerge to form the serum antibody response. Other B cells making lower affinity antibodies, acquiring nonsense mutations, or expressing autoreactivity as a result of somatic mutation undergo an apoptotic cell death and are not efficiently sampled in current analyses of B-cell hybridomas. We have demonstrated that expression of bcl-2 in the NSO myeloma fusion partner leads to a higher yield of viable hybridomas, with a selective increase in hybridomas from B cells that produce autoantibodies and are seldom recovered when spleen cells from non-autoimmune mice are fused to the conventional NSO cell line. Using this fusion partner, we have generated hybridomas from anti-DNA antibody-producing transgenic B cells that are anergic in vivo and destined for apoptosis. These studies provide a strategy to sample the repertoire of B cells that arise in vivo but are not selected to contribute to the expressed antibody response. Furthermore, they demonstrate that restricted expression of bcl-2 in B cells contributes to the maintenance of self-tolerance in secondary lymphoid organs.

Animals↗

Investigating discharge destinations for schizophrenic patients.

An audit of hospital records of 542 patients diagnosed as having schizophrenia discharged in the years 1986-88 from the Princess Alexandra Hospital, Brisbane, showed that 46% of patients left hospital to live with other family members, usually parents or spouses. Analysis of destination suggested that the extent of patient-family connectedness increases when the patient is younger, has had fewer admissions, or has had the illness for a shorter period of time.

Activities of Daily Living↗

Rehabilitation outcomes for brain injured patients in Australia: functional status, length of stay and discharge destination.

This study describes the rehabilitation length of stay (LOS), discharge destination and discharge functional status of 149 patients admitted with traumatic brain injury (TBI) to an Australian hospital over a 5-year period. Hospital charts of patients admitted between 1993-1998 were reviewed. Average LOS over the 5-year time period was 61.8 days and only decreased nominally over this time. Longer LOS was predicted by lower admission motor FIM scores and presence of comorbidities. Mean admission and discharge motor FIM scores were 58 and 79, which represented a gain of 21 points. Higher discharge motor FIM scores were predicted by higher admission motor FIM scores and younger age. FIM gain was predicted by cognitive status and age. Most patients, 88%, were discharged back to the community, with 30% changing their living setting or situation. Changing living status was predicted by living alone and having poorer functional status on admission.

Activities of Daily Living↗