Differences in Dialysis Practice Are the Main Reasons for the High Mortality Rate in the United States Compared to Japan

The cumulative survival of Japanese hemodialysis patients is more than 2.5 times better than that of dialysis patients in the United States (U.S.). The difference is particularly pronounced in older patients, being 4 times better in patients over the age of 50 years. The mortality in U.S. patients has increased from 10 to 25% over the last three decades, but has remained stable at around 10% in Japan.
There is no obvious difference in patient selection. The Japanese accept almost as high a proportion of diabetic patients as does the United States, and the mean age of incident patients is higher in Japan.
Renal transplantation, virtually absent in Japan, should increase mortality in U.S. dialysis patients by removing patients with the highest probability of survival, but even if one adds surviving transplant patients and studies prevalent populations, the survival rate is much better in Japan. Genetic factors are unlikely to explain differences in mortality, as older Americans live much longer than older Japanese.
We speculate that the difference lies in the practice of dialysis. Patients in the United States are generally treated by much faster and shorter dialysis than in Japan. This puts a severe burden on the cardiovascular system of older patients, leading to the poorer survival rate. Japanese physicians also appear to be better trained in dialysis and to spend more time with their patients. The nursing shortage in the United States may also contribute to the increased mortality. Whatever the explanations, the U.S. dialysis community must work to equal and, hopefully, surpass the now superior survival of Japanese dialysis patients.     

Temporal and spatial aspects of an environmental stimulus influence the dynamics of behavioral regulation of the Aplysia siphon-withdrawal response.

Exposure to turbulence, an environmental stimulus, produces behavioral adaptation in the Aplysia siphon-withdrawal response (SWR). The authors show that the duration and spatial extent of turbulence influence adaptation recovery. In terms of duration, recovery in whole animals and reduced preparations (tail, siphon, and CNS) was more rapid after longer exposures to turbulence (10 min) than after briefer exposures (10 s-5 min). In terms of spatial extent, recovery in reduced preparations was more rapid after diffuse turbulence (tail and siphon together) compared with focal turbulence (siphon alone). Furthermore, spatial extent and duration interact: Duration regulates recovery only when turbulence is diffuse. Results suggest that SWR adaptation reflects a composite of cellular processes, including short-term synaptic enhancement in L30 inhibitory interneurons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modeling Effects of Rhythmic Context on Perceived Duration: A Comparison of Interval and Entrainment Approaches to Short-Interval Timing.

Relative merits of interval and entrainment conceptions of the internal clock were assessed within a common theoretical framework by 4 time-judgment experiments. The timing of tone onsets marking the beginning and ending of standard and comparison time intervals relative to a context rhythm were manipulated: onsets were on time, early, or late relative to the implied rhythm, and 2 distinct accuracy patterns emerged. A quadratic ending profile indicated best performance when the standard ended on time and worst performance when it was early or late, whereas a flat beginning profile (Experiments 1-3) indicated uniform performance for the 3 expectancy conditions. Only in Experiment 4, in which deviations from expected onset times were large, did significant effects of beginning times appear in time-discrimination thresholds and points of subjective equality. Findings are discussed in the context of theoretical assumptions about clock resetting, the representation of time, and independence of successive time intervals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

一种转移脉冲宽度可调的CCD驱动电路

本文以TCD132D线阵CCD为例,介绍了一种用循环计数器和拨码开关共同作用改变CCD转移脉冲的CCD驱动电路。该电路结构简单,工作可靠,调整方便。     

等温脉冲自由射流压力场动态特性的实验研究

针对冶金工业过程脉冲燃烧及脉冲流技术所进行研究的基础部分,借助于计算机辅助信号分析手段,运用湍流统计理论,对等温脉冲自由射流压力场动态特性进行了系统的实验研究。实验的Re范围为19486～93936,st范围为0～0.057,所对应的射流脉冲频率为0～25Hz。研究结果表明;脉冲射流极大地提高了射流区压力波动水平,任何受气体的动量、热量和质量传递制约的工业过程均可望通过适当地采用脉冲流技术加以强化.     

中和室脉冲进气的蒙特卡罗模拟及实验验证

对于中和室内的脉冲气体，用蒙特卡罗方法模拟了气体压力沿轴向的分布。并用模拟进气系统和气压瞬时测量系统，对模拟结果进行了验证。得到与模拟结果较为一致的曲线，从而为注入器真空系统的设计提供了可靠的依据。并通过实验结果，给出了气体靶厚的建立时间约为６０ｍｓ。     

电脉冲快速退火对铁基非晶合金性能的影响

采用大电流交流脉冲对非晶Ｆｅ７８Ｂ１３Ｓｉ９合金进行了去应力退火。初步探讨了电脉冲加热对加热速率和该合金内应力释放、退火脆化以及最终软磁性影响的基本规律。结果表明：电脉冲加热可以得到远高于常规退火的加热速率，选择合适工艺参数可使非晶合金内应力释放９０％，软磁性（Ｈ＿ｃ和Ｂ＿ｓ）达常规退火后的９５％以上，与此同时使合金的延性（断裂应变ε＿ｆ）维持在０．９以上，从而有望实现非晶合金磁性与延性的合理配合。     

双极性步进电机细分驱动器的设计与实现

论述了一种双极性步进电动机驱动器的工作原理，该驱动器能较好地改善步进电动机的运行性能，具有实用性强，结构简单，成本低的优点。针对实际调试中出现的问题进行分析后，提出了对策；最后给出了试验结果。     

无机熔盐中脉冲铝镀层的研究

在190℃的AlCl3-NaCl—KCl共融盐中，对321型不锈钢板进行脉冲镀和直流镀。在钢板上获得银白色铝镀层。X射线衍射结果表明，两种情况均得面心立方结构的铝，但由脉冲镀所得的铝晶粒较小。对镀层进行性能测试分析。发现同为厚10μm的铝镀层，脉冲镀层硬度比由直流镀层高65HV，且脉冲镀层在耐蚀性和与不锈钢基体的的结合力上明显优于直流镀层.     

20keV～17MeV中子能谱测量

基于质子反冲方法，建立了一套宽能区，高效率的中子谱仪系统，分别用三支充不同气压氢和甲烷的球形正经计数管和一个有机闪烁探没器分段测量２０ｋｅＶ～１７ＭｅＶ的中子能谱，为了去除γ射线本底，对两种探测器分别采用了两种不同的脉冲形状别技术，谱仪直接测量的是中子在探测器中产生的反冲质脉冲幅度谱，通过解决矩阵方程的方法得到中子谱，解谱中所用的各个探测器的中子响应矩阵均蒙特－卡洛方法计算得到，谱仪在全能区的中子