Jurassic Robots

The robots are coming, and they are Japanese. About 50 percent of the world’s population of robots five on the island of Japan, and a large shore of the rest living outside have been exported from there. Japan manufactures the mythic image of robot plural, of comprising a countless, advancing army of robotic dinosaurs; it is the source of nearly all the millions of robot toys and epic Saturday-morning robot cartoons. This book surveys life in robotto okuku, the Japanese nickname for their own Robot Kingdom, and illuminates the way a culture aspires to, and eventually accommodates, the ways and metaphors of robot.

These robots were precision-scale models of the seemingly endless varieties of robots in the ever-expanding Gundam animation universe, plus some extras, and by then a total of one hundred million had been sold, nearly one for every man, woman and child in Japan. Most were assembled from kits, but some were also sold in completed form. One, the Deluxe Mobile Suit MSZO06 Z Gundam, retailed in for around thirty dollars and, as the box design shouts in English (for advertising effect), is a “perfect detailed super heavy version.” It is also designed with the complexity of an origami masterpiece; to transform it into a fighter plane requires nearly forty different twists and turns. But if a boy cannot figure out the complex movements, all is not lost. Bandai was one of the first Japanese toy makers to guarantee its wares in 1958 and like most major toy companies today has a national network of walk-in service centres where specially trained staff answer questions and complaints from consumers – and demonstrate how to properly transform robots.
Source: http://dinotoyreview.com/robots/the-top-robot-dinosaur-toys-for-2015/

A Trip To Thailand Might Not End Well

A 26-year-old woman has persistent diarrhea and dehydration. She recently returned from a two-week vacation in Thailand. Before her trip, she had been immunized with tetanus and diphtheria toxoids, oral poliovirus vaccine, immune globulin, and typhoid vaccine; she also took mefloquine HC1 to prevent malaria.

Not All Trips To Thailand End Well

Trip To Thailand and Chiang Mai

The patient attempted to follow strict food and water precautions to prevent traveler’s diarrhea. Several days after returning to the United States, however, she experienced watery, nonbloody diarrhea (6-8 times per day) associated with nausea and vomiting. Over the next few days, her condition worsened, and she had abdominal cramps, anorexia, and lightheadness on standing. She felt feverish and was unable to ingest fluids without vomiting.

Her medical history and a review of systems were unremarkable. Vomiting precluded her taking mefloquine after returning home. She denied having any allergies, a history of drug abuse, or significant alcohol intake.

At examination, she was not in acute distress. Her temperature was 100.8 [degrees]F (38.2 [degrees]C), respiratory rate was 16 breaths per minute, pulse rate was 104 beats per minute, and blood pressure was 105/60 mmHg while lying down. On sitting, the patient’s heart rate increased to 130 beats per minute, and her blood pressure dropped to 85/55 mmHg. Her sclerae were nonicteric. Her mouth was dry. Lung and cardiac examination findings were normal except for a sinus tachycardia. There was no abdominal tenderness or organomegaly, and her stool was negative for occult blood. The remainder of the examination was normal.

Laboratory values were a white blood cell count of 8,600/[unkeyable]L with a normal differential. Thick and thin malarial smears were negative. Blood urea nitrogen and creatinine levels were 28 mg/dL and 1.0 mg/dL, respectively. The electrolyte concentrations and liver function tests were within normal limits.

* What would you do now?

* What is the differential diagnosis?

* What will confirm the diagnosis?

* What is the treatment of choice?

COMMENT

The patient was admitted to the hospital for treatment of dehydration and evaluation of her diarrhea. Stool samples were obtained for a fecal leukocyte count, culturing, and examination for parasites. A diagnosis of traveler’s diarrhea was made pending identification of an etiologic agent.

* Traveler’s diarrhea By far the most common health problem encountered by Americans venturing to developing countries is traveler’s diarrhea (also known as Delhi belly, Montezuma’s revenge, and la turista, among others). It often develops 5-15 days after arrival in an underdeveloped country, but it may occur at any time during or even after the trip.

The incidence of traveler’s diarrhea is 4-51%, depending on the countries visited and the duration of the trip; in general, the rate approaches 50% for a stay of two weeks or longer. In persons older than 25 years, the attack rate decreases, perhaps reflecting the more adventurous itineraries and eating habits of younger people. The most important determinant for acquiring traveler’s diarrhea is destination: High-risk areas include Africa, Asia, the Middle East, and South and Central America. Less risky areas are southern Europe and a few of the Caribbean islands.

The typical symptoms of traveler’s diarrhea are malaise, anorexia, nausea, abdominal cramps, and watery diarrhea. About one third of patients have low-grade fever. Vomiting occurs in approximately 15% of patients and patients and bloody stools or high fevers in 2-10%. Diarrhea usually lasts 1-5 days but may extend over 10 days.

Traveler’s diarrhea is acquired through ingestion of fecally contaminated food or water. Salads, uncooked vegetables, and raw meat and seafood are particularly risky. Tap water, ice, and unpasteurized milk or other dairy products may also be associated with increased risk.

The etiology of traveler’s diarrhea usually involves an infectious agent (see Table 1). The most common pathogen, found in about 50% of cases, is enterotoxigenic Escherichia coli. Salmonella may cause gastroenteritis or dysentery, characterized by the passing of small stools containing bloody mucus. Likewise, shigellae may cause dysentery and, in a small number of individuals, watery diarrhea. Campylobacter jejuni is another cause of traveler’s diarrhea, as is Vibrio cholerae, the etiologic agent in cholera. Cholera was rarely a serious problem for travelers from the United States in the past. With the recent epidemic in South America, however, you should consider it in any patient with watery diarrhea, especially if they are returning from Latin America.

Viruses, most frequently rotaviruses and the Norwalk virus, and enteric parasites, such as Giardia lamblia and Entamoeba histolytica, are also occasional causes of diarrhea in returning travelers. Of note is that patients with malaria may also have gastrointestinal symptoms that suggest traveler’s diarrhea.

TABLE 1
Common causes
of traveler’s diarrhea
Bacterial enteric pathogens
Escherichia coli
Salmonella sp
Shigella sp
Campylobacter jejuni
Vibrio parahaemolyticus
Aeromonas hydrophila
Yersinia enterocolitica
Plesiomonas shigelloides
Vibrio cholerae (non-O1)
Viral enteric pathogens
Rotavirus
Norwalk virus
Parasitic enteric pathogens
Giardia lamblia
Entamoeba histolytica
Cryptosporidium parvum
Strongyloides stercoralis

Traveler’s diarrhea can be treated with a variety of medications while patients are still overseas. Antimotility drugs such as diphenoxylate HC1/atropine sulfate (Lomotil) and loperamide HCl (Imodium) offer prompt symptomatic but temporary relief of uncomplicated traveler’s diarrhea. They should not be used when patients have high fever or bloody stools. Antimicrobial treatment with such agents as trimethoprim/sulfamethoxazole (Bactrim, Cotrim, Septra, etc.), doxycycline hyclate (Doryx, Vibramycin, Vibra-Tabs, etc.), or ciprofloxacin HCl (Cipro) may also be helpful. In addition, bismuth subsalicylate (Pepto-Bismol) has been shown to decrease the duration and severity of traveler’s diarrhea. Travelers should seek medical help if their diarrhea does not respond to these standard approaches, is severe, or is associated with high fever or bloody stools.

In this case, a modified acid-fast stain of a stool smear demonstrated numerous oocysts of the parasite Cryptosporidium. No other enteric pathogens were identified. Results of stool cultures and fecal leukocyte examinations were negative. The patient was given intravenous fluids. Over the next several days, her vomiting and diarrhea diminished, and she was able to tolerate oral fluids. She was discharged, and two weeks later a stool examination was negative for cryptosporidial oocysts.

* About cryptosporidiosis Cryptosporidium parvum is a small, coccidian protozoan that causes enteric infection in animals as well as humans. More than 30 species of animals are known to be infected with this parasite, and before 1976 Cryptosporidium was considered exclusively a veterinary pathogen. After that date, it was recognized as a sporadic cause of disease in immunocompromised humans.

In 1982, Cryptosporidium was found to be a significant cause of diarrhea in patients with AIDS. The Centers for Disease Control estimate that 34% of AIDS patients have cryptosporidial enteritis, and some centers report rates as high as 10-20%. The infection in these patients is characterized by protracted, voluminous diarrhea with nausea, vomiting, and abdominal pain. Profound weight loss and malnutrition may lead to death.

Diarrhea due to infection with this pathogen is also seen in immunocompetent patients. Examples include children in day-care centers, members of communities with contaminated public water supplies, animal handlers, health care workers, and residents of developing countries.

As in our patient, diarrhea secondary to infection with Cryptosporidium may develop in travelers to underdeveloped countries. Infection may be acquired in most underdeveloped countries worldwide, but the precise epidemiology remains undefined and the frequency of diarrhea induced by Cryptosporidium in travelers is unknown.

Contaminated food and water has been implicated as an infection source–no contact with animals is necessary. The onset of illness is within several weeks of a trip abroad, at which time watery diarrhea, anorexia, crampy abdominal pain, malaise, and, occasionally, fever develop. In an immunocompetent individual, the illness is self-limited, with symptoms typically present for 10-14 days (although they may last longer). Fecal clearance of the oocysts lags behind resolution of the clinical illness by 1-3 weeks.

* Diagnosis and treatment Establishing the diagnosis of Cryptosporidium infection is by identification of oocysts in the stool (see Figure 1). Staining techniques include various acid-fast techniques (cold Kinyoun modified, hot Kinyoun, and Ziehl-Neelsen methods), the fluorescent auramine-rhodamine stain, and periodic acid-Schiff’s and carbofuchsin stains. Stool concentration techniques often improve the diagnostic yield in immunocompetent patients.

At present, no therapy is available for the treatment of cryptosporidiosis. This patient did not have any risk factors for infection with the human immunodeficiency virus (HIV), and an HIV-1 antibody titer was negative. For travelers with an intact immune system, the disease is self-limited, and only supportive therapy, such as electrolyte and fluid replacement and lactose avoidance, is necessary. The role of nonspecific antidiarrheal medications is unclear.

Bonds For Projects

Bonds For Projects

The primary political issue in Washington was not so much that the specific state agencies would lose the revenue from the issuance of particular debt of an entity in their area,” said one source. “There was really more concern that they weren’t going through the state-level approval process.”

But opponents of the deal, which was abandoned in December after concerns over its legality first surfaced, say they still harbor reservations.

Nevertheless, First Chicago expects to complete the deal in the next two months. Officials at the firm did not return telephone calls this week.

Bob J. Nash, president of the authority, yesterday declined to comment on the deal, speaking through an intermediary. The intermediary said that “major questions” could “only be answered after the transaction is completed.”

As many as four hospital systems are expected to borrow from the deal’s proceeds, which could reach $60 million, a source familiar with the transaction said.

According to a draft official statement, the bonds would be convertible from fixed to variable rates, and they would be backed by a letter of credit from Fuji Bank Limited. Early this week, closing was tentatively slated for May 7.

Potential borrowers belong to American Healthcare Systems, a nonprofit association of hospital systems, many with holdings in more than one state and comprising 1,086 hospitals.

The deal’s promoters hope the transaction will be the first of many, all of which would come to market through the Arkansas Development Finance Authority.

The Arkansas authority, a First Chicago employee said last fall, is perhaps the sole conduit agency capable of exporting tax-exempt loans to other states.

“The ADFA has the statutory approval to enter into a program like this,” said Thomas P. Fischer, then a vice president at First Chicago. “To our knowledge, no other authority has the ability.” Mr. Fischer is no longer employed by the company.

Annual borrowing for the multistate pool could total $200 million a year, a source said in November.

In return for giving its imprimatur to the deals, the authority would collect fees to fund health clinics in Arkansas. That, officials at the authority have said, would satisfy state requirements that tax-exempt bond issues benefit the citizens of Arkansas.

The novel financing raised hackles, both in Washington and among the nation’s hospital financing authorities, when it became known last fall. An aide for Rep. Brian Donelly, D-Mass., said he opposed it.

The aide, Thomas Barker, said yesterday that he had not heard of any steps taken to address concerns about the financing. “It is safe to say my boss would still oppose it,” Mr. Barker said.

In addition, representatives of a national association of hospital financing corporations loudly protested the transaction.

Lawyers for the National Council of Health Facilities Finance Authorities, a consortium of 26 tax-exempt bond conduits, contended that the the multistate hospital lending pool would “frustrate” their mission and not meet TEFRA standards.

In addition, they also said that the transaction would violate the spirit of federal law, if not the letter.

“The privilege granted to states by Congress to issue tax-exempt bonds for health care organizations is traditionally rooted in the understanding that the financed projects will serve a public purpose in the host state,” says the letter, which was drafted by attorneys at the Boston firm of Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C. The letter was submitted to the authority on Dec. 5 in Little Rock.

Kid’s Toys Rarely Hurt

Toy Dangers Overestimated

The recent, widely-publicized episode of the hair-eating Cabbage Patch doll brings back into public consciousness the perennial issue of the safety of children’s toys. Like similar scares in recent years, such media focus on a particular product heightens parental anxiety about all the toys they have purchased for their offspring.

This worry–whether about Cabbage Patch dolls in particular or kids’ toys in general–is largely misplaced. I don’t mean that toys never harm children; obviously they do, despite the best efforts of toy manufacturers and consumer watchdog groups. But the harm done to children by toys, even to those at the ages most vulnerable to toy-based injuries (especially the under fives), pales by comparison with other items around the house which parents, ironically, are less apt to worry about.

To see what I mean, ponder some recent data from the Consumer Product Safety Commission (CPSC).

They show that the probability that a child under five will be seriously injured by a toy this year is about one in 250. If that seems on the high side, consider the fact that a child is eight times more likely to be seriously injured by home furnishings and fittings. Stairs alone are responsible for three times more injuries to infants than all toys combined. Chairs injure 50% more young children than toys. Doors around the house injure more children than toys–so do accidental drug poisonings. Still worse, the severity of injuries from these other sources tends to be much greater than toy-related injuries are. Kid’s bows and arrows, for example, prove far less daunting in the statistics than one might first think.

The fact is that parental preoccupation with toy safety–aided and abetted by media fixation with toy dangers–displaces attention from many of the factors that are most likely to do harm to little Johnny or Susie. Some parents are apt to suppose that, provided their tots’ toys pose few threats, parental vigilance around the house can be put on autopilot.

What the data from the CPSC make clear is that–if our interest is in minimizing threats to life and limb of our children, especially the younger ones–we need to look for improvements outside the area of toy design and manufacture. We must think about how to design household furniture and fittings so as to make them more young-user-friendly. Architects and builders need to figure out how to build safer stairways. Parents need to keep infants out of parental beds, which are responsible for far more infant injuries and deaths than purpose-built cribs are.

The silliness of this obsession with the safety of toys becomes even more apparent as our focus shifts to children beyond the stage of infancy, especially in the 5-14 age group. There the annual risk of toy injury hovers around one in 1,000, while other risks increase dramatically.

For instance, a child in this age group is 10 times more likely to be injured playing basketball, football, or baseball than by anything they might find in the toy chest. As I have suggested on other occasions, sports constitute the single largest source of injury to young Americans.

If we were serious about injury reduction, we would stop worrying about toys and focus on what our youngsters are doing on the sand-lot, the basketball court, and in the living room.

A postscript: Just before we went to press, Mattel–in conjunction with the CPSC–announced a “voluntary” nationwide recall of its hair-eating dolls. This, despite the fact that, as the CPSC acknowledged: neither Mattel’s nor CPSC’s testing of the product had identified a serious safety hazard associated with the dolls.  Mattel’s chief executive officer, added: “If any of our products are causing concerns, we are committed to responding in a responsible manner.” At a $40 refund per pop, this amounts to about $50-$100 million for a product that, to the best of anybody’s knowledge, has never caused serious harm.

 

Tales From Arkansas

Cabot, Tales From Arkansas

On the afternoon of Dec. 3, 1982, Robert Clay operated two Town & Country supermarkets in Hardy, Ark., a tiny hamlet along the banks of the Spring River. By the following morning, both stores had been destroyed–one by a tornado, the other by a flash flood. It was not a pleasant night.

Cabot Ark

Cabot, Tales From Arkansas

“We had not taken any precautions because we weren’t expecting bad weather,” says Clay, who owns 13 supermarkets operating under the names Town & Country, Price Chopper and New Way Food in north central Arkansas.

When the tornado struck north of town at about 6 p.m., 12 people were in one of the stores. The store manager, who as a resident of the tornado-prone Arkansas hills knew what to do, had everyone huddle behind some cases in the back, shielding them from the storm’s fury and the collapsing store.

When the winds hit, the roof was blown off, most of it landing more than 50 feet away. Heavy rain poured into the store, leaving about 2 inches of water behind. The health department condemned the store’s entire stock. Only about 10% of the fixtures could be salvaged.

Late that night, as Clay digested the tragic news, he received another telephone call. Water had just come crashing through the front windows of his other store in town, a 12,000-footer about five miles away from the unit struck by the tornado. Even though this supermarket was located one-fourth of a mile from the river, atop a 100-year flood plain, the water in the store rose to more than 7 feet before it began to recede.

The tornado-ravaged store was fully insured, but Clay could not convince the owners of the plaza to rebuild. The flooded store was a different story, however.

A Drive Through Cabot


As soon as the water receded, Clay and his crew began clearing out the store. He estimates that at least 2 inches of river sludge covered the floor and the fixtures. “That was the most smelly substance that you could imagine,” he says.

All merchandise was removed and dumped. The crew and 20 volunteers from town took out shovels and began digging out the mud. Most of the equipment had to be discarded.

“It’s much easier to build a new store than to clean one up after it’s full of river water,” Clay says. The people in the store worked feverishly, putting in 18 to 20 hours of work a day. After all the unsalvageable merchandise was removed, the walls were steam cleaned again and again. The back-breaking labor continued for six weeks.

By mid-January, the store was ready to reopen. Local residents, who had been traveling at least 10 miles to shop, flocked back to the Town & Country store, which, due to the closing of its sister store, was now recording a volume well above its previous level.

Business was too brisk for the 12,000-square-foot conventional unit to handle, so Clay decided to open a larger store across the street. He built a 25,000-square-foot warehouse market, under the Price Chopper name. Volume at the new store is as strong as it was at his two stores combined before the disaster. (The flooded store is now being operated as a conventional supermarket by another independent grocer.)

“We would not have built the new store if the tornado had not hit town,” says Clay. “Both Town & Country units were producing profits.” But Clay has found the silver lining within the cloud. After all, the Price Chopper may have roughly the same square footage as the two smaller and older stores, but it also has reduced payroll percentages and other efficiencies due to the warehouse format.

What did Clay learn from the double dose of disaster? “Mother Nature can really put the fear of God in you. But no matter what happens, you should never give up. You should always try to do the best that you can with the cards that are presented to you,” Clay says.

A Blessing in Disguise
When 140-mile-an-hour winds brought the near destruction of King’s Super Valu in July 1983, Bill King probably never imagined he’d feel lucky about the whole thing. But he has his reasons to feel lucky today.

Forty people were inside the store when the winds came, yet no one was hurt. Also, his store suffered less damage than those of other retailers in the four-year-old Champlin Plaza because some curious employees left the back door open before the storm hit. And since the store reopened with a new decor package and merchandising approach, sales have jumped by more than 30%.

“I wouldn’t say this if anyone had been injured, but we are in better shape today than before the windstorm,” says King, who manages the store, which is owned by his father, Lyle.

“I was driving up toward the store when I heard a report on the radio that the Champlin Plaza had been demolished,” recalls King. “It was the worst feeling I’ve ever had in my life.” Although much of the plaza was completely destroyed, King’s Super Valu was spared somewhat, thanks to the curiosity of some weather-watching employees.

“Some people in the backroom had opened the receiving door to look outside because the sky was turning scary colors,” King says. At the instant the door was opened, the winds hit the opposite side of the mall, completely destroying a drugstore and traveling down the front of the mall with the force of a bomb blast. Roofs were torn off stores, and walls were blown down. The open door in the Super Valu gave the wind an outlet, saving the store’s back wall.

The employees standing by the back door were lifted 20 feet in the air and tossed against the coolers. As the roof started to cave in, everyone in the store dived for the floor. “The ceiling tiles were flying around like deadly Frisbees,” says King. Miraculously, nobody within the supermarket was seriously injured. A half dozen cars in the parking lot were totaled, however.

Within hours, the account executive and policy claims manager from Risk Planners, Super Valu’s insurance subsidiary, were on the scene. Several field counselors from the wholesaler also arrived, as did the president of the Minneapolis division. “To see the division president there in his street clothes ready to go to work if needed really impressed me,” says King.

The cleanup began as soon as the damage was surveyed. Frozen food was hauled out first, and placed in a Super Valu truck. Even though it was July, none of the food had thawed, allowing the insurance company to sell it to a salvage firm. “As soon as the storm hit, every food product we had belonged to the insurance company,” King says. The two-store independent’s total losses from the disaster amounted to $325,000, all of which was covered by Risk Planners.

The six scanners and the store computers, which were removed immediately and placed under fans, were about the only equipment not heavily damaged. The insurance people and Lyle King set July 31, four weeks from the date of the storm, as the target for the reopening.

Faced with the need to put the store back together, the Kings decided to refashion its image and decor. “When we opened the store four years ago, we went with rich looking wallpaper and other decor touches that made the store look fancy. It seemed wise at the time, but in the long run the decor was creating a high-price image. Expensive decor doesn’t really affect your pricing, but a lot of consumers think it does,” King says.

A simpler looking decor and brighter lighting created a different image for the market. Although the pricing structure is the same as it was before the storm, consumers perceive the store to be lower-priced. The price perception of local consumers is particularly important because King’s Super Valu sits within several miles of two Cub Food stores and two other warehouse markets.

Cabot Tornado 1976


King has also laid the plans to deal with any future storms. Since the store is located in a strip of land known locally as “tornado alley,” near the upper Mississippi River, King’s management has had several meetings to discuss how to prepare for severe weather. “The safest place seems to be inside the coolers and freezers, which sustained little damage. That’s where employees and customers should go when severe weather is approaching,” King says.

You’ve Gotta Have Heart
On a may morning in 1983, Guy Fisher returned home to begin his recovery from bypass surgery. When he arrived home, he learned that one of his two IGA stores had suffered a serious fire the night before.

“A bypass operation and a fire within the same week is tough,” says Fishers, who operates Fisher IGA supermarkets in Cherry Valley and Wynne, Ark. “I’m thankful that I have some able sons plus dedicated employees to help me. I just let them take care of everything having to do with the fire because my doctor said that I should not get involved.”

The fire began in an oven in the meat department at about midnight. Fortunately, at 4 a.m., the head checker happened to pass by the store and noticed smoke coming out of the roof. She went in, discovered the fire and called the fire department. They had the flames out within 30 minutes.

The fire never traveled more than 30 feet from the oven, but smoke spread throughout the store. All merchandise was smoke damaged and had to either be dumped or sold to a salvage company. The total damage amounted to $250,000, but the entire amount was paid by Fisher’s insurance policy through Wetterau, his wholesaler.

When Fisher realized that everything in the market would have to be removed for steam cleaning, he decided to make changes that he had wanted to implement since acquiring the store two years before. “It would have been too costly to remodel the store from scratch,” he says, “but since everything had to be removed anyway, we decided to take advantage of the situation.”

While the employees were breaking down and cleaning the equipment, all of which was smoke damaged, but none of which was destroyed, Fisher and his key people planned changes. The dairy cooler and freezer were moved outside, allowing 15 feet of backroom space to be added to the selling area. Total square footage was expanded from 7,200 to 7,500 square feet.

By moving the meat department along the rear wall back by 15 feet, Fisher was able to give customers more space to shop the case. He added 17 feet to the dairy case and 20 feet to frozens, and installed new checkouts. The extra space allowed him to have a greater selection and to offer a more comfortable shopping atmosphere.

Since then, the store and its owner have recuperated just fine. The supermarket reopened in August, four months after the fire, and sales have been strong considering Cherry Valley’s population of 500. Fisher is back on the job full time and feeling fine.