cssi/SciSciGPT-SciSciNet huggingface dataset:
Electronic Order Volume as a Meaningful Component in Estimating Patient Complexity and Resident Physician Workload.

Author(s): Groningen, Nicole Van; Prasad, Priya A; Najafi, Nader; Rajkomar, Alvin; Khanna, Raman R; Fang, Margaret C | Abstract: BackgroundThough patient census has been used to describe resident physician workload, this fails to account for variations in patient complexity. Changes in clinical orders captured through electronic health records may provide a complementary window into workload. We aimed to determine whether electronic order volume correlated with measures of patient complexity and whether higher order volume was associated with quality metrics.MethodsIn this retrospective study of admissions to the internal medicine teaching service of an academic medical center in a 13-month period, we tested the relationship between electronic order volume and patient level of care and severity of illness category. We used multivariable logistic regression to examine the association between daily team orders and two discharge-related quality metrics (receipt of a high-quality patient after-visit summary (AVS) and timely discharge summary), adjusted for team census, patient severity of illness, and patient demographics.ResultsOur study included 5,032 inpatient admissions for whom 929,153 orders were entered. Mean daily order volume was significantly higher for patients in the intensive care unit than in step-down units and general medical wards (40 vs. 24 vs. 19, P l .001). Order volume was also significantly correlated with severity of illness (P l .001). Patients were 12% less likely to receive a timely discharge summary for every 100 additional team orders placed on the day prior to discharge (OR 0.88; 95% CI 0.82-0.95).ConclusionsElectronic order volume is significantly associated with patient complexity and may provide valuable additional information in measuring resident physician workload.
The formation of highly ordered graphitic interphase around embedded CNTs controls the mechanics of ultra-strong carbonized nanofibers

Abstract Templating graphitization, i.e., the transformation of certain polymers to highly-ordered graphitic (HOG) domains upon pyrolysis in the vicinity of graphitic nanomaterials, such as carbon nanotubes (CNTs), is known to be an effective approach to modify the microstructure of carbon nanofibers (CNFs). In this work, the microstructure of CNFs subjected to the templating effect of functionalized single-walled CNTs (f-SWNTs) and the effect of templating on mechanical properties of CNF/f-SWNTs hybrid nanofiber are studied. The CNF/f-SWNTs were fabricated via pyrolysis of electrospun polyacrylonitrile precursors with CNT inclusions. Prior to pyrolysis, the precursors were subjected to thermomechanical treatments, known as hot-drawing, to enhance chain and CNT alignment and packing. The study of the microstructure of the precursor and CNFs indicates the crucial role of precursor hot-drawing in enhancing the microstructure of the precursor and CNFs, leading to drastically enhanced templating effect, as evidenced from the thickness of the HOG that forms around CNTs. Mechanical tests on single nanofibers using custom-designed microdevices led to the realization that the templating effect of CNTs on CNFs, when properly implemented via precursor hot-drawing, can considerably increase the strength of CNFs. The average tensile strength and modulus of CNF/f-SWNTs in which HOG domains had clearly formed were measured to be 7.6 and 268 GPa, respectively, which are the highest value reported to date among similar types of materials. The existence and evolution of the HOG around CNTs inside CNFs and mechanical reinforcing of HOG were thoroughly discussed in conjunction with finite element models of building blocks of CNFs, alluding to the stress fields around HOG and CNTs in the CNF. The high-performance 1-D hybrid graphitic nanostructure developed here, CNF/f-SWNTs, can serve as an outstanding reinforcement material for weight sensitive applications.
Clinical Reasoning: A case of bilateral orbital mass lesions presenting with acute monocular vision loss.

An 80-year-old man with medical history of hypertension developed a sudden loss of vision in the left eye without any associated pain, flashes, or floaters. The review of systems was negative for any headaches, jaw claudication, scalp or temporal tenderness, or other symptoms suggestive of polymyalgia rheumatica (PMR). The patient's medications were benazepril and amlodipine for the treatment of hypertension. Clinical examination showed normal vital signs. Visual acuity testing revealed 20/20 vision on the right and hand movement perception only in the temporal field of the left eye, with no light perception on the nasal field of the same eye. Pupils were 3 mm bilaterally, round, and reactive with a relative afferent pupillary defect on the left. Dilated funduscopic examination was unremarkable on the right side and revealed macular whitening and retinal blanching with cherry-red spot on the left. Temporal artery pulses were present. The remainder of the neurologic examination was unremarkable. Laboratory investigations including erythrocyte sedimentation rate, C-reactive protein, lipid profile, and glycosylated hemoglobin were normal.
Summary of Working Group 6: Laser-Plasma Acceleration of Ions

Here we summarize the work presented during Working Group 6, Laser-Plasma Acceleration of Ions, at the 18th Advanced Accelerator Concepts Workshop in 2018.
Designs and Analytical Methods In Multi-Omics Studies of Complex Diseases

Abstract Complex human diseases involve multiple molecular mechanisms and pathways with dynamic relationships. High-throughput technologies enable omics studies interrogating thousands to millions of makers with similar biochemical properties (e.g. transcriptomics for RNA transcripts). However, a single layer of ‘omics’ can only provide limited insights into the biological mechanisms of a disease. Genomic studies discovered many loci and genes associated with disease traits but provided limited insights about their functional roles and the changing disease risk across the life span. DNA, RNA, protein, and metabolite often have complementary roles to jointly perform a certain biological function. Such complementary effects and synergistic interactions between omic layers in the life-course can only be captured by integrative study of multiple molecular layers. Multi-omics approaches integrate data obtained from different omic levels to understand their interrelation and combined influence on the disease processes. Thus, properly designed multi-omics studies may improve the understanding the molecular function and disease etiology. We summarize major omics approaches available in population research, and review integrative approaches and methodologies interrogating multiple omic layers, which enhance the gene discovery and functional analysis of human diseases. We seek to provide analytical recommendations for different types of multi-omics data and study designs to guide the emerging multi-omic research, and to suggest improvement of the existing analytical methods.
Adding Value to the Oral Presentation

The US healthcare system has a culture of overspending and overtreatment that has led to astronomical costs of care with little improvement in important health outcomes. High-value care has been proposed as a way to change this unsustainable culture. The goal of high-value care is to improve patient outcomes while decreasing unnecessary healthcare costs and harms. Medical students can learn to identify overuse and propose rational and cost-effective treatments that align with their patients’ goals and values. SOAP-V is a tool that medical students can use to add a discussion of value to their oral presentations and written notes. By addressing evidence of value, patient values, and relative cost in their case presentations, students can stimulate important high-value care conversations on rounds and in the clinic. The most effective way to discuss value is to embed it in the assessment in plan, along with guidelines, clinical trials, and other evidence to support it. Examples of SOAP-V oral presentations and two practice cases are included to reinforce the high-value care concepts discussed in this chapter.
An Embedded Inductive Coupling Transceiver for Internet of Things Applications

A low-complexity transceiver circuit for wireless communications through inductive coupling is presented here. This transceiver is fully passive (obtaining its power from a nearby reader) and therefore, it is suitable for IoT applications that require a wireless means of communications while avoiding periodic battery re-charging. The simplicity of the transceiver circuit makes it attractive for low-cost sensing solutions. Communication between the transceiver and a reader (uplink) is achieved using load-shift keying or backscatter modulation, while communication between a reader and the transceiver (downlink) is accomplished amplitude-shift keying. In both cases, data is formatted using an asynchronous serial format. The transceiver was implemented using off-the-shelf components. A small $8\ \text{mm}\times 10.8\ \text{mm}$ printed circuit board including the transceiver, a microcontroller and a sensor was fabricated. The performance of the uplink was assessed at different distances between the antennas and at a maximum rate of 2 Mbps. It was found that at 2 Mbps, a bit error rate of $9.07\times 10^{-4}$ can be achieved.
P166 Exploratory Test of ASA24 to Collect 24-Hour Recalls in the Expanded Food and Nutrition Education Program

Background Interest exists to standardize and improve data collection and coding in Expanded Food and Nutrition Education Program (EFNEP) classes by switching from a paper-and-pencil 24-hour recall to the Automated Self-Administered 24-hour Recall (ASA24); however, it is important to address the feasibility of putting this into practice. Objective To do an initial pilot test to compare the use of ASA24 with paper-and-pencil recalls with EFNEP participants. Study Design, Settings, Participants Ten EFNEP paraprofessional educators were recruited from three states and trained to use ASA24. Participants were randomized at the class level to complete either ASA24 or a paper-and-pencil recall at program entry and the alternate method at exit. Participants (n = 37 entry, n = 30 exit) and paraprofessionals completed questionnaires about usability, confidence, preference, and perceived accuracy at entry and exit. Seven paraprofessionals participated in online focus groups or qualitative interviews. Measurable Outcome/Analysis Questions about usability, confidence, and perceived accuracy were scored on a Likert scale from strongly disagree (1) to strongly agree (5); scores were analyzed using descriptive statistics. Qualitative interviews and focus groups were transcribed, and two researchers coded and developed themes using inductive content analysis. Results Average scores for usability, confidence, and perceived accuracy were very similar for ASA24 and the paper-and-pencil recall. When asked which method they preferred, both the participants and paraprofessionals were evenly split. In the qualitative interviews, almost all of the paraprofessionals felt that ASA24 would result in more accurate recalls. The major barriers mentioned were lack of computer literacy of some participants and problems with internet connectivity. Conclusion ASA24 may be comparable to the paper-and-pencil recall in usability, confidence, perceived accuracy, and preference for both EFNEP participants and paraprofessionals. Qualitative analysis indicates that ASA24 may work better with participants who are computer literate, and may yield more accurate results. Funding USDA.
New CT-based diagnoses of torso cancer is low in the emergency department setting

The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types of new CT-based torso cancer diagnoses in the ED. A total of 19,496 CT reports including all or parts of the torso from 2017 were searched for the keywords: “mass”, “tumor”, “neoplasm”, “malignancy”, or “cancer”. Each report and corresponding medical record was evaluated for presence of a new cancer. Cases were scored as no cancer, subcentimeter lung nodule, known cancer, new cancer, or suspicious, but unconfirmed for new cancer. Each mass was characterized as symptom-related or incidental. At least one keyword was found in 2086 reports. Of these 706, 126 and 905 were known cancer cases, subcentimeter lung nodules, and non-cancerous cases, respectively. There were 251 confirmed new cancers and 98 suspicious cases which lacked adequate diagnostic workup. Depending on whether only definite or definite and suspicious cases were included together, the number of new cancer cases per 100 torso CT exams was 1.3 or 1.8, respectively. Gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers were most common. Only 58 of the confirmed cases (23%) were deemed as incidental findings. CT-diagnosis of new torso cancers was uncommon in our setting. Still, while extensive knowledge of cancer staging may not be necessary for ED radiologists, knowledge of the most common types of cancer including gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers may improve sensitivity for these diagnoses and may expedite appropriate referrals for the newly diagnosed patients.
Demonstration of Krypton: optimized CNN inference for occlusion-based deep CNN explanations

In this demonstration, we present Krypton, a system for accelerating occlusion-based deep convolution neural network (CNN) explanation workloads. Driven by the success of CNNs in image understanding tasks, there is growing adoption of CNNs in various domains, including high stakes applications such as radiology. However, users of such applications often seek an "explanation" for why a CNN predicted a certain label. One of the most widely used approaches for explaining CNN predictions is the occlusion-based explanation (OBE) method. This approach is computationally expensive due to the large number of re-inference requests produced. Krypton reduces the runtime of OBE by up to 35x by enabling incremental and approximate inference optimizations that are inspired by classical database query optimization techniques. We allow the audience to interactively diagnose CNN predictions from several use cases, including radiology and natural images. A short video of our demonstration can be found here: https://youtu.be/1OWddbd4n6Y
Anal HPV Infection and HPV-Associated Disease

Abstract Anal HPV infection, precancer and cancer, share many biological similarities with their cervical counterparts. The incidence of anal cancer has been rising in both men and women in the general population for decades, However, it is less common than cervical cancer and attracted relatively little attention until the incidence was shown to be substantially elevated in at-risk groups such as men who have sex with men and HIV-infected individuals. Techniques were modified from the cervix to allow for anal HPV testing, disease assessment and treatment. Studies also show a high prevalence and incidence of anal HPV infection, anal high-grade squamous intraepithelial lesions and anal cancer in women with history of cervical and vulvar cancer, and individuals with immunocompromise due to solid organ transplant. Comparative studies between cervical and anal HPV infection and HPV-associated disease at these two anatomic sites offer valuable insight into HPV biology.
The paradox of opposite directions of gene expressions in MCI and AD suggests possible therapy to prevent progression of MCI to AD

One of the puzzling observations concerning mild cognitive impairment (MCI) and Alzheimer's disease (AD), is that many gene expressions in MCI may be in the opposite direction of those seen in AD. Several examples of this paradox are provided. The likely explanation lies in in the control mechanisms of gene transcription. These mechanisms include (1) modification of DNA and histones by methylation or acetylation, affecting the balance between the Compass group of proteins that enhances mRNA formation, and the Polycomb group that suppresses it; (2) compensation for the loss of one gene's function by another gene with overlapping functions; (3) reduced control of the entire neural RNA production; and (4) response to microRNAs (miRNA). Although data are inadequate to exclude with certainty any one of the indicated mechanisms, the available evidence favors overall reduced control of neural mRNA production, including the effect of miRNA. The switch occurs at a specific stage, somewhere between Braak 0-1 and Braak 2-3, in the progression from MCI to AD, which reduces the number of its likely causes. Two strong but related candidates are the repressor element-1 silencing transcription factor (REST), which in adult neurons impairs plasticity; and a miRNA, for example, miRNA124, that represses REST. Another possible explanation is that only those patients with MCI who will not progress to AD are the ones that have gene expressions in the opposite direction as in AD. The solution to the paradox may have pragmatic value.
Descriptive Epidemiology of Adolescent Clavicle Fractures: Results From the FACTS (Function after Adolescent Clavicle Trauma and Surgery) Prospective, Multicenter Cohort Study.

Background:The majority of previous investigations on operative fixation of clavicle fractures have been related to the adult population, with occasional assessments of the younger, more commonly a...
Expressivism at the beginning and end of life

Some disability rights advocates criticise prenatal testing and selective abortion on the grounds that these practices express negative attitudes towards existing persons with disabilities. Disability rights advocates also commonly criticise and oppose physician-assisted suicide (PAS) and euthanasia on the same grounds. Despite the structural and motivational similarity of these two kinds of arguments, there is no literature comparing and contrasting their relative merits and the merits of responses to them with respect to each of these specific medical practices. This paper undertakes such a comparison. My thesis is that a number of potentially significant weaknesses of the expressivist argument against reproductive technologies are avoided when the argument is used against PAS. In particular, I try to show that three common criticisms of the expressivist argument applied to reproductive technologies, whatever merit they have, have even less merit when they are used to reply to the expressivist argument applied to PAS. This is important because the expressivist argument applied to the end of life scenario does not get as much attention as the argument applied to the beginning of life scenario, and yet it has a relatively stronger position.
Model Reference Adaptive Control of Switched Dynamical Systems with Applications to Aerial Robotics

This paper presents an adaptive control law for unknown nonlinear switched plants that must follow the trajectory of user-defined linear switched reference models. The effectiveness of the proposed control architecture is proven in two alternative frameworks, that is, analyzing Caratheodory and Filippov solutions of discontinuous differential equations. Numerical and experimental data verify the applicability of the theoretical results to problems of practical interest. The proposed numerical simulation involves the design of a model reference adaptive control law to regulate the roll dynamics of a reconfigurable delta-wing aircraft. The proposed flight tests involve an aerial robot tasked with autonomously mounting a camera of unknown inertial properties to a vertical surface.
Identifying Opportunities to Enhance Thoracic Surgery Using Human Factors

The study of human factors has become a considerable focus in the field of thoracic surgery, given the complex nature of operations, multidisciplinary teams necessary in many clinical scenarios, and the constantly evolving technology incorporated into patient care. The degree of coordination necessary for routine thoracic surgery care makes it imperative to analyze the system and ensure communication among team members is concise and efficient. This chapter begins with a case study outlining a scenario encountered in a relatively common general thoracic surgery case, followed by a review of current human factors research and insights.
Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds.

Racial, ethnic, and gender disparities in cardiovascular care are well-documented. This review aims to highlight the disparities and impact on a group particularly vulnerable to disparities, women from racial/ethnic minority backgrounds. Women from racial/ethnic minority backgrounds remain underrepresented in major cardiovascular trials, limiting the generalizability of cardiovascular research to this population. Certain cardiovascular risk factors are more prevalent in women from racial/ethnic minority backgrounds, including traditional risk factors such as hypertension, obesity, and diabetes. Female-specific risk factors including gestational diabetes and preeclampsia as well as non-traditional psychosocial risk factors like depressive and anxiety disorders, increased child care, and familial and home care responsibility have been shown to increase risk for cardiovascular disease events in women more so than in men, and disproportionately affect women from racial/ethnic minority backgrounds. Despite this, minimal interventions to address differential risk have been proposed. Furthermore, disparities in treatment and outcomes that disadvantage minority women persist. The limited improvement in outcomes over time, especially among non-Hispanic Black women, is an area that requires further research and active interventions. Understanding the lack of representation in cardiovascular trials, differential cardiovascular risk, and disparities in treatment and outcomes among women from racial/ethnic minority backgrounds highlights opportunities for improving cardiovascular care among this particularly vulnerable population.
Demystifying East Asian language monograph publishing: Contemplations on the current status, challenges, and opportunities

Abstract Library budgets are being restructured to reflect a growing trend that shifts resources from print to electronic media. This trend has been further accelerated by the ongoing global COVID-19 pandemic. However, this e-preferred trend could potentially weaken the collective purchasing power of North American East Asian collections and consequently slow advances in the field of East Asian Studies in the long run. Humanities and social sciences scholars and students utilize significantly more books and book chapters than journal articles in their research outputs and prefer print materials, as evidenced in surveys and citation analyses studies. This article surveys the state of the monograph publishing landscape in East Asia, with a focus on China, Japan, and Korea. Drawing on existing statistics, interviews with leading vendors, and librarians' perspectives, the authors explore major issues and deficiencies in East Asian e-book publishing, and make recommendations for future improvement. We conclude that East Asian studies librarians must battle the trend toward e-centric collection development approach to ensure a well-curated collection that reflects the concept of equity, diversity, and inclusion.
Randomized, Double-Blind Trial on the Impact of Word Count in Cancer Clinical Trial Consent Forms.

PURPOSE:This randomized, double-blind study sought to understand whether cancer clinical trial consent form verbosity detracts from patients' decision making on trial enrollment.METHODS:This trial ...
Rotation Measurement Using Spatially Incoherent Light and the Rotational Doppler Shift

We measure the rotational Doppler shift from a spinning target illuminated with spatially and temporally incoherent light. This demonstrates that a well-defined orbital angular momentum spectrum is not required to observe a rotational Doppler shift.
Gastric blood flow and acid secretion during direct intraarterial histamine administration.

Summary Gastric blood flow and acid secretion were closely related during the intraarterial administration of histamine to exteriorized gastric segments of dog stomach. The increase in total gastric blood flow preceded the onset of acid secretion by several minutes and remained unaltered during inhibition of acid secretion by sodium thiocyanate. The ratio of mucosal to total blood flow during acid secretion was constant over a wide dose range.
Evaluating the Impact of Dietary Choices to Lifespan, Do They Match Up to Marketing Claims?

Considerable research indicates that a plant-based vegan diet is the optimal dietary choice which will maximize life expectancy for both genders. Operating on this assumption, using hierarchical multiple regression analysis, one objective is to evaluate using a plant-based vegan diet as a base diet, the impacts of the components of the base diet to maximize life expectancy using global statistics of life expectancy as well as the kcal/day consumption rate of various food stuffs compiled from eighty-six different countries. Another objective is to identify as a diet expands beyond a vegan diet into a vegetarian, and then a vegetarian-inclined diet what are the impacts of the added foodstuffs as well as if they are statistically significant to the new, overall diet in increasing life expectancy. This will be done to evaluate marketing claims made by consumer advocacy groups, industry groups, and firms which tout their respective food stuff as reducing the risk of various health ailments. Essentially, it is evaluated if the benefits touted by the consumption of their respective foodstuffs actually have an impact on life expectancy. It was observed that a vegan diet is fairly significant to increasing and maximizing life expectancy; however the diary options of cheese and milk statistically significantly contributed to increasing life expectancy, as well as the protein source of poultry. Conversely, bovine meat as a protein source, coffee, and wine never provided any statistical significance to improving life expectancy, and wheat as well as nuts are not a necessary part of a plant-based vegan diet to maximize life expectancy. In effect, these two food stuffs never statistically contributed to maximizing life expectancy in any dietary variation, and when broken down in the form of an equation to calculate life expectancy nuts were actually shown to decrease life expectancy. This analysis intends to serve as a credible, but rudimentary basis to be built upon for further evaluation of the impact of foodstuffs to maximizing life expectancy, the usage of other data analysis techniques, and the inclusion of gender, race, income, crime rates, and other impacts to overall life expectancy are recommended.
Culture confirmation of Campylobacter spp. by latex agglutination

A commercial latex agglutination test [Meritec-Campy (jcl), Meridian Diagnostics, Cincinnati, Ohio] was evaluated for identification of Campylobacter jejuni, C. coli, C. laridis, and other Campylobacter isolates. The test had 100% sensitivity in detecting C. jejuni and C. coli but low sensitivity with C. laridis isolates. C. upsaliensis strains reacted with the test. The test had 100% specificity for 101 non-Campylobacter organisms.
Novel links between troubled marriages and appetite regulation: marital distress, ghrelin, and diet quality

Distressed marriages enhance risk for health problems; appetite dysregulation is one potential mechanistic pathway. Research suggests that ghrelin and leptin, appetite-relevant hormones connected to shorter and longer-term energy balance, may differentially affect people with a higher versus lower body mass index (BMI). During this double-blind randomized crossover study, both members of a couple (N=86 participants) ate a standardized meal at the beginning of two visits. Observational recordings of a marital conflict assessed marital distress. Ghrelin and leptin were sampled pre-meal and post-meal at 2, 4, and 7 hours. Diet quality was measured using the USDA 24-Hour Multiple-Pass Approach. People in more distressed marriages had higher post-meal ghrelin (but not leptin) and a poorer quality diet than those in less distressed marriages, but only among participants with a lower BMI. These effects were consistent for both spouses. Ghrelin and diet quality may link marital distress to its corresponding negative health effects.
Suppression and recovery of a one-trial avoidance response after a single ECS

Groups of rats were subjected to either a single ECS or no ECS within a few sec. after receiving 1 or 2 punishing shocks in a box in which they had been trained to drink from a water spout. ECS groups drank more (avoided less) than no ECS controls at both 1 and 24 hr. after the punishing shocks. Two shock ECS groups tested at 24 hr., however, drank less than 2 shock ECS groups tested at 1 hr. These results were considered in terms of the notion of memory consolidation.
IMMUNE COMPLEX NEPHRITIS ASSOCIATED WITH CHRONIC BACTEREMIA (SHUNT NEPHRITIS)

Although the evidence to date suggests that, as in lupus nephritis, the diffuse proliferative nephritis associated with chronic bacteremia from infected ventriculoatrial shunts is produced by circulating immune complexes, the antigen in the complexes has not been demonstrated. A complement reactive cryoglobulin composed of IgG, IgM, C3 and C4 was isolated from a patient with shunt nephritis due to staphylococcal epidermidis. Antibody produced in rabbits to the patient's washed cryoglobulin reacted by double diffusion in agarose to the techoic acid isolated from the infecting Staphylococcal epidermidis. In vitro, the cryoglobulin activated complement by the classical pathway. Both the patient's serum and the cryoglobulin contained heat stable Clq precipitins (Agnello, et.al., JEM 134:228s, 1971). Serum C3, C4 and properdin levels were initially depressed while C5 and C3 proactivator levels were normal. Following removal of the infected shunt, the C3 level rose into the normal range in 10 days while the C4 and properdin levels became normal after 3 weeks. These observations support the concept that, as in lupus nephritis and experimental immune complex nephritis, circulating complement reactive antigen-antibody complexes manifested in vitro as cryoglobulins are responsible for the nephritis.
An Optimal Control Approach to Minimizing Entropy Generation in an Adiabatic IC Engine With Fixed Compression Ratio

Entropy generation due to combustion destroys as much as a third of the theoretical maximum work that could have been extracted from the fuel supplied to an engine. In this paper, an optimal control problem is set up to minimize the entropy generation in an adiabatic internal combustion engine, with the piston velocity profile serving as the control input function. The compression ratio of the engine is fixed, thereby imposing a constraint on the piston motion. The switching conditions for the optimal bang-off-bang control is determined based on Pontryagin's maximum principle. In thermodynamic terms, the optimal solution reduces to a strategy of equilibrium entropy minimization. This result is independent of the underlying combustion mechanism.© 2006 ASME
Status inconsistency effects on sexual liberalness.

One of the most researched questions concerns the method to distinguish those who do not engage in more permissive forms of pre‐marital and post‐marital sexual behavior and attitudes. The general tactic taken in researching this tradition has been to look at various measures of socio‐economic status (i.e., income, education, occupation) under the assumption that higher S.E.S. is related to liberalness in general which, in turn is related to sexual permissiveness. An alternative, but non‐researched (to my knowledge), hypothesis is that status inconsistency (i.e., differences in status such as high education and low occupation) are related to sexual permissiveness. There is a large literature showing status inconsistency to be related to differences in political, economic and religious liberalness. Hence, this paper analyzes, and confirms, the effects of status inconsistency on reported sexual attitudes. It also analyses, compares and discusses the S.E.S. literature in relation to this study's findings.
Articular oxalate crystals and the taxonomy of gout.

In this issue ofTHE JOURNAL, Rosenthal et al 1 report the case of an anephric, dialyzed patient experiencing acute arthritis associated with calcium oxalate crystals. Together with reports from Hoffman et al, 2 Schumacher et al, 3 and Reginato et al, 4 this observation establishes an unequivocal place for oxalate among the solutes that abnormally crystallize in and around human joints. As yet, these authors, who together with Paul Dieppe are the leading students of crystalinduced disease, have not settled on a simple name for this
Effect of hepatitis C coinfection on discontinuation and modification of initial HAART in primary HIV care.

Objectives: To estimate the effect of hepatitis C (HCV) coinfection on time to first occurrence of either discontinuation or modification of initial HAART among previously antiretroviral therapy-naive HIV-infected patients. Methods: The analysis included antiretroviral therapy-naive patients who initiated HAART prior to November 2003 and were participating in the University of North Carolina Center for AIDS Research, HIV/AIDS observational clinical cohort. The effect of HCV status on time to first occurrence of either HAART discontinuation or modification was assessed using Kaplan-Meier survival estimates and multivariable proportional hazards regression was used to estimate hazard ratios. Results: Of 296 patients initiating HAART, 22% were coinfected with HCV. During a median follow-up of 473 days [interquartile range (IQR), 167-940] from HAART initiation, 104 (35%) patients discontinued and 91 (31%) modified their first regimen. Reasons for discontinuation and modification were comparable by HCV serostatus and included treatment failure (12%), toxicity (41%), and barriers to adherence (47%). The median time to first occurrence of either discontinuation or modification among HCV-infected patients was 401 days (IQR, 128-821), and among HCV-uninfected patients was 493 days (IQR, 204-952) (P = 0.22). After adjustment for baseline demographic and clinical characteristics, the hazard ratio contrasting HCV-infected with HCV-uninfected patients was 1.39 (95% confidence interval, 0.95-2.03; P = 0.09). Conclusion: HCV coinfection was only marginally associated with a shorter duration of an initial HAART regimen, suggesting optimization of a first HAART regimen may not appreciably depend on HCV serostatus.
Enzymatic Processing of Platinated RNAs

The broadly prescribed antitumor drug cisplatin coordinates to DNA, altering the activity of cellular proteins whose functions rely upon sensing DNA structure. Cisplatin is also known to coordinate to RNA, but the effects of RNA-Pt adducts on the large number of proteins that process the transcriptome are currently unknown. In an effort to address how platination of an RNA alters the function of RNA processing enzymes, we have determined the influence of [Pt(NH(3))(2)](2+)-RNA adducts on the activities of 3'-->5' and 5'-->3' phosphodiesterases, a purine-specific endoribonuclease, and a reverse transcriptase. Single Pt(II) adducts on RNA oligonucleotides of the form (5'-U(6)-XY-U(5)-3': XY = GG, GA, AG, GU) are found to block exonucleolytic digestion. Similar disruption of endonucleolytic cleavage is observed, except for the platinated XY = GA RNA where RNase U2 uniquely tolerates platinum modification. Platinum adducts formed with a more complex RNA prevent reverse transcription, providing evidence that platination is capable of interfering with RNA's role in relaying sequence information. The observed disruptions in enzymatic activity point to the possibility that cellular RNA processing may be similarly affected, which could contribute to the cell-wide effects of platinum antitumor drugs. Additionally, we show that thiourea reverses cisplatin-RNA adducts, providing a chemical tool for use in future studies regarding cisplatin targeting of cellular RNAs.
Analytical model for dual-interfering sources diffuse optical tomography

An analytical model to perform tomographic reconstructions for absorptive inclusions in highly scattering media using dual interfering sources was derived. A perturbation approach within the first order Rytov expansion was used to solve the heterogeneous diffusion equation. Analytical weight functions necessary to solve the inverse problem were obtained. The reconstructions performance was assessed using simulated data of breast-like media after contrast agent enhancement. We further investigated the reconstruction quality as a function of object depth location, modulation frequency and source separation. The ability of the algorithm to resolve multi-objects was also demonstrated.
Localization of cations in the peripheral nerve fiber by the K-pyroantimonate method.

Abstract The distribution of cation in the peripheral nerve fibers of a few representative vertebrate types was examined using the potassium-pyroantimonate method. Heavy accumulation of electron-opaque precipitates of pyroantimonate-cation complex presumably including Na + , Ca 2+ , and Mg 2+ was a consistent feature in the incisure of myelin where the precipitate was located either in the Schwann cytoplasm of the incisures, in the extracellular space denoting the intraperiod line or in both places. There was little or no precipitate in the paranodal loops. The physiological implications of these findings are discussed. The results suggest to us that the incisures serve among other functions as compartments in which are sequestered some cations important for the regulation of the ionic environment of the axon. Inside the axon, cations were precipitated along the neurofilaments with a regular spacing of about 450–700 A, a distribution reminiscent of muscle troponin. Repeated electrical stimulation of the nerve caused a notable movement of cation from the clefts into the axon.
Understanding disparities in subpopulations of women who smoke.

Tobacco use is the leading known cause of preventable death and disease among women. In this paper we use fundamental concepts and definitions from the general health-disparities literature to examine smoking behavior among subpopulations of women. We focus on three factors associated with disparities in smoking behavior among subgroups of women—race and/or ethnicity, educational status, and acculturation. We suggest that research on smoking behavior among subpopulations of women is beginning to reveal not only different smoking behavior but disparities among women in different subpopulations. We conclude that subpopulation-based understanding of gender differences and disparities in smoking is critical to improvement of research design, intervention objectives, and public health policy on smoking in women.
Density Functional Theory Investigations of the Forbidden Double Insertion of Diazomethane into Zr−C Bonds of Cp2Zr(CH3)2

The potential energy surfaces involved in the insertion of diazomethane species R2CN2 (R = H, Ph) into the Zr−CH3 bonds of Cp2Zr(CH3)2 are examined using density functional methods. The first insertion leads to the experimentally observed mono-hydrazonato complex Cp2Zr(CH3)(CH3−N−NCPh2), for which the reaction energy is calculated to be −37 kcal/mol. Insertion of a second diazomethane molecule into the remaining Zr−Me bond leads to the bis-hydrazonato complex Cp2Zr(CH3−N−NCPh2)2, which is calculated to be a stable species with an overall reaction exothermicity of −27 kcal/mol. While the first insertion proceeds with a small activation barrier (2−7 kcal/mol), a more substantial activation barrier (25 kcal/mol) is found for the second insertion, but not sufficiently large to preclude formation of the bis-hydrazonato complex. This formally 20-valence-electron species is hence predicted to be a target for synthesis. The bonding in the bis-hydrazonato complexes shows significant Zr 4d admixture in the MOs invo...
Structure of human serum cholinesterase.

Summary Human cholinesterase has recently been sequenced and cloned. It is a glycoprotein of 4 identical subunits, each subunit containing 9 carbohydrate chains and 3.5 disuljide bonds. Protein folding is likely to be very similar in human cholinesterase and Torpedo acetylcholinesterase. The cholinesterases have no significant sequence homology with the serine proteases and seem to belong to a separate serine esterase family.
Longitudinal analysis of abstinence-specific social support and smoking cessation.

Objectives: (1) To replicate previous research finding that abstinence-specific social support during the active phase of quitting predicts short- and long-term smoking cessation treatment outcome. (2) To describe time-related changes in abstinence-specific support, including how support provided during middle and later phases of the quitting process is associated with treatment outcome. Design: Combined data from three randomized clinical trials of smoking cessation treatment (N = 739) were analyzed using logistic regression and analysis of variance. Main Outcome Measures: Measures included the Partner Interaction Questionnaire (PIQ; Cohen & Lichtenstein, 1990), a measure of smoking-related social support, and smoking status according to 7-day point-prevalence abstinence. Results: Longitudinal analyses found that positive support peaked at week 12, decreasing thereafter. Positive support provided after week 12 did not differentiate between those who never quit smoking, those who quit and relapsed, and those who maintained abstinence. In contrast, negative support was monotonic and was useful at follow-up points for distinguishing between outcome groups. Conclusion: These results suggest that positive and negative support are both important factors in the early phase of quitting, but it is the continued minimization of negative support that best predicts maintenance of nonsmoking.
Critical problems in developing databases for upland areas: The potential value of GIS techniques

Abstract There are increasingly complex patterns of policy boundaries which identify those upland and other rural areas which can benefit from particular forms of economic or other assistance. These boundaries seek to identify the areas which exhibit distinctive problems, yet this remains far from simple because even the definition of rural areas remains problematic in Britain. Monitoring the continuing appropriateness of existing policy boundaries by compiling up-to-date data for these areas is made more difficult by the fact that these non-standard areas are not recognized by the units used for reporting relevant statistics. This technical problem is explored through the example of compiling Population Census data for Less Favoured Areas: these upland area definitions provide a stern test of the possible benefits from a geographic information system (GIS) approach. The results from this experiment raise again key questions in the definitions of rural and upland areas, and how these areas should be represented statistically.
Early onset and origin of 100-kyr cycles in Pleistocene tropical SST records

Abstract The large 100-kyr cycles evident in most late-Pleistocene (0–0.6 Ma) paleoclimatic records still lack a satisfactory explanation. Previous studies of the nature of the transition from the early Pleistocene (1.2–1.8 Ma) 41-kyr-dominated climate regime to the 100-kyr world have been based almost exclusively on benthic foraminiferal oxygen isotopic (δ18O) data. It is generally accepted that the late Pleistocene 100-kyr cycles represent a newly evolved sensitivity to eccentricity/precession, superimposed on an earlier, and largely constant, response to obliquity and precession forcing. However, orbitally-resolved Pleistocene sea surface temperature (SST) records from a variety of oceanic regions paint a rather different picture of the global climate transition across the mid-Pleistocene transition (MPT, 0.6–1.2 Ma). Reanalysis of these SST records shows that: (1) an early onset of strong 100-kyr-like cycles in two low-frequency bands (∼ 120–145 kyr and ∼ 60–80 kyr), derived from the bundling of two/three obliquity cycles into grand cycles (obliquity subharmonics), occurred in tropical SST records during the early Pleistocene, (2) these two early Pleistocene periods converge into the late-Pleistocene 100-kyr period in tropical SST records, (3) the dominance of 100-kyr SST power in the late Pleistocene coincides with a dramatic decline in the 41-kyr SST power, and (4) the correlation of timing of glacial terminations with eccentricity/precession variation could well extend back into the early Pleistocene. We demonstrate that most of these features also occur in δ18O records, but in a much more subtle manner. These features could be explained in two plausible ways: a shift in climate sensitivity from obliquity to eccentricity/precession (a modified version of the conventional view) or an increasingly nonlinear response to orbital obliquity across the MPT. However, our examination of the development of ∼100-kyr cycles favors an obliquity bundling mechanism to form late Pleistocene 100-kyr cycles. We therefore suggest that the late Pleistocene 100-kyr climatic cycles are likely a nonlinear response to orbital obliquity, although the timing of late Pleistocene 100-kyr climatic cycles and their early forms appears to be paced by eccentricity/precession.
Measurement of Dietary and Dentifrice Effects Upon Calculus Accumulation Rates in the Domestic Ferret

Most animal models for the study of calculus accumulation and control currently use rodents or dogs. In an effort to overcome limitations inherent in the use of these species, we investigated calculus formation in domestic ferrets, a species used by King et al. in the 1940's and 1950's. Ferrets are much smaller than dogs, and, unlike rodents, can be scored while alive. In this study, we examined the kinetics of calculus formation in female ferrets fed with moist canned cat food-either plain or supplemented with sucrose-and two combinations of mineral salts. An additional group given supplemented cat food was treated twice daily with regular Crest toothpaste. Animals were sedated with a 1:1 mixture of ketamine and xylazine solutions and given a mechanical prophylaxis prior to the trial period, then scored for area and extent of calculus accumulation at two, four, six, and eight weeks thereafter. The data showed that the mineral-supplemented groups accumulated calculus at a significantly faster rate than th...
Highs and hopes

Messengers of Paradise: Opiates and the Brain. By Charles F. Levinthal. Anchor Press/Doubleday, New York:1988. Pp. 229. $16.95.
THE IMPACT OF THE WOMEN'S LIBERATION MOVEMENT ON CHILD DEVELOPMENT BOOKS

Women's movement publications have raised searching questions in the field of child care and development. Five specific propositions are identified that are common to the movement and that relate specifically to this field. These concern roles of the nuclear family and the biological mother in influencing development; imposition of gender role and its effects on the child; and the relative values of individual or communal methods of child rearing. Recent books are surveyed, and it is concluded that most texts in this field show a lack of responsiveness to the issues so widely discussed.