The specification logic νZ

This paper introduces a wide-spectrum specification logic νZ. The minimal core logic is extended to a more expressive specification logic which includes a schema calculus similar (but not equivalent) to Z, new additional schema operators, and extensions to programming and program development logics.     

Risk factors for a medically inappropriate admission to a Department of Internal Medicine

OBJECTIVE: To identify patient- and admission-related risk factors for a medically inappropriate admission to a department of internal medicine. METHODS: Cross-sectional study of a systematic sample of 500 admissions to the department of internal medicine of an urban teaching hospital. The appropriateness of each admission and reasons for inappropriate admissions were assessed using the Appropriateness Evaluation Protocol. Risk factors included the time (day of week and holidays) and manner (through emergency department or direct admission) of admission, patient age and sex, health status of patient and spouse, living arrangements, formal home care services, and informal support from family or friends. RESULTS: Overall, 76 (15.2%) hospital admissions were rated as medically inappropriate by the Appropriateness Evaluation Protocol. In multivariate analysis, the likelihood of an inappropriate admission was increased by better physical functioning of the patient (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1-2.1 [for 1 SD in Physical Functioning scores]), lower mental health status of the patient's spouse (OR, 2.6; 95% CI, 1.3-5.6), receipt of informal help from family or friends (OR, 3.3; 95% CI, 1.5-7.2), and hospitalization by one's physician (OR, 3.6; 95% CI, 1.7-7.5). Receiving formal adult home care was not associated with inappropriateness of hospitalization. CONCLUSIONS: Inappropriate admissions to internal medicine wards are determined by a mix of factors, including the patient's health and social environment. In addition, the private practitioners' discretionary ability to hospitalize their patients directly may also favor medically inappropriate admissions.     

Learning to Predict Non-Deterministically Generated Strings

In this article we present an algorithm that learns to predict non-deterministically generated strings. The problem of learning to predict non-deterministically generated strings was raised by Dietterich and Michalski (1986). While their objective was to give heuristic techniques that could be used to rapidly and effectively learn to predict a somewhat limited class of strings, our objective is to give an algorithm which, though impractical, is capable of learning to predict a very general class. Our algorithm is meant to provide a general framework within which heuristic techniques can be effectively employed.     

Dynamic stiffness vibration analysis using a high‐order beam model

This work presents the derivation of the exact dynamic stiffness matrix for a high‐order beam element. The terms are found directly from the solutions of the differential equations that describe the deformations of the cross‐section according to the high‐order theory, which include cubic variation of the axial displacements over the cross‐section of the beam. The model has six degrees of freedom at the two ends, one transverse displacement and two rotations, and the end forces are a shear force and two end moments. Using the dynamic stiffness matrix exact vibration frequencies for beams with various combinations of boundary conditions are tabulated and compared with results from the Bernoulli–Euler and Timoshenko beam models. Copyright © 2003 John Wiley & Sons, Ltd.     

A branch and cut algorithm for the VRP with satellite facilities

An important aspect of the vehicle routing problem (VRP) that has been largely overlooked is the use of satellite facilities to replenish vehicles during a route. When possible, satellite replenishment allows the drivers to continue making deliveries until the close of their shift without necessarily returning to the central depot. This situation arises primarily in the distribution of fuels and certain retail items. When demand is random, optimizing customer routes a priori may result in significant additional costs for a particular realization of demand. Satellite facilities are one way of safeguarding against unexpected demand. This paper presents a branch and cut methodology for solving the VRP with satellite facilities subject to capacity and route time constraints. We begin with a mixed-integer linear programming formulation and then describe a series of valid inequalities that can be used to cut off solutions to the linear programming relaxation. Several separation heuristics are then outlined that are used to generate the cuts. Embedded in the methodology is a VRP heuristic for finding good feasible solutions at each stage of the computations. Results are presented for a set of problems derived from our experience with a leading propane distributor.     

Localization of G-proteins in macrophages and E. coli during phagocytosis

Heterotrimeric GTP-binding proteins (G-proteins) have been shown to play an important role in cellular signalling. However, G-protein involvement in the intracellular spreading of bacterial pathogens is still poorly understood. In this study, antibodies, that recognize G-protein alpha-subunits (anti-G alpha), were used to investigate the localization of G-proteins in the macrophage-like cell line P388D1 and E. coli, also in their L-forms, during phagocytosis. In E. coli, anti-G alpha-binding sites were detected preferably in the cell wall and septa of the whole bacterial forms as well as in the cytoplasm of L-forms. Western blotting of bacterial lysates demonstrated protein bands with positive immunoreaction to antibodies against Gs alpha, Gi alpha, and Gcommon alpha with a higher affinity to the antibody against Gs alpha. Immunoreaction with the anti-Gs alpha-antibody was markedly higher in pathogenic strains of E. coli. Because of the conserved structure in all GTP-binding proteins which seem to derive from a single primordial protein involved in signal transduction mechanisms, it is reasonable to assume that some anti-Ga-positive proteins in E. coli might be related to G-proteins of higher organisms. A putative candidate for bacterial G-proteins seems to be a 36 kDa protein. Enhancement in G-protein immunostaining in the cytoplasm of macrophages around the internalized bacteria testifies to the involvement of G-proteins in mediation of endocytosis responses of phagocytes.     

Energy Trapping in Dications

The energy interaction curves of a number of diatomic and polyatomic dication systems were calculated in order to study their energy-trapping properties. Generally, the ab initio complete active space multiconfiguration self-consistent field method was used in an extended valence + polarization basis set, with compact effective potentials replacing the core electrons. The diatomic dications include all ten possible binary combinations of oxygen, sulphur, selenium, and tellurium. O₂²⁺ shows the largest exothermicity, measured from equilibrium to the monocation combination asymptote, and highest barrier to dissociation. The calculated equilibrium bond length and harmonic vibrational frequency agree very well with experiment. The O₂²⁺, SO²⁺, SeO²⁺, and TeO²⁺ series show progressively decreasing exothermicities but similar barrier heights. The non-oxides, in contrast, show similar exothermicities but decreasing barriers with increasing size of the atom constituents. These trends are interpreted in terms of both valence bond curve-crossing and molecular orbital bonding models. The ozone dication, O₃²⁺, is found to have a number of low-lying singlet and triplet stationary state structures spanning near-linear to D_3h2+ symmetries. Although the calculated exothermicity is even larger than for O₂²⁺, the barrier to O₂⁺ + O⁺ dissociation is predicted to be low in each case. O₂²⁺ surrounded by six argon atoms to model an isolating environment shows increased equilibrium O–O bond length, decreased exothermicity, and increased barrier to dissociation, relative to the bare dication. O₂²⁺ flanked at each end by a perpendicularly oriented H₂ molecule in a staggered conformation is obstructed from direct conversion to the water dimer dication by a high barrier. However, [(H₂O)₂]²⁺ dissociates smoothly from equilibrium to two water monocations with a large exothermicity but a small barrier.     

Left ventricular outflow tract obstruction after mitral valve replacement

A method of posterior mitral annulus remodeling is presented. The posterior annulus is divided into three segments, each segment encircled by a suture that is passed in a tourniquet. Coaptation of the leaflets can be achieved by tightening the tourniquets while the ventricle is being filled. This technique is simple and quick, avoids the use of foreign material, and requires less expertise and judgment than traditional annuloplasties.     

MR monitoring of focused ultrasonic surgery of renal cortex: experimental and simulation studies

The aim of the study was to test the hypothesis that magnetic resonance (MR) imaging-guided and -monitored noninvasive ultrasonic surgery can be performed in highly perfused tissues from outside the body. A simulation study was performed to evaluate the optimal sonication parameters. An MR-compatible positioning device was then used to manipulate a focused ultrasound transducer in an MR imager, which was used to sonicate kidneys of five rabbits at various power levels and different durations. Temperature elevation during sonication was monitored with a T1-weighted spoiled gradient-echo sequence. The simulation study demonstrated that a sharply focused transducer and relatively short sonication times (30 seconds or less) are necessary to prevent damage to the overlying skin and muscle tissue, which have a much lower blood perfusion rate than kidney. The experiments showed that the imaging sequence was sensitive enough to show temperature elevation during sonication, thereby indicating the location of the beam focus. Histologic evaluations showed that kidney necrosis could be consistently induced without damage to overlying skin and muscle. The study demonstrated that highly perfused tissues such as the renal cortex can be coagulated from outside the body with focused ultrasound and that MR imaging can be used to guide and monitor this surgery.