bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic Progress, Social Regress?
Authors: FARMER AMY , KALI RAJA
Published: June 2007

A central issue in the debate regarding the relevance of social capital is whether the decline in social embeddedness that has attended modernization over the last 40 years in the United States is as harmful as Putnam, among others, claim it to be. Critics of Putnam's thesis argue that various arms‐length institutions fulfil the roles performed by social capital thereby mitigating the negative impact of its recent decline. We develop a framework that provides insight into when such institutions may be adequate and when they might not. We find that if market (economic) and non‐market (social) interactions differ in their payoffs but are interlinked through the modernization of the economy, the optimal level of modernization in market interactions will be higher than that in non‐market interactions. Further, market supporting institutions are likely to increase the divergence between economic and social interactions since analogs for market institutions that constrain opportunistic behavior are usually nonexistent in social contexts. In this sense, economic progress may be accompanied by social regress.
Problems of Democratic Accountability in Network and Multilevel Governance
Authors: Papadopoulos Yannis
Published: June 2007

Abstract:  Most studies converge on the growth of processes of ‘multilevel governance’ (MLG) in policy making, related to the often combined trends towards supranationalism and regionalism. Such processes are usually analysed under the angle of their efficiency, while their impact on the quality of democracy is neglected. This article first defines the concepts of multilevel governance and accountability, and then identifies the various dimensions of the latter. It further argues that MLG generates novel forms of accountability, but undermines its democratic dimension mainly for the following reasons: the weak visibility of MLG networks, their selective composition and the prevalence of peer over public forms of accountability.
Democratic Accountability and National Parliaments: Redefining the Impact of Parliamentary Scrutiny in EU Affairs
Authors: Auel Katrin
Published: June 2007

Abstract:  The question of strengths and weaknesses of national parliaments in EU affairs, one of the most salient in the debate on the democratic legitimacy of the EU, is generally answered by assessing formal parliamentary powers which can influence their governments' EU policy. Such an evaluation, however, is flawed: Formal mandating rights are usually incompatible with the overall logic of parliamentary systems, which explains why most national parliaments make very little use of them. Even more importantly, it unduly reduces parliamentary functions to the legislative or policy‐making function. Drawing on agency theory, it will instead be argued that the functions of public deliberation and of holding the government publicly to account are at least as important and therefore need to be included in a redefined concept of parliamentary strength. In particular, the article proposes a distinction between two different elements of accountability—monitoring and political scrutiny—which recognises parliamentary majority and opposition as two distinct agents of the electorate.
Accountable Multilevel Governance by the Open Method of Coordination?
Authors: Benz Arthur
Published: June 2007

Abstract:  In multilevel governance arrangements policies are coordinated across levels, usually in negotiations or networks of executives and representatives of special interests. Actors committed in such arrangements can hardly be held accountable by parliaments or citizens, and this is one of the main reasons for the democratic deficit of the EU. With the open method of coordination (OMC) the EU introduced a new mode of multilevel governance. The article focuses on the question whether problems of accountability can be solved by this mode. It is argued that the OMC framework includes two types of coordination. Whereas the dominating ‘deliberative’ mode does not improve accountability, the ‘competitive’ mode seems to be more promising. It supports transparency, reduces the costs of control for parliaments and stimulates public discussion on policies. However, multilevel coordination by policy competition at the lower levels of government does not work effectively under all conditions, and this therefore has to be carefully investigated.
Malignancies in HIV‐infected Thai patients*
Authors: Kiertiburanakul S , Likhitpongwit S , Ratanasiri S , Sungkanuparph S
Published: June 2007

Of 1416 HIV‐infected patients seen at Ramathibodi Hospital over a 5‐year period (1999–2003), 42 were diagnosed with malignancies, giving a prevalence of 3%. Twenty‐one of these patients (50%) were men and their mean age was 40.8 years. The median CD4 cell count was 235 cells/μL. AIDS‐related malignancies were found in 26 patients (62%). The most common AIDS‐related malignancies were non‐Hodgkin's lymphoma (NHL) (33%), cervical cancer (21%) and Kaposi's sarcoma (KS) (5%). Breast cancer was the most common non‐AIDS‐related malignancy (10%). Eleven patients (26%) died. The 75% survival time of patients who received treatment for their malignancy was longer than that of patients who received no treatment (18.3 vs 1.2 months; P<0.01).
Circannual periodicity of migraine?
Authors: Alstadhaug K. B. , Bekkelund S. , Salvesen R.
Published: June 2007

Seasonal rhythm of migraine attacks may support a role of the suprachiasmatic nucleus of the hypothalamus in the pathophysiology of migraine. The objective of this study was to provide evidence for seasonal variation in migraine. Eighty‐nine female migraineurs volunteered to record every migraine attack in detail for 12 consecutive months. Attacks associated with sleep complaints were defined as insomnia‐related. By using Edwards’ model for recognition and estimation of cyclic trends, time‐series analysis was made. Fifty‐eight patients, of which 26 had migraine without aura (MO) and 32 had migraine with aura (MA), completed the study. A total of 1840 attacks were recorded. The mean age ± SD was 36.9 ± 6.0. Patients with a lifetime history of MA showed marked seasonal fluctuation with more attacks in the light season compared to the dark. Time of peak was May 21. Peak/low ratio was 1.30 (95% CI: 1.08–1.55). When insomnia‐related attacks (n = 312) were removed the seasonal variation became insignificant. There is a seasonal trend with more migraine attacks in the light season compared to the dark season in females with MA, but not MO, living in an arctic area. This is caused by the seasonal variation of insomnia‐related attacks in patients with MA.
Acute ischemic stroke and transient ischemic attack in the very old – risk factor profile and stroke subtype between patients older than 80 years and patients aged less than 80 years
Authors: Rojas J. I. , Zurrú M. C. , Romano M. , Patrucco L. , Cristiano E.
Published: June 2007

Old age groups have different risk profile and stroke features compared to younger groups. Our aim was to examine the risk factor profile and stroke subtype in patients older than 80 years with ischemic stroke. Data of 535 patients with ischemic stroke or transient ischemic attack (TIA) were prospectively recorded. Cardiovascular risk factors and stroke subtype in individuals aged 80 years or older were compared with patients under 80. Of 535 patients a total of 179 were over 80 years (33.5%). The mean age was 84.4 ± 4.4 years (61.8%; 111 women). The most common risk factors included hypertension (82.7%) and hyperlipidemia (40.2%). Lacunar stroke was the most frequent subtype of stroke (41.7%). When the groups were compared, we observed the following risk factors more frequently in the group older than 80: female patients (P = <0.001), hypertension (OR = 1.62), atrial fibrillation (OR = 2.64); whereas diabetes (OR = 0.54), hyperlipidemia (OR = 0.57), smoking (OR = 0.17) and obesity (OR = 0.58) were more frequent in the group younger than 80. In the old group we found a high incidence of ischemic stroke in women. We also found a higher frequency of hypertension and atrial fibrillation. The available and future epidemiological data will provide a better knowledge about the effect of typical risk factors in old people.
Mutant SOD1G93A microglia are more neurotoxic relative to wild‐type microglia
Authors: Xiao Qin , Zhao Weihua , Beers David R. , Yen Albert A. , Xie Wenjie , Henkel Jenny S. , Appel Stanley H.
Published: June 2007

Recent studies suggest that microglia over‐expressing mutant human superoxide dismutase (mSOD1G93A) may contribute to motoneuron death in a transgenic mouse model of familial amyotrophic lateral sclerosis. To further assess the relative neurotoxicity of wild‐type microglia, mSOD1G93A microglia, and microglia over‐expressing wild‐type human SOD1, we used primary cultures of microglia and motoneurons in the presence and absence of lipopolysaccharide stimulation. Following activation with lipopolysaccharide, mSOD1G93A microglia released more nitric oxide, more superoxide, and less insulin‐like growth factor‐1 than wild‐type microglia. In microglia/motoneuron co‐cultures, mSOD1G93A microglia induced more motoneuron death and decreased neurite numbers and length compared with wild‐type microglia. Mutant SOD1G93A microglia also induced more motoneuron injury than microglia over‐expressing wild‐type human SOD1 in microglia/motoneuron co‐cultures. Motoneuron survival was inversely correlated with nitrate + nitrite concentrations in mSOD1G93A co‐cultures, suggesting the important role of nitric oxide in microglia‐induced motoneuron injury. Thus, relative to wild‐type microglia, mSOD1G93A microglia were more neurotoxic and induced more motoneuron injury than similarly treated wild‐type microglia.
Apoptotic action of E2F1 requires glycogen synthase kinase 3‐β activity in PC12 cells
Authors: Espada Lilia , Udapudi Basavaraj , Podlesniy Petar , Fabregat Isabel , Espinet Carme , Tauler Albert
Published: June 2007

Both E2F1 and GSK3β have been described as essential targets in neuronal apoptosis. Previous studies have demonstrated that GSK3β binds to E2F1 in vivo. We wanted to investigate whether these proteins could share a common apoptotic signal pathway in neuronal cells. With this intention, we developed a PC12 ER‐E2F1 stable cell line in which E2F1 activity was dependent on the presence of 4‐hydroxitamoxifen. E2F1 activation produced apoptosis in naive and post‐mitotic cells; serum and nerve growth factor respectively protected them from E2F1 apoptotic stimuli. The presence of specific GSK3β inhibitors SB216763 and LiCl completely protected cells from apoptosis induced by E2F1 activation. In addition, knocked down GSK3β experiments by small interference RNAs have demonstrated that a reduction of GSK3β protein levels can lower the apoptotic effect of E2F1. Finally, we demonstrated that the apoptotic effect of E2F1 is not due to the regulation of GSK3β activity, and that the inhibitory effect of GSK3β inhibitor SB216763 on E2F1 induced apoptosis could be due to an alteration in the E2F1‐regulated transcription gene pattern. In summary, we have demonstrated that the apoptotic action of E2F1 requires GSK3β activity.
champuru 1.0: a computer software for unraveling mixtures of two DNA sequences of unequal lengths
Authors: FLOT JEAN‐FRANÇOIS
Published: June 2007

champuru is an interactive, user‐friendly web software that facilitates the deconvolution of mixed chromatograms obtained when sequencing directly mixtures of two DNA templates of unequal lengths. The program takes as input two strings of characters describing the forward and reverse chromatograms as obtained by direct sequencing and returns, most often after several iterations aimed at correcting basecalling errors, the sequences of the two templates present in the mixture. champuru was written in perl, with a web interface accessible online at http://134.157.186.185/champuru/champuru.htm.
The Impact of Private Insurance Coverage on Veterans' Use of VA Care: Insurance and Selection Effects
Authors: Shen Yujing , Hendricks Ann , Wang Fenghua , Gardner John , Kazis Lewis E.
Published: June 2007

Objective. To examine private insurance coverage and its impact on use of Veterans Health Administration (VA) care among VA enrollees without Medicare coverage.

Data Sources. The 1999 National Health Survey of Veteran Enrollees merged with VA administrative data, with other information drawn from American Hospital Association data and the Area Resource File.

Study Design. We modeled VA enrollees' decision of having private insurance coverage and its impact on use of VA care controlling for sociodemographic information, patients' health status, VA priority status and access to VA and non‐VA alternatives. We estimated the true impact of insurance on the use of VA care by teasing out potential selection bias. Bias came from two sources: a security selection effect (sicker enrollees purchase private insurance for extra security and use more VA and non‐VA care) and a preference selection effect (VA enrollees who prefer non‐VA care may purchase private insurance and use less VA care).

Principal Findings. VA enrollees with private insurance coverage were less likely to use VA care. Security selection dominated preference selection and naïve models that did not control for selection effects consistently underestimated the insurance effect.

Conclusions. Our results indicate that prior research, which has not controlled for insurance selection effects, may have underestimated the potential impact of any private insurance policy change, which may in turn affect VA enrollees' private insurance coverage and consequently their use of VA care. From the decline in private insurance coverage from 1999 to 2002, we projected an increase of 29,400 patients and 158 million dollars for VA health care services.
Is There a Role for Bisphosphonates in Chronic Kidney Disease?
Authors: Miller Paul D.
Published: June 2007

Patients with stage 5 chronic kidney disease (CKD) including those on dialysis can and do develop osteoporosis. They also develop a wide range of other metabolic bone diseases that may look like osteoporosis when it is defined by either the World Health Organization bone mineral density (BMD) criteria or by the development of fragility fractures. Those dialysis patients with osteoporosis that is due to gonadal hormone deficiency such as postmenopausal osteoporosis, glucocorticoid‐induced osteoporosis, or male osteoporosis may benefit from the administration of bisphosphonates (BPs). The challenges lie in the diagnosis of osteoporosis in this population where adynamic, osteomalacic, hyperparathyroid, or aluminum bone disease are also prevalent, with concommitant low BMD and low trauma fractures, but where BPs may be contraindicated. The only secure means to diagnose osteoporosis in this patient population is by quantitative bone histomorphometry demonstrating low trabecular bone volume and disrupted microarchitecture. Once the diagnosis of osteoporosis is established, BPs should be considered for a well‐defined brief period of time (e.g., 2–3 years), even though there is no evidence for a fracture reduction benefit in this population. If a BP is chosen there may be a need for dose adjustment or slower infusion rates (for the intravenous formulations), as a greater bone retention may occur for these renally cleared agents. While it is unknown what consequences could develop from increased bone retention in patients with little renal function, data are needed if more bone retention of BP might lead to a greater risk of the development of adynamic bone disease and lower bone strength. More data are needed to define the risks and benefits of BPs in patients with stage 5 CKD.
The Acute Cardiac Effects of Dialysis
Authors: Selby Nicholas M. , McIntyre Christopher W.
Published: June 2007

It is well recognized that the procedure of hemodialysis is associated with significant changes in blood pressure and systemic hemodynamics; 20–30% of treatments are complicated by intradialytic hypotension (IDH). There are now an increasing number of studies using electrocardiographic, isotopic and echocardiographic techniques that show that subclinical myocardial ischemia occurs during dialysis. This concept is supported by some studies showing that dialysis can induce acute rises in troponins and creatinine kinase MB, although this has not been found by all authors. Some of this controversy may at least in part be due to the collection of blood samples immediately postdialysis, which is likely to be too early to reliably detect dialysis‐induced elevations of cardiac enzymes. Cardiovascular death is the biggest single cause of mortality in dialysis patients and of this sudden death comprises the largest proportion. As such, there is a large body of evidence examining whether dialysis is pro‐arrhythmogenic. It is clear that dialysis can increase QTc interval and QT dispersion and is capable of inducing arrhythmias on Holter monitoring, likely due to the interaction of multiple factors, some of which prime for the development of arrhythmias (particularly the presence of preexisting cardiac disease), and some of which act as triggers. However, the link between these electrocardiographic alterations and sudden death is relatively poorly studied. This review summarizes the available literature regarding the acute cardiac effects of dialysis in relation to the above, and discusses how these acute changes may contribute to the genesis of uremic cardiomyopathy and longer term cardiac outcomes.
Effects of Distraction Versus Spatial Discrimination on Laser‐Evoked Potentials in Migraine
Authors: de Tommaso Marina , Baumgartner Ulf , Sardaro Michele , Difruscolo Olimpia , Serpino Claudia , Treede Rolf‐Detlef
Published: June 2007

Objectives.— To evaluate whether migraine patients exhibit less inhibition to painful stimuli when distracted from pain as compared to healthy subjects, testing the spatial discrimination of painful stimuli, the performance during the mental arithmetic task used to contrast the discrimination performance and the behavior of N1 and N2‐P2 laser‐evoked potentials (LEPs) amplitudes during spatial discrimination and during distraction.

Methods.— Eight migraine patients and 8 healthy controls were examined. During repetitive series of painful laser stimulation of the hand, they had to (1) perform a spatial discrimination task, contrasted by (2) a mental arithmetic task that served as distraction.

Results.— Patients made 50% to 100% more mistakes than controls in the spatial discrimination task (P < .001) as well as during mental arithmetic (P < .05). Whereas healthy subjects showed a marked decrease of the LEP vertex potential amplitudes during distraction compared to the discrimination task, no such attenuation of LEPs was seen in migraine patients (group × task interaction, P < .05). N1 amplitude exhibited a left‐hemisphere dominance in both groups, significantly smaller amplitude in migraine patients, but no significant task modulation.

Conclusion.— Migraine patients exhibited reduced inhibition by attentional modulation of pain processing, accompanied by impaired spatial discrimination of painful stimuli.
Comparative Overview of Cardiac Output Measurement Methods: Has Impedance Cardiography Come of Age?
Authors: De Maria Anthony N. , Raisinghani Ajit
Published: June 2007

Cardiac output, usually expressed as liters of blood ejected by the left ventricle per minute, is a fundamental measure of the adequacy of myocardial function to meet the perfusion needs of tissue at any time. Decreases in cardiac output over time (when cardiac output is measured under similar conditions) may signal myocardial functional deterioration and the onset or progression of heart failure. Conversely, improvements in cardiac output may indicate a positive response to medical therapy. However, most methods for evaluating cardiac output are technically demanding, require specialized training and specialized environments for measurement, and are costly. Therefore, most measurement techniques are impractical for routine evaluation of disease progression and/or response to treatment in the prevention and/or management of heart failure. This paper provides a comparative overview of commonly employed cardiac output measurement strategies with emphasis on developments in impedance cardiography which suggest that impedance cardiography has the potential to make routine assessment and trending of cardiac output a viable alternative to assist in the management of both chronically and acutely ill patients, including those with heart failure.
Reproducibility of Impedance Cardiography Hemodynamic Measures in Clinically Stable Heart Failure Patients
Authors: Greenberg Barry H. , Hermann Denise D. , Pranulis Maryann F. , Lazio Lucia , Cloutier David
Published: June 2007

Background and Aims. One of the greatest challenges confronting physicians who are managing the care of patients with heart failure is to acquire objective data that signals treatment effectiveness and/or disease progression. The aim of this study was twofold: 1) to determine the extent to which (real time) impedance cardiography measurements obtained with a specific medical device (the BioZ®) were reproducible in outpatients with clinically stable heart failure; and 2) to establish “normal” ranges of one week hemodynamic variability in this population of patients. Information of this nature would help clinical cardiologists and primary care practitioners to evaluate the implications of their patient's visit‐to‐visit hemodynamic variability.

Methods. A one group, prospective, time series design was used. The sample consisted of 62 patients who had clinically stable heart failure and who were being treated in an outpatient heart failure clinic at a university medical center. BioZ® hemodynamic measures of cardiac output, contractility, and after load were obtained at five points in time: two, 10, and 60 minutes resting following a 40–50 foot walk on the first day and at two and 10 minutes resting following a 40–50 foot walk on the second day, one week later.

Results. Small but significant changes in cardiac output and cardiac index (mainly due to changes in heart rate) were seen during the 60 minute period on week one. Stroke index did not change during this period. In general, reproducibility between measurements taken on the same day and between days was quite good. Establishment of 95% confidence intervals helped define boundaries of variability in this population. Further clinical evaluation of the four patients whose values exceeded the 95% confidence intervals revealed unexpected, potentially relevant changes that could have accounted for their interday variability. Conclusion. The BioZ® impedance cardiography measurements are responsive to hemodynamic activity‐rest changes and are reproducible at a one week interval in clinically stable heart failure patients being treated in an outpatient clinic. Stroke index is a better measure of patient status than cardiac output or cardiac index.
Bioimpedance Monitoring: Better Than Chest X‐Ray for Predicting Abnormal Pulmonary Fluid?
Authors: Peacock William Franklin , M. Albert Nancy , D. White Richard , L. Emerman Charles
Published: June 2007

Bioimpedance monitoring may aid in treating heart failure. Mean thoracic electrical impedance (Zo) is inversely proportional to thoracic fluid volume and may offer greater sensitivity for detecting thoracic fluid. Objective. Compare bioimpedance monitoring thoracic fluid detection to that of chest x‐ray.

Method. Prospective convenience sample.

Setting. 1000 bed teaching hospital.

Participants. Patients with suspected heart failure and shortness of breath. A single blinded radiologist interpreted chest x‐rays as: normal, cardiomegaly, or abnormal pulmonary fluid.

Statistics. General linear model with post hoc Bon Ferroni pairwise comparisons.

Results. 131 patients, mean age 66.8 years, 64.3% male, with an initial mean Zo=18 ohms. There was a significant difference (p<0.0002) between patients with cardiomegaly (Zo=17.5±5.5) or abnormal pulmonary fluid on chest x‐ray (Zo=17.2±4.2) compared to normals (Zo=23.4±5.4). There was no difference between cardiomegaly and abnormal pulmonary fluid patients. Conclusion. Bioimpedance measurement may detect pulmonary fluid not apparent on chest radiograph.
Are All ß Blockers the Same for Heart Failure?
Authors: Kukin Marrick L.
Published: June 2007

Based on impressive morbidity and mortality data using β blockers in heart failure, this therapy has now become part of the standard of care for patients with New York Heart Association II/III symptoms. The question remains whether there are clinically relevant differences between the β blockers that have shown beneficial effects. This review summarizes the major mortality trials, and examines the smaller comparative trials of second and third generation β blockers.
The Feasibility of a Telecommunications Service in Support of Outpatient Congestive Heart Failure Care in a Diverse Patient Population
Authors: Nanevicz Tania , Piette John , Zipkin Daniella , Serlin Michelle , Ennis Stephanie , Marco Teresa De , Modin Gunnard
Published: June 2007

A home telemonitoring system for patients with congestive heart failure was studied for feasibility and efficacy in a diverse patient population. Fifty patients used the service, in which they weighed themselves and answered yes/no questions about symptoms. Changes in patient weights or symptoms prompted a nurse to call the patient and/or the physician. Patients were given educational and quality of life surveys at enrollment, at 30 days, and at 6 months. The average daily usage rate was 94%. Patients were contacted 57 times—prompting 57 physician notifications, eight medication changes, and 11 nonroutine clinic visits. Patient response to lifestyle surveys showed an improvement in quality of life and improved understanding of prevention measures. Eighty‐four percent of patients and 65% of physicians reported satisfaction with the system. This pilot study suggests that home telemonitoring is feasible and has clinical utility in diverse patient groups, and may improve patients' satisfaction and knowledge of self‐care.
Quantification of Interventions and Outcomes in an Outpatient Telemanagement and Care Management Congestive Heart Failure Program
Authors: Palladino Marie , LeVan Patricia , Spear Sharon , Scurlock Nancy , McGarvey Joseph F.X. , Applestein Bruce , Cassel Carol , Miller Lynne , Cerkan Joan , Brush Heidi , McGovern Virginia
Published: June 2007

The congestive heart failure continuum was developed in collaboration with the medical management committee of our hospital in response to a need to decrease readmissions for this chronic and progressive disease. This is accomplished via a multidisciplinary team that provides education and long term telemanagement, as well as care management to assist these patients in maintaining an optimum level of functioning and the ability to remain in their homes for as long as possible. Since October 1996 there have been 375 patients referred with a decrease in the 31‐day readmission rate from 21% to an average of 5%. Costs are presently $55.00 per month per patient. Evaluation of the congestive heart failure phone management tool revealed a strong 77% positive correlation between the patient's score and the number of interventions needed to stabilize the patient. Care management visits, when necessary, help reduce the need for hospitalization.
Bridge to ß Blockade in Severe Heart Failure: The Use of Phosphodiesterase Inhibitors
Authors: Muhammad Khalid , Ventura Hector O. , Stapleton Dwight D. , Smart Frank W.
Published: June 2007

The authors describe the use of milrinone as a bridge to β blockade in a patient with severe heart failure. This case is clinically important because in patients with severe heart failure phosphodiesterase inhibitors, unlike β agonists, will retain their positive inotropic and vasodilator effects in the presence of β blockade and, in addition, these agents will attenuate the negative inotropic side effects of β blockers. Conversely, a β blocker associated with a phosphodiesterase inhibitor will protect against myocyte loss and arrhythmias, may prevent sudden death, and will improve long term symptoms and exercise tolerance. This combination is being investigated in a large, multicenter, double‐blind, randomized trial of intravenous milrinone vs. placebo as a therapeutic tool to allow the initiation of carvedilol orally in patients hospitalized with Class III/IV heart failure.
Ventricular Remodeling and the Renin Angiotensin Aldosterone System
Authors: Patten Richard D. , Konstam Marvin A.
Published: June 2007

Ventricular remodeling in patients with left ventricular systolic dysfunction is an indolent process that is associated with a poor prognosis. Clinical and experimental data support the central role played by the renin‐angiotensin‐aldosterone system in the pathophysiology of remodeling. ACE inhibitors improve the natural history of ventricular remodeling and the syndrome of heart failure. Experimental and preliminary clinical data suggest that angiotensin II type I receptor blockade also impacts favorably on remodeling. Some experimental studies suggest a possible synergistic effect when combining ACE inhibitors and angiotensin II type I receptor antagonists. Aldosterone, the regulation of which, in part, is independent of angiotensin II, is a direct mediator of the interstitial component of remodeling, and its blockade has been found to improve clinical outcomes. Future research will more precisely define the mechanism for ventricular remodeling and will yield more effective means of achieving a clinically relevant impact on this process.
Simple Methods of Assessing Physical Activity in Patients with Chronic Heart Failure
Authors: Asakuma Susumu , Ohyanagi Mitsumasa , Iwasaki Tadaaki
Published: June 2007

This article reviews simple, noninvasive ways to assess physical activity in patients with chronic heart failure. Six‐ or 9‐minute walk tests appear to be useful not only for selecting patients with relatively advanced heart failure but also as prognostic screening tests. The Master‐Borg test (Master's two‐step testing and 10‐point Borg scale) is useful for assessing symptoms during exercise. Weekly pedometer counts show that the level of activity in patients with heart failure is dramatically less than in healthy controls. Physical activity can be determined directly by an ambulatory calorie counter that measures step scores and energy expenditure using specific accelerometers. Careful clinical interviewing regarding symptoms, together with submaximal exercise testing and use of motion sensors, are recommended as useful, simple, noninvasive alternatives for assessing physical activity in this patient populatio.
The Oxygen Uptake Efficiency Slope and Its Value in the Assessment of Cardiorespiratory Functional Reserve
Authors: Baba Reizo
Published: June 2007

Oxygen uptake efficiency slope is a new index of cardiorespiratory functional reserve derived from the logarithmic relation between oxygen uptake (Vo2) and minute ventilation during incremental exercise. The oxygen uptake efficiency slope represents how effectively oxygen is extracted and taken into the body from the air, and then ventilated. The physiologic backgrounds of the index are based on: 1) the development of metabolic acidosis that is controlled by the distribution of blood to the skeletal muscles; 2) the physiologic dead space that is affected by the perfusion to the lungs; and 3) arterial carbon dioxide partial pressure. One of the greatest advantages of the oxygen uptake efficiency slope is that it can be calculated by exercise data of submaximal levels. Another advantage is that it is mathematically determined from a set of gas analysis data and, therefore, is completely an objective measurement. Moreover, the oxygen uptake efficiency slope is shown to be highly reproducible. Clinical applications of the oxygen uptake efficiency slope have been reported initially from a population of pediatric patients with heart disease, then from adult patients with chronic heart failure, and finally from elite endurance athletes. Further applications are expected with the use of this sophisticated index.
Circulatory Assist Devices 2000: An Update
Authors: Dyke David B.S. , Pagani Francis D. , Aaronson Keith D.
Published: June 2007

Mechanical circulatory assist devices have been used in clinical practice as a bridge to transplantation since the late 1960s. In 1982, the first totally artificial heart designated as permanent therapy was implanted, but relatively few totally artificial hearts are implanted today. In the last several years, there has been a shift toward the use of left ventricular assist devices as a bridge to cardiac transplantation. Likewise, there is increasing interest in the use of ventricular assist devices as a bridge to recovery for patients with myocarditis, dilated cardiomyopathy, and following myocardial infarction or cardiotomy. This review presents basic information on the present use of these devices as they relate to transplantation and recovery, and as permanent therapy. Individual devices will briefly be described, as will indications for, and timing of, implantation. Other related issues, such as right heart failure, pulmonary hypertension, arrhythmias, anticoagulation, and infections, will be addressed. In closing, the future of mechanical circulatory devices will be discussed.
Optimization of Cardiac Resynchronization Devices Using Acoustic Cardiography: A Comparison to Echocardiography
Authors: Hasan Ayesha , Abraham William T. , Quinn‐Tate Lori , Brown Lei , Amkieh Ali
Published: June 2007

Optimization of pacemaker settings for cardiac resynchronization therapy (CRT) remains challenging and problematic. Several noninvasive methods are offered to customize the programmed parameters for individual patients, but so far only echocardiographic imaging has established itself as an accepted method. The authors examined the value of acoustic cardiography as a fast and more cost‐efficient alternative to established echocardiographic imaging techniques for the optimization of CRT devices. The atrioventricular delay in 22 subjects with implanted CRT devices was independently optimized using echocardiography (Doppler transmitral flow) as well as acoustic cardiography, and the recommended settings from each method were later compared. Doppler echocardiography and acoustic cardiography recommendations matched within a mean value ± SD of 17±16 milliseconds and gave a correlation coefficient of r=0.90 (p<0.001). In 17 of the 22 cases (77.3%), the difference between echocardiographic and acoustic cardiogram CRT optimization results was ≤20 milliseconds. Furthermore, the echocardiographic transmitral flow pattern was not significantly different for the setting independently chosen by the echocardiographic expert and the acoustic cardiographer for the cases with a difference of >20 milliseconds (22.7%). In addition, it took less time for the acoustic cardiogram to collect sufficient information to make a recommendation, and it was found that the acoustic cardiogram data trend is easier to interpret.
A Randomized, Controlled Trial of tai chi for the Prevention of Falls: The Central Sydney tai chi Trial
Authors: Voukelatos Alexander , Cumming Robert G. , Lord Stephen R. , Rissel Chris
Published: June 2007

OBJECTIVES: To determine the effectiveness of a 16‐week community‐based tai chi program in reducing falls and improving balance in people aged 60 and older.

DESIGN: Randomized, controlled trial with waiting list control group.

SETTING: Community in Sydney, Australia.

PARTICIPANTS: Seven hundred two relatively healthy community‐dwelling people aged 60 and older (mean age 69).

INTERVENTION: Sixteen‐week program of community‐based tai chi classes of 1 hour duration per week.

MEASUREMENTS: Falls during 16 and 24 weeks of follow‐up were assessed using a calendar method. Balance was measured at baseline and 16‐week follow‐up using six balance tests.

RESULTS: Falls were less frequent in the tai chi group than in the control group. Using Cox regression and time to first fall, the hazard ratio after 16 weeks was 0.72 (95% confidence interval (CI)=0.51–1.01, P=.06), and after 24 weeks it was 0.67 (95% CI=0.49–0.93, P=.02). There was no difference in the percentage of participants who had one or more falls. There were statistically significant differences in changes in balance favoring the tai chi group on five of six balance tests.

CONCLUSION: Participation in once per week tai chi classes for 16 weeks can prevent falls in relatively healthy community‐dwelling older people.
OPTIMALITY OF INDEPENDENT DECISION‐MAKING FOR TWO INDEPENDENT RISK SITUATIONS*
Authors: NETER J. , WILLIAMS C. A. , WHITMORE G. A.
Published: June 2007

This paper investigates the optimality of making two insurance decisions independently in the expected utility framework, when the two risks under consideration are independent. It is shown that when the disutility function embodies constant risk aversion, independent decision‐making is identical to optimal joint decision‐making. When the disutility function has strictly decreasing risk aversion, joint decision‐making is always not less conservative than independent decision‐making, and the opposite holds when the disutility function has strictly increasing risk aversion. Stronger results are obtained for some particular disutility functions. Finally, some implications of these results for empirical research in utility and decision theory are considered.
DESIGN AND IMPLEMENTATION PHILOSOPHY FOR QUANTITATIVELY ORIENTED UNDERGRADUATE BUSINESS PROGRAMS
Authors: BLACK JAMES A.
Published: June 2007

While the quantitative content of business programs has increased over the last decade, there is still room for improvement. One of the problems facing many schools is lack of mathematical ability among students. This is particularly true in schools with open admission policies. As an alternative to high admission standards, a school may partition its student body on the basis of mathematical ability and offer different programs to each group. Initially all students would follow a non‐terminal mathematies sequence. Those performing well in this sequence would be encouraged to elect advanced courses in mathematics. A core of quantitative business courses would be provided. Quantitative programs in the functional areas of business would be built around this core. Alternative programs would be offered for non‐quantitatively oriented students.
MULTI‐ITEM INVENTORY SYSTEMS WITH AMALGAMATION OF ORDERS TO SUPPLIERS*
Authors: THOMPSON H. E. , FEDER T. L. , KRAJEWSKI L. J.
Published: June 2007

This paper extends the analysis of the multi‐item inventory systems with amalgamation of orders to the case where there is more than one possible supplier. The problem is to assign each inventory item to an order period and a supplier such that the total inventory costs are minimized. The model is formulated as an integer programming problem which can be solved by standard linear programming techniques. In addition to providing the framework for selecting the supplier for an item, the model can include different ordering and review costs, price differentials between suppliers, quantity discounts, inventory constraints and ordering constraints. Numerical examples illustrating the use of the model are provided.
PRODUCTION FACTORS IN POLICING SERVICES*
Authors: HOFFMAN RICHARD B.
Published: June 2007

The demand for increased public protection has become a major public issue of our times. The usual American response of increased resources has been applied but has had less than the desired effects. This paper analyzes the existing production factors in the provision of policing services in terms of the efficiency with which these services are delivered. The efficiency analysis occurs on a number of levels: (1) the use of existing resources, (2) alternative allocation at the existing resource level, (3) alternative technologies, and (4) the tasks and services which should be undertaken. The effects and implications of exogenous changes upon crime and policing services are considered and the problems and needs for change in the production factors for policing services are presented.
INPUT COSTS OF PRODUCING UNIVERSITY DEGREES: A CASE STUDY
Authors: EWALD A. A. , KIKER B. F.
Published: June 2007

In this paper, we devise a cost allocation matrix and employ it to estimate the average input (net of capital) cost to the University of South Carolina of producing various degrees. The end product of our technique permits a statement of the comparative input costs of producing degrees from each of the several product (degree‐granting) divisions within the university. These cost estimates should be useful to administrators concerned with establishing tuition rates.

Although our data are for a particular university, factor inputs used by this university for transmitting knowledge are taken from regional, national and international markets. Curricula for similar degrees in different universities are similar in composition. Hence, our study should have general applicability.
THE EFFECTIVE UNIT OF THE POISSON DISTRIBUTION AND DEMAND FORECASTING
Authors: RAINE JESSE E.
Published: June 2007

This short paper deals with some of the difficulties which have been found in applying the effective unit concept of estimating the Poisson distribution in order to forecast demand in a major industry. It points to two special cases in which the common formulation produces misleading results, discusses the frequency with which these two special cases could be expected to occur based on this one major industry, and proposes some pragmatic solutions to the problems resulting.
APPLICATIONS OF A RISK AVERSION CONCEPT
Authors: BERHOLD MARVIN
Published: June 2007

In decision theory the concept denoted variously as “risk aversion increment” or “risk premium” has not been fully exploited, although it is neither new nor complex. In this paper we will show how the concept of the risk aversion increment can be used for developing an alternative to the explicit use of the utility function. For most people the use of a risk aversion increment provides a better conceptual reference than does the use of a utility function.

To illustrate the usefulness of the concept as a basis for gaining insight into problem statements and their analysis, the following applications are developed:

1) general results for the exponential utility function. 2) estimation of utility functions. 3) general results for various combinations of utility functions and probability distributions. 4) use in sequential decisions. 5) application in the theory of incentives.
SUCCESSFUL MODELS I HAVE KNOWN*
Authors: ARNOFF E. LEONARD
Published: June 2007

Formal education equips the modern decision scientist with an ample bag of mathematical tools. Among these are a wide variety of models, supplemented by techniques for creating new models and augmenting old ones. The purpose of a model, however, is not to serve only as a classroom exercise, but, rather, to represent reality in mathematical terms. Therefore, the performance of a model under real‐life conditions determines its success or failure.

In this paper, the author examines the characteristics of successful models, concentrating on the potential pitfalls in both the formulation and implementation stages. Finally, the author discusses the implications of his views for business schools, especially in terms of the improvements in course requirements and teaching techniques which are needed to prepare students of quantitative methods for careers as effective decision scientists.
A STUDY OF TIMING AND WITHDRAWALS OF STUDENT ADMISSIONS APPLICATIONS*
Authors: HAUSMAN WARREN H. , SHEARER ROBERT E.
Published: June 2007

This study explores two important characteristics of admissions applications to an M.B.A. and M.P.A. program: the timing of applications throughout the year preceding entrance, and the withdrawal rate by students whose applications have been accepted. Specifically, for the years 1961 through 1967, the aggregate patterns of timing and withdrawals (across all applications) are compared to the corresponding data for four groups of applications, ranging from low quality to high quality. (Quality is measured in terms of a first‐year predicted grade point average, and is estimated by a linear regression equation using the applicant's total ATGSB score and his undergraduate grade point average.) The results are in the expected directions: “better” students tend to apply earlier, and also have a higher tendency to withdraw after their applications have been accepted. Potential usefulness of the results in forecasting total applications and estimating withdrawal rates is explored.
An Information‐Theoretic Approach*
Authors: KERNAN JEROME B. , HAINES GEORGE H.
Published: June 2007

This paper examines the search aspect of decision making. An experiment was conducted to assess the amount of information utilized by subjects prior to committing themselves to a choice. By construing the information environment in the form of a maze and measuring “transmitted” information according to the Shannon‐Weaver logarithmic metric, the power of subjects' search heuristics was assessed.
DECISION ANALYSIS THROUGH GOAL PROGRAMMING
Authors: LEE SANG M.
Published: June 2007

In recent years, decision making based on systematic analysis has been greatly emphasized. Yet, decision analysis is often carried out without analyzing the limitations of certain quantitative techniques. This paper presents the concept, solution method, and application potential of goal programming which eliminates many limitations of conventional linear optimization models.
STAFFING SERVICE ACTIVITIES WITH WAITING LINE MODELS
Authors: PAUL ROBERT J. , STEVENS ROBERT E.
Published: June 2007

The problem of scheduling service activities and variable tasks has traditionally been solved subjectively. The lack of objective approaches has been due to the absence of formal standards and delay costs and by the high cost of examination and measurement. Some recent developments in work measurement concepts may permit the development of more objective standards, which when used in conjunction with scientific methodology such as waiting line theory, make possible objective scheduling of the variable service type activity.

The work of a salesperson in a retail store provides an example of both the variable service type activity and the waiting line problem. The manager attempts to balance the cost of service facilities (sales personnel) against the cost of a waiting line (customer ill will). The necessary data inputs for the waiting line model were obtained from field studies by means of work sampling. Computer simulation was then utilized to study various sized sales forces in an attempt to determine the most economical staff allocation.
ASSIMILATION TIME AS A FACTOR OF PERFORMANCE IN QUANTITATIVE ANALYSIS
Authors: TERSINE RICHARD J. , FLEMING RICHARD J.
Published: June 2007

The schedule, length, and number of class meetings have tended to be dictated by tradition, space availability, and instructor convenience. A significant factor which must receive attention is the assimilation time of the student. With the increased emphasis on quantitative analysis as well as the expansion of the boundaries of course content, the ability of the student to successfully absorb and digest the material must be considered. The authors have statistically studied assimilation time as a performance factor in a mathematically‐oriented course. Their conclusions indicate that the length and number of class meetings can be modified to a degree with equifinality, but administrators and instructors should empirically verify the best mix for their specific needs.