bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoothing, Nonsynchronous Appraisal and Cross‐Sectional Aggregation in Real Estate Price Indices
Authors: Bond Shaun A. , Hwang Soosung
Published: August 2007

In this article three econometric issues related to private‐equity return indices, such as real estate indices, are explored (smoothing, nonsynchronous appraisal and cross‐sectional aggregation). Under certain assumptions, it is found that index returns based on appraisals follow an ARFIMA(1, d, 1) (autoregressive fractionally integrated moving average) process, where the long memory parameter (d) explains the level of smoothing and the AR and MA parameters represent the level of persistence in marketwide fundamentals and the nonsynchronous appraisal, respectively. The empirical results show that: (1) the level of smoothing in appraisal‐based real estate indices is far less than assumed in many academic studies (2) there is weak evidence of nonsynchronous appraisal in the UK, IPD (Investment Property Databank) index and (3) marketwide fundamentals are highly persistent for the IPD index returns. On the other hand, there is no evidence of nonsynchronous appraisal or a persistent common factor in the U.S. NCREIF (National Council of Real Estate Investment Fiduciaries) index.
In vivo Effects of Mutant HERG K+ Channel Inhibition by Disopyramide in Patients with a Short QT‐1 Syndrome: A Pilot Study
Authors: SCHIMPF RAINER , VELTMANN CHRISTIAN , GIUSTETTO CARLA , GAITA FIORENZO , BORGGREFE MARTIN , WOLPERT CHRISTIAN
Published: August 2007

Introduction:
Quinidine has been evaluated in patients with a short QT‐1 syndrome caused by an IKr gain‐of‐function mutation of HERG. Recently, in vitro data with disopyramide showed an even stronger effect on the N588K mutant current. The aim of the present study was to test the in vivo effects of disopyramide in patients with short QT‐1 syndrome caused by a N588K mutation in HERG.

Methods and Results:
Repetitive ECGs were recorded in two female patients with short QT‐1 syndrome with a N588K‐HERG mutation off drugs, on oral quinidine, and on oral disopyramide. One patient underwent exercise testing on drugs to determine the QT interval to heart rate relation, whereas the QT interval was calculated to the peak of the T wave in lead V3. In the same patient, drug‐induced changes in ventricular effective refractory periods were determined by programmed ventricular stimulation via the ICD lead. Disopyramide increased the QT interval from QTc 329 ms/QTc 315 ms, respectively, off drugs to QTc 358 ms/QTc 333 ms in both patients and restored the heart rate dependence of the QT interval toward normal subjects (−0.39 ms/bpm off drugs, −0.58 ms/bpm on disopyramide vs. 1.29 ± 0.33 ms/bpm in normal subjects). The ventricular effective refractory period increased under disopyramide by 40 ms.

Conclusion:
These preliminary observations suggest that oral disopyramide may be a suitable alternative to quinidine for prolonging the QT interval and ventricular effective refractory periods in patients with short QT‐1 syndrome. Further studies of this pharmacologic approach are warranted.
Response to Cardiac Resynchronization Therapy Predicts Survival in Heart Failure: A Single‐Center Experience
Authors: CHA YONG‐MEI , REA ROBERT F. , WANG MING , SHEN WIN‐KUANG , ASIRVATHAM SAMUEL J. , FRIEDMAN PAUL A. , MUNGER THOMAS M. , ESPINOSA RAUL E. , HODGE DAVID O. , HAYES DAVID L. , REDFIELD MARGARET M.
Published: August 2007

Objective: To determine whether survival after cardiac resynchronization therapy (CRT) is related to improvement in clinical or echocardiographic parameters.

Background: In clinical trials, CRT improved symptoms, left ventricular (LV) structure, function, and survival. In clinical practice, response to CRT is highly variable and whether survival benefit is confined to those patients who experience improvement in clinical status or cardiac structure and function is unclear.

Methods: This is a single‐center study of patients receiving clinically indicated CRT between January 2002 and December 2004.

Results: Of 309 patients (age 68 ± 11 years, 83% male) receiving CRT at our institution during the study period, 174 returned for follow‐up and 127 had repeat echocardiography. Baseline clinical characteristics and survival were similar among those who did or did not return for follow‐up. In paired analyses, New York Heart Association (NYHA) class (−0.56 ± 0.07, p < 0.0001), ejection fraction (EF, 6.3 ± 0.7%, P < 0.0001), LV dimension (−2.7 ± 0.6 mm, P < 0.0001), pulmonary artery systolic pressure (PASP, −4.6 ± 1.3 mm Hg, P = 0.0007), and MR severity grade (−0.20 ± 0.05, P = 0.0002) improved after CRT. Survival after CRT was associated with decrease in NYHA class (risk ratio [RR]= 0.43, P = 0.0004), increase in EF (RR = 0.94, P = 0.02), and decrease in PASP (RR = 0.96, P = 0.03). Change in EF and NYHA class were correlated (r =−0.46, P < 0.0001) and, adjusting for this covariance, change in NYHA (P = 0.04) but not EF (P = 0.12) was associated with improved survival.

Conclusion: Patients who experience improved symptoms, ventricular function, and/or hemodynamics have better survival after CRT. These data enhance understanding of the relationship between CRT clinical response and survival benefit in clinical practice.
The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory
Authors: MARUYAMA MITSUNORI , KOBAYASHI YOSHINORI , MIYAUCHI YASUSHI , INO TAKESHI , ATARASHI HIROTSUGU , KATOH TAKAO , MIZUNO KYOICHI
Published: August 2007

Introduction: Despite recent advances in clinical electrophysiology, diagnosis of atrial tachycardia (AT) originating near Koch's triangle remains challenging. We sought a novel technique for rapid and accurate diagnosis of AT in the electrophysiologic laboratory.

Methods: Sixty‐two supraventricular tachycardias including 18 ATs (10 ATs arising from near Koch's triangle), 32 atrioventricular nodal reentrant tachycardias (AVNRTs), and 12 orthodromic reciprocating tachycardias (ORTs) were studied. Overdrive pacing during the tachycardia from different atrial sites was performed, and the maximal difference in the postpacing VA intervals (last captured ventricular electrogram to the earliest atrial electrogram of the initial beat after pacing) among the different pacing sites was calculated (delta‐VA interval).

Results: The delta‐VA intervals were >14 ms in all AT patients and <14 ms in all AVNRT/ORT patients, and thus, the delta‐VA interval was diagnostic for AT with the sensitivity, specificity, and positive and negative predictive values all being 100%. When the diagnostic value of the delta‐VA interval and conventional maneuvers were compared for differentiating AT from atypical AVNRT, both a delta‐VA interval >14 ms and “atrial‐atrial‐ventricular” response after overdrive ventricular pacing during the tachycardia were diagnostic. However, the “atrial‐atrial‐ventricular” response criterion was available in only 52% of the patients because of poor ventriculoatrial conduction.

Conclusions: The delta‐VA interval was useful for diagnosing AT irrespective of patient conditions such as ventriculoatrial conduction.
The Batista Operation in Patients with Dilated Cardiomyopathy
Authors: Isomura Tadashi , Suma Hisayoshi , Horii Taiko , Sato Toru , Kikuchi Norio , Iwahashi Ken
Published: August 2007

Abstract Between December 1996 and October 1998,34 patients with nonischemic dilated cardiomyopathy (DCM) received cardiac volume reduction surgery. The patients' ages ranged from 14 to 67 years (mean = 48 years) and included 28 males and 6 females. Associated mitral regurgitation was present in 31 patients, tricuspid regurgitation in 19 patients, and aortic regurgitation in 4 patients. We performed a partial left ventriculectomy (PLV) using antegrade intermittent warm blood cardioplegia in 15 patients (group A), and in 19 patients (group B) PLV was performed using the on‐pump beating heart technique. In group A, the mean aortic clamping time was 79 ± 33 minutes and the total cardiopulmonary bypass time was 155 ± 58 minutes. In group B the mean cardiopulmonary bypass time was 121 ± 43 minutes. There were eight hospital deaths (five in group A and three in group B). Five of 10 survivors of group A required inotropic support for 13.8 ± 25.3 days after the operation, while 5 of 12 survivors in group B required inotropes for 4.2 ± 3.1 days. Hospital mortality was 86% in 7 emergent cases and 7% in 27 elective cases. Echocar‐diographic study showed that the left ventricular ejection fraction improved from a mean of 18.7% to 30.3% and the left ventricular diameter decreased from a mean of 80.2 mm to 62.3 mm after the operation. All 26 hospital survivors were followed for 1 to 20 months. Three patients died at early follow‐up because of congestive heart failure, thrombosed valve, and hepatic failure, respectively. Nineteen patients were in New York Heart Association (NYHA) Class I or II and four were in NYHA Class III. In conclusion, cardiac volume reduction surgery is effective when the operative technique and proper judgment of patient selection are established, and emergent operation is avoided.
Quantitative Digital Angiography as an Adjunct to the lntraoperative Placement of Endovascular Stents in Congenital Heart Disease
Authors: Ohye Richard G. , Cohen Daniel M. , Wheller John J. , Allen Hugh D.
Published: August 2007

Abstract Clearly identifiable intraoperative landmarks render the placement of intraoperative stents difficult. Preoperative use of quantitative digital angiography helps the surgeon accurately insert endovascular stents intraoperatively. By using defined points of reference, we were able to carefully select the size and lengths of stents before the operation and precisely place these stents in the operating room. Furthermore, we have been able to redilate these stents using the same techniques at subsequent operations. Our results reflect the efficacy of this technique.
Operative Treatment of Hypertrophic Obstructive Cardiomyopathy and Aortic Valve Disease in Infants
Authors: van Son Jacques A.M. , Hambsch Jörg , Bossert Torsten , Mohr Friedrich W.
Published: August 2007

Abstract Background: The indications for operative intervention for symptomatic hypertrophic obstructive cardiomyopathy (HOCM) in infancy and childhood are not well defined because of the rarity of the lesion. The traditional surgical procedure consists of septal myectomy. In an attempt to further improve the outcome of HOCM associated with concentric left ventricular hypertrophy and aortic valve disease in infancy, we have combined resection of the left ventricular septum and free wall with a Ross‐Konno procedure. Methods: Three infants (aged 3, 4, and 10 months) with HOCM (left ventricular aortic gradients of 75, 95, and 110 mmHg), associated concentric left ventricular hypertrophy, and valvar aortic stenosis (n = 1) or combined valvar aortic stenosis and regurgitation (n = 2) underwent extensive resection of fibroelastosis and subendocardial myocardium of the left ventricular septum and free wall in combination with a Ross‐Konno operation. All three patients had marked systolic anterior motion of the mitral valve. The length of the incision into the ventricular septum was 1.8, 2.0, and 2.3 cm. Results: In all three patients this procedure resulted in a marked reduction of width of the left ventricular septum (median 9 mm vs 14 mm preoperatively) and the left ventricular posterior free wall (median 8 mm vs 12 mm preoperatively) and an almost twofold increase of the left ventricular end‐diastolic volume (median 13.5 cm3 vs 7.0 cm3 preoperatively). The neo‐aortic valve functioned normally. Systolic anterior motion of the anterior leaflet of the mitral valve had completely resolved in two patients and had markedly regressed in the remaining patient. At follow‐up of 15, 17, and 26 months, two patients had absence of a left ventricular outflow tract gradient and the third patient had a residual sub‐valvar gradient of 15 mmHg. Conclusions: The reported procedure may be a valuable technique in severe forms of hypertrophic cardiomyopathy associated with aortic valve disease. The operation results in enlargement of the left ventricular stroke volume and improvement of the left ventricular diastolic function, restores aortic valve anatomy and function, and abolishes or decreases systolic anterior motion of the mitral valve. (J Card Surg 1999:14:273–278)
Coronary Ostial Aneurysms After Composite Graft Replacement
Authors: Ito Masayoshi , Kazui Teruhisa , Tamia Yukihiko , Ingu Akira , Ikeda Katsuya , Abe Tomio
Published: August 2007

Abstract Coronary ostial aneurysms after composite graft replacement of the ascending aorta and aortic valve is a rare complication. We report two patients with Marfan syndrome who developed coronary ostial aneurysms at the sites of the coronary anastomosies, presumably because of oversized windows made in the graft. They were successfully treated by redo composite graft replacement. To prevent this complication, it is important to consider that the hole made in the tube graft should not be larger than the diameter of the respective coronary ostium to avoid exposure of the diseased aortic wall to the circulating blood as much as possible, and that the suture used to anastomose the coronary buttons should pass through the rim of the ostium rather than through the aortic wall surrounding it. (J Card Surg 7999;14:301–305)
Color Flow Imaging in Cardiomyopathies: Observations and Implications
Authors: MILLS T. J. , SEWARD J. B. , KHANDHERIA B. K. , KLEIN A. L. , OH J. K. , TAJIK A. J.
Published: August 2007

Color flow imaging provides useful hemodynamic insight into the altered pathophysiology of cardiomyopathies. The abnormal flow patterns delineated by flow imaging often cannot be appreciated by conventional Doppler examination. Color flow imaging has become an essential component of a complete noninvasive anatomical, hemodynamic, and pathophysiological evaluation of the cardiomypathies.
Limitations of Flow Detection by Color Doppler: In Vitro Comparison to Conventional Doppler
Authors: BIBRA HELENE VON , STEMPFLE HANS‐ULRICH , POLL ALEXANDER , SCHERER MICHAEL , BLÜML GÜNTHER , BLOMER HANS
Published: August 2007

There is little awareness of the limitations of flow detection with the commercially available color Doppler flow mapping system. The influence of flow velocity, ultrasound attenuation, and penetration depth on flow detection in color Doppler (Toshiba SSH 65A) were therefore studied in vitro and compared with conventional Doppler. The flow model had physiological flow volumes and laminar flow with parabolic velocity profile in a horizontal tube ofLucite with < 3° of coincidence. Conventional Doppler flow velocity measurements correlated highly with laser Doppler anemometry results (r= 0.99, SEE= 3 cm/sec). Signal strength of color Doppler and pulsed Doppler was semi‐quantitatively graded using a scale from 0 to 5. Scale 1 (sparse signals) was useless for any assessment in color Doppler but just allowed velocity measurement in pulsed Doppler. Using 19‐dB attenuation, flow velocities > 100 cm/sec had good scores with moderate gain, 60–100 cm/sec needed increasing gain, and velocities < 40 cm/sec were not detectable with color Doppler but readily so with pulsed Doppler. With increasing attenuation (1–29 dB) and also with increasing penetration depth, flow detection was reduced significantly(P < 0.001) more in color Doppler than in the pulsed technique (P < 0.01). In conclusion, low flow velocities, high attenuation, and > 8 cm penetration depth may hamper flow detection in color Doppler and, thus, diagnostic accuracy. Conventional Doppler with its superior accuracy and sensitivity should therefore consolidate diagnostic ultrasound assessment. (ECHOCARDIOGRAPHY, Volume 8, November 1991)
Identification of an Unusual Right Atrial Mass as a Chiari Network By Biplane Transesophageal Echocardiography
Authors: KATZ EDWARD S. , FREEDBERG ROBIN S. , RUTKOVSKY LISA , MARTIN JOANNE C. , KRONZON ITZHAK
Published: August 2007

An unusual right atrial mass was visualized on the transthoracic and single planar transesophageal echocardiograms of a young female patient. Biplane transesophageal echocardiography, however, clearly demonstrated this structure to be a prominent Chiari network. Large eustachian valves and Chiari networks may mimic tumor or thrombus formation when conventional noninvasive diagnostic techniques are used. Multiplanar imaging can be essential in defining anatomical relationships of normal variant structures, eliminating concern for pathological entities and the need for further invasive work‐up.
Effect of Loading Conditions on Doppler‐Derived Transmitral Flow Indices in Normal Subjects and Patients with Coronary Artery Disease
Authors: TAK TAHIR , CHOUDHARY RANJIV S. , CHATTERJEE SATYABRATA , WIDERHORN JOSEF , RAHIMTOOLA SHAHBUDIN H. , CHANDRARATNA P. ANTHONY N.
Published: August 2007

The influence of alterations in preload and afterload on left ventricular diastolic filling using echocar‐diography was examined in nine normal volunteers (NLS) and nine patients (PTS) with coronary artery disease. The sequential interventions used were handgrip to increase afterload, nitroglycerin to decrease preload, and nifedipine to decrease afterload. Transmitral flow was measured using pulsed‐Doppler echocardiography. Measurements were made pre‐ and post interventions. With increase in afterload using handgrip, the A and E wave velocities and the A/E ratio increased in both groups: 0.62 ± 0.14 versus 0.86 ± 0.17 in NLS; 0.75 ± 0.45 versus 0.84 ± 0.50 in PTS (P<0.05). Following administration of nitroglycerin to reduce preload, the A wave velocities increased, the E wave velocity decreased in both groups, and the A/E ratio increased 0.57 ± 0.11 versus 0.67 ± 0.13 in NLS; 0.78 ± 0.40 versus 0.91 ± 0.44 in PTS (P<0.05). Following use of nifedipine, the A and E wave velocities decreased in both groups with an increase in the A/E ratio in the patient group 0.83 ± 0.13 versus 0.89 ± 0.11 (P=NS). Thus, both normal subjects and patients with coronary artery disease had similar changes in Doppler‐derived indices of left ventricular filling following interventions that changed left ventricular preload and afterload.
Limitations and Potentialities of Doppler Echocardiography in the Evaluation of Mitral Flow
Authors: BRIDDA ANTONIO , FABBRO SILVIO DAL , CAVALLINI CLAUDIO
Published: August 2007

Doppler ultrasound has improved the evaluation of mitral valve diseases. There are, however, some limitations to its use. We describe a case of mitral valve disease in which an unusual concomitant rhythm disturbance highlights the limitations of the Doppler‐derived pressure half‐time method in evaluating the valve area, and the different behavior of the diastolic regurgitation across the two atrioventricular valves.
Prenatal Diagnosis and Outcome of Ebstein's Anomaly and Tricuspid Valve Dysplasia in Relation to Lung Hypoplasia
Authors: SATOMI GENGI , MOMOI NOBUO , KIKUCHI NORIKO , NAKAZAWA MAKOTO , MOMMA KAZUO
Published: August 2007

Although not all newborns with Ebstein's anomaly present with severe cardiomegaly in utero, some of them cannot live after birth because of the lung hypoplasia. To clarify the relationship between the intrauterine cardiomegaly and the outcome of the patients with Ebstein's anomaly or tricuspid valve dysplasia, we calculated the ratio of the area of the heart against the thorax (CTAR) in the transverse view of the thorax at the level of the cardiac four‐chamber view in the fetal echocardiogram and compared it to the outcome. The study population consisted of four patients with Ebstein's anomaly and one patient with tricuspid valve dysplasia who were diagnosed in utero. The ranges obtained from 53 normal fetal cases were 20%± 8% (mean ± 2 SD) at below 20 week's gestation, 25%± 10% at the gestational age of 21 to 30 weeks, and 29%± 6.4% at the gestational age of 31 to 40 weeks. The CTARs of these five cases measured 81.6%, 51%, 55.2%, 47.5%, and 75.6%, respectively, and were abnormally higher than the normal value. Two fetuses died in utero with severe hydrops fetalis. Two fetuses whose cardiothoracic ratios by chest X ray were 100% died at twelve hours of life. One patient died at 110 days. The cross‐sectional area of the thorax was smaller than the normal range in 3 (cases 1, 4, and 5) out of these 5 cases. Thus, we conclude that fetal Ebstein's anomaly and tricuspid valve dysplasia associated with massive tricuspid regurgitation with a large CTAR ratio (higher than 50%) and small thoracic cross‐sectional area has a very poor prognosis bothprena‐tally and neonatally. (ECHOCARDIOGRAPHY, Volume 11, May 1994)
Anomalous Origin of the Right Coronary Artery from the Pulmonary Trunk:
Authors: VESELKA JOSEF , KAUTZNER JOSEF
Published: August 2007

Anomalous origin of the right coronary artery from the pulmonary trunk is a rare congenital anomaly, which may be detected noninvasively by echocardiography. We report a case of definitive diagnosis of this anomaly using transesophageal echocardiography and Doppler color flow mapping in a 36‐year‐old woman. Of special interest is the fact that the most prominent echocardiographic feature was turbulent flow in the region of the interventricular septum streaming into the dilated RCA.
Effect of a Stabilized Microbubble Contrast Agent on CW Ultrasound Induced Red Blood Cell Lysis In Vitro
Authors: MILLER M. W. , AZADNIV M. , DOIDA Y. , BRAYMAN A. A.
Published: August 2007

Human red blood cells (RBCs) in vitro at various fractional hematocrits (HCTs) were exposed for 60–120 seconds in a dialysis tubing vessel to 1 MHz continuous wave ultrasound (0–5 W/cm2 SPTA intensity); exposure vessels were either rotated at 200 rpm or stationary. Some RBC suspensions also contained Albunex® (ALX; a commercially‐produced microbubble clinical ultrasound contrast agent) at final concentrations ranging from 0–41 μL/mL RBC suspension. Isonation was either by one transducer or by two opposing, continuously‐gated, balanced transducers. For the vessel rotation / no rotation experiments, ultrasound‐induced cell lysis was always increased with the ALX regimen relative to that of the no‐ALX regimen at HCTs up to about 10%; at higher HCTs (including whole blood), ultrasound‐induced hemol‐ysis essectially ceased to occur. The data are consistent with reports of the ineffectiveness of continuous wave ultrasound at 3–5 W/cm2 to lyse cells in vitro at physiological cell densities with or without echocontrast medium supplemantation.
Left Ventricular Thrombus After Pregnancy
Authors: MÜLLER SILVANA , BARTEL THOMAS , LAUBE HORST
Published: August 2007

Two idiopathic thrombi loosely attached to the left ventricular wall were detected by dynamic three‐dimensional echocardiography. Because the thrombi were shown to be lobulated and extremly mobile, urgent surgical treatment was mandatory. Three‐dimensional image reconstruction enhanced appreciation of left ventricular thrombi by enabling accurate imaging of the spatial relationship between the thrombus, the myocardial wall, and the valvular apparatus, so that the most advantageous surgical access could be chosen.
Transesophageal Echocardiographic Imaging for Congenital Lesions of the Left Ventricular Outflow Tract and the Aorta
Authors: ALBOLIRAS ERNERIO T. , GOTTEINER NINA L. , BERDUSIS KALIOPE , WEBB CATHERINE L.
Published: August 2007

A comprehensive transthoracic echocardiographic imaging is possible for most pediatric patients. However, for patients in whom accurate anatomical and physiological assessment is not possible, transesophageal echocardiography (TEE) provides a supplemental diagnostic modality. Imaging the left ventricular outflow tract and the aorta involves a complicated technique of rotation, flexion, and changes in the depth of the transesophageal probe because the areas of interrogation involve multiple planes within the thoracic cavity. Furthermore, the relationship between the esophagus and the cardiovascular structures changes at various levels of the thorax. Transesophageal probes having characteristics of frequency agility, all forms of Doppler capability, and a higher number of crystal elements are now available. Abnormalities of the subaortic area, the aortic valve, coronary arteries, and the entire thoracic aorta can be clearly demonstrated. TEE also has played a complementary role in diagnostic and interventional catheterization. It has become vital in the operating room for the preoperative definition of certain aspects of the anatomy and for immediate postoperative evaluation of the result of surgery.
Timing of Death and Myocardial Infarction in Patients with Non‐ST Elevation Acute Coronary Syndromes: Insights From Randomized Clinical Trials
Authors: MEHTA RAJENDRA H. , GREENBAUM ADAM B. , LOKHNYGINA YULIYA , NEWBY L. KRISTIN , VAN DE WERF FRANS , ARMSTRONG PAUL W. , PIEPER KAREN S. , CALIFF ROBERT M. , GRANGER CHRISTOPHER B. , HARRINGTON ROBERT A.
Published: August 2007

Background:
Adverse events occur following non‐ST elevation acute coronary syndromes (NSTE ACS). However, the timing of these events in relation to index event is less clear.

Methods:
Accordingly, we evaluated 26,466 NSTE ACS patients from the Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes (GUSTO‐IIb), Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT), and Platelet IIb/IIIa Antagonism for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network (PARAGON) A and B trials to ascertain the timing of adverse events. Outcomes of interest were death, myocardial infarction (MI), and death or MI at 180 days. Logistic regression modeling for death was used to categorize patients into low‐, medium‐, and high‐risk groups.

Results:
At 6 months, 6.2% of patients died, 12.1% had MI, and 15.7% suffered death or MI. From 15% to 40% of these events occurred beyond 30 days. At 6 months, 3%, 4%, and 13% of patients died in low‐, medium‐, and high‐risk groups, respectively. However, the proportion of patients dying beyond 30 days was similar in the three groups (44%, 43%, and 41% of death, respectively). Similarly, whereas death or MI increased with higher risk (11%, 14%, and 23%, respectively), the proportion of patients with this event beyond 30 days did not differ in the three strata (22%, 20%, and 25%, respectively).

Conclusions:
Our study provides important insights into the timing of adverse events and suggests that the substantial proportion of patients suffer subsequent adverse events after their index NSTE ACS. Thus, these data call for continuous surveillance for these events and efforts beyond the acute phase at increasing adherence to evidence‐based therapies to improve the outcomes of these patients.
Assessing the Effects of Age, Gestation, Socioeconomic Status, and Ethnicity on Labor Inductions
Authors: Wilson Barbara L.
Published: August 2007

Purpose

: To evaluate the likelihood of cesarean births, related to race, ethnicity, socioeconomic status (SES), maternal education and age, and gestational status for labor inductions on primiparous and multiparous women.

Design and Methods

: A retrospective descriptive correlational design was used with 1,325 women scheduled for induction at a large tertiary hospital in a southwestern U.S. state from January 1 through December 31, 2005. Birth outcomes were matched against inpatient hospital scheduling induction logs to verify the reason for induction, whether elective or clinically indicated.

Findings

: Age and gestation had nonlinear and significant associations with cesarean birth. Elective inductions for primiparous women significantly increased the likelihood of cesarean delivery. The independent effect of being a primiparous woman with an elective induction increased the probability of a cesarean birth by 50%, but this association was not significant for multiparous women. Mother's educational level was a significant predictor for cesarean births with multiparous women being induced. Ethnicity and SES did not increase the odds of cesarean delivery following labor induction for either primiparous women or multiparous women.

Conclusions

: Elective inductions for primiparous women increased the probability of cesarean births. Elective labor induction for primiparous women should be offered with caution, particularly for women with advanced maternal age.
An Update on the Representational Approach to Patient Education
Authors: Donovan Heidi Scharf , Ward Sandra E. , Song Mi‐Kyung , Heidrich Susan M. , Gunnarsdottir Sigridur , Phillips Christopher M.
Published: August 2007

Purpose:

To provide an update on the representational approach to patient education.

Organizing Construct:

The representational approach to patient education to guide a wide‐range of educational interventions.

Methods:

Four intervention trials based on the representational approach are discussed: the representational intervention to decrease cancer pain (RIDcancerPain), patient‐centered advance care planning (PC‐ACP), an individualized representational intervention to improve symptom management (IRIS), and the written representational intervention to ease symptoms (WRITE symptoms).

Results:

Findings from these trials show that interventions based on the representational approach are efficacious. Results of these trials have provided information for strengthening the approach and extending it to novel clinical problems and delivery modes.

Conclusions:

The representational approach to patient education appears to be adequately flexible to guide interventions in different patient care situations, while also sufficiently structured to be replicable and testable.
Genetic improvements in major US crops: the size and distribution of benefits
Authors: Frisvold George B. , Sullivan John , Raneses Anton
Published: August 2007

The distribution of welfare gains of genetic improvements in major US crops is estimated using a world agricultural trade model. Multi‐market welfare estimates were 75% larger than estimates based on the price‐exogenous ‘change in revenue’ method frequently used by plant breeders. Annual benefits of these genetic improvements range from US$ 400–600 million depending on the supply shift specification. Of this, 44–60% accrues to the US, 24–34% accrues to other developed countries. Developing and transitional economies capture 16–22% of the welfare gain. The global benefits of a one‐time permanent increase in US yields are US$ 8.1 billion (discounted at 10%) and US$ 15.4 billion (discounted at 5%). Gains to consumers in developing and transitional economies range from US$ 6.1 billion (10% discount rate) to US$ 11.6 billion (5% discount rate).
Natural resource‐collection work and children's schooling in Malawi
Authors: Nankhuni Flora J. , Findeis Jill L.
Published: August 2007

This paper presents results of research that investigates if long hours of work spent by children in fuel wood and water‐collection activities, i. e., natural resource‐collection work, influence the likelihood that a child aged 6–14 attends school. Potential endogeneity of resource‐collection work hours is corrected for, using two‐stage conditional maximum likelihood estimation. Data from the 1997–1998 Malawi Integrated Household Survey (IHS) conducted by the Malawi National Statistics Office (NSO) in conjunction with the International Food Policy Research Institute (IFPRI) are used. The study finds that Malawian children are significantly involved in resource‐collection work and their likelihood of attending school decreases with increases in hours allocated to this work. The study further shows that girls spend more hours on resource‐collection work and are more likely to be attending school while burdened by this work. Consequently, girls may find it difficult to progress well in school. However, girls are not necessarily less likely to be attending school. Results further show that presence of more women in a household is associated with a lower burden of resource‐collection work on children and a higher probability of children's school attendance. Finally, the research shows that children from the most environmentally degraded districts of central and southern Malawi are less likely to attend school and relatively fewer of them have progressed to secondary school compared to those‐from districts in the north.
Rural taxation and government regulation in China
Authors: Tao Ran , Lin Justin Yifu , Liu Mingxing , Zhang Qi
Published: August 2007

This paper places the problem of Chinese rural taxation in the context of government regulation and seeks to present an integrated theoretical framework of Chinese rural development in the past two decades. Our theoretical framework reconciles the seemingly contradictory facts that the average level of rural taxation relative to rural net income did not increase quickly from 1990, but rural taxation became a very serious problem in this period. Our findings suggest that this is in large part due to increases in rural income disparity from 1990 and uneven tax distribution among different income groups. We argue that differentiated enforcement of government regulations such as grain procurement and birth control play an important role in the rural taxation problem, and more generally, the problem of local government expansion and rising rural income disparity. The empirical findings support our hypotheses.
Interlinked credit and farm intensification: evidence from Kenya
Authors: Jayne T. S. , Yamano Takashi , Nyoro James
Published: August 2007

This paper addresses the potential for interlinked credit/input/output marketing arrangements for particular cash crops to promote food crop intensification. Using panel survey data from Kenya, we estimate a household fixed‐effects model of fertiliser use per hectare of food crops, using an instrumental variables approach for addressing the endogeneity of participation in interlinked credit arrangements. Results indicate that households engaging in interlinked marketing programs for selected cash crops applied considerably greater fertiliser on other crops (primarily cereals) not directly purchased by the cash crop trading firm. These findings suggest that, in addition to the direct stimulus that interlinked cash crop marketing arrangements can have on small farmer incomes, these institutional arrangements may provide spill‐over benefits for the productivity of farmers' other activities such as food cropping.
Diversification economies and specialisation efficiencies in a mixed food and coffee smallholder farming system in Papua New Guinea
Authors: Coelli Tim , Fleming Euan
Published: August 2007

Smallholder farming systems in Papua New Guinea are characterised by an integrated set of cash cropping and subsistence food cropping activities. In the Highlands provinces, the subsistence food crop sub‐system is dominated by sweet potato production. Coffee dominates the cash cropping sub‐system, but a limited number of food crops are also grown for cash sale. The dynamics between sub‐systems can influence the scope for complementarity between, and technical efficiency of, their operations, especially in light of the seasonality of demand for household labour and management inputs within the farming system. A crucial element of these dynamic processes is diversification into commercial agricultural production, which can influence factor productivity and the efficiency of crop production where smallholders maintain a strong production base in subsistence foods.

In this study we use survey data from households engaged in coffee and food crop production in the Benabena district of Eastern Highlands Province to derive technical efficiency indices for each household over two years. A stochastic input distance function approach is used to establish whether diversification economies exist and whether specialisation in coffee, subsistence food or cash food production significantly influences technical efficiency on the sampled smallholdings.

Diversification economies are weakly evident between subsistence food production and both coffee and cash food production, but diseconomies of diversification are discerned between coffee and cash food production. A number of factors are tested for their effects on technical efficiency. Significant technical efficiency gains are made from diversification among broad cropping enterprises.
Policy dependency and reform: economic gains versus political pains
Authors: Harvey David R.
Published: August 2007

Economic analysis condemns market intervention in favour of farmers as inefficient and ineffective, and therefore worthy of radical reform. Practical experience, however, indicates that such lessons are hard to learn and implement. Economic analysis tends to ignore the path dependencies generated by the policy evolution process. Without reform strategies that take full account of these dependencies, policy reform will continue to be reluctant, slow and frequently counter‐productive. This paper reconsiders the evolution of farm policies and the economic assessment of their costs and benefits. In so doing, it re‐phrases conventional economic arguments in terms which seem to accord better with sensible intuition, which may prove more accessible and credible to policymakers and advisors. The difficulties of reconciling economic efficiency with political acceptability are identified. The paper concludes with a substantial challenge to the agricultural economics profession.
REPRODUCTION AMONG FEMALE MENTAL PATIENTS: OBSTETRIC COMPLICATIONS AND PHYSICAL SIZE OF OFFSPRING
Authors: McNeil T. F. , Kaij L.
Published: August 2007

Rates of obstetric complications, deviations in prenatal development and predischarge neonatal disturbances were studied in 171 reproductions to female psychiatric patients and 171 reproductions to demographicallymatched control women from the same hospital delivery series. The patients were diagnostically categorized as ‘endogenous psychotics’ (process schizophrenia, manic‐depressive psychosis, schizophrenic‐like‐psychoses) and ‘other patients’ (psychopathy and diverse diagnoses). No significant difference was found between any patient group vs. its control group on rates of total pregnancy complications, labor‐birth complications, placental characteristics, predischarge neonatal disturbances or all complications. Significantly fewer of the offspring of endogenous psychotics, as contrasted with controls, were markedly preterm. Additional results concerning the relationship between complications and offspring sex and between complications and timing of mother's first psychiatric hospitalization are presented.
PROGNOSTIC VALUE OF THYROTROPIN‐ RELEASING HORMONE STIMULATION TEST IN ENDOGENOUS DEPRESSION
Authors: Kirkegarrd C. , Nørlem N. , Lauridsen U. B. , Bjørum N.
Published: August 2007

Throtropin‐releasing hormone (TRH) stimulation tests were performed in 19 patients with endogenous depression before treatment and when they had apparently recovered following antidepressive treatment. An increase in the maximal serum thyrotropin (TSH) response to TRH of more than 2.0 μU/ml was found in all of ten patients who did not relapse, while such an increase was found in only one of nine patients who did relapse within 6 months. I. e., a correct prognosis was posible in 94.7% (95% confidence limits 74.0 ‐ 99.9%). Though significant changes were found in serum thyroxine (T4), free T4 index, serum triiodothyronine (T3) and free T3 index, these fidings were of no prognostic value.
THE PSYCHOPATHOLOGY OF ANANCASTIC ENDOGENOUS DEPRESSION
Authors: Videbech Th.
Published: August 2007

From a sample of 1,005 patients admitted to the Psychiatric Hospital in Aarhus for the first time during the period 1950–1959 and diagnosed as suffering from manic‐depressive psychosis or endogenous depression (affective psychoses), a subsample of 104 manic‐depressive patients with anancastic symptoms in the history was selected. The 104 probands were individually matched with 104 non‐anancastic probands with affective psychoses. The study was designed as a follow‐up study, and the patients who were still living were seen personally. In the search for factors which could be used to distinguish affective psychoses with anancastic symptoms from affective psychoses without these traits, the incidence of a number of psychopathological features was evaluated based on the case histories and the information given by the patients at the follow‐up. There was no difference as far as atypical, schizophrenia‐like symptoms were concerned between the anancastic probands and the controls. Manic and hypomanic features were more frequent among the controls, corresponding to a greater number of bipolar psychoses among them. At the same time, the controls showed a significant preponderance of decidedly psychotic symptoms such as disturbances of consciousness, delusions and delusion‐like ideas and hallucinations. Furthermore, retardation was more frequent among the controls. There was no difference in the suicidal behaviour of the two groups. Symptoms which were more often met among the anancastic depressives were: anxiety, agitation, diurnal variation of mood and early awakening. Seasonal variation in symptomatology was also more frequent among the anancastic probands. The same held true for depersonalization. The anancastic probands showed a significant preponderance of anancastic premorbid personality features. A positive correlation was found between the number of anancastic personality features and the following symptoms: agitation, anxiety, diurnal fluctuation, seasonal variation, hypochondriacal attitude and depersonalization. On the other hand, objective retardation or flight of ideas showed a significant negative correlation.

The pattern of the anancastic symptoms was rather uniform; aggressive obsessions, mostly in the form of suicidal and homicidal obsessions, were present in more than two thirds of the cases. The anancastic depressions were often less severe than non‐anancastic depressions in that the latter were more often complicated by decidedly psychotic symptoms.

It is possible to interpret the symptomatology of anancastic depressions as a pathoplastic influence of the anancastic personality, but it cannot be excluded that some of the symptoms like anxiety and agitation are linked to the presence of anancastic symptoms as such.
Sleep deprivation as treatment for endogenous depression
Authors: Larsen J. K. , Lindberg M. L. , Skovgaard B.
Published: August 2007

Twenty‐six depressed patients, 19 of whom suffered from an endogenous depression, were sleep‐deprived for one night, and eight of these were additionally sleep‐deprived for three to nine nights with two sleep deprivations per week. While the sleep deprivation was being carried through, none of the patients were treated with tricyclic antidepressants. The patients were rated before and after the sleep deprivation(s).

Sleep deprivation appeared to be effective for both unipolar and bipolar depressions. According to the rating scale an improvement was registered especially when the clinical picture was characterized by depressed mood, psycho‐motor retardation and anxiety.

As sleep deprivation cured 25 % of the patients and further incidentally improved another 20 % of the patients, it can be concluded that sleep deprivation seems to be a valuable treatment, especially in retarded endogenous depressions.
Lithium in adult anorexia nervosa
Authors: Barcai A.
Published: August 2007

Two patients suffering from anorexia nervosa for many years who wished to gain weight were treated successfully with lithium carbonate.

One patient gained 12 kg and the other 9 kg within 6 weeks. The weight‐gain was maintained for a year of follow‐up with lithium maintenance therapy.
Aspects of suicide and parasuicide
Authors: Garzotto N. , Buglass D. , Holding T. A. , Kreitman N.
Published: August 2007

Five aspects of suicidal behaviour in Edinburgh from 1968 to 1974 were examined. The data referred to 478 suicidal deaths and to parasuicide (attempted suicide) admissions to the Regional Poisoning Treatment Centre (R.P.T.C.).

Firstly: 28 % of suicides were found to have had a parasuicide admission and there was some evidence of a slight excess of deaths in the years immediately following parasuicide. Secondly: among suicides preceded by parasuicide, those with a recent episode (within 2 years of death) were found to be essentially similar to those with a longer interval. Thirdly: a history of previous parasuicide at any time was found to be important in delineating two groups of suicide. Suicides with prior parasuicide died more often from poisoning with drugs and were more likely to have a history of psychiatric treatment; suicides without prior parasuicide died more often from poisoning with domestic gas or violent means, were older, of higher social class and less often married. Fourthly: parasuicides who killed themselves within 2 years of admission to the R.P.T.C. were compared with a group of (broadly nonsuicidal) parasuicides. And lastly: a scale predictive of repetition of parasuicidal behaviour was used in an attempt to distinguish parasuicides who killed themselves from those who did not. The scale did not discriminate between the two groups.
Reliability and validity of a nurses' rating scale of depression
Authors: DElia G. , Raotma H.
Published: August 2007

In order to test the reliability and the construct validity of a nurses' depression‐rating scale (NRS) patients with a depressive syndrome of endogenous or mixed endogenous‐psychogenic aetiology were assessed initially, during and after treatment, by NRS, doctors' rating scale (Cronholm & Ottosson) and self‐rating (Zung). Global ratings were also made.

The inter‐rater reliability of the NRS was 0.41–0.90 for the symptoms, 0.90 for the depression‐anxiety syndrome, 0.79 for the retardation syndrome and 0.89 for the total depressive syndrome.

As indicators of construct validity three criteria were used: treatment criterion (to discriminate between untreated and treated patients), group difference criterion (to discriminate between groups of treated patients), and convergent validity (correlation to other depression scales). Further, the degree of the discriminating ability, the sensitivity of the scale, was examined.

The NRS discriminated well between untreated and ECT treated patients and satisfactorily between recovered and much improved patients.

The correlations between NRS and doctors' ratings were positive and significant, although not very high. They indicate that nurses' rating and doctors' rating probably measure partly different aspects of the depressive symptomatology. The simultaneous use of both ratings may thus give a more complete estimate of depression.

Doctors' rating was superior to nurses' rating in sensitivity and showed somewhat higher reliability. The results do not justify the replacement of doctors' rating by other ratings.

Self‐rating appeared to be of little value as an additional assessment.
A clinical trial comparing sustained release amitriptyline (Saroten® Retard) and conventional amitriptyline tablets (Saroten®) in endogenously depressed patients with simultaneous determination of serum levels of amitriptyline and nortriptyline
Authors: Liisberg P. , Mose H. , Amdisen A. , Jørgensen A. , Petersen H. E. Høpfner
Published: August 2007

The clinical effect of a sustained release preparation of amitriptyline has been compared with that of conventional amitriptyline tablets in a double‐blind cross‐over study with 24 patients suffering from endogenous depression. The sustained release preparation was given in a single evening dose (9 p.m.) of two thirds the total daily dose of conventional tablets, which was given in a three times‐a‐day regimen (8 a.m., 12 a.m. and 9 p.m.). Serum concentrations of amitriptyline and its active metabolite, nortriptyline, were determined.

No difference was found between the two preparations as regards either clinical effect or side effects. No correlation could be shown between the clinical effects and the serum concentrations of amitriptyline and nortriptyline.