bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal return policy and modular design for build‐to‐order products
Authors: Mukhopadhyay Samar K. , Setoputro Robert
Published: December 2004

A build‐to‐order product gives the firm the opportunity to customize the product to the requirement of the customers. The firm will see an increase in demand, but face some operational difficulties. One of these is related to the return policy which is now a recognized tool to win customer orders. This is even more true for increasingly popular Internet sales where the opportunity to physically examine the product is absent. A tremendous advantage can be gained by the Internet firm if it could offer a return policy for BTO products. We propose the use of modularity in the product design as a solution to this problem. From manufacturer's point of view, following a policy of modularization and offering a generous return policy would increase revenue, but also increase the cost due to increased likelihood of return and increased cost of design. We develop a profit maximization model to jointly obtain optimal polices for return policy and modularity level in terms of certain market reaction parameters. We obtain a number of managerial guidelines for using marketing and operational strategy variables to influence those reaction parameters so as to obtain the maximum benefit from the market.
Wind‐forced setup of upwelling, geographical origins, and numerical models: The role of bottom drag
Authors: Middleton John F. , Leth Ole K.
Published: December 2004

An analysis is made to determine the properties and scales for the setup of upwelling driven by an impulsively started, steady, uniform wind of semi‐infinite fetch. The backward edge of the wind field acts as a geographical origin for the generation of coastal‐trapped waves (CTWs). A perturbation analysis is used to show that prior to the arrival of the nth mode CTW, the alongshore velocity is shown to asymptote to a constant value, (set by bottom drag) and over a timescale Tn. As this viscous limit is achieved, the upwelling becomes increasingly confined to the bottom boundary layer and bottom stress balances wind stress: Interior upwelling is shut down. The viscous limit may not be achieved, since after the arrival of the nth CTW mode, a gradient in the alongshore velocity is set up and its divergence acts to feed the offshore Ekman transport and shut the upwelling down. Numerical results are used to show that the frictional length and timescales predicted by the perturbation analysis are unrealistically small due to an underestimation of thermal wind shear. Moreover, the theory underpredicts the importance of the first CTW mode, which is shown to largely determine the setup and shutdown of upwelling. A simple first‐mode model for upwelling is developed and used to evaluate the validity of a numerical, open boundary condition in determining the correct degree of upwelling. A case study for the Chilean shelf is presented.
Seismic reflection imaging of water mass boundaries in the Norwegian Sea
Authors: Nandi Papia , Holbrook W. Steven , Pearse Scott , Páramo Pedro , Schmitt Raymond W.
Published: December 2004

Results from the first joint temperature and seismic reflection study of the ocean demonstrate that water mass boundaries can be acoustically mapped. Multichannel seismic profiles collected in the Norwegian Sea show reflections between the Norwegian Atlantic Current and Norwegian Sea Deep Water. The images were corroborated with a dense array of expendable bathythermographs and expendable conductivity‐temperature depth profiles delineating sharp temperature gradients over vertical distances of ∼5–15 m at depths over which reflections occur. Fine structure from both thermohaline intrusions and internal wave strains is imaged. Low‐amplitude acoustic reflections correspond to temperature changes as small as 0.03°C implying that seismic reflection methods can image even weak fine structure.
Thermal expansion of Mg2SiO4 ringwoodite at high pressures
Authors: Katsura Tomoo , Yokoshi Sho , Song Maoshuang , Kawabe Kazuyuki , Tsujimura Tomoyuki , Kubo Atsushi , Ito Eiji , Tange Yoshinori , Tomioka Naotaka , Saito Keiko , Nozawa Akifumi , Funakoshi Ken‐ichi
Published: December 2004

Unit cell volumes of Mg2SiO4 ringwoodite were measured at temperatures from 300 to 2000 K and pressure from 15 to 24 GPa and at a temperature of 300 K and pressure from 0 to 21 GPa. The measurements were conducted using a Kawai‐type multianvil apparatus that is equipped with an oscillation system to obtain high‐quality diffraction pattern against grain growth. We obtained the following relations and parameters describing the pressure‐volume‐temperature relations of Mg2SiO4 ringwoodite. The unit cell volume of Mg2SiO4 ringwoodite at 0 GPa and 300 K is 524.8(1) Å3 (values in parentheses are errors). Fixing the isothermal bulk modulus to 182 GPa, its pressure derivative is 4.6(2). The thermal expansion coefficient at 0 GPa is α0 = 2.57(9) × 10−5 + 1.42(8) × 10−8 (T − 300) K−1, where T is absolute temperature in K, and its logarithmic volume dependence, Anderson‐Grüneisen parameter, is 6.9(4). The temperature derivative of the isothermal bulk modulus is (∂KT/∂T) = −0.029(1) GPa K−1. The Debye temperature, Θ, is 846(26) K. The Grüneisen parameter and its logarithmic volume dependence are 1.93(3) and 3.5(3), respectively. The adiabatic temperature gradient in the mantle largely depends on temperature. That in the model Mg2SiO4 mantle increases from 0.29 to 0.40 K km−1 when temperature increases from 1600 to 2000 K.
Spatial variability of deep‐ocean motions above an abyssal plain
Authors: van Haren Hans
Published: December 2004

Near‐bottom current observations are discussed from an array of moorings separated by 8–40 km horizontally in the Madeira abyssal plain, North Atlantic Ocean. The area is topographically smooth, but observed currents varied strongly over short distances. Across horizontal scales O(10 km), “incoherent” internal wave properties were retrieved such as conservation of relative frequency bandwidth and internal wave polarization at inertial, tidal, and higher harmonics frequencies. In the vertical (between 10–110, 110–650 m above the bottom (mab) at ∼5000 m), the current differences (∼shear) were predominantly at the local inertial frequency f. Near f the largest variance was found at 110 mab, with peaks in power at 0.99f and 1.03f. As stratification was weak (N ≈ 2f) the subinertial frequency peak was well within the combined internal inertio‐gravity wave band. At 650 mab, N ≈ 4f, and smaller peaks at ∼1.00f and 1.03f were observed. Toward the bottom subinertial currents increased in magnitude. The horizontal scale of variation of subinertial and inertial motions was small: ∼30 km. The magnitude of horizontal current differences in these frequency bands was equal to that in the tidal band. Although the energetically dominant, highly deterministic tidal currents were predominantly barotropic, confirming a previous study, their horizontal scale of variation was ∼300 km, due to small bottom relief. Results are discussed relevant for matching records from nearby moorings, to generate extra long time series.
Turbulence Slope After Atrial Premature Complexes Is an Independent Predictor of Mortality in Survivors of Acute Myocardial Infarction
Authors: WICHTERLE DAN , CAMM A. JOHN , MALIK MAREK
Published: December 2004

Introduction: Heart rate turbulence is a potent postinfarction risk predictor that originally was investigated when it was triggered by ventricular premature complexes. Similar heart rate response is present after atrial premature complexes. “Atrial” turbulence slope (TSA) moderately correlates with “ventricular” turbulence slope (TSV). This study investigated the value of TSA assessed in 24‐hour Holter recordings for postinfarction risk stratification.

Methods and Results: Predictive power of TSA was investigated in the placebo arm of the European Myocardial Infarction Amiodarone Trial, which enrolled patients surviving acute myocardial infarction with left ventricular ejection fraction (LVEF) ≤40%. Of 633 patients with available 24‐hour Holter recordings, 87 died during the follow‐up period of 662 ± 105 days. The same methodology was used to calculate TSA and TSV. TSA was significantly lower in nonsurvivors compared to survivors (2.0 ± 2.7 vs 3.0 ± 3.3 msec/RR, P = 0.014). TSA≤0.8 msec/RR was associated with relative risk all‐cause mortality of 2.5 (95% confidence interval 1.6–3.9, P = 0.000046). In a multivariate Cox regression model including age, LVEF, QRS duration, mean RR interval, heart rate variability index, presence of nonsustained ventricular tachycardia, and TSV, TSA remained a significant predictor of total mortality with relative risk of 2.0 (95% confidence interval 1.2–3.4, P = 0.014).

Conclusion: TSA is a significant and independent predictor of all‐cause mortality in postinfarction patients with left ventricular dysfunction.
Easy Surgical Approach for Completion of Biventricular Pacing
Authors: FISHER JOHN D. , GARCIA JOSE , KIM SOO G. , FERRICK KEVIN J. , PALMA EUGEN C. , CROOKE GREGORY , MOSKOWITZ ROBERT , LEJEMTEL THIERRY
Published: December 2004

Placement of a pacing lead into a branch of the coronary sinus for biventricular pacing sometimes is difficult or impossible. Surgical completion typically has included immediate or subsequent thoracotomy lead placement with hookup to the device at the time of chest surgery. We describe an alternative procedure of complete device‐lead hookup and permanent pocket closure in the electrophysiology laboratory. The left ventricular lead is an epicardial type. The lead is tunneled to a position where the surgeon subsequently can recover it using the thoracotomy incision and implant the lead on the epicardium using device‐based testing.
Synergistic Action of Atrial Dilation and Sodium Channel Blockade on Conduction in Rabbit Atria
Authors: EIJSBOUTS SABINE C.M. , HOUBEN RICHARD P.M. , BLAAUW YURI , SCHOTTEN ULRICH , ALLESSIE MAURITS A.
Published: December 2004

Introduction: The aim of this study was to investigate the interaction of atrial dilation and blockade of the rapid sodium channel on atrial conduction and degree of anisotropy.

Methods and Results: The right atrium was acutely dilated by increasing intra‐atrial pressure from 2 to 9 cm H2O in 14 isolated rabbit hearts. A rectangular mapping array of 240 electrodes (spatial resolution 0.5 mm) was positioned on the free wall of the right atrium during pacing from four different directions at intervals of 240 and 140 msec. In nondilated atria, 0.5 and 1.0 mg/L of the use‐dependent INa blocker flecainide prolonged the total conduction time under the mapping electrode by 15% to 75%. In dilated atria, flecainide depressed conduction by 24% to 89% (P < 0.05). The incidence of intra‐atrial conduction block increased from 0.6%–0.8% to 3.3%–7.2% in nondilated atria and from 3.9%–4.6% to 13%–21% in dilated atria (P < 0.05). The direction of activation relative to the crista terminalis and major pectinate muscles was of major importance for occurrence of conduction block. During rapid pacing, the degree of anisotropy in conduction increased by the combination of atrial dilation and flecainide (1.0 mg/L) from 1.7 ± 0.1 to 2.2 ± 0.4 (P < 0.05). The effects of dilation and flecainide on conduction were clearly synergistic. The effect of flecainide on the atrial refractory period also was enhanced by atrial dilation.

Conclusion: In dilated atria, blockade of the rapid sodium channels caused a higher degree of local conduction delay and intra‐atrial conduction block than in nondilated atria.
AZD7009:
Authors: GOLDSTEIN ROBERT N. , KHRESTIAN CELEEN , CARLSSON LEIF , WALDO ALBERT L.
Published: December 2004

Introduction:We tested the hypothesis that AZD7009 terminates induced atrial fibrillation (AF) and flutter (AFL) and prevents their reinduction, and that effects on refractoriness, conduction, and excitability are predominantly on the atria.

Methods and Results:Thirty‐eight electrophysiologic studies were performed during AZD7009 infusion in 11 dogs with sterile pericarditis. The effects of AZD7009 on refractoriness, conduction, and capture threshold were studied and its antiarrhythmic efficacy tested. Simultaneous multisite biatrial mapping was performed in 7 dogs to assess arrhythmia termination. AZD7009 prolonged arrhythmia cycle length (CL) from 121 ± 7.8 to 157 ± 9.7 msec (P < 0.001) before terminating 23 of 23 AF/AFL episodes. Mapping demonstrated that AF/AFL CL prolonged and then terminated in area(s) of slow conduction in a reentrant circuit. Arrhythmia reinduction failed in 19 of 20 attempts. At 400‐msec CL, atrial and ventricular refractoriness and QT interval increased 33%, 17% (P < 0.001 vs atrial refractoriness), and 9%, respectively. Atrial capture threshold increased in a CL‐dependent manner: 1.8 ± 0.3 to 2.2 ± 0.3 mA (CL 400 msec); 2.1 ± 0.3 to 2.8 ± 0.5 mA (CL 300 msec), and 2.2 ± 0.3 to 5.3 ± 0.8 mA (CL 200 msec). Only minor nonsignificant changes occurred in the ventricles: 0.95 ± 0.05 to 0.98 ± 0.06 mA (CL 400 msec), and 1.14 ± 0.12 to 1.16 ± 0.13 mA (CL 333 msec). Atrial conduction time increased 8 ± 1.4 msec (CL 400 msec), 8.3 ± 1.5 msec (CL 300 msec), and 13.2 ± 1.6 msec (CL 200 msec, all P < 0.001), but ventricular conduction time was unchanged.

Conclusion:AZD7009 is highly efficacious in terminating AF/AFL and preventing reinduction in this model. It exhibits marked effects on atrial electrophysiology but has only modest effects on the ventricle.
Effect of Chronic Amiodarone Therapy on Excitable Gap During Typical Human Atrial Flutter
Authors: MAURY PHILIPPE , ZIMMERMANN MARC
Published: December 2004

Introduction: Class I antiarrhythmic drugs increase duration of the excitable gap (EG) during typical atrial flutter whereas intravenous class III drugs decrease the EG. The effect of chronic oral amiodarone therapy on the EG is unknown.

Methods and Results: EG was prospectively determined by introducing a premature stimulus and analyzing the response pattern during typical atrial flutter in 30 patients without antiarrhythmic drugs and in 20 patients under chronic oral amiodarone therapy. EG was calculated by the difference between the longest coupling interval leading to resetting and the effective atrial refractory period (EARP). A fully EG was defined by the portion of EG where the response curve of the return cycles was flat. A partially EG was defined by the portion of EG where the return cycle increases while coupling interval decreases. A resetting response curve was constructed by plotting the duration of the return cycle against the value of the coupling interval. Cycle length (CL; 222 ± 17 vs 267 ± 20 msec, P < 0.0001), EARP (128 ± 16 vs 152 ± 18 msec, P < 0.0001), and EG (54 ± 19 vs 70 ± 21 msec, P = 0.01) were significantly longer in patients taking amiodarone than in controls. Compared to CL, the relative part of the EARP (57 ± 7 vs 57 ± 6%, P = 0.96) and EG (24 ± 7 vs 26 ± 8%, P = 0.41) were comparable in both groups. The fully EG was larger in patients under chronic amiodarone therapy than in controls (39 ± 21 vs 26 ± 20 msec, P = 0.03). Neither duration of the partially EG (28 ± 15 vs 31 ± 15 msec, P = 0.42) nor slope of the ascending portion of the resetting response curve (1.15 ± 0.5 vs 1.13 ± 0.4 msec/msec, P = 0.71) differed between the two groups.

Conclusion: EG in patients under chronic amiodarone therapy is significantly larger than in controls, mainly because of a longer fully EG. This observation may be explained by opposite effects on conduction velocity and refractoriness.
Simulating the Formation of Secondary Organic Aerosol from the Photooxidation of Toluene
Authors: Johnson David , Jenkin Michael E. , Wirtz Klaus , Martin-Reviejo Montserrat
Published: December 2004

Environmental Context. Atmospheric particulate material can affect climate by absorbing and scattering solar radiation and by altering the properties of clouds. They are also implicated as a health risk. Secondary organic aerosol (SOA) material makes an important contribution to this particulate burden. SOA material results from the transfer of gas-phase species into a particle state after the formation of products from the reaction of atmospheric volatile organic compounds (VOCs) with oxygen. SOA from the oxidation of aromatic hydrocarbons, such as toluene, a gasoline fuel component, is important in the polluted urban environment and yet formation mechanisms are not well understood.
Abstract. The formation and composition of secondary organic aerosol (SOA) from the gas-phase photooxidation of toluene has been simulated using the Master Chemical Mechanism version 3.1 (MCM v3.1) coupled to a representation of the transfer of organic material from the gas phase to a particle phase. The mechanism was tested against data from a series of toluene photooxidation experiments performed at the European Photoreactor (EUPHORE) outdoor smog chamber in Valencia, Spain. Simulated aerosol mass concentrations compared reasonably well with the measured SOA data after absorptive partitioning coefficients were increased by a factor of between 20 and 80, although the simulated onset of SOA growth was delayed with respect to the experiments. A simplified representation of peroxyhemiacetal adduct formation, from the reaction of organic hydroperoxides with aldehydes in the condensed organic phase, was included in the mechanism and this reduced the required scaling of partitioning coefficients and reduced the time-lag in simulated SOA growth. These observations, and the dependence of SOA formation efficiency upon the initial NO concentration, strongly imply the significant occurrence of association reactions in the condensed organic phase and the important role of organic hydroperoxides in SOA formation. Aerosol data from photooxidation experiments of intermediate degradation products (butenedial, 4-oxo-pentenal, and ortho-cresol) were also simulated using the developed mechanism.
The distribution and abundance of the estuarine crocodile, Crocodylus porosus, in Queensland
Authors: Read Mark A. , Miller Jeffrey D. , Bell Ian P. , Felton Adam
Published: December 2004

A total of 6444 Crocodylus porosus (4303 non-hatchlings and 2141 hatchlings) were recorded during 196 vessel-based surveys of 103 waterways to determine the distribution and abundance of Crocodylus porosus in Queensland. The surveys, conducted from January 1994 to December 2000, covered 4174.3 km of waterway. Population structure was biased towards immature crocodiles, with 91% of all animals sighted being less than the minimum breeding size for individuals in the Northern Territory. The mean relative density of non-hatchling C. porosus was highest in waterways of north-western Cape York Peninsula and Lakefield National Park, and lowest for waterways along the populated east coast of Queensland. The highest numbers of hatchlings were recorded from waterways of north-western Cape York Peninsula, where nearly 74% of all hatchlings were recorded during the seven-year survey period. The C. porosus population in northern Queensland appears to be undergoing a limited recovery, with marginal increases in the mean relative density of non-hatchlings in seven of the eight crocodile biogeographic regions. On the basis of the distribution and abundance of hatchling and non-hatchling crocodiles, the north-western Cape York Peninsula region contains the best habitat for C. porosus in Queensland, particularly in the Wenlock River and Tentpole Creek area.
Population trend of feral camels in the Northern Territory, Australia
Authors: Edwards Glenn P. , Saalfeld Keith , Clifford Bretan
Published: December 2004

We conducted a broad-scale aerial survey between 20 August and 12 October 2001 to ascertain the distribution and abundance of feral camels in the southern part of the Northern Territory. There was a minimum of 80 533 feral camels in the Northern Territory at the time of the survey. This figure is corrected for perception bias (a result of observers missing animals that are potentially visible), but not for availability bias (a result of some animals being concealed from the observers). The population of feral camels in the Northern Territory increased at a mean annual exponential rate, r, of 0.093 between 1993 and 2001. This represents an increase of ~10% per year or an approximate doubling in population size every 8 years. This trend is likely to continue for the foreseeable future. We use the results of an earlier survey (which included the Northern Territory, South Australia and Western Australia) to give a minimum figure of 300 000 feral camels for Australia in 2001. We discuss what is known of the impacts of feral camels in Australia, the inadequacy of current management practices and issues to be considered in designing an effective long-term management strategy for the species.
Movements and home ranges of radio-tracked Crocodylus porosus in the Cambridge Gulf region of Western Australia
Authors: Kay Winston R.
Published: December 2004

VHF radio-tags were attached to 16 estuarine crocodiles that were tracked between October 2001 and May 2003. Male (n = 12) and female (n = 4) crocodiles exhibited distinctly different patterns of movement. Females occupied a small core linear range (1.3 ± 0.9 km) on the main river channel during the dry season and moved up to 62 km to nesting habitat during the wet season, returning to the same core area the following dry season. They occasionally made excursions away from their core areas during the dry season. Males moved considerable distances along the Ord River throughout the year. The largest range recorded was 87 km for a 2.5-m juvenile male. However, ranges of males did not appear to be related to body size, with the largest two ranges being recorded for the smallest (2.5 m) and largest (4.3 m) males tagged. Rates of movement of males did not differ significantly between three size classes of males but there were significant seasonal differences, with the highest mean rates of movement occurring during the summer wet season (4.0 ± 5.4 km day–1). However, males were quite mobile during the dry season and the highest rate of movement detected was 23.3 km day–1 for a 4.3-m male at the end of July. The highest rate of sustained movement was 9.8 km day–1 for a translocated 2.6-m juvenile male, which travelled 118 km in 12 days to return to the area of its capture. Neither males nor females showed exclusive habitat preferences for any of four broad riverine habitats identified on the Ord River. However, the three largest males had activity centres that they returned to frequently despite numerous excursions throughout the year, both up- and downriver. Males had substantial range overlaps with no obvious spatial partitioning, suggesting that territoriality is not an important behavioural characteristic of free-ranging male crocodiles along the Ord River.
Profit Sharing, Credit Market Imperfections and Equilibrium Unemployment*
Authors: Koskela Erkki , Stenbacka Rune
Published: December 2004

We investigate the interaction between labour and credit market imperfections for equilibrium unemployment in the presence of profit sharing. In a partial equilibrium with exogenous outside options, increased bargaining power of banks has adverse employment effects. In a general equilibrium with endogenous outside options, this relationship is frequently reversed; reduced credit market imperfections increase equilibrium unemployment if the labour market imperfections—measured by the bargaining power of trade unions—are sufficiently strong and the benefit–replacement ratio is sufficiently high. Finally, we show that higher bankruptcy risks increase equilibrium unemployment under similar conditions.
Does the Gap in Family‐friendly Policies Drive the Family Gap?*
Authors: Nielsen Helena Skyt , Simonsen Marianne , Verner Mette
Published: December 2004

Segregation of the labour market into a family‐friendly and a non‐family‐friendly sector implies that women self‐select into sectors depending on institutional constraints, preferences for family‐friendly working conditions and expected wage differences. We take this sector dimension into account and find a severe penalty after birth‐related leave in the non‐family‐friendly sector, so that women who would be affected by this penalty self‐select into the family‐friendly sector. The penalty is a combination of a large human‐capital depreciation effect, a child penalty and no recovery.
Female Suicide, Subjectivity and the State in Eighteenth‐Century China
Authors: Theiss Janet
Published: December 2004

This article examines the social and political significance of female suicide in Qing Dynasty China and its implications for women's agency, feminine subjectivity and the state's interpretation of violence. Tracing the development of state and elite interpretations of the propriety of women's suicides, it situates the discourse on female suicide in the context of state efforts to control the definition and enactment of moralised violence and pervasive rhetoric about women's incapacity for moral agency. Demonstrating the problematic ethical and judicial status of suicides committed in the wake of a violation of chastity, in particular, it argues that such suicides represented a distinctively female definition of moral order and the role of violence within it.
Precarious Conditions: A Note on Counter‐Insurgency in Africa after 1945
Authors: White Luise
Published: December 2004

This paper looks at the politics of surfaces, and the practices of veiling (and unveiling) and of white men wearing blackface in counter‐insurgency efforts in post‐war Africa. The sten gun beneath the veil, the unveiled woman with a bomb in her handbag and the counter‐gangs masquerading as African guerillas all embody specific kinds of violence; they also embody a political imaginary in which racial and cultural lines are more fluid than previous studies of these periods suggest; indeed, they raise questions about what makes a race, a gender or a regiment: are racial and national categories learned, mimicked, or are they literally skin deep? My question, however, is not why do people dress up as guerillas or as Western women to wreak havoc on their enemies, but how historians of post‐war Africa might understand such actions. To this end I want to read accounts of counter‐insurgency, Fanon's famous essay, the memoirs of British soldiers in Kenya and Rhodesian soldiers in Rhodesia and some of the volumes of Rhodesian wartime fiction through the lens of transgender literature, looking at how various crossings, and the multiple markers thereof, shed light on broader issues of hierarchy, race and gender at the time of decolonisation.
Un/safe/ly at Home: Narratives of Sexual Coercion in 1920s Egypt
Authors: Booth Marilyn
Published: December 2004

This paper takes up an Arabic narrative genre that appeared in the 1920s. Its distinctive narrative properties included adoption of a first‐person female experiental voice and a focus on `impolite' social realms. Combining confessional exposé and social polemic in what I am calling `simulated memoirs', these narrating voices offered readers the narrative authority of first‐hand experience in Cairo's underworld and critique of elite politics and spaces of behaviour from the constructed perspective of subaltern social figures. I argue that these text's inscriptions of bodily coercion trace an anxiety about growing female visibility throughout urban space. Construction of feminine narrative voices apparently wrests authority to speak about gendered bodily violence away from elite, mostly male commentators and representatives of the state, transferring that authority to the figure of the `fallen' female who `speaks'. But this is an act of ventriloquism: complex layerings of authorial and narrative attribution recoup that authority, reasserting the disciplinary power of the patriarchal father over the lives and vulnerabilities of the young.
NEPAD: The Need and Obstacles
Authors: Ilorah Richard
Published: December 2004

Abstract:  Africa performs poorly in the global economy. The continent lacks investments, jobs, real output, and basic social services. Aggravating the poor performance is poor management. This paper argues that the establishment of the New Partnership for Africa's Development (NEPAD) to grapple with Africa's economic problems makes sense but only if necessary policies are properly implemented. It argues that Africa should pursue interest politics through NEPAD as an economic integration. On the issue of financing the budget, which has in the past been a major constraint to OAU‐initiated projects, this paper strongly recommends that it should be made mandatory that all multinational companies operating in all NEPAD member countries pay a certain percentage of their earnings into the NEPAD budget.
Sovereign Credit Ratings and Private Capital Flows to Low‐income Countries
Authors: Lehmann Alexander
Published: December 2004

Abstract:  As low‐income countries obtain sovereign credit ratings in increasing numbers, this paper examines the potential effects on the composition and volume of private capital flows. Sovereign credit ratings are unlikely to overcome the informational asymmetries that impede private capital flows, and due to new international capital adequacy rules may actually raise the costs of capital for private borrowers. Nevertheless, they could help develop local and regional securities markets and assist mature private borrowers in hitherto unrated countries. Also, there may be beneficial disciplining effects on policy makers, and a growing differentiation between countries subject to an Africa‐wide risk premium.
Does Schooling Promote Economic Growth?
Authors: Gutema Paulos , Bekele Mekonnen
Published: December 2004

Abstract:  This paper revisits the debate on schooling and economic growth with particular reference to the case of sub‐Saharan Africa. Following the endogenous growth model developed by Lucas (1988) that considers human capital as one factor of production and schooling as a means of human capital accumulation, two results of schooling are explicitly stated: accumulation of privately owned and publicly owned human capital. By developing a growth estimating equation containing these two types of schooling results from the model and confronting it with empirical data, the hypothesis that schooling has got growth effect is tested. The analytic result suggests that in the indicated economies, for the period covered by the study (1966–2000), schooling that leads to accumulation of publicly owned human capital is associated with per capita income growth. Likewise, the analysis provides supporting evidence for the argument that primary schooling level is more associated with growth than other levels of schooling.
B‐Type natriuretic peptide and the prediction of outcome in patients admitted to intensive care
Authors: Cuthbertson B. H. , Patel R. R. , Croal B. L. , Barclay J. , Hillis G. S.
Published: December 2004

B‐type natriuretic peptide is known to predict outcome in congestive cardiac failure and myocardial infarction. We aimed to determine whether measurement of B‐type natriuretic peptide would predict hospital mortality in patients admitted to an intensive care unit. We conducted a prospective observational cohort study in 78 consecutive patients. Demographics, clinical details and clinical outcomes were recorded. Admission and 24 h B‐type natriuretic peptide and cardiac troponin I levels were measured. B‐type natriuretic peptide and cardiac troponin I levels taken on intensive care admission and 24 h after admission did not accurately predict hospital mortality for all patients, including patients with severe sepsis or septic shock (all p > 0.05). B‐type natriuretic peptide levels were higher in patients with severe sepsis and septic shock (p = 0.02), in patients ≥ 65 years (p = 0.04) and in patients with raised creatinine ≥ 110 μmol.l−1 (p = 0.02). We concluded that B‐type natriuretic peptide, measured soon after admission to intensive care, does not usefully predict outcome after intensive care.
A comparative study of preload‐adjusted maximal and peak power: assessment of ventricular performance in clinical practice
Authors: Amà R. , Claessens T. , Roosens C. , Segers P. , Verdonck P. , Poelaert J.
Published: December 2004

This study was performed to determine whether preload‐adjusted peak power can act as a surrogate for preload‐adjusted maximal power in the assessment of left ventricular performance in the clinical setting. Ninety‐nine consecutive patients who had undergone elective coronary artery bypass grafting were studied. Fifty‐five of these patients were divided into four study groups. Afterload was changed with phenylephrine (n = 12) or glyceryl trinitrate (n = 13), preload was increased with intravenous colloid (n = 18), and contractility was increased with dobutamine (n = 12). There was excellent correlation between the two indices (r = 0.99, y = 1.0168x + 0.0769; p < 0.0001). Manipulation of neither preload nor afterload affected the indices. Both indices increased significantly during dobutamine infusion (p = 0.002). In conclusion, preload‐adjusted peak power can be used as a substitute for preload‐adjusted maximal power in the determination of ventricular performance in clinical practice.
Patient controlled analgesia for labour: a comparison of remifentanil with pethidine*
Authors: Blair J. M. , Dobson G. T. , Hill D. A. , McCracken G. R. , Fee J. P. H.
Published: December 2004

We compared the analgesic efficacy and safety of remifentanil and pethidine via patient controlled analgesia for women in established uncomplicated labour. Women received either remifentanil 40 μg with a 2‐min lockout (n = 20) or pethidine 15 mg with a 10‐min lockout (n = 19). Visual analogue scores for pain during the study and for overall pain were similar for both groups (mean (SD) 6.4 (1.5) cm for remifentanil and 6.9 (1.7) cm for pethidine). The area under the curve for visual analogue scores of satisfaction with analgesia was higher for remifentanil than for pethidine (p = 0.001). Maternal arterial oxygen saturation was similar in both groups. Neurologic and Adaptive Capacity Scores at 30 min were higher for remifentanil than for pethidine (median (interquartile range [range]) 36 (34.5–37 [32–39]) vs 34 (33–35 [30–35]), respectively; p = 0.003).
A quantitative analysis of anaesthetist–patient communication during the pre‐operative visit
Authors: Kindler C. H. , Szirt L. , Sommer D. , Häusler R. , Langewitz W.
Published: December 2004

Previous communication research in general medical practice has shown that effective communication enhances patient compliance, satisfaction and medical outcome. It is expected that communication is equally important in anaesthesia, since patients often suffer from anxiety and lack of knowledge about anaesthetic procedures. However, little is known about the nature of communication during routine anaesthetic visits. The present study of 57 authentic anaesthetic visits provides the first results on the structure and content of communication in the pre‐operative setting using the Roter Interaction Analysis System (RIAS). Patient‐centred communication behaviours of anaesthetists and the extent of patient involvement were particularly investigated. From the 57 pre‐operative visits, 18 267 utterances were coded. The mean (SD) [range] duration of the visit was 16.1 (7.8) [3.7–42.7] min. Anaesthetists provided 169 (68) and patients 153 (82) utterances per visit (53.5% vs. 46.5%). Physician and patient gender had no impact on the distribution of utterances and the duration of the visit. Conversation mainly focussed on biomedical issues with little psychosocial discussion (< 0.1% of all anaesthetist utterances). However, anaesthetists quite frequently used emotional comments toward patients (7%) and involved them in the conversation. The use of facilitators, open questions and emotional statements by the anaesthetist correlated with high patient involvement. The amount of patient participation in anaesthetic decisions was assessed with the Observing Patient Involvement Scale (OPTION). Compared with general practitioners, anaesthetists offered more opportunities to discuss treatment options (mean (SD) OPTION score 26.8 (16.8) vs. 16.8 (7.7)).
Postoperative course and anabolic‐androgenic steroid abuse – a case report
Authors: Medras M. , Tworowska U. , Jozkow P. , Dumanski A. , Dubinski A.
Published: December 2004

It is estimated that 80% of weight lifters and body‐builders take anabolic‐androgenic steroids. Their long‐term use is associated with a variety of pathological conditions and premature death. Anabolic‐androgenic steroid abuse may lead to changes in the presentation and progression of some conditions. It remains unclear whether anabolic steroids should be given to patients with a history of abuse of these drugs who are to undergo surgery. We report on a fatal outcome following surgery in a 48‐year‐old weight lifter.
Interaction between infusion equipment resulting in drug overdose in a critically ill patient
Authors: Sundaram R. , Dell A. E.
Published: December 2004

A critically ill septic patient on haemofiltration for acute renal failure suffered sudden circulatory and respiratory collapse. The cause of the collapse was traced to an interaction between mechanical devices (syringe driver infusion pumps and haemofiltration equipment) connected to two central venous catheters.
Drug related critical incidents
Authors: Khan F. A. , Hoda M. Q.
Published: December 2004

Drug related incidents are a common form of reported medical errors. This paper reviews the critical incidents related to drug errors reported from the main operating theatre suite in a teaching hospital in a developing country from January 1997 to December 2002. Each report was evaluated individually by two reviewers using a structured process. During this period, 44 874 anaesthetics were administered; 768 critical incidents were reported, 165 (21%) of which were related to drug errors. Underdosage, side‐effect/drug reaction and syringe swap were the most common. A total of 76% were classified as preventable; 56% due to human error and 19% due to system error. High risk incidents accounted for 10% of all drug errors and most of these were related to the use of neuromuscular blocking drugs. This analysis has been found useful in addressing some issues about priorities.
Spinal anaesthesia despite combined clopidogrel and aspirin therapy in a patient awaiting lung transplantation: effects of platelet transfusion on clotting tests
Authors: Herbstreit F. , Peters J.
Published: December 2004

The risk of central neuraxial blockade in patients treated with newer antiplatelet drugs is unclear. We report the case of a woman awaiting lung transplantation who presented for emergency groin surgery. She had recently undergone a coronary artery stent implantation and was treated with both clopidogrel and aspirin. Despite this dual antiplatelet therapy, uneventful spinal anaesthesia was administered following platelet transfusion. While thromboelastography was of no help in assessing the degree of anticoagulation, the effects of platelet transfusion were reflected by adenosine diphosphate and epinephrine aggregometry. Thus, in selected patients, platelet transfusion may be appropriate to enable central neuraxial blockade when deemed necessary.
Interpretation of fine needle aspiration cytology of the breast: a comparison of cytological, frozen section, and final histological diagnoses
Authors: Bofin A. M. , Lydersen S. , Isaksen C. , Hagmar B. M.
Published: December 2004

This study examines the performance of the preliminary, on‐site interpretation by the pathologist of fine needle aspiration (FNA) cytology smears compared to the final cytology report, the frozen section diagnosis and the final histopathological report. We found that both the preliminary and the final cytology reports gave satisfactory results over the minimum standards for quality assurance required by both the Norwegian breast screening programme and the NHS BSP in the UK with the exception of the ‘suspicious’ rate. We noted that the preliminary report had fewer false negatives (2.1%) than the final report (4.3%). We show that an unequivocal cytological diagnosis of malignancy is a reliable diagnosis, and in cases where mammography/ultrasonography and clinical examination are in agreement with FNA, frozen section examination is unnecessary. However, cases with a suspicious or equivocal FNA should be considered for frozen section analysis.
Fine needle aspiration cytology of mammary carcinoma with osteoclast‐like giant cells
Authors: Vicandi B. , Jiménez‐Heffernan J. A. , López‐Ferrer P. , Hardisson D. , Pérez‐Campos A. , González‐Peramato P. , Viguer J. M.
Published: December 2004

Carcinoma with osteoclast‐like giant cells (OCGC) is an uncommon neoplasm characterized by giant cells, prominent vascularization, haemorrhage and areas of cribriform epithelial growth with moderate atypia. Multinucleated giant cells (MGC) have been described in several other breast lesions raising an interesting differential diagnosis, mainly with benign disorders. Due to its rarity few cases have been described cytologically. We retrospectively reviewed 13 fine needle aspiration samples from nine patients with this variant of carcinoma. Nine corresponded to breast tumours and four to axillary, liver, subcutaneous and mediastinal metastatic lesions. The expression of CD68 by giant cells was evaluated immunocytochemically in six cases. All patients had a complete pathological study of the breast neoplasm. Smears showed a double component of epithelial and giant cells. Epithelial clusters were predominantly of intermediate size with irregular contours. Most were cohesive but others showed cellular dissociation with scarce to moderate cellular pleomorphism. Giant cells had well defined, deeply stained cytoplasm and round to elongated morphology. Two metastatic cases were devoid of them. Haemosiderin‐laden macrophages were common in smears from breast tumours. In the six cases tested CD68 was expressed in MGC. Cytological features of mammary carcinoma with OCGC correlate closely with the histological ones. Most cases are clearly recognizable as malignant but in others cytological atypia may be minimal, mimicking a benign lesion. In difficult cases the presence of haemosiderin‐laden macrophages and the histiocytic nature of the MGC are helpful diagnostic features.
Assessing HER‐2 status in fresh frozen and archival cytological samples obtained by fine needle aspiration cytology
Authors: Tomás A. R. , Praça M. J. , Fonseca R. , André S. , Mendonça E.
Published: December 2004

Determination of HER‐2 status is an essential prerequisite in considering a patient's eligibility for anti‐HER‐2 therapy; few studies have focused on its evaluation on cytological material. We present a new method of assessing HER‐2 status on cytological samples, by fluorescence in situ hybridization (FISH) with an automated detection system, using fresh frozen (FF) and May–Grünwald–Giemsa (MGG) stained smears, and we evaluate the reliability of HER‐2 determination on fine needle aspiration cytology (FNAC). The pre‐treatment protocol for FF smears is easier and faster than for MGG stained slides. However, with the described procedure, FISH is also feasible on archival MGG stained slides. We conclude that with this method, cytological samples obtained by FNAC, either FF or MGG, are a reliable option for assessing HER‐2 status.
Chromogenic in situ hybridization analysis of HER‐2/neu status in cytological samples of breast carcinoma
Authors: Kim G. Y. , Oh Y. L.
Published: December 2004

The current use of humanized monoclonal antibody trastuzumab for the treatment of patients with metastatic breast cancer has made evaluation of HER‐2/neu status an important clinical issue. Chromogenic in situ hybridization (CISH), in which the DNA probe is detected with an immunohistochemistry (IHC)‐like peroxidase reaction, has been recently developed for the assessment of HER‐2/neu status in formalin‐fixed breast cancer specimens. We have applied the technique of dual‐colour CISH using HER‐2/neu and chromosome 17 centromere probes in 27 cytological smears, and these cytological samples were obtained from scrapings of fresh breast tumours. We also investigated HER‐2/neu amplification and protein overexpression in the corresponding surgical tissues by CISH and IHC using the monoclonal antibody CB11. Of the 27 cytological cases, HER‐2/neu gene amplification was observed in nine cases that were positive cases (2+ and 3+) for IHC. Among the 13 IHC positive cases (2+ and 3+), four of them showed no gene amplification. Identical results for the CISH technique were obtained in the matched surgical samples. The scrape samples from fresh breast tumour offer a monolayer cell population that is especially suitable for CISH. This study has shown that the cytological smear might be a good alternative for the CISH test.
Comparison of root canal preparation using RaCe and ProTaper rotary Ni‐Ti instruments
Authors: Paqué F. , Musch U. , Hülsmann M.
Published: December 2004

Aim  To compare various parameters of root canal preparation using RaCe (FKG Dentaire, La‐Chaux‐de‐Fonds, Switzerland) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) nickel‐titanium (Ni‐Ti) instruments.

Methodology  Fifty extracted mandibular molars with mesial root canal curvatures between 20° and 40° were embedded in a muffle system. All root canals were prepared to size 30 using RaCe or ProTaper rotary instruments in low‐torque motors with torque control and constant speed of 300 r.p.m. (ProTaper with ATR Tecnika, Advanced Technology Research, Pistoia, Italy; RaCe with EndoStepper, S.E.T., Olching, Germany). In both groups irrigation was performed with 2 mL NaOCl (3%) after each instrument size. Calcinase‐Slide (lege artis, Dettenhausen, Germany) was used as a chelating agent with each instrument. The following parameters were evaluated: straightening of curved root canals, postoperative root canal cross‐sections, safety issues and working time. Cleanliness of the root canal walls was investigated under the SEM using 5‐score indices for debris and smear layer. Statistical analysis was performed using the following tests: Wilcoxon's test for straightening and working time was used (P < 0.05); Fisher's exact test for comparison of cross‐sections and root canal cleanliness (P < 0.05).

Results  Both Ni‐Ti systems maintained curvature well; the mean degree of straightening was less than 1° for both systems. Following preparation with RaCe, 49% of the root canals had a round or oval diameter and 50% an irregular diameter, ProTaper preparations resulted in a round or oval diameter in 50% of the cases. For debris, RaCe and ProTaper achieved 47 and 49% scores of 1 and 2, respectively; there was no significant difference. For smear layer, RaCe and ProTaper achieved 51 and 33% scores 1 and 2, respectively; no statistically significant differences were apparent for the coronal and middle sections of the root canals, but RaCe performed significantly better in the apical region (Fisher's exact test, P = 0.0392). Two roots lost working length with RaCe instruments, whilst ProTaper preparation resulted in two roots loosing working length and one fractured instrument. Mean working time was shorter for ProTaper (90.9 s) than for RaCe (137.6 s); the difference was significant (Wilcoxon's test, P = 0.011).

Conclusions  Both systems respected original root canal curvature well and were safe to use. Cleanliness was not satisfactory for both systems.