bluuebunny/crossref_metadata_2025 huggingface dataset:
Frontal-subcortical circuits: the anatomic basis of executive, social and motivated behaviors
Authors: Masterman Donna L. , Cummings Jeffrey L.
Published: March 2007

A series of discrete, parallel frontal-subcortical circuits have been demonstrated to link specific areas of the frontal lobe to areas within the basal ganglia and thalamus. A variety of circuit-specific behaviors can be described involving the dorsolateral prefrontal, orbitofrontal and anterior cingulate circuits. Interruptions or imbalance occurring at various levels within these closed looped circuits is felt to underlie the characteristic behavioral patterns seen. The intricate neurochemical arrangement of the striatum and the complex neurotransmitter interactions that occur within these key subcortical structures form the basis for modulatory influences that can affect these circuits.
The frontal lobes and neurosurgery for psychiatric disorders
Authors: Malizia Andrea L.
Published: March 2007

The frontal lobe has been the main target for surgical treatment of mental illness over the last 60 years. Initially the surgery was crude and performed on patients with many different psychiatric disorders. Contemporary surgery utilizes stereotactic lesions which interrupt fronto-thalamic and/or fronto-cingulate fibres. The findings of clinical, neurochemical, neuroimaging, neuropsychological and physiological research in this area are summarized. Current advances in clinical neuroscience methods should be used in patients with these lesions to elucidate the neural substrate of post-operative changes and optimize clinical practice.
Anxiogenic action of caffeine: an experimental study in rats
Authors: Bhattacharya Salil K. , Satyan Kalkunte S. , Chakrabarti Amit
Published: March 2007

The anxiogenic action of caffeine (10, 25 and 50 mg/kg, i.p.) was investigated in rats and compared with that of yohimbine (2 mg/kg, i.p.). The experimental methods used were the open-field, elevated plus-maze, social interaction and novelty-suppressed feeding latency tests. Caffeine produced a dose-related profile of behavioural changes, which were qualitatively similar to those induced by yohimbine and which indicate an anxiogenic activity in rodents. Thus, both the drugs reduced ambulation and rears, and increased immobility and defaecation in the open-field test. They decreased the number of entries and time spent on the open arms of the elevated-plus maze, reduced social interaction in paired rats and increased the feeding latency in an unfamiliar environment in 48-h food-deprived rats. Lorazepam, a well known benzodiazepine anxiolytic agent, attenuated the anxiogenic effects of caffeine and yohimbine. Subchronic administration of caffeine (50 mg/kg, i.p.) for 21 days, in different groups of animals, induced a significant degree of tolerance in the elevated plus-maze test, which was statistically significant after 14 and 21 days' treatment. Yohimbine, however, did not induce similar tolerance. When caffeine (50 mg/kg, i.p.) was withdrawn after 21 days' administration, to a separate group of rats, significant withdrawal anxiety was observed 48 h later as noted in the elevated plus-maze test. The investigations support clinical evidence of caffeine-induced anxiety, tolerance to anxiety on continued use, and withdrawal anxiety in chronic caffeine-containing beverage users.
Intravenous administration of haloperidol to healthy volunteers: lack of subjective effects but clear objective effects
Authors: Williams J.H. , Wellman N.A. , Geaney D.P. , Rawlins J.N.P. , Feldon J. , Cowen P.J.
Published: March 2007

Healthy volunteers who received i.v. injections of either saline or haloperidol (0.5 or 1.0 mg) made visual analogue scale ratings of subjective mood, tension, shakiness and the global feeling of having received an active drug. The subjective ratings of volunteers who received haloperidol did not differ, overall, from those who received saline. In contrast, the drug caused clear objective changes in several psychological tests. I.v. administration of low doses of haloperidol may permit double-blind testing of the psychological actions of haloperidol in healthy volunteers.
A conceptual framework for explaining drug addiction
Authors: Heather Nick
Published: March 2007

The aim of this paper is to describe a conceptual framework of questions which an adequate theory of drug addiction must attempt to answer. First, a satisfactory definition of addiction is sought and it is concluded that it is best defined by repeated failures to refrain from drug use despite prior resolutions to do so. This definition is consistent with views of addiction that see decision-making, ambivalence and conflict as central features of the addict's behaviour and experience. On this basis, a three-level framework of required explanation is set out, consisting of (1) the level of neuroadaptation, (2) the level of desire for drugs and (3) the level of 'akrasia'or failures of resolve. The crucial argument is made that explanatory concepts used at the 'lower' levels in this framework can never be held to be sufficient as explanations at higher levels, i.e. the postulation of additional determinants is always required at Levels 2 and 3. In particular, it is a failure to address problems at the highest level in the framework that marks the inadequacy of most existing theories of addiction. The paper concludes by considering the relevance of the ideas presented to the concept of 'compulsive drug use' and concludes that this concept is no longer useful in the explanation of addiction.
Integrating the cognitive and physiological aspects of craving
Authors: Weinstein Aviv , Feldtkeller Barbara , Malizia Andrea , Wilson Sue , Bailey Jayne , Nutt David J.
Published: March 2007

'Craving is generally considered a significant factor in opiate addiction that is associated with drug-dependence and in relapse to drug use after treatment'—ARC expert consensus (Pickens and Johanson, Drug and Alcohol Dependence 30: 127-131). There are however difficulties in defining craving and urges to use drugs and in associating craving with drug use and relapse. Tiffany [Psychological Review 97(2): 147-168] has reviewed a considerable number of studies that associated reports of craving with consumption measures of drugs and revealed only an overall modest correlation of 0.4. These findings call into question the general assumption that subjective cravings are invariably associated with drug use. Furthermore, it led to Tiffany's provocative argument that cravings are not necessary for drug use. We have addressed these issues by using a range of complementary techniques derived from research in related fields such as the cognitive psychology of anxiety and depression, physiological response measurements and positron emission tomography (PET) neuro-imaging. Initially we developed computerized assessments to probe cognitive dysfunction in addiction that related to biased processing of automatic thoughts and beliefs about craving and drug use in opiate-dependent subjects and alcoholics. Subsequently in an attempt to develop a reliable method of inducing craving we explored an imagery-based technique that relied on the memory of craving experiences. These experiments were conducted both in opiate addicts who had achieved abstinence and in those undergoing detoxification. Finally, we have begun a study to understand the neural mechanisms of craving using imagery-based procedures at the same time as performing PET studies of regional blood flow using the O15 -labelled water technique.
Cognitive performance in recreational users of MDMA or 'ecstasy': evidence for memory deficits
Authors: Parrott A.C. , Lees A. , Garnham N.J. , Jones M. , Wesnes K.
Published: March 2007

Cognitive task performance was assessed in three groups of young people: 10 regular users of 3,4- methylenedioxymethamphetamine (MDMA) who had taken 'ecstasy' 10 times or more; 10 novice MDMA users who had taken 'ecstasy' one to nine times; and 10 control subjects who had never taken MDMA. A computerized battery of cognitive tasks (Cognitive Drug Research system) was undertaken on a day when subjects were drug free. Performance on the response speed and vigilance measures (simple reaction time, choice reaction time, number vigilance), was similar across the three subgroups. However on immediate word recall and delayed word recall, both groups of MDMA users recalled significantly less words than controls. Animal research has shown that MDMA can lead to serotonergic neurodegeneration, particularly in the hippocampus and frontal cortex. Although the design of this study was far from ideal, these data are consistent with other findings of memory decrements in recreational MDMA users, possibly caused by serotonergic neurotoxicity.
5 -HT1A Receptor agonist (8-OH-DPAT) and 5-HT2 receptor agonist (DOI) disrupt the non-cognitive performance of rats in a working memory task
Authors: Ruotsalainen Sirja , MacDonald Ewen , Koivisto Esa , Stefanski Roman , Haapalinna Antti , Riekkinen Paavo , Sirviö Jouni
Published: March 2007

The present study investigated the role of 5-HT1A and 5-HT2 receptors in the execution of a working memory task (delayed non-matching to position, DNMTP) by assessing the influence of 8-OH-DPAT (5-HT1A receptor agonist) and DOI (5-HT 2 receptor agonist) on the performance of rats lesioned with 5,7-dihydroxytryptamine (5,7-DHT) and their controls. Post-mortem neurochemical analysis revealed that serotonin and 5-hydroxyindoleacetic acid levels were reduced in examined brain areas (especially in the hippocampus where there was a 90 percent reduction). Noradrenaline concentrations were also decreased (mostly on the same side of the injection) by about 20 percent. 5,7-DHT lesioned rats did not significantly differ from their controls in performance in the DNMTP task. At the 30 μg/kg dose, 8-OH-DPAT did not affect the DNMTP-performance of rats, but at the higher dose (100 μg/kg) it reduced the probability of responding to the sample lever. DOI (100 and 300 μg/kg) also interfered with the non-cognitive performance of rats. Since neither of these agonists affected significantly the choice accuracy, they do not appear to influence the working memory per se. The 5,7-DHT lesioned rats did not differ from their controls in response to these agonists.

These results suggest that the combination of 5-HT1A receptor stimulation by 8-OH-DPAT and 5-HT2 receptor stimulation by DOI can interfere with the non-cognitive performance of rats in the DNMTP task. The results further indicate that the effect of 8-OH-DPAT may be mediated through post-synaptic rather than pre-synaptic 5-HT1A receptors.
Enhancement of latent inhibition in the rat at a high dose of clozapine
Authors: Trimble Karen M. , Bell Robert , King David J.
Published: March 2007

The present experiments investigated clozapine (2.5, 5 and 10 mg/kg) and haloperidol (0.1 mg/kg) administration on latent inhibition (LI) in rats. Clozapine's ability to antagonize amphetamine-induced disruption of LI was also assessed. A conditioned emotional response procedure was employed. In the pre-exposure stage, 'pre- exposed' rats received 10 (Experiment 1) or 40 (Experiment 2) presentations of a flashing light stimulus without reinforcement. During the conditioning phase, the light stimulus was paired with a footshock. At test, LI was expressed by the extent of suppression of water licking during flashing light presentation. Both clozapine (10 mg/kg) and haloperidol (0.1 mg/kg) significantly facilitated LI. In addition, clozapine significantly reversed the disruption of LI induced by amphetamine (1.0 mg/kg). These results with clozapine illustrate that LI is sensitive to antipsychotics which differ in their mode of action and furthermore emphasize the value of LI as a test model for detecting the antipsychotic potential of novel drugs.
Evidence that NMDA-dependent limbic neural plasticity in the right hemisphere mediates pharmacological stressor (FG-7142)-induced lasting increases in anxiety-like behavior
Authors: Adamec Robert E.
Published: March 2007

The findings of this study support the hypothesis that N-methyl-D-aspartate (NMDA) receptors mediate the initiation of long-term potentiation (LTP) and behavioral changes induced by the anxiogenic β-carboline, FG- 7142. Unlike previous work, this study examined the effects of FG-7142 on LTP of amygdala efferents in both hemispheres. 7-amino-phosphono-heptanoic acid (AP7), a competitive NMDA receptor blocker, given prior to administration of FG-7142, prevented LTP in amygdala efferent transmission to the medial hypothalamus and periacqueductal gray (PAG). When given FG-7142 alone, cats showed lasting behavioral changes accompanied by LTP in all pathways studied. Duration of LTP, and its relationship to behavioral change, depended on the pathway and the hemisphere of the pathway Correlation and covariance analyses indicate that LTP in the left amygdalo-ventromedial hypothalamic pathway mediates initiation, but not maintenance, of increased defensiveness. This finding replicates previous work. A new finding is that increased local excitability in the right basal amygdala (reduced threshold for evoked response), and LTP in the right amygdalo-PAG pathway, may be important for maintenance of increases in defensive behavior. Furthermore, the effects of flumazenil, a benzodiazepine receptor antagonist, on behavior and physiology single out the importance of right amygdalo- PAG LTP as a critical mediator of increased defensiveness. Flumazenil reversed the increase in defensiveness produced by FG-7142 in a drug-dependent manner as described in Adamec (1998a). Moreover, flumazenil reversed LTP only in the right amygdalo-PAG pathway. The findings of the present study suggest that response to FG-7142 may be a useful model of the effects of traumatic stressors on limbic system function in anxiety, especially in view of the recent data in humans implicating right hemispheric function in persisting negative affective states.
A randomized, double-blind, parallel-group comparison of venlafaxine and clomipramine in outpatients with major depression
Authors: Samuelian J.C. , Hackett David
Published: March 2007

A multicentre, randomized, double-blind study was conducted to compare the safety and antidepressant efficacy of venlafaxine and clomipramine in 102 outpatients with major depression. The patients received either venlafaxine or clomipramine at a dose titrated from 50 mg to a maximum of 150 mg/day during the first 2 weeks of treatment. Treatment was continued for up to 43 days. Montgomery Asberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HAM-D) scores decreased significantly (p≤ 0.05) from baseline in each treatment group but were not significantly different between groups. Response rates on the MADRS and HAM-D were 62% and 59%, respectively, with venlafaxine and 54% and 43%, respectively, with clomipramine. Treatment-emergent study events were the primary reason for withdrawal in only 13% of venlafaxine-treated patients and 20% of clomipramine-treated patients. On questionnaires, the incidence of anticholinergic-type events was 60% with venlafaxine and 68% with clomipramine. However, significantly (p=0.043) more patients in the clomipramine group reported multiple anticholinergic events than in the venlafaxine group. In the clomipramine group, mean ventricular heart rate increased significantly (p=0.003) and mean systolic blood pressure decreased significantly (p=0.028) from baseline, but no clinically significant electrocardiographic changes were observed. These results confirm the efficacy and safety of venlafaxine in the treatment of outpatients suffering from major depression.
The analgesic effects of selective serotonin reuptake inhibitors
Authors: Smith Andrew J.
Published: March 2007

This paper endeavours to provide a critical clinical review of the use of selective serotonin reuptake inhibitors (SSRIs) in the management of pain. Case reports, placebo-controlled trials and trials comparing SSRIs with tricyclic antidepressants (TCAs) are considered. The analgesic effects of TCAs are well known and this review suggests that there is little evidence for their replacement by SSRIs in pain management. There are, at present, too few comparative drug trials to make a definitive statement, although the trend is clearly against SSRIs.
Children and Families in the "High Tech" Era: Problems and Prospects
Authors: Crouter Ann C. , MacDermid Shelley
Published: March 2007

This essay explores some of the implications of microchip technology for children's development. It examines the relevant research literature from an "ecological perspective," meaning that attention is paid to the consequences of microchip technology for the settings in which children develop, for the interconnections between these settings, and for the role of parents, teachers, and other socializing agents as "translators" of the rapidly changing environment to the developing child.
Prediction of Individual Patient Prognosis
Authors: De Dombal F.T. , Clamp Susan E. , Softley Angela , Unwin Biba J. , Staniland John R.
Published: March 2007

Physicians take both diagnosis and prognosis into account when allocating treatment. How ever, by "prognosis" physicians usually imply a somewhat vague impression concerning large groups of patients. One possible task for decision support studies is to design and construct systems that accurately predict individual patient prognoses. The authors con structed and tested such systems in three areas of medicine (inflammatory bowel disease, upper gastrointestinal tract hemorrhage, and acute chest pain). In each area, the individual patient's symptoms were compared with a computer-held database of information via a Bayesian analysis, prior and conditional probabilities being derived from large-scale real-life surveys. Prospective trials designed to test these predictive systems by reference to test series comprising over 4,000 patients indicate that a firm prognostic prediction can generally be made; where made, the accuracy of prediction is over 90%. Ways in which this type of prediction may be of clinical value are discussed. Key words: chest pain; computers; en doscopy ; hematemesis; inflammatory bowel disease; prognosis. (Med Decis Making 6:18- 22, 1986)
Comparing the Areas under More Than Two Independent ROC Curves
Authors: McClish Donna Katzman
Published: March 2007

For a diagnostic test, the area under the associated receiver operating characteristic (ROC) curve is considered a measure of the efficacy of the test. Statistical methodology for the comparison of the areas under more than two independent ROC curves is developed. The jackknife is used to devise an F test using the pseudovalues as data. A Studentized range (SR) test is also considered using the original area estimates. A Monte Carlo study is performed to evaluate the significance level and power of the two test statistics. Both statistics conform well to the 0.10, 0.05, and 0.01 significance levels when the sampling design is balanced between cases with and without the disease. Power is also comparable. For unbalanced designs, the SR test on the original area estimates is very conservative while the F test on pseudovalues performs well. The F test is recommended as the method of choice for comparing the areas, although for balanced designs the SR test, with its com putational simplicity, may be preferred.
ROC Steady
Authors: Diamond George A.
Published: March 2007

This paper describes a simple method for constructing receiver operating characteristic (ROC) curves based on boundary conditions that restrict its theoretical shape. The resultant curve is identical to that for logistic distributions with equal variance. Although the underlying assumptions are highly restrictive, this method nevertheless possesses several attractive properties which are illustrated by its application to 2,567 patients undergoing a variety of noninvasive diagnostic tests for coronary artery disease: 1) the area under the curve is defined by a single parameter; 2) the associated standard deviation is analytically defined and readily computed; 3) the curve is completely invariant with respect to selection bias. Key words: coronary artery disease; diagnostic tests; ROC analysis; ROC curves; selection bias. (Med Decis Making 7:238-243, 1987)
The Women's Health Trial as an Investment
Authors: Urban Nicole , Baker Mary
Published: March 2007

The Women's Health Trial (WHT), a large, multi-unit randomized controlled trial, would have cost a total of $130 million to test the hypothesis that a 50% reduction in the percentage of calories from dietary fat would yield a detectable reduction in breast cancer incidence. However, the WHT was discontinued because evidence to support the hypothesized rela tionship between dietary fat and breast cancer was judged insufficient to justify the trial. The analysis presented here was undertaken in order to contribute an economic perspective on this issue. Principles of decision analysis and cost-effectiveness analysis are employed to obtain a preliminary estimate of the expected cost per year of life saved of the WHT, as a function of the prior probability that the hypothesis is true (PRIOR). Under specified base- case assumptions, the estimated expected costs per year of life saved range from $11,900 when PRIOR is assumed to be 0.9 to $25,615 when PRIOR is assumed to be 0.1. Sensitivity analyses suggest that the results are most sensitive to assumptions about the strength of the relationship between dietary fat and breast cancer risk, and that cost-effectiveness is improved when it is assumed that dietary change can be achieved by an inexpensive in tervention. The expected cost-effectiveness of the WHT is well within the range of estimates of cost-effectiveness of other disease prevention interventions.
N-Way Sensitivity Analysis
Authors: Hughes Christopher , Hughes Katharine Kostbade
Published: March 2007

The purpose of this paper is to describe the development of N-way sensitivity analysis, a modified version of traditional sensitivity analysis that was created for the purpose of verifying the stability of decisions made by a completely subjective decision-analytic tree. The tech nique was developed during research that addressed whether nurses make clinical decisions that coincide with those recommended by a decision-analytic model. Since all parameters of the model were derived from subjective assessment, traditional one-way or two-way sensitivity analysis was deemed inappropriate. Consequently, N-way sensitivity analysis was developed and used for the verification of the decision model's results. Key words: sensitivity analysis; stability; decision trees. (Med Decis Making 1990;10:68-74)
Testing for Fetal Pulmonary Maturity
Authors: Hunink Maria G.M. , Richardson Douglas K. , Doubilet Peter M. , Begg Colin B.
Published: March 2007

The lecithin/sphingomyelin ratio (US) and the measured value of saturated phosphatidyl choline (SPC), amniotic fluid determinations obtained to assess fetal pulmonary maturity, were evaluated with receiver operating characteristic (ROC) curve analysis. The effects of covariates on the ROC curves were analyzed with a regression methodology that took into account all the available data when constructing an ROC curve for each subgroup. To correct for verification bias the authors used a logistic regression analysis to model the probability of verification, thereby permitting correction for verification bias of a fully stratified data set in spite of small cell frequencies. They examined combination testing with prediction rules using prospective logistic modeling, including as variables test results and clinical features. The US was found to be significantly better than SPC for assessing fetal pulmonary maturity. For older gestational age the US and SPC performed better than for younger gestational age. Contamination of the specimen degraded the ROC curves. Correcting for verification bias did not influence the ROC curves significantly but changed the cutoff value of the test variable for any particular operating point. Prediction rules to evaluate combination testing showed that obtaining the SPC level in addition to the US ratio added no significant infor mation compared with the US only. Including gestational age in the prediction rule of either test improved the prediction. Key words: receiver operating characteristic curve; fetal pul monary maturity testing; covariates; verification bias; combination testing. (Med Decis Mak ing 1990;10:201-211)
The Efficacy of Diagnostic Imaging
Authors: Fryback Dennis G. , Thornbury John R.
Published: March 2007

The authors discuss the assessment of the contribution of diagnostic imaging to the patient management process. A hierarchical model of efficacy is presented as an organizing structure for appraisal of the literature on efficacy of imaging. Demonstration of efficacy at each lower level in this hierarchy is logically necessary, but not sufficient, to assure efficacy at higher levels. Level 1 concerns technical quality of the images; Level 2 addresses diagnostic ac curacy, sensitivity, and specificity associated with interpretation of the images. Next, Level 3 focuses on whether the information produces change in the referring physician's diagnostic thinking. Such a change is a logical prerequisite for Level 4 efficacy, which concerns effect on the patient management plan. Level 5 efficacy studies measure (or compute) effect of the information on patient outcomes. Finally, at Level 6, analyses examine societal costs and benefits of a diagnostic imaging technology. The pioneering contributions of Dr. Lee B. Lusted in the study of diagnostic imaging efficacy are highlighted.
Bayesian Reasoning in Medicine
Authors: O'Connor Gerald T. , Sox Harold C.
Published: March 2007

The role of Bayesian reasoning in medicine is explored from the perspective of the writings of Dr. Lee B. Lusted. Starting with the influential article by Ledley and Lusted published in Science in 1959, the contributions of Dr. Lusted and his coauthors to medical education and clinical medicine are chronicled. An explication of Bayes' theorem and its reliance on the conditional independence assumption is followed by a summary of some applications to the interpretation of diagnostic tests. Opportunities for and challenges to the widespread appli cation of Bayesian reasoning in daily clinical medicine are described.
The Influence of Positive Affect on Clinical Problem solving
Authors: Isen Alice M. , Rosenzweig Andrew S. , Young Mark J.
Published: March 2007

This study investigated the influence of positive affect, induced by report of success on an anagram task, on medical decision making among third-year medical students. The subjects were asked to decide which one of six hypothetical patients, each of whom had a solitary pulmonary nodule, was most likely to have lung cancer. They were asked to verbalize their clinical reasoning as they solved the problem. The positive-affect and control groups did not differ in the tendency to make a correct choice, but subjects in the positive-affect condition were significantly earlier in identifying their choices. These subjects were also significantly more likely to go beyond the assigned task, expressing interest in the cases of the other patients and trying to think about their diagnoses, even though that task was not assigned. The positive-affect subjects also showed evidence of configural or integrative consideration of the material to a reliably greater extent than did control subjects, and there was significantly less evidence of confusion or disorganization in their protocols than in those of controls. These findings are compatible with earlier work suggesting a different organizational process and greater efficiency in decision making among people in whom positive affect had been induced, and with recent work suggesting that positive affect facilitates flexibility and inte gration in problem solving. They also indicate that these effects may apply to the problem- solving strategies of professionals in clinical probem-solving situations. Key words: positive affect; medical decision making; problem solving; diagnostic reasoning. (Med Decis Making 1991;11:221-227)
Gains in Accuracy from Replicated Readings of Diagnostic Images
Authors: Metz Charles E. , Shen Jong-Her
Published: March 2007

From the perspective of signal detection theory, human variation in image reading degrades diagnostic accuracy by broadening the statistical distributions of perceived evidence upon which decisions were based. A new multivariate "random-effects" model formulates the total variation in a diagnostic decision variable as a sum of three uncorrelated components that represent differences among cases, readers, and repeated readings by a given reader. This model provides a basis for quantitative predictions concerning the amount by which diagnostic accuracy, as specified by ROC analysis, can be enhanced by the replication of image readings. Although these predictions apply exactly only to the hypothetical situation in which normally distributed decision variables from equivalent readers are averaged, computer- simulation studies and an analysis of mammographic image-reading data from five radiol ogists show that similar gains in accuracy can be achieved by averaging discrete confidence ratings. Key words diagnostic accuracy, random-effects model; image interpretation; ROC analysis. (Med Decis Making 1992;12:60-75)
Assessing Physicians Estimates of the Probability of Coronary Artery Disease
Authors: Schulman Kevin A. , Escarce José J. , Eisenberg John M. , Hershey John C. , Young Mark J. , McCarthy David M. , Williams Sankey V.
Published: March 2007

The authors assessed physicians' probability estimates of coronary artery disease (CAD) in 250 patients undergoing a screening exercise stress test. True likelihood of disease (prev alence) was derived from the literature. Discrimination and calibration were assessed by comparing physicians' probability estimates and prevalence using pairwise comparisons, rank correlation, and linear regression. There were differences in the discriminative abilities of the physicians based on patient characteristics For example, the physicians had better discriminative ability for patients with typical cardiac chest pain compared with atypical chest pain. The physicians were able to predict the prevalences of CAD in broad groups of patients. However, they overestimated probabilities for patients with low prevalence of disease and underestimated probabilities for patients with high prevalence of disease The authors con clude that physicians make consistent errors in the use of probability estimates The quality of these estimates depends on patient characteristics such as type of chest pain and true likelihood of disease. Key words: calibration; decision making, probabilistic judgments; heart disease; exercise stress test; women; linear regression; medical judgments; discrimination; models (Med Decis Making 1992; 12:109-114)
Validation of a Model of Breast Cancer Screening
Authors: Shwartz Michael
Published: March 2007

As part of a validation of a mathematical model of breast cancer, the Health Insurance Plan of Greater New York (HIP) randomized controlled trial of breast cancer screening and the uncontrolled Breast Cancer Detection Demonstration Projects (BCDDP) trial were simulated. Model predictions were in accord with the nine-year survival experience of women in the HIP trial, and, with the exception of women 40-44 years old, with HIP data on 18-year survival. Five-year survival rates of screen-detected cases in the BCDDP were very close to the model's predictions. However, the model did not predict the high survival rate of women who had interval cancers in the BCDDP. By the end of the BCDDP, almost 85% of the participants performed breast self-examination (BSE) regularly. Consistent with this obser vation, an appealing hypothesis to explain the high survival rate of women who had interval cancers is that BSE is of value in detecting breast cancers earlier. Consideration of model outliers can be of value in increasing understanding of the phenomena being modeled. Key words: breast self-examinations; breast cancer screening; mathematical models; model val idation. (Med Decis Making 1992;12:222-228)
Data-source Effects on the Sensitivities and Specificities of Clinical Features in the Diagnosis of Rheumatoid Arthritis
Authors: Bernelot Moens Hein J. , Hirshberg Alan J. , Claessens Angela A.M.C.
Published: March 2007

An experimental computer system was developed to support diagnosis of rheumatic disorders by computing diagnostic probabilities using modified likelihood ratios. The authors examined whether the performance of the model was affected by the settings in which the data used to derive the likelihood ratios were collected. The sensitivities and specificities of various clinical features for diagnosing rheumatoid arthritis (RA) were obtained from: 1) a study of 1,570 consecutive outpatients at a rheumatology clinic; 2) a review of the literature; 3) estimates by rheumatologists; and 4) a population study. Considerable variations in sensitivity and specificity but satisfactory agreement in likelihood ratios were found across the four data sets. The likelihood ratios were then used to compute the probabilities of RA in a test series of 570 of the rheumatology clinic outpatients. The model's diagnoses with likelihood ratios from the other sources were adequate. When the likelihood ratios from these sources were combined, discrimination came close to what could be achieved by using the likelihood ratios based on the data from the clinic. The method applied in the study, which makes use of variation of input data instead of variation of test series, and the results are relevant to assessing the external validity and transferability of Bayesian decision-support systems. Key words: rheumatoid arthritis; diagnosis; decision analysis; knowledge acquisition. (Med Decis Making 1992;12:250-258)
A Neural-network Approach to Predicting Admission Decisions in a Psychiatric Emergency Room
Authors: Somoza Eugene , Somoza John R.
Published: March 2007

Clinical decision making is based on recognizing complex patterns of patients' signs and symptoms. Neural networks have been shown to be very effective at this type of pattern recognition, and in this study a neural-network approach was used to predict which patients seen in a psychiatric emergency room required admission and which did not. Data from all walk-in patients ( N = 658) evaluated during normal working hours in a psychiatric emergency room during a one-year period were used either to train a neural network or to test its performance. The network had 53 input nodes, one hidden layer, and an output layer with a single node. The back-propagation method was used to train the network. The neural network's admitting decisions were in substantial agreement with those of the clinicians (kappa coefficient = 0.63). When used as a diagnostic test for admission it had a specificity of 94%, a sensitivity of 70%, and an overall accuracy of 91%. The information gain was 35% of that of a perfect diagnostic test. These results show that a neural network can be trained to make clinical decisions that are in substantial agreement with those of experienced cli nicians. Key words: neural networks; admission decisions; pattern recognition; psychiatric emergency room. (Med Decis Making 1993;13:273-280)
Comparison of the Rating Scale and the Standard Gamble in Measuring Patient Preferences for Outcomes of Gallstone Disease
Authors: Bass Eric B. , Steinberg Earl P. , Pitt Henry A. , Griffiths Robert I. , Lillemoe Keith D. , Saba George P. , Johns Christina
Published: March 2007

To estimate patient preferences for gallstone-related treatments and outcomes, and assess how preferences vary by patient characteristics and scaling technique, the authors randomly assigned 40 patients without gallstones to interviews based on a rating scale (n = 22) and a standard gamble (n = 18). The patients assigned preference values (possible values 0 to 1) to open cholecystectomy (mean 0.45 by rating scale, 0.78 by standard gamble), laparoscopic cholecystectomy (0.71, 0.91), extracorporeal shock-wave lithotripsy (0.77, 0.89), acute cholecystitis (0.36, 0.77), lifetime biliary colic (0.41, 0.71), postcholecystectomy syn drome (0.43, 0.79), asymptomatic stone necessitating treatment with bile acids (0.76, 0.96), and surgical scar (0.79, 0.998). Preferences varied little by age, gender, or race. Standard gamble values were highly correlated with, but significantly greater than, rating scale values. The authors conclude that patients' preferences for gallstone-related conditions generally are significantly less than one, and differ markedly by the scaling technique used to derive them. These results should be considered when patient preferences are incorporated into analyses of gallstone treatments. Key words: patient preference values; rating scale; stan dard gamble; gallstones; cholecystectomy; lithotripsy. (Med Decis Making 1994;14:307- 314)
Mass-Ed (Mastery Aimed Student Self Evaluation and Diagnosis
Authors: Buchanan Richard W.
Published: March 2007

As business school enrollments explode, class sizes are almost bound to increase. Unfortunately, the class sizes making up the most efficient mass sections frequently burn up the instructor's time at an alarming rate. This paper isolates one major time waster associated with large classes and then details the success of a system designed to make it manageable.
A Finite Element Dynamic Analysis of Flexible Manipulators
Authors: Jonker Ben
Published: March 2007

A finite element - based method is presented for analyzing the dynamic behavior of flexible manipulators, including the effects of the manipulator's control system. The method involves a nonlinear finite-element formulation in which both links and joints are considered as specific finite elements. The governing equations of motion are formulated in terms of two sets of coordinates, namely generalized coordinates of the manipulator with rigid links and deformation mode coordinates that characterize deformation of the links. The method also permits generation of locally linearized models about a nominal trajectory.

The numerical performance of the presented finite element method is demonstrated by analyzing the closed-loop behav ior of a flexible three-degree-of-freedom manipulator in which the position of the end effector is to be sensed. On the basis of the linearized system description, controllability is discussed in terms of the modal representations of the system. Uncontrollable manipulator configurations have been indi cated for bending vibrations of the out-of-plane motion of the manipulator. Fast and precise closed-loop tip position control has been obtained for the in-plane motion with a bandwidth that is three times the bandwidth achieved with actuator joint feedback. However, no significant increase in the bandwidth has been obtained for the out-of-plane motion. The improve ment for the latter motion is strongly limited by the nonmini mum phase behavior.
Symmetry From Shape and Shape From Symmetry
Authors: Van Gool L. , Moons T. , Ungureanu D. , Pauwels E.
Published: March 2007

This article discusses the detection and use of symmetry in planar shapes. The methods are especially useful for indus trial workpieces, where symmetry is omnipresent. "Symmetry" is interpreted in a broad sense as repeated, coplanar shape fragments. In particular, fragments that are "similar" in the mathematical sense are considered symmetric. As a general tool for the extraction and analysis of symmetries, "Arc Length Space" is proposed. In this space symmetries take on a very simple form: they correspond to straight-line segments, as suming an appropriate choice is made for the shapes' contour parameterizations. Reasoning about the possible coexistence of symmetries also becomes easier in this space. Only a restricted number of symmetry patterns can be formed. By making ap propriate choices for the contour parameters, the essential properties of Arc Length Space can be inherited for general viewpoints. Invariance to affine transformations is a key is sue. Specific results include the (informal) deduction of the five possible symmetry patterns within single connected con tour segments, the importance of rotational rather than mirror symmetries for deprojection purposes, and relations between simultaneous symmetries and critical contour points.
Understanding Action and Sensing by Designing Action-Based Sensors
Authors: Erdmann Michael
Published: March 2007

This article proposes a method for automatically designing sensors from the specification of a robot's task, its actions, and its uncertainty in control. The sensors provide the information required by the robot to perform its task, despite uncertainty in sensing and control. The key idea is to generate a strategy for a robot task by using a backchaining planner that assumes perfect sensing while taking careful account of control uncer tainty. The resulting plan indirectly specifies a sensor that tells the robot when to execute which action. Although the planner assumes perfect sensing information, the sensor need not ac tually provide perfect information. Instead, the sensor provides only the information required for the plan to function correctly.
From Sisters to Wives and 'Slaves'
Authors: Lovett Margot L.
Published: March 2007

■ This article explores the interconnected historical processes of the redefinition of matriliny and the progressive loss, between 1885 and 1955, of the authority exercised by Lakeside Tonga women. Primarily based in a re-reading of the work of J. van Velsen, it details the adoption by the Tonga of practices such as bridewealth and virilocal residence that are more commonly associated with patrilineal groups, and analyzes their impact on the role of women as sisters and mothers. It contrasts the standing of a sister with that of a wife, and identifies the migrant labor system as the primary reason why Tonga women and their hus bands' kin came to conceive of the position of a wife as roughly analogous to that of a slave. It argues that this designation furnishes evidence for the declining status of women as a whole within Tonga society during this time.
Can NOT-Capitalism Lie at the End of History, or Is Capitalism's History Drawing to an End ?
Authors: Blim Michael
Published: March 2007

■ This article argues that capitalism's victory over 'actually existing social ism' implies no telos or ultimate end in human history. Rather, capitalism is being assimilated, principally in China, in ways which may yet alter or transform its structures and which are inconsistent with Francis Fukuyama's vision. New forms of collective and communal property in industrializing China are discussed and contrasted with privatization schemes in Eastern Europe and the Russian Feder ation.
Islamic Prayer Groups in Indonesia
Authors: Weix G.G.
Published: March 2007

■ Islamic renewal in Southeast Asia has invited scholars to examine forums in which Muslims express devotion, including prayer groups known as pengajian in Indonesia. Because Indonesian women rarely lecture publically and often comprise the audiences of pengajian, it is assumed that these forums serve the state-sponsored project of domestication of married women into housewives. Based on fieldwork in central Java in the 1980s, this essay cites several urban women's reading group practices, especially their vernacular commentary on Qur'anic verse, as examples of 'resistant reading' and an ethnographic critique of these claims.
Report of tne First Open Meeting of the Working Group on Library Service to Ethnic and Linguistic Minorities
Authors: Zielinska Marie
Published: March 2007

The Working Group on Library Services to Ethnic and Linguistic Minorities of the Section of Public Libraries, established in April, 1980, held an open meeting on 19 August, during the annual IFLA Council and General Conference in Leipzig. The meeting was chaired by Flemming Ettrup, the Section's Secretary. Since this was the first open meeting it seemed appropriate to start with some historical details to give all those attending background information on the circumstances which led to the creation of the Working Group.
Distance Education in Library and Information Science in Asia and the Pacific Region
Authors: Sacchanand Chutima
Published: March 2007

Ms Chutima Sacchanand received her BA and MA in Library Science from Chulalongkorn University, and a Diploma in Teaching from the Ministry of Education in Thailand. She received the UNESCO/UNDP Scholarship to follow the Post- Graduate Training Course for Science Information Specialists in Southeast Asia at the University of the Philippines where she received her Post-Graduate Diploma in Information Science and to further her study there with the Masters of Library Science under the same scholarship. Ms Sacchanand is an Associate Professor in Library Science, School of Liberal Arts, and Vice President for Operations at Sukhothai Thammathirat Open University where she was Dean. She is also an immediate President of the Thai Library Association and a member of the Standing Committee of the IFLA Section on Library Theory and Research. She has completed 10 research studies, written books and more than 100 articles, and has presented papers to major regional and international library and information conferences such as CONSAL and IFLA. She has received many awards and honors, including "Outstanding Person in Thai Library and Information Science for the Year 1995" awarded by the Thai Library Association. Ms Sacchanand may be contacted at Sukhothai Thammathirat Open University, Bangpood, Pakkred, Nonthaburi 11120, Thailand (fax: +(662) 5033607; e-mail: laasschu@samsorn.stou.ac.th).
The Right to Information: Is It Possible for Developing Countries?
Authors: Yllmaz Bülent
Published: March 2007

Bülent Yilmaz graduated from Hacettepe University's Faculty of Letters, Department of Library Science, where he received both his MS and Ph.D. He edited Turkish Librarianship and was Vice President of the Turkish Librarians' Association between 1996-1998. He is at present Assistant Professor in Hacettepe University's Department of Library Science. Mr Yilmaz may be contacted at Hacettepe University, Faculty of Letters, Department of Library Science, Beytepe-Ankara, Turkey (fax: +(90-312) 2351968; e-mail : byilmaz@hun.edu.tr).
Romantic Love or Material Interest: Choosing Partners in Nineteenth-Century Germany
Authors: Borscheid Peter
Published: March 2007

Influenced by the Enlightenment and the Romantic era, the "love-match" (Liebesheirat) became established as an ideology and norm at the beginning of the nineteenth century. Although "love" and the "love-match" initially figured more prominently in the lives of a small, elite minority, early nineteenth- century literature gives the impression that these had already become democratized. In reality, however, this publicly touted norm was not strongly followed. A comparison of each partner's financial contribution to the marriage, further substantiated by autobiographical and case file material, reveals the marriage still rested, as in previous centuries, on a search for partners of equal financial standing. The factor of "love" did not disrupt the order of selection criteria. Money remained central; social status and prestige determined choice ofpartner. "Cinderella" marriages happened only in fairy tales. The majority of the population endorsed the idea of love, but at the decisive moment of partner choice discarded it as a dream.