bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Relation Between Trust and Fairness in Environmental Risk Management
Authors: Earle Timothy C. , Siegrist Michael
Published: July 2008

In this study, we empirically examine the relations between trust, fairness, and cooperation within two environmental risk management contexts, one in which the focal issue is of high personal moral importance and the other in which the focal issue is of low moral importance. Using an experimental design embedded in two parallel survey questionnaires, one mailed to residents of Washington State, the other to German‐speaking residents of Switzerland, we either manipulated or constructed three factors, issue importance (high/low), procedural fairness (fair/unfair), and policy outcome (risk averse/risk accepting). This design enabled us to compare the predictions of the standard account of procedural fairness, that trust and cooperation are determined by judgments of fairness, with the predictions of an alternative account, that trust and cooperation will be determined by judgments of procedural fairness only when the issue involved is not morally important. Results for the American case showed that under conditions of high issue importance, policy outcome affected judged fairness, trust, and cooperation. Under conditions of low issue importance, policy outcome had no effect on judged fairness or trust but did have a moderate impact on cooperation. Analyses also showed that when issue importance was high, procedural fairness had no effects. When issue importance was low, procedural fairness had moderate effects on judged fairness and trust. Results for the Swiss case replicated the main findings for the American case. Together, these results support the alternative model of the relation between trust and fairness, suggesting that the efficacy of fair procedures is strictly limited.
Attitudes as an Expression of Knowledge and “Political Anchoring”: The Case of Nuclear Power in the United Kingdom
Authors: Costa‐Font Joan , Rudisill Caroline , Mossialos Elias
Published: July 2008

Attitudes toward the use of nuclear energy pose fundamental issues in the political debate about how to meet future energy needs. Development of new nuclear power facilities faces significant opposition both from knowledgeable individuals who display an understanding of the risks attached to various forms of power generation and those who follow strict politically based ideological dogmas. This article employs data from a 2005 Eurobarometer survey of UK citizens to examine the influence of both political preferences and knowledge in explaining support of nuclear power. Findings reveal that attitudes about nuclear power are highly politically motivated while the influence of knowledge about radioactive waste is dependent upon beliefs about the consequences of nuclear energy use. Perceptions of being informed about radioactive waste and trust in sources providing information about radioactive waste management also predict attitudes toward nuclear power generation.
Mobilizing Interest: The Effects of Money on Citizen Participation in State Supreme Court Elections
Authors: Hall Melinda Gann , Bonneau Chris W.
Published: July 2008

In this article, we investigate one highly significant aspect of the role of money in judicial elections: whether campaign spending increases citizen participation in the recruitment and retention of judges. Specifically, by using a two‐stage modeling strategy that allows us to separate the effects of challengers from the effects of money, we assess whether relatively expensive campaigns improve the chances that citizens will vote in the 260 supreme court elections held from 1990 through 2004 in 18 states using partisan or nonpartisan elections to staff the high court bench. We find that increased spending significantly improves citizen participation in these races. Whether measured as the overall spending in each election or in per capita terms, greater spending facilitates voting. We conclude, contrary to conventional wisdom about the deleterious effects of money in judicial elections, that by stimulating mass participation and giving voters greater ownership in the outcomes of these races, expensive campaigns strengthen the critical linkage between citizens and the bench and enhance the quality of democracy.
Who Consents? Competing Pivots in Federal Judicial Selection
Authors: Primo David M. , Binder Sarah A. , Maltzman Forrest
Published: July 2008

The salience of judicial appointments in contemporary American politics has precipitated a surge of scholarly interest in the dynamics of advice and consent in the U.S. Senate. In this article, we compare alternative pivotal politics models of the judicial nominations process, each capturing a different set of potential veto players in the Senate. We use these spatial models to guide empirical analysis of rejection patterns in confirmation contests for the lower federal courts. Using data on the outcomes of all nominations to the U.S. Courts of Appeals and the U.S. District Courts between 1975 and 2006, we show that models incorporating the preferences of the majority party median and the filibuster pivots best account for confirmation patterns we observe at the appellate and trial court levels, while advice and consent for trial courts has more recently been influenced by home‐state senators.
The Value of Vagueness: Delegation, Defiance, and Judicial Opinions
Authors: Staton Jeffrey K. , Vanberg Georg
Published: July 2008

An established line of research demonstrates that vague judicial opinions are less likely to be implemented than clear opinions. Vague opinions thus present a puzzle. Why would judges craft opinions that risk noncompliance? We argue that the relationships between judges and other policy makers in separation‐of‐powers systems are central to understanding this puzzle. Opinion vagueness can reflect efforts to resolve core tradeoffs associated with judicial policymaking that bear some resemblance to standard accounts of political delegation. Vagueness offers judges the ability to manage their uncertainty over policy outcomes and to hide likely defiance from public view. At the same time, vagueness removes a central source of pressure for compliance that judges can place on other policy makers. Using a game‐theoretic model, we identify conditions under which judges use vagueness precisely as legislatures use statutory discretion. We also demonstrate conditions under which judges use vagueness in ways unanticipated by standard delegation accounts.
Assessing the “Experience Bonus” Through Examining Strategic Entry, Candidate Quality, and Campaign Receipts in U.S. House Elections
Authors: Maestas Cherie D. , Rugeley Cynthia R.
Published: July 2008

This article examines nonincumbent fundraising through the lens of two theories that have not been applied in other studies of fundraising—strategic candidate entry and ambitious amateur candidates—to test whether candidates with prior office experience are advantaged in raising funds for U.S. House campaigns. A selection model that takes into account the strategic entry of strong candidates demonstrates that electoral experience matters for only a select subset of experienced candidates. In contrast to previous research, the results show that much of the fundraising difference between amateurs and experienced candidates can be attributed to a selection process where the strongest candidates seek the best races. The results have implications for how we understand the relative importance of various conditions that shape fundraising. Competitive local or national conditions that encourage strong candidacies also allow nonincumbents to accumulate sufficient funds to mount credible campaigns.
The Color of Devolution: Race, Federalism, and the Politics of Social Control
Authors: Soss Joe , Fording Richard C. , Schram Sanford F.
Published: July 2008

In this article, we seek to advance scholarship on the origins and consequences of policy devolution by analyzing state decisions to give local authorities control over welfare policy. The first part of our analysis explores the political forces that systematically influence state decisions to cede policy control to lower‐level jurisdictions. In this context, we propose a general Racial Classification Model of how race influences social policy choice. Our findings support this model as well as social control perspectives on welfare provision. Building on these results, we then show how modest but consistent racial effects on policy choices concatenate to produce large disparities in the overall policy regimes that racial groups encounter in the federal system. The empirical findings illuminate the fundamental role that federalism plays in the production of contemporary racial disparities and in the recent turn toward neoliberal and paternalist policies in American poverty governance.
Outside Funding and the Dynamics of Participation in Community Associations
Authors: Gugerty Mary Kay , Kremer Michael
Published: July 2008

The poor and disadvantaged are widely seen as having weak organizations and low rates of participation in community associations, impeding their political representation and economic advancement. Many policy initiatives aim to build civic participation among the disadvantaged by funding local community associations. Taking advantage of random assignment in a program supporting women's community associations in Kenya, we find little evidence that outside funding expanded organizational strength, but substantial evidence that funding changed group membership and leadership, weakening the role of the disadvantaged. The program led younger, more educated, and better‐off women to enter the groups. New entrants, men, and more educated women assumed leadership positions. The departure of older women, the most socially marginalized demographic group, increased substantially. The results are generalized through a formal model showing how democratic decision making by existing members of community associations can generate long‐run outcomes in which the poor and disadvantaged either do not belong to any associations or belong to weak organizations.
Of Time and the Development of Partisan Polarization
Authors: Stoker Laura , Jennings M. Kent
Published: July 2008

In this article we address the topic of increasing partisan polarization in the American mass public, focusing on the twin influences of individual‐level development and cohort replacement and the interaction between the two. We posit a model of individual development that consists of declining openness to change beyond young adulthood, an increase in party‐issue constraint as age advances, and cohort‐specific responsiveness to changes in the partisan environment. Results from a long‐term panel study provide initial evidence of these dynamics. We then use simulations to generate expectations about how these developmental processes play out across cohorts, issues, and time. These expectations are evaluated through a cohort analysis of National Election Studies data from 1972 to 2004. Overall, our results provide a new perspective on the dynamics of individual political development and their implications for the timing, extent, and future trajectory of partisan polarization in the U.S. electorate.
Equilibrium Party Government
Authors: Patty John W.
Published: July 2008

In this article, I present an equilibrium model of party government within a two‐party legislature. The theory is predicated upon members of the majority party having potentially conflicting individual and collective interests. In response to this potential conflict, the members of the majority party endogenously choose a degree of control to grant to their leadership. The equilibrium level of party strength is decreasing in the size of the majority party and increasing in the strength of opposition among members of the minority party. The theory implies that the average performance of W‐Nominate estimates of majority party members' ideal points will be a decreasing function of the size of the majority party while the performance of these estimates for members of the minority party will not be affected by the size of the majority party. Using data from the U.S. House and Senate between 1866 and 2004, the theory's predictions are largely consistent with roll‐call voting in both chambers.
Fear of Floating and the External Effects of Currency Unions
Authors: Plümper Thomas , Troeger Vera E.
Published: July 2008

The introduction of the Euro has considerably affected the de facto monetary policy autonomy—defined as independence from monetary policy in the key currency areas—in countries outside the European Currency Union (ECU). Using a standard open economy framework, we argue that de facto monetary policy autonomy has significantly declined for countries that dominantly trade with the ECU and slightly increased for countries that dominantly trade with the Dollar zone. The predictions of our model find support in the data. We estimate the influence of the Bundesbank's/ECB's and the Fed's monetary policies on various country groups. The de facto monetary policy autonomy of both non‐Euro EU members and EFTA countries declined with the introduction of the Euro. This effect was slightly stronger for the EU member countries than for EFTA countries as our theory predicts. At the same time, the de facto monetary policy autonomy of Australia and New Zealand vis‐à‐vis the US Dollar has (moderately) increased.
Dynamic Conditional Correlations in Political Science
Authors: Lebo Matthew J. , Box‐Steffensmeier Janet M.
Published: July 2008

Time‐varying relationships and volatility are two methodological challenges that are particular to the field of time series. In the case of the former, more comprehensive understanding can emerge when we ask under what circumstances relationships may change. The impact of context—such as the political environment, the state of the economy, the international situation, etc.—is often missing in dynamic analyses that estimate time‐invariant parameters. In addition, time‐varying volatility presents a number of challenges including threats to inference if left unchecked. Among time‐varying parameter models, the Dynamic Conditional Correlation (DCC) model is a creative and useful approach that deals effectively with over‐time variation in both the mean and variance of time series. The DCC model allows us to study the evolution of relationships over time in a multivariate setting by relaxing model assumptions and offers researchers a chance to reinvigorate understandings that are tested using time series data. We demonstrate the method's potential in the first example by showing how the importance of subjective evaluations of the economy are not constant, but vary considerably over time as predictors of presidential approval. A second example using international dyadic time series data shows that the story of movement and comovement is incomplete without an understanding of the dynamics of their variance as well as their means.
A Comparison of Acoustic Cardiography and Echocardiography for Optimizing Pacemaker Settings in Cardiac Resynchronization Therapy
Authors: ZUBER MICHEL , TOGGWEILER STEFAN , QUINN‐TATE LORI , BROWN LEI , AMKIEH ALI , ERNE PAUL
Published: July 2008

Background: Cardiac resynchronization therapy (CRT) is useful in managing patients with refractory heart failure. To increase efficacy, pacemaker settings are optimized, with Doppler echocardiography being the preferred method. Recently, acoustic cardiography, an automated method that records, analyzes, and displays simultaneous ECG and heart sound data, has been developed. In this study, the suitability of acoustic cardiography as an alternative to Doppler echocardiography in CRT optimization is evaluated.

Methods: We studied 43 CRT patients undergoing optimization. Using Doppler echocardiography, we determined the optimal atrioventricular (AV) delay with a transmitral flow assessment. For optimization of the interventricular (VV) delay, we used the left ventricular outflow tract velocity time integral (VTI). For acoustic cardiography, we used the electromechanical activation time (EMAT, the interval from QRS onset to the S1). Reproducibility of echocardiography and acoustic cardiography was determined by programming 10 different delay settings twice in random order.

Results: All 43 subjects underwent AV optimization, and 14 had CRT devices allowing VV optimization. While the intraobserver variability of EMAT and Doppler echocardiography parameter was similar (9.9% vs 8.5%), the reproducibility of EMAT was the highest (r = 0.91) and VTI was the lowest (r = 0.35). The correlation between the optimal AV delays determined by EMAT versus transmitral flow assessment was 0.86 (P < 0.001). The correlation between the optimal VV delays determined by EMAT versus VTI was 0.58 (P < 0.05), perhaps due to the poor reproducibility of the VTI.

Conclusion: For CRT optimization, acoustic cardiography provides results similar to echocardiography but with improved reproducibility and ease of use.
A Radial Global Dyssynchrony Index as Predictor of Left Ventricular Reverse Remodeling after Cardiac Resynchronization Therapy
Authors: ASCIONE LUIGI , IENGO RAFFAELE , ACCADIA MARIA , RUMOLO SALVATORE , CELENTANO EDUARDO , D'ANDREA ANTONELLO , DE MICHELE MARIO , MUTO CARMINE , CARRERAS GIOVANNI , MAGLIONE MARCO , TUCCILLO BERNARDINO , ROELANDT JOS
Published: July 2008

Background: Cardiac mechanical efficiency requires that opposing left ventricular regions are coupled both in shortening and lengthening during the same phase of cardiac cycle. Aim of this study was to evaluate whether global measures of mechanical dyssynchrony are able to predict reverse remodeling of the left ventricle in patients receiving cardiac resynchronization therapy (CRT).

Methods: Sixty‐two patients underwent a clinical examination, including New York Heart Association class evaluation and 6‐minute walking distance and both echocardiographic study before and 6 months after CRT. Intraventricular dyssynchrony was evaluated by two‐dimensional strain echocardiography, measuring the amount of uncoordinated contraction and relaxation between septum and free wall for both longitudinal and radial function and was presented as the longitudinal global dyssynchrony index (LGDI) and the radial global dyssynchrony index (RGDI). Reverse remodeling was defined by a left ventricular end systolic volume reduction ≥ 15%.

Results: After CRT 39 patients showed reverse remodeling. In this group, RGDI (0.74 ± 0.26 vs 0.32 ± 0.30; P = 0.0001) and LGDI (0.52 ± 0.28 vs 0.30 ± 0.24; P = 0.002) were significantly higher than in nonresponders. A receiver‐operating characteristic curve analysis showed that RGDI >0.47 and LGDI >0.34 had a sensitivity and a specificity to predict reverse remodeling of 87% and 74%, 82%, and 74%, respectively. Stepwise forward multiple logistic regression analysis showed that RGDI (O.R.:13.4; 95%C.I.:4.2–120.5; P < 0.0001) was an independent determinant of a positive response to CRT.

Conclusion: A radial global dyssynchrony index predicts left ventricular reverse remodeling after CRT.
Left Ventricular Diastolic Filling Prior to Cardiac Resynchronization Therapy: Implications for Atrioventricular Delay Programming
Authors: WAGGONER ALAN D. , DE LAS FUENTES LISA , FADDIS MITCHELL N. , GLEVA MARYE J. , SPENCE KAREN E. , DAVILA‐ROMAN VICTOR G.
Published: July 2008

Background: The programmed atrioventricular delay (AVD) is an important determinant of the response in left ventricular (LV) systolic performance during cardiac resynchronization therapy (CRT). It is not well established if the optimal AVD for CRT may be influenced by the LV diastolic filling pattern.

Methods: Thirty patients were studied pre‐ and post‐CRT at programmed AVD of 60–160 ms. Doppler measurements included the aortic and mitral velocity time integral (VTI), mitral early (E) and late diastolic filling (A) wave velocities, E‐ and A‐wave VTI, and diastolic filling time (DFT). The optimal AVD for each of the Doppler variables was defined by the maximal improvement compared to pre‐CRT. Patients were grouped by the pre‐CRT mitral inflow pattern as impaired relaxation (IR, mitral E/A ≤1, n = 15) or pseudonormalized/restrictive filling (PNF/RF, mitral E/A >1, n = 15).

Results: The percentage of improvement in aortic VTI was greater in the PNF/RF group (P = 0.03). Mitral E‐wave velocity decreased in the PNF/RF group (P < 0 .001), E‐wave VTI increased in both groups (P < 0 .05) and A‐wave VTI increased in the PNF/RF group. DFT increased in both groups. The optimal AVD that maximized aortic VTI was longer than the AVD that improved DFT.

Conclusions: The effects of various programmed AVD during CRT on the response in LV stroke volume and diastolic filling are influenced by the pre‐CRT LV filling characteristics. AVD optimization based on maximizing DFT is shorter compared to the aortic VTI method.
Leisure‐Time Activities of Patients with ICDs: Findings of a Survey with Respect to Sports Activity, High Altitude Stays, and Driving Patterns
Authors: KOBZA RICHARD , DURU FIRAT , ERNE PAUL
Published: July 2008

Background: Physicians who are caring for patients with implantable cardioverter‐defibrillators (ICDs) are regularly confronted with questions concerning daily activities. This study evaluates the habits of ICD patients with respect to sports activities, stays at high‐altitude, and driving patterns.

Methods: A survey was performed in 387 patients with ICDs who were followed at two hospitals in Switzerland. The special‐designed questionnaire addressed lifestyle practices concerning sports activity, high‐altitude visits, and driving motor vehicles.

Results: Fifty‐nine percent of ICD patients participated in some kind of sports activity; an ICD shock was experienced in 14% of these patients. Fifty‐six percent of the patients reported a stay at high altitudes at least 2,000 m above the sea level; 11% of them stayed regularly above 2,500 m; 4% of these patients experienced an ICD shock during high altitude stay. Seventy‐nine percent of the patients drove a motor vehicle; 2% of them experienced an ICD shock during driving, but none of them reported loss of consciousness or a traffic accident.

Conclusion: It is accepted that ICD patients disqualify for competitive sports. However, the patients may be encouraged to continue leisure‐time physical activities at low‐to‐moderate intensity. Staying at high altitudes and driving motor vehicles are very rarely associated with ICD shocks. Therefore, these activities that are likely to contribute to a better quality of life should not be discouraged in most ICD recipients in the absence of other medical reasons.
Shocks, Personality, and Anxiety in Patients with an Implantable Defibrillator
Authors: VAN DEN BROEK KRISTA C. , NYKLÍČEK IVAN , VAN DER VOORT PEPIJN H. , ALINGS MARCO , DENOLLET JOHAN
Published: July 2008

Background: Studies have examined the relationship between shocks and anxiety, but little is known about the role of personality. Our aim was to examine the determinants of self‐reported and interviewer‐rated anxiety following implantable cardioverter defibrillator (ICD) implantation.

Methods: At baseline, that is, 0–3 weeks following ICD implantation, 308 ICD patients (82% men, mean age = 62.6 years) completed the DS14 (Type D personality) and ASI (anxiety sensitivity). The STAI (self‐reported symptoms of state‐anxiety) was assessed at baseline and follow‐up, which was 2 months following ICD implantation. At this follow‐up, the HAM‐A interview (interviewer‐rated anxiety) was assessed in a subsample (57%); the occurrence of ICD shocks was deduced from medical records.

Results: Analysis of covariance (ANCOVA) for repeated measures showed a significant interaction effect between time and shocks (F = 9.27, P = 0.003) with patients who had experienced a shock experiencing higher levels of self‐reported anxiety at follow‐up. The main effects of Type D personality (F = 33.42, P < 0.0001) and anxiety sensitivity (F = 66.31, P < 0.0001) were significant, indicating that these patients scored higher on self‐reported anxiety across time points. Multivariable linear regression analyses yielded Type D personality (β= 0.18, P = 0.021) and anxiety sensitivity (β= 0.19, P = 0.016), but not shocks, as independent predictors of interviewer‐rated anxiety. Covariates included gender, marital status, education, age, ICD indication, cardiac history, and comorbidity.

Conclusions: Type D personality and anxiety sensitivity were independent predictors of both self‐reported and interviewer‐rated anxiety outcomes while ICD shocks were related to an increase in levels of self‐reported anxiety only. Identification and support of ICD patients with Type D personality, increased anxiety sensitivity, or shocks is important.
Peripheral Arterial Disease Alters Heart Rate Variability in Cardiovascular Patients
Authors: GOERNIG MATTHIAS , SCHROEDER RICO , ROTH TINO , TRUEBNER SANDRA , PALUTKE INGO , FIGULLA HANS R. , LEDER UWE , VOSS ANDREAS
Published: July 2008

Background: Autonomic regulation analysis is useful in risk stratification of ventricular tachycardia and sudden cardiac death in chronic heart failure (CHF). Heart rate variability (HRV) reflects the condition of autonomic regulation. For analyzing the autonomic control the whole cardiovascular system has to be considered. Therefore, the aim of our study was to assess the influence of peripheral arterial disease (PAD) on the autonomic regulation.

Methods: In 53 men (age: 67 ± 11 years) from the cardiovascular unit we compared standard HRV parameters in 27 with (ankle brachial index, ABI < 0.9) and 26 patients without (ABI >0.9) PAD as well as with 12 healthy subjects as reference. High‐resolution electrocardiograms were recorded over 30 minutes under resting conditions. Pulse wave velocity as well as ABI was estimated using the vascular screening system VASERA.

Results: In cardiac patients with PAD, we found both significant differences in linear and nonlinear HRV parameters. Higher increase of low‐than high‐frequency components indicated higher elevated sympathetic than vagal activation. Altered autonomic control can be interpreted as a compensatory mechanism for diminished vascular arteriolar vasodilator capacity in PAD. To maintain the arterial blood pressure, an elevated setpoint of sympathovagal balance is required.

Conclusions: Our data indicate PAD alters the HRV in cardiaovascular patients. PAD should be considered in the assessment of cardiac autonomic regulation especially in risk stratification.
Time‐Domain and Morphological Analysis of the P‐Wave. Part I: Technical Aspects for Automatic Quantification of P‐Wave Features
Authors: CENSI FEDERICA , RICCI CHIARA , CALCAGNINI GIOVANNI , TRIVENTI MICHELE , RICCI RENATO P. , SANTINI MASSIMO , BARTOLINI PIETRO
Published: July 2008

Introduction: Time‐domain and morphological analysis of P‐wave from surface electrocardiogram has been extensively used to identify patients prone to atrial arrhythmias, especially atrial fibrillation (AF). However, since no standard procedure exists for P‐wave preprocessing, standardization of cut‐off values for P‐wave duration and morphological features is difficult. This study is a methodological investigation of P‐wave preprocessing procedures for automatic time‐domain and morphological analysis.

Methods: We compared, on simulated and real data, the P‐wave template obtained applying three alignment algorithms with that obtained without alignment, in terms of template error, shift error, P‐wave duration, and morphological parameters. We also proposed automatic algorithms for estimation of P‐wave duration.

Results: We found that alignment is necessary for a reliable extraction of P‐wave template by the averaging procedure, in order to perform time‐domain and morphological analysis. On simulated and real data, the error on P‐wave duration can be as high as 30 ms on a template obtained without alignment; if alignment procedure is performed, the error on P‐wave duration is negligible. Analogously, morphological features are correctly estimated only on a P‐wave template obtained with P‐waves alignment. We also found that the proposed algorithm for the automatic estimation of the P‐wave duration gave reliable results.
The Effect of Altitude on P‐Wave and QT Duration and Dispersion
Authors: GUNTEKIN UNAL , GUNES YILMAZ , TUNCER MUSTAFA , GUMRUKCUOGLU HASAN ALI , KAYA YUKSEL
Published: July 2008

Background: Short‐term and long‐term exposure to high altitude has been reported to change the surface electrocardiogram. We aimed to compare P‐wave and QT parameters between healthy people living at high altitude and sea level.

Methods: Twelve‐lead electrocardiographies of 38 healthy people living at sea level (Antalya,Turkey) and 38 healthy people living at high altitude (Van, Turkey; 1,700–1,800 m) were obtained. Minimum and maximum P‐wave durations, P‐wave dispersion, minimum and maximum corrected QT intervals, and corrected QT dispersion were calculated.

Results: There was no significant difference between the two groups in respect to heart rate and QT variables. Mean Pminimum values were slightly but significantly lower in the high altitude group (P = 0.029). Mean Pmaximum values tended to be lower at high altitude but did not reach statistical significance (P = 0.085). However, there was no significant difference in respect to P‐wave dispersion values.

Conclusions: In a sample of men and women living at high altitude in Turkey, significant reduction of Pminimum and borderline reduction of Pmaximum duration, but no significant change of P‐wave and QT dispersion, were observed.
Effect of Pacing for Soft Indications on Mortality and Heart Failure in the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial
Authors: KUTALEK STEVEN P. , SHARMA ARJUN D. , McWILLIAMS MICHAEL J. , WILKOFF BRUCE L. , LEONEN ANNA , HALLSTROM ALFRED P. , KUDENCHUK PETER J. ,   the DAVID Investigators
Published: July 2008

Background: The dual chamber and VVI implantable defibrillator (DAVID) trial demonstrated that dual chamber (DDDR) pacing in defibrillator candidates with impaired ventricular function and no established indication for pacing resulted in worsened congestive heart failure (CHF) or death. Many patients had abnormalities for which pacing is often advocated to improve the management of ventricular dysfunction.

Objectives: Evaluate the impact and interaction of nonessential but potentially justifiable reasons to pace (“soft indications”), together with pacing mode, on outcome.

Methods: DAVID patients were stratified by those with and without “soft indications” for pacing (rate < 60 beats/min or first‐degree atrioventricular block) (n = 169; n = 335, respectively). This analysis also stratified patients by normal and abnormal QRS conduction (QRS ≥ 110 ms), who were previously found to be affected differently by DDDR pacing. Groups were analyzed according to the combined endpoint of mortality or CHF hospitalization.

Results: When assigned to treatment that promoted pacing (DDDR), the incidence of death or CHF tended to be higher in patient subgroups with and without “soft indications,” consistent with results from DAVID. Patients with, compared to those without, these abnormalities neither benefited nor were less adversely affected when actively paced. The presence or absence of “soft indications” also provided no additional explanation for the differing outcomes in patient cohorts with and without abnormal QRS conduction.

Conclusions: Sinus bradycardia or first‐degree atrioventricular block did not ameliorate the poor outcomes associated with dual‐chamber compared with VVI pacing, and do not justify conventional dual‐chamber pacing in defibrillator recipients with ventricular dysfunction.
Coronary Vein Rupture during Venoplasty for LV Lead Placement
Authors: WORLEY SETH J. , GOHN DOUGLAS C. , PULLIAM ROBERT W.
Published: July 2008

Coronary vein rupture is a potential complication of venoplasty for LV lead placement. Vein rupture in a patient with a virgin pericardium would be anticipated to have a profound hemodynamic impact from bleeding into the pericardial space. This report describes an elderly woman with a virgin pericardial space who underwent cardiac resynchronization therapy (CRT). Venoplasty of a lead limiting venous stenosis was performed on the lateral coronary vein. The stenosis was unresponsive to a standard noncompliant balloon with side wire. When the inflation pressure was increased beyond the rated burst pressure the balloon ruptured, perforating the vein. We describe our experience in successfully placing the left ventricular lead safely despite the problems arising from these circumstances.
A Case of Catecholaminergic Polymorphic Ventricular Tachycardia Caused by Two Calsequestrin 2 Mutations
Authors: DE LA FUENTE SAM , VAN LANGEN IRENE M. , POSTMA ALEX V. , BIKKER HENNI , MEIJER ALBERT
Published: July 2008

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an uncommon heritable disease presenting with syncope or sudden cardiac death. Two genes involved in calcium homeostasis, the ryanodine receptor gene and the calsequestrin 2 (CASQ2) gene, have been implicated in this disease. We describe a young man presenting with exercise‐induced syncope, clinically diagnosed as CPVT. Genetic analysis revealed two mutations, p.Y55C (c.164A>G) and p.P308L (c.923C>T), in the CASQ2 gene. Subsequent familial analysis indicates a compound heterozygous form of inheritance.
Magnetic Resonance Imaging of Implantable Cardiac Rhythm Devices at 3.0 Tesla
Authors: GIMBEL J. ROD
Published: July 2008

Background: A relaxation of the prohibition of scanning cardiac rhythm device patients is underway, largely because of the growing experience of safe scanning events at 1.5T. Magnetic resonance imaging (MRI) at 3T is becoming more common and may pose a different risk profile and outcome of MRI of cardiac device patients.

Methods: No restrictions were placed on pacemaker dependency, region scanned, device type, or manufacturer. Sixteen scans at 3T were performed with an electrophysiologist present on 14 patients with a variety of devices from various manufacturers. An “MRI‐S” strategy was used. Multimodal monitoring was required. Device interrogation was performed prior to, immediately after, and 1–3 months after the MRI. For nonpacemaker‐dependent device patients, attempts were made to turn all device features off (with OOO programming the goal) conceptually rendering the device “invisible.” In pacemaker‐dependent patients, the device was programmed to asynchronous mode at highest output for the duration of the scan with the goal of rendering the device conceptually “invulnerable” to MRI effects. The specific absorption rate (SAR) was limited to 2W/kg.

Results: All patients were successfully scanned. No arrhythmias were noted. No significant change in the programmed parameters, pacing thresholds, sensing, impedance, or battery parameters was noted. The insertable loop recorder (ILR) recorded prolonged artifactual asystole during MRI. One patient noted chest burning during the scan.

Conclusions: Device patients may undergo carefully tailored 3T MRI scans when pre‐MRI reprogramming of the device occurs in conjunction with extensive monitoring, supervision, and follow‐up.
Mortality of Heart Failure Patients After Cardiac Resynchronization Therapy: Identification of Predictors
Authors: BAI RONG , BIASE LUIGI DI , ELAYI CLAUDE , CHING CHI KEONG , BARRETT CONOR , PHILIPPS KAREN , LIM PASCAL , PATEL DIMPI , CALLAHAN TOM , MARTIN DAVID O. , ARRUDA MAURICIO , SCHWEIKERT ROBERT A. , SALIBA WALID I. , WILKOFF BRUCE , NATALE ANDREA
Published: July 2008

Introduction: A direct comparison of survival benefits between cardiac resynchronization therapy‐pacemaker (CRT‐P) and defibrillator (CRT‐D) was not yet performed, leaving clinicians to question whether CRT‐P alone is enough to protect congestive heart failure (CHF) patients from sudden cardiac death and whether CRT‐D should be implanted to all CHF patients indicated for biventricular pacing. This study attempts to make this type of comparison in a large CHF population and seeks to identify predictors of death in patients with different comorbidities.

Methods and Results: Study population consisted of 542 consecutive patients who were implanted with either CRT‐P (N = 147) or CRT‐D (N = 395) between 1999 and 2005. Patients' clinical and follow‐up data were entered in a prospective registry and retrieved for analysis. The primary endpoint of this study was all‐cause mortality during follow‐up. Total all‐cause mortality was significantly lower among patients with CRT‐D (18.5% vs. 38.8% of CRT‐P, χ2= 25.11, P < 0.001). Patients with one of three comorbidities—chronic renal failure (OR = 4.885, P = 0.005), diabetes mellitus (OR = 4.130, P = 0.003), and history of atrial fibrillation (OR = 1.473, P = 0.036)—appeared to have higher risk of death, while treatment with beta‐blocker (OR = 0.330, P = 0.002) or CRT‐D device (OR = 0.334, P = 0.003) seemed to be associated with lower mortality.

Conclusions: Data from this nonrandomized study indicate that CRT‐D has additional survival benefits over CRT‐P. Given these findings, CRT‐D should be recommended to most CHF patients with indications for biventricular pacing. After CRT implant, chronic renal failure, diabetes mellitus, and history of atrial fibrillation are strong independent predictors of death.
Endocardial Transcatheter Stimulation of the AV Nodal Fat Pad: Stabilization of Rapid Ventricular Rate Response During Atrial Fibrillation in Left Ventricular Failure
Authors: BIANCHI STEFANO , ROSSI PIETRO , SCALA ALBERTO DELLA , KORNET LILIAN
Published: July 2008

Introduction: Recent acute studies demonstrated that atrioventricular (AV) node vagal stimulation during atrial fibrillation (AF) decreases the mean ventricular rate, thus improving hemodynamics.

Methods and Results: We report a case of a woman with acute heart failure (HF), chronic AF with untreatable ventricular rapid response, in severe hypotensive state due to a cardiogenic shock. The patient underwent left ventricular (LV) pacemaker implantation and received 50 Hz AV node stimulation, delivered through a posteroseptal atrial lead, thus allowing a 100% pacing. Hemodynamics improvements allowed carvedilol titration; the rate was below 85 bpm after 4 days, then the atrial lead was removed.

Conclusions: This novel strategy may allow controlling the rapid AV response in patients undergoing pacemaker implantation.
Milk Teeth and Jet Planes: Kin Relations in Families of Sri Lanka's Transnational Domestic Servants
Authors: GAMBURD MICHELE R.
Published: July 2008

This essay examines the confluence of local and global dynamics, exploring how transnational migration affects and is affected by gender roles, kinship relations, intergenerational obligations, and ideologies of parenthood. Journeying to the Middle East repeated on two‐year labor contracts, many of Sri Lanka's migrant housemaids leave behind their husbands and children. Women's long‐term absences reorganize and disrupt widely accepted gendered attributions of parenting roles, with fathers and female relatives taking over household tasks. Migrants say that economic difficulties prompt migration, and assess commitment to kin in financial terms. The government also benefits from remittances. Nevertheless, stakeholders (villagers, politicians, and the national media) worry about the social costs born by children. Drawing on interviews with the adult children of migrant mothers in four extended families in the Sri Lankan coastal village of Naeaegama, I examine the long‐term effects of transnational labor migration on local households. The case studies do not support media claims that children suffer abuse and neglect in their mothers’ absence, but do in part support survey information on reduced education, shifting marriage patterns, and paternal alcohol consumption.
Strategic Transnationalism: The Indian Diasporic Elite in Contemporary Bahrain
Authors: GARDNER ANDREW M.
Published: July 2008

This paper provides an ethnographic window into the lives of the middle and upper classes of the substantial Indian diaspora in Bahrain. Like all the Gulf States, Bahrain hosts an extraordinarily large contingent of guest workers. Through a variety of historical conjunctures, Indians have long predominated in the flow of foreigners to the small island. In this paper I consider the experiences of the elite minority of that diaspora. While many aspects of their day‐to‐day experiences differ from those of their impoverished diasporic countrymen and countrywomen, I argue that they also face a variety of noteworthy vulnerabilities and dilemmas unique to their class position. In the final accounting, members of this Indian diasporic elite deploy a strategic transnationalism against the systemic vulnerabilities rendered by the sponsorship system currently in place in Bahrain.
The Search for Miss Philippines Bahrain—Possibilities for Representation in Expatriate Communities
Authors: NAGY SHARON
Published: July 2008

Based on participant observation within the organizing committee of a beauty pageant produced by the Filipino Club in Bahrain, this paper explores group interactions within Bahrain's multinational population. More specifically, the paper asks whether semi‐public events staged by expatriate community organizations serve as nodes of interaction across boundaries of nationality. The first half of the paper describes the transnational context and expatriate community organizations in Bahrain and the type of activities they host. An important distinction is made between activities hosted on the club premises and/or for club members and performance events that are potentially open to non‐members. The second half of the paper uses a beauty pageant organized by the Filipino Club to examine how semi‐public performance events provide a venue for both the construction of community identity and its potential presentation to other nationalities resident in Bahrain. By describing the range of activities organized by the Filipino Club—from professional networking to aromatherapy classes from Christmas parties to beauty pageants—this research expands our ideas of the nature of expatriate lives in the Gulf. The ethnographic analysis of the beauty pageant demonstrates that semi‐public events may not fulfill their potential for reciprocal inter‐group communication.
Low‐Temperature Synthesis of Bismuth Titanate by an Aqueous Sol–Gel Method
Authors: Du Xianfeng , Xu Youlong , Ma Hanxiao , Wang Jie , Li Xifei
Published: July 2008

Homogeneous and fine bismuth titanate (BIT) nanoplate‐like powders were synthesized by a modified and simple sol–gel method. The thermal gravimetry‐differential thermal analysis‐derivative differential thermal analysis indicated that BIT gel decomposes in two steps posited at approximately 278° and 432°C, and BIT began to crystallize before 450°C. Based on the high‐temperature X‐ray diffraction results, it was concluded that the crystallization temperature of BIT synthesized by the present method was about 425°C and there was no evidence of the formation of an intermediate phase. The BIT crystal structure belonged to the orthorhombic phase with lattice parameters a=5.420 Å, b=5.431 Å, and c=33.273 Å. Field emission‐scanning electron microscopy revealed that fine and uniform BIT nanoplate‐like powders, about 30 nm in size, were obtained after sintering at 500°C. With increasing temperature, the BIT grains rapidly grew and the coalescence of adjacent grains took place. The synthesis temperatures adopted were substantially lower than those reported in the other literatures.
Room‐Temperature Degradation of t‐Zr(Pr)O2 in an Aqueous Suspension Revealed by Perturbed Angular Correlations
Authors: Caracoche María C. , Martinez Jorge A. , Rivas Patricia C. , Andreola Fernanda , Bondioli Federica , Ferrari Anna Maria , Manfredini Tiziano
Published: July 2008

This paper deals with the phase stability of an aqueous suspension of tetragonal Zr0.9Pr0.1O2 (20 wt%/vol%) at room temperature as a function of the aging time. The suspension is investigated in situ using the highly localized Perturbed Angular Correlations technique. The results indicate that an almost fully reversible degradation process toward monoclinic zirconia takes place through a first‐order reaction of rate constant k=0.7 day−1. Two successive diffusion mechanisms are observed that are interpreted as OH− ions' migration in the grain surface and then, as proton defects' diffusion into the bulk.
Energetics of SixOyCz Polymer‐Derived Ceramics Prepared Under Varying Conditions
Authors: Morcos Riham Michelle , Navrotsky Alexandra , Varga Tamas , Blum Yigal , Ahn Dongjoon , Poli Fabrizia , Müller Klaus , Raj Rishi
Published: July 2008

Incorporation of carbon at the molecular level can create unusual amorphous and nanostructures of Si–C–O polymer‐derived ceramics by controlled pyrolysis of crosslinked polysiloxanes. These ceramics can resist crystallization to ultrahigh temperatures. In this work, we support earlier studies that the resistance to crystallization of these nanodomain networks is due to thermodynamic as well as kinetic factors. Calorimetric measurements of heats of dissolution in a molten oxide solvent show that these ceramics posses a negative enthalpy relative to their crystalline constituents (silicon carbide, cristobalite, and graphite). Si–C–O ceramics pyrolyzed at 1000° and 1450°C appear somewhat more energetically stable than those prepared at 1200°C.
Combustion Synthesis of Molybdenum Disilicide (MoSi2) Fine Powders
Authors: Nersisyan Hayk H. , Won Hyung Il , Won Chang Whan
Published: July 2008

The combustion characteristics of a MoO3+SiO2+Mg system diluted with sodium chloride have been studied in order to synthesize molybdenum disilicide (MoSi2) fine powders. The effect of processing variables, including the sodium chloride content and the reactants proportion on the phase composition and microstructure of the final products, was obtained. Both the combustion temperature and the wave velocity decreased with an increase in the amount of sodium chloride. With the appropriate processing parameters, the reacted product consisted of solid crystalline MoSi2, and an MgO phase was prepared in the molten sodium halide matrix at 1100°–1350°C. The final product purification resulted in MoSi2 powder with a particle size of 100–500 nm. The mechanism of the MoSi2 formation in the sodium chloride matrix is discussed by analyzing the phase evaluation in the extinguished combustion wave.