bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of sampling techniques for parallel analysis of transcript and metabolite levels in Saccharomyces cerevisiae
Authors: Margarida Martins Ana , Sha Wei , Evans Clive , Martino‐Catt Susan , Mendes Pedro , Shulaev Vladimir
Published: January 2007

Mathematical modelling of cellular processes is crucial for the understanding of the cell or organism as a whole. Genome‐wide observations, at the levels of the transcriptome, proteome and metabolome, provide a high coverage of the molecular constituents of the system in study. Time‐course experiments are important for gaining insight into a system's dynamics and are needed for mathematical modelling. In time‐course experiments it is crucial to use efficient and fast sampling techniques. We evaluated several techniques to sample and process yeast cultures for parallel analysis of the transcriptome and metabolome. The evaluation was made by measuring the quality of the RNA obtained with UV‐spectroscopy, capillary electrophoresis and microarray hybridization. The protocol developed involves rapid collection by spraying the sample into −40 °C tricine‐buffered methanol (as previously described for yeast metabolome analysis), followed by the separation of cells from the culture medium in low‐temperature rapid centrifugation. Removal of the residual methanol is carried out by freeze‐drying the pellet at −35 °C. RNA and metabolites can then be extracted from the same freeze‐dried sample obtained with this procedure. Copyright © 2007 John Wiley & Sons, Ltd.
Towards a nanoscale view of fungal surfaces
Authors: Dague Etienne , Gilbert Yann , Verbelen Claire , Andre Guillaume , Alsteens David , Dufrêne Yves F.
Published: January 2007

In the past years, atomic force microscopy (AFM) has offered novel possibilities for exploring the nanoscale surface properties of fungal cells. For the first time, AFM imaging enables investigators to visualize fine surface structures, such as rodlets, directly on native hydrated cells. Moreover, real‐time imaging can be used to follow cell surface dynamics during cell growth and to monitor the effect of molecules such as enzymes and drugs. In fact, AFM is much more than a microscope in that when used in the force spectroscopy mode, it allows measurement of physicochemical properties such as surface energy and surface charge, to probe the elasticity of cell wall components and macromolecules, and to analyse the force and localization of molecular recognition events. Copyright © 2007 John Wiley & Sons, Ltd.
Lipid Metabolism in Rats is Modified by Nitric Oxide Availability Through a Ca++‐Dependent Mechanism
Authors: Marra Carlos A. , Nella Julio , Manti Damián , de Alaniz María J. T.
Published: January 2007

We studied lipid metabolism and the antioxidant defense system in plasma and liver of rats fed diets supplemented with lω‐nitro‐l‐arginine methyl ester (l‐NAME), isosorbide dinitrate (DIS), l‐arginine (Arg), or the associations of these drugs. Liver hydroperoxide and thiobarbituric‐acid‐reactive substance (TBARS) levels were decreased by Arg and increased by l‐NAME or DIS treatments. Oxidized glutathione and conjugated dienes were increased by DIS. Nitrate + nitrite levels and serum calcium ([Ca++]) were incremented by Arg or DIS and reduced by l‐NAME. Superoxide dismutase and catalase activities decreased under Arg treatment, while l‐NAME or DIS caused stimulation. Liver high‐density lipoprotein (HDL) cholesterol was increased by DIS or NAME (alone or associated with Arg). Free fatty acids and neutral and polar lipids were increased by Arg, l‐NAME, and DIS. However, predominating phospholipid synthesis increased the neutral/polar ratio. Decreased levels of nitric oxide (NO) (low [Ca++]) was directly associated with increased fatty acid synthetase, decreased phospholipase A2, carnitine‐palmitoyl transferase, and fatty acid desaturase activities. Raised NO (high [Ca++]) inversely correlated with increased phospholipase‐A2 and acyl‐coenzyme A (CoA) synthetase and decreased fatty acid synthetase and β‐oxidation rate. Arg or DIS produced changes that were partially reverted by association with l‐NAME. Based on these observations, prolonged therapeutical approaches using drugs that modify NO availability should be carefully considered.
A Docosahexaenoic Acid‐Functional Food During Pregnancy Benefits Infant Visual Acuity at Four but not Six Months of Age
Authors: Judge Michelle P. , Harel Ofer , Lammi‐Keefe Carol J.
Published: January 2007

Within the visual system, docosahexaenoic acid (DHA, 22:6n−3) is an important structural component for retinal photoreceptors and cortical gray matter. There is a marked decrease in neural DHA accumulation in the face of DHA deficiency. DHA is accumulated at an accelerated rate during pregnancy, especially in the third trimester. However, pregnant women in the US and Canada have dietary DHA intakes that are significantly below the optimal level. The main objective of this study was to determine whether a DHA‐functional food during pregnancy would benefit infant visual acuity at four and six months of age measured behaviorally using the acuity card procedure (ACP). In a randomized, longitudinal, double‐blinded, and placebo‐controlled trial, 30 pregnant women received either the DHA‐functional food (n = 16) or the placebo (n = 14). There were significant main effects for visual acuity at four months of age (P = 0.018). The mean acuity scores were 3.8 ± 1.1 cycles/degree in the DHA group versus 3.2 ± 0.7 cycles/degree in the placebo group. At six months there were no group differences. Based on our results, we conclude that DHA supplemented during pregnancy plays a role in the maturation of the visual system.
Stability and change in personality type membership and anxiety in adolescence
Authors: Akse Joyce , Hale William W. , Engels Rutger C.M.E. , Raaijmakers Quinten A.W. , Meeus Wim H.J.
Published: January 2007

Although the stability and changeability of personality has long been debated, many studies now agree that personality changes over the life course. Although the changes in rank‐order and mean‐level stability are well established, the stability in personality type membership during adolescence is not yet clear. Little research has been conducted on the associations between change in personality type membership and anxiety. A total of 827 adolescents (10–20 years) completed personality and anxiety questionnaires on 2 waves of the CONflict And Management Of RElationships study (CONAMORE). We found that the stability in personality type membership was moderate. The change from undercontroller to overcontroller was the most frequently occurring change. Furthermore, the stability in type membership was related to stability in anxiety level and change in type membership was related to anxiety change. More specifically, the resilient‐overcontroller group demonstrated an increase in anxiety level, whereas the overcontroller‐resilient group demonstrated a decrease.
Functional characterization of a NapA Na+/H+ antiporter from Thermus thermophilus
Authors: Furrer Esther M. , Ronchetti Mirco F. , Verrey François , Pos Klaas M.
Published: January 2007

Na+/H+ antiporters are ubiquitous membrane proteins and play an important role in cell homeostasis. We amplified a gene encoding a member of the monovalent cation:proton antiporter‐2 (CPA2) family (TC 2.A.37) from the Thermus thermophilus genome and expressed it in Escherichia coli. The gene product was identified as a member of the NapA subfamily and was found to be an active Na+(Li+)/H+ antiporter as it conferred resistance to the Na+ and Li+ sensitive strain E. coli EP432 (ΔnhaA, ΔnhaB) upon exposure to high concentration of these salts in the growth medium. Fluorescence measurements using the pH sensitive dye 9‐amino‐6‐chloro‐2‐methoxyacridine in everted membrane vesicles of complemented E. coli EP432 showed high Li+/H+ exchange activity at pH 6, but marginal Na+/H+ antiport activity. Towards more alkaline conditions, Na+/H+ exchange activity increased to a relative maximum at pH 8, where by contrast the Li+/H+ exchange activity reached its relative minimum. Substitution of conserved residues D156 and D157 (located in the putative transmembrane helix 6) with Ala resulted in the complete loss of Na+/H+ activity. Mutation of K305 (putative transmembrane helix 10) to Ala resulted in a compromised phenotype characterized by an increase in apparent K
m for Na+ (36 vs. 7.6 mM for the wildtype) and Li+ (17 vs. 0.22 mM), In summary, the Na+/H+ antiport activity profile of the NapA type transporter of T. thermophilus resembles that of NhaA from E. coli, whereas in contrast to NhaA the T. thermophilus NapA antiporter is characterized by high Li+/H+ antiport activity at acidic pH.
The Effect of Flexor Digitorum Profundus Quadriga on Grip Strength
Authors: HORTON T. C. , SAUERLAND S. , DAVIS T. R. C.
Published: January 2007

This study evaluated the flexor digitorum profundus quadriga effect by mimicking stiffness of one finger and observing its effect on the strengths of the other three fingers of the same hand. Thermoplastic wedges were used to simulate mild, moderate and severe stiffness of each finger and the individual strengths of each finger during power grip were measured using a digit-grip™ dynamometer in ten healthy adult volunteers. Middle, ring, and little fingers strength diminished significantly ( P < 0.05) when each of the other fingers, including the index, was stiffened. Index finger strength was largely unaffected by simulated stiffness of the other fingers. The degree of simulated stiffness influenced the strength of the other fingers, but there was considerable intersubject variability, suggesting that the significance of the quadriga effect varies between individuals. An anatomical basis for our findings is suggested.
Barriers to supply chain information integration: SMEs adrift of eLands
Authors: Harland C.M. , Caldwell N.D. , Powell P. , Zheng J.
Published: January 2007

The literature extols the potential benefits of supply chain integration and the crucial role of integrated eBusiness to deliver those benefits. However, adoption of eBusiness in supply chains has been slower than expected, particularly in small to medium sized enterprises (SMEs). This paper reports findings of a longitudinal study of four supply chains in different sectors over a 4‐year period. Specifically it examines the barriers to adoption of eBusiness technologies and therefore to achievement of integrated information in supply chains. Differences between firms in supply chains and between supply chains are examined. The study reveals disparity between existing and planned use of eBusiness by larger downstream firms compared to upstream SMEs. The SMEs are cautious, only planning to invest in eBusiness if dominant downstream customers force them; however, they do not appreciate the full benefits to be gained from eBusiness adoption. The downstream larger businesses are forging ahead with eBusiness in ‘eIsolation’ and are not providing supply chain leadership. They are creating eLands with SMEs adrift of them.
The e‐integration dilemma: The linkages between Internet technology application, trading partner relationships and structural change
Authors: Power Damien , Singh Prakash
Published: January 2007

The evidence from an empirical study involving 281 Australian organizations suggests that the availability, open nature, and (comparative) ease of implementation of Internet technologies for integration with trading partners, whilst on the one hand providing the means by which organizations can integrate processes and systems in a cost effective way, can amplify the need for both structural change and closer collaboration with trading partners. The relationships proposed and tested in the model are justified and explained based on a number of theoretical perspectives. These include Transaction Cost Economics, Socio‐technical Systems, Resource Dependency, Knowledge Based View, Stakeholder Theory and Organizational Learning. The implications of the findings for Transaction Cost Theory are noteworthy firstly because they support the appropriateness of the inter‐organizational governance structure in the context of this study, and secondly because although application of these technologies may reduce information search and related costs, whether this necessarily leads to reduced coordination costs is problematic. The potential benefits from improved coordination may be constrained by the perceived costs, and risks, of transition to new structural forms. The implication for practice is that increased use of Internet technologies creates substantial pressure to invest in organizational change. The attractiveness of investing in technologies that place managers in a position where they need to promote organizational change in order to extract adequate returns creates a significant dilemma. On the one hand Internet technologies enable extensive sharing and integration of data among trading partners, but at the same time they create conditions requiring managers to embrace fundamental organizational change in order to leverage the potential of such integration.
An empirical study of the impact of e‐business technologies on organizational collaboration and performance
Authors: Sanders Nada R.
Published: January 2007

The use of e‐business technologies between supply chain organizations has been thematic in recent literature. Organizational collaboration, the foundation of supply chain management, has been enabled by the development and use of e‐business technologies. Organizational collaboration and information sharing, in turn, are expected to improve organizational performance. We propose and test a model of the relationship between organizational use of e‐business technologies, organizational collaboration, and performance, using empirical data. Our model differs from past studies in that collaboration is viewed as two unique constructs, differentiating between intra‐ and inter‐organizational collaboration. Our findings show that use of e‐business technologies impacts performance both directly and indirectly by promoting both measures of collaboration. Intra‐firm collaboration is also found to have a direct impact on organizational performance. However, the impact of inter‐organizational collaboration on performance is found to be only indirect, through the impact of intra‐organizational collaboration. These findings reveal the complexity of organizational collaboration, underscore the importance for companies to promote internal collaboration, and invest in information technologies that facilitate it.
Relationships among information technology, inventory, and profitability: An investigation of level invariance using sector level data
Authors: Shah Rachna , Shin Hojung
Published: January 2007

Researchers studying multi‐level theories use homologous models to represent parallel nomological networks among similar constructs across different levels of analysis. We use the logic underlying homologous models to examine whether relationships established at the firm level of data aggregation are also evident at the economic sector level. Specifically, we investigate the process‐model which posits that the relationship between IT investment and financial performance is mediated by operational performance, albeit in the manufacturing sector using firm level data. We examine the process‐model using publicly available sector level data from 1960 to 1999 in the manufacturing, retail and wholesale sectors of the U.S. economy. Our results provide strong support for the process‐model and highlight inter‐sector variations, suggesting that different contextual factors may be at play in the three sectors. Finally, examining the process‐model at a higher level of aggregation contributes to the scant multi‐level empirical research.
Linking forward and reverse supply chain investments: The role of business uncertainty
Authors: Kocabasoglu Canan , Prahinski Carol , Klassen Robert D.
Published: January 2007

This paper explores managerial efforts in reverse supply chains (RSC), where the focus is on the capture and exploitation of used products and materials. The RSC can potentially reduce negative environmental impacts of extracting virgin raw materials and waste disposal. If so, investment in the reverse supply chain should not be made in isolation, but instead must be integrated with investments selected to improve the forward supply chain. After defining and operationalizing these constructs, a survey of plant managers was used to empirically assess the linkages between supply chain investments, organizational risk propensity (i.e., willingness to take risk) and business uncertainty. Reverse supply chain investment had two primary dimensions: reconditioning (i.e., high‐value recovery) and recycling and waste management (i.e., low‐ or no‐value recovery). Ongoing investment in the forward supply chain was significantly related to investment in recycling and waste management, but not to investment in reconditioning. Moreover, risk propensity was found to mediate the relationship between the external business uncertainty and investment in the forward and reverse supply chain.
‘Relationships Based on Love and Relationships Based on Needs’: Emerging Trends in Youth Sex Culture in Contemporary Urban Vietnam
Authors: NGUYEN PHUONG AN
Published: January 2007

This paper addresses one of the important dimensions of the experience of youth in contemporary urban Vietnam; that is their sexual practices, behaviour and attitudes. Within a conceptual framework that focuses on sexuality and social change in a modernising and increasingly open society, and based on data collected from ethnographic fieldwork in Hanoi from 1999 to 2004, this paper describes an emerging sexual culture among urban youth. It highlights the emerging trends, issues, and activities which constitute youth sex culture in present-day urban Vietnam. It further argues that the emerging trends in youth sexual culture are reflective of rapid and diverse changes in Vietnamese society as well as the impacts of market reforms on its moral codes, values, and perceptions. There has been a continuation of the ‘traditional’ perceptions of gender roles (particularly the expectation of women to uphold propriety and chastity) and, at the same time, a recognition of the increasingly assertive role of young women in ‘modern’ sexuality and hence of increasing gender equality in this regard. Meanwhile, young Vietnamese nowadays form heterosexual relationships based on both the grammar of love and the grammar of the market.
Imperial Solution of a Colonial Problem: Bhils of Khandesh up to c. 1850
Authors: BENJAMIN N. , MOHANTY B. B.
Published: January 2007

Khandesh region in Maharashtra is an extensive plain interspersed with ranges of hills. It is nearly surrounded by broad chains of mountains covered with vegetation. It was inhabited by the Bhils. They lived in hovels which often crested the tops of isolated hills where approach was immediately discovered and easily defended. They shifted to new habitats after a few weeks or months. Turbulent by disposition and skilful hunters by necessity, they obtained their supplies of roots, berries and game from the jungles. As Captain D. C. Graham put it, ‘To barter anything but what was reaped by the hand of violence was an offence against the tribe; to cultivate or engage in mechanical craft deeply degrading; and no employment was considered to be correct which in any way interfered with the cherished burden of the long-bow, and the ponderous sheaf of arrows’.
Who is a Brahmin in Singapore?
Authors: PARAMESWARAN ASHVIN , SEBASTIAN RODNEY
Published: January 2007

Brahmin identity and community—these are the essentials. Melody cannot be understood except by the notes and spaces that constitute it. So too with the group. To know it, we must understand individuals and their interactions. Failure to do this sacrifices accuracy for simplicity; realities get replaced with poor simulacra of themselves. Consider caste names; are they contested? A common assumption is that they are not.
The Great Bengal Famine and the Question of FAD Yet Again
Authors: ISLAM M. MUFAKHARUL
Published: January 2007

The famine of 1943 cost the Bengal province some three millions lives. Following Amartya Sen's proposition that the famine was not caused by a significant decline in food availability as such the last two decades or so have witnessed a renewed scholarly interest in the subject. On the basis of a fresh look at the available crop statistics this essay supports his basic contention. But at the same time it argues that his proposition is not quite new. Secondly, it suggests that for a fuller understanding of the severity of the crisis it will not be enough to analyse the problem exclusively from the point of view of exchange entitlement failure and with reference to the events in 1943 or thereabout. In other words, the crisis needs to be viewed from a broader and larger perspective.
Inclusion without Influence? NGOs in European Trade Policy
Authors: DÜR ANDREAS , DE BIÈVRE DIRK
Published: January 2007

The actions of nongovernmental organisations (NGOs) concerned with such issues as development, human rights, and the protection of the environment voicing concerns to public authorities raises the questions: Do these newly mobilised societal actors influence EU trade policy outcomes? We answer in the negative, arguing that such groups, which have diffuse costs and benefits from trade policies, do not dispose of resources with which they can threaten or enhance political actors' chances of re-election or re-appointment. A survey of NGOs and business groups as well as two in-depth case studies on the negotiations concerning the EU's Economic Partnership Agreements and the EU's policy on access to medicines in developing countries support our reasoning. The analysis shows that although NGOs have gained access to policy-makers, they have largely failed to shift policy outcomes in their favour.
Leading the Dance? Power and Political Resources of Business Lobbyists
Authors: WOLL CORNELIA
Published: January 2007

Studies of lobbying try to determine the influence and power of non-governmental actors on public policy. Although influence is very difficult to measure empirically, many continue to push for better research design to solve the problem. Through case studies of business-government relations in the United States and the European Union, this article argues that the difficulties with power and influence concern not only their operationalisation, but they also reflect conceptual confusions. Trying to determine the ‘winners’ and ‘losers’ of a policy issue can be misleading, since power also structures apparently harmonious exchange relationships. The perceived success of business lobbying in the cases studied depended on the governments' receptiveness to their demands, which in turn depended on strategic advantages they saw for themselves in international negotiations. Even when business appears to lead the dance, it is more promising to look at resource distribution and the interdependence of both sides, instead of assuming the domination of business power over policy outcomes.
Towards multipurpose autonomous manipulation with the UJI service robot
Authors: Prats M. , Sanz P. J. , del Pobil A. P. , Martínez E. , Marín R.
Published: January 2007

This paper presents a modular control architecture that enables a mobile manipulator to be compliant and perform manipulation tasks in partially known everyday human environments. An impedance velocity/force controller that allows the execution of a great variety of tasks under the Task Frame Formalism (TFF) is implemented.

Tasks are represented as a net of basic abilities which are performed by the robot using the impedance controller. Mechanisms for switching between abilities according to the robot's perceptual state are defined.

We show the validity of our approach on the UJI Service Robot, making it to perform a common daily task such as opening a door. Finally, we apply this framework to make progress on the new version of the UJI Librarian Robot, making a great step forward in the way the robot manipulates books.
Ethical evaluation in health technology assessment reports: An eclectic approach
Authors: Autti-Rämö Ilona , Mäkelä Marjukka
Published: January 2007

Objectives:Ethical evaluation has become an important part of health technology assessment (HTA), but so far no generally accepted method for doing this exists. This article explains the eclectic approach developed at the Finnish HTA office.

Methods:Each HTA report is produced in cooperation with the methodological and clinical experts from various levels of healthcare organizations. An open framework for ethical evaluation when assessing different types of interventions is used to identify all possible stakeholders for each particular intervention. The ethical consequences for each party are identified during the entire process of the HTA project.

Results:The results of an ethical evaluation in four different HTA projects (two on screening, one on surgical intervention, and one in rehabilitation) show that an open framework is useful for opening discussion and understanding the scope of each ethical evaluation. Both content and methodological experts have found the process to be useful in capturing the broad consequences of implementing a new method.

Conclusions:Ethical evaluation is a continuous process that considers the prevalent morals, values, and behavioral models of the society. An in-depth ethical evaluation helps the decision-makers to realize the consequences that implementing a new method has on individual citizens, the healthcare system, and society.
Differences between research ethics committees
Authors: Edwards Sarah J. L. , Stone Tracey , Swift Teresa
Published: January 2007

Objectives:To examine differences in the ethical judgments made by Research Ethics Committees (RECs) or Institutional Review Boards (IRBs).

Methods:We did a review of the literature and included any study that attempted to compare the ethical judgments made by different RECs or IRBs when reviewing one or more protocol.

Results:There were twenty-six articles reporting such discrepancies across Europe, within the United Kingdom, Spain, and United States. Of these studies, there were only five reports of some RECs approving while others rejecting the same protocol. All studies, however, reported differences in the clarifications and revisions asked of researchers regarding consent, recruitment, risks and benefits, compensation arrangements, and scientific issues.

Conclusions:The studies were generally anecdotal reports of researchers trying to do research. New rules requiring a single ethical opinion for multi-site research at least in European Member States may simply conceal problematic issues in REC decision making. In the last analysis, we should expect a certain degree of variation and differences if we are to keep a committee system of review, although there is a pressing need to investigate the way in which RECs make these judgments. In particular, we need to identify the source of any aberrations, distortions, or confusions that could arbitrarily affect these judgments. Furthermore, local conditions remain important ethical considerations and should not be sidelined in pursuit of greater “consistency.”
Patient-based health technology assessment: A vision of the future
Authors: Bridges John F. P. , Jones Christopher
Published: January 2007

Background:In conjunction with other important movements in contemporary medicine, including evidence-based medicine (EBM), health technology assessment (HTA) has promoted a culture of critical evaluation. Despite this impact, institutional and methodological challenges are associated with HTA. For example, only in recent years has HTA attempted an open dialogue with patients; however, this is normally done by giving them a “seat” at the HTA decision-making table, rather than by more scientific means.

Objectives:The aim of this study was to develop a working definition of patient-based HTA, to identify the current barriers to adopting a patient-based model, and to formulate a vision of how a patient-based HTA could be used to promote patient empowerment and patient-centered care.

Results:In the ideal setting, a patient-based HTA would promote patient knowledge by providing access to information and promoting an informed dialogue between patients and their healthcare professionals. To implement a patient-based HTA, the focus must turn to the patient's issues and incorporate each patient's unique perspective and preferences. Processes must change to increase patient participation in all levels of HTA and aim to promote empowered patients who can make informed decisions.

Conclusions:Present-day HTA is broad and has numerous stakeholders, with none so important as the patient. By asking patient-oriented questions in HTA and better involving patients throughout the entire process, we can easily promote patient empowerment, and as such make patients more capable to play a more active role in healthcare decision making.
Assessing the economic challenges posed by orphan drugs
Authors: Drummond Michael F. , Wilson David A. , Kanavos Panos , Ubel Peter , Rovira Joan
Published: January 2007

Historically, patients with rare diseases have been underserved by commercial drug development. In several jurisdictions, specific legislation has been enacted to encourage the development of drugs for rare diseases (orphan drugs), which would otherwise not be commercially viable. However, because of the small market, these drugs are often very expensive. Under the standard methods of health technology assessment (HTA) incorporating economic evaluation, orphan drugs do not usually prove to be cost-effective and this, coupled with their high cost, means that funding and patient access may be limited. However, these restrictions may not be in line with societal preferences. Therefore, this study discusses whether the standard methods of HTA are adequate for assisting decisions on patient access to and funding of orphan drugs and outlines a research agenda to help understand the societal value of orphan drugs and issues surrounding their development, funding, and use.
Clinical effectiveness and cost-effectiveness of implantable cardioverter defibrillators for arrhythmias: A systematic review and economic evaluation
Authors: Bryant Jackie , Brodin Hakan , Loveman Emma , Clegg Andrew
Published: January 2007

Objectives:The clinical effectiveness and cost-effectiveness of implantable cardioverter defibrillators (ICD) for arrhythmias was assessed.

Methods:A systematic review of the literature of systematic reviews and randomized controlled trials that reported mortality outcomes associated with implantable cardioverter defibrillators compared with antiarrhythmic drug therapy in people at risk of sudden cardiac death due to arrhythmias was undertaken. Economic evaluations were also sought. Inclusion criteria, data extraction, and quality assessment were undertaken by standard methodology. A decision analytic model was constructed using best available evidence to determine cost-effectiveness in a UK setting.

Results:Eight randomized controlled trials, two systematic reviews, and a meta-analysis met the inclusion criteria and were of variable quality. Evidence suggests that ICDs reduce mortality in both secondary and primary prevention, although the magnitude of benefit depends on baseline risk for sudden cardiac death. Incremental cost per quality-adjusted life year ranged from £52,000 ($98,000) to over £200,000 ($379,000), depending on mortality risk and assumptions made.

Conclusions:Evidence suggests that ICDs reduce total mortality but may be cost-effective only in some subgroups of patients at high risk of ventricular arrhythmias. Further research is needed on risk stratification of patients in whom ICDs are most likely to be clinically and cost-effective.
Primary prevention of cardiovascular disease: Cost-effectiveness comparison
Authors: Franco Oscar H. , der Kinderen Arno J. , De Laet Chris , Peeters Anna , Bonneux Luc
Published: January 2007

Objectives: The aim of this study was to evaluate the cost-effectiveness of four risk-lowering interventions (smoking cessation, antihypertensives, aspirin, and statins) in primary prevention of cardiovascular disease.

Methods: Using data from the Framingham Heart Study and the Framingham Offspring study, we built life tables to model the benefits of the selected interventions. Participants were classified by age and level of risk of coronary heart disease. The effects of risk reduction are obtained as numbers of death averted and life-years saved within a 10-year period. Estimates of risk reduction by the interventions were obtained from meta-analyses and costs from Dutch sources.

Results: The most cost-effective is smoking cessation therapy, representing savings in all situations. Aspirin is the second most cost-effective (€2,263 to €16,949 per year of life saved) followed by antihypertensives. Statins are the least cost-effective (€73,971 to €190,276 per year of life saved).

Conclusions: A cost-effective strategy should offer smoking cessation for smokers and aspirin for moderate and high levels of risk among men 45 years of age and older. Statin therapy is the most expensive option in primary prevention at levels of 10-year coronary heart disease risk below 30 percent and should not constitute the first choice of treatment in these populations.
Cost-effectiveness of an education and activation program for patients with acute and subacute shoulder complaints compared to usual care
Authors: De Bruijn Camiel , Goossens Marielle , de Bie Rob , Ament Andre , Geraets Jacques , Dinant Geert-Jan
Published: January 2007

Objectives: Shoulder complaints (SCs) constitute the second largest group of musculoskeletal disorders after low back pain. The economic burden in terms of costs of healthcare use and costs due to work absenteeism underlines the need for a cost-effectiveness analysis of the interventions involved. The education and activation program (EAP) is a newly developed early intervention to prevent the development of chronic SCs. A cost-effectiveness analysis should provide more information on the effect of an EAP on total costs related to SCs.

Methods: We conducted a cost-effectiveness analysis alongside a randomized clinical trial comparing the effectiveness of the EAP in addition to usual care (EAP group) with that of usual care alone (UC group) in terms of preventing chronicity in patients with acute SCs. The aim of the cost-effectiveness analysis was to compare the observed difference in costs with the clinical effectiveness (i.e., patient-perceived recovery after 26 weeks), using bootstraps.

Results: The comparison of total costs between treatment groups showed no significant (p = .077) difference after 26 weeks. The majority (82 percent) of the cost-effect pairs after bootstrap analysis were located in the northeast quadrant, suggesting more effect but at higher costs.

Conclusions: In view of the clinical relevance of the clinical outcomes and the considerable costs needed to achieve this, it can be concluded that the EAP is currently not cost-effective.
Cost-effectiveness of surveillance programs for families at high and moderate risk of hereditary non-polyposis colorectal cancer
Authors: Olsen Kim R. , Bojesen Stig E. , Gerdes Anne-Marie M. , Lindorff-Larsen Karen , Bernstein Inge T.
Published: January 2007

Objectives:Surveillance programs are recommended to both families at high risk (Amsterdam-positive families with known- and unknown mutation) and moderate risk (families not fulfilling all Amsterdam criteria) of colorectal cancer (CRC). Cost-effectiveness has so far only been estimated for the group at high risk. The aim of the present study is to determine cost-effectiveness of surveillance programs where families at both high and moderate risk of HNPCC participate.

Methods:A decision analytic model (Markov model) is developed to assess surveillance programs where families at high and moderate risk of HNPCC are offered surveillance from age 25 and age 45, respectively. The model includes costs for all families referred to genetic counseling, including genetic risk assessment, mutation analysis, and surveillance in relevant families with or without known mutation, plus the costs related to any surgical treatment. The risk of metachronous CRC is also modeled.

Results:Incremental costs per life year gained are estimated to be €980 when families at both high and moderate risk of HNPCC undergo surveillance (€508 for high risk and €1600 for moderate risk) and €1947 when the moderate risk group is evaluated genetically but not offered surveillance. Sensitivity analysis showed these findings to be robust, although cost-effectiveness can be improved in cases of more conservative referrals to genetic counseling.

Conclusions:The result for high risk families confirms the findings in similar studies. Somewhat surprisingly, cost-effectiveness improves when surveillance of the moderate risk groups are included in the decision model.
Exploration of the difference in results of economic submissions to the National Institute of Clinical Excellence by manufacturers and assessment groups
Authors: Chauhan Deven , Miners Alec H. , Fischer Alastair J.
Published: January 2007

Objectives:A recent study showed that estimates of cost-effectiveness submitted to National Institute for Health and Clinical Excellence (NICE) by manufacturers had significantly lower incremental cost-effectiveness ratios (ICERs) than those submitted by university-based Assessment Groups. This study extends that analysis.

Methods:Data were abstracted from relevant NICE documentation for thirty-two of eighty-two possible appraisals.

Results:The results from the analysis showed that sources of the difference in ICERs appear to be the effectiveness estimates relating to the comparator technology and the cost estimates relating to the technology under evaluation. That is, manufacturers estimated lower average benefits for the comparator technology and lower costs relating to the technology under evaluation compared with estimates submitted by the Assessment Groups.

Conclusions:These findings may be particularly important, given the introduction of the “Single Technology Appraisal.” Considerable difficulties were encountered when undertaking this study, highlighting, above all else, the complexity of explaining why results from economic evaluations purporting to answer the same question diverge.
Association of study type, sample size, and follow-up length with type of recommendation produced by the National Institute for Health and Clinical Excellence Interventional Procedures Programme
Authors: Campbell William Bruce , Barnes Steven J. , Kirby Rebecca A. , Willett Sarah L. , Wortley Sally , Lyratzopoulos Georgios
Published: January 2007

Objectives:The association between type and amount of clinical evidence and type of National Institute for Health and Clinical Excellence recommendations for interventional procedures was examined.

Methods:The evidence about 736 studies (including 183,729 patients) relating to 130 different interventional procedures and about relevant recommendations was analyzed. Associations were examined between type of recommendation (“normal arrangements” or “cautionary guidance”) and evidence type, total number of treated patients, and mean follow-up length. Evidence type was categorized as (a) randomized, (b) nonrandomized controlled, and (c) case series/reports. The main outcome measures were frequency of evidence type, total number of patients treated, and mean follow-up length, by type of recommendation.

Results:“Normal arrangements” recommendations were made for 70 (54 percent) procedures and “cautionary guidance” was issued for 60 (46 percent) procedures. Procedures supported by at least one randomized study (34 percent,n= 44) were more likely to receive a “normal arrangements” recommendation (relative risk 1.38,p= .063). Overall, there were 85 (12 percent), 135 (18 percent), and 516 (70 percent) studies in categories a–c, respectively. The number of treated patients was significantly larger among procedures with “normal arrangements” (median, 605; range, 26–6,842) than among those with “cautionary guidance” (median, 240; range, 1–3,261;p< .001) recommendation. Mean follow-up length was longer in studies relating to procedures with “normal arrangements” recommendation (median, 16.7; range, 0–84 months) compared with those with “cautionary guidance” (median, 14.6; range, 0–67 months;p= .160).

Conclusions:Procedures supported by randomized studies, and with larger numbers of patients and longer follow-up length, were more likely to receive positive guidance. Future research and development on interventional procedures should aim to produce better and more relevant evidence to optimize the possibility of such procedures being accepted by policy makers.
An experimental study of the influence of individual participant characteristics on formal consensus development
Authors: Carpenter James , Hutchings Andrew , Raine Rosalind , Sanderson Colin
Published: January 2007

Objectives:The aim of this study was to examine the influence of participants' characteristics on the results produced by formal consensus methods.

Methods:The approach was an experimental study of 346 participants in 20 groups rating the appropriateness of four mental health interventions for the treatment of chronic fatigue syndrome, irritable bowel syndrome, and chronic back pain. There were four factors in the design: systematic literature review provided or not, decisions made under realistic or “ideal” resource assumptions, clinically mixed (general practitioners and mental health professionals) or homogenous group (general practitioners only), convened or mail-only group. A group's rating was defined as the median of participants' ratings. The influence of participants' characteristics (age, sex, and specialty) was examined using multilevel models.

Results:The largest differences were between the GPs and mental health professionals, both in their initial ratings of the different interventions, and in how much they altered their ratings between rounds. There were smaller but statistically significant (p<.05) differences between specialty and age groups in initial ratings for the treatment (by whatever means) of different conditions, and for certain conditions women increased their ratings more than men. Women rated intervention more favorably when assuming “ideal” rather than realistic levels of resources, but men did not.

Conclusions:Our findings support the practice of treating professional specialty as an important determinant of the results in consensus panels.
Dialysis care, cardiovascular disease, and costs in end-stage renal disease in Brazil
Authors: Sesso Ricardo , da Silva Camilla Barbosa , Kowalski Sérgio C. , Manfredi Silvia R. , Canziani Maria E. , Draibe Sergio A. , Elgazzar Heba A. , Ferraz Marcos B.
Published: January 2007

Objectives: This study evaluates the cost of dialysis care in Brazil, including costs of ambulatory care and hospital admissions due to all causes and cardiovascular events.

Methods: Data were analyzed for 200 patients with end-stage renal disease (ESRD) on chronic hemodialysis in Brazil between 2001 and 2004. Main end points were all-cause mortality, all-cause hospital admissions, and cardiovascular events. Direct costs of dialysis treatment and complications were computed from the perspective of two payers, the Ministry of Health (MoH) and private health insurance (PHI).

Results: Mean number of days of hospitalization was 12 per patient-year. There were 105 cardiovascular events; the most frequent events were coronary disease (n = 59, 56 percent) and congestive heart failure (n = 26, 25 percent). The rate of cardiovascular events was 193 per 1,000 patient-years. There were 43 deaths, and the death rate was 79 per 1,000 patient-years. Median cost per hospital admission was US$ 675 and US$ 932 from the perspective of the MoH and PHI. For admissions due to cardiovascular causes, the corresponding costs were US$ 1,639 and US$ 4,499, respectively. Mean global cost per patient-year for chronic hemodialysis therapy was US$ 7,980 and US$ 13,428 from the perspective of the MoH and PHI, respectively.

Conclusions: Patients on chronic hemodialysis care incur significant healthcare resources due to the costs of dialysis and complications, notably cardiovascular disease. New disease management programs aimed at reducing cardiovascular morbidity and efficient use of resources are critical to ensuring the sustainability of treatments for ESRD in Brazil.
Benefits of and barriers to involving users in medical device technology development and evaluation
Authors: Shah Syed Ghulam Sarwar , Robinson Ian
Published: January 2007

Objectives:This study investigated the benefits of and barriers to user involvement in medical device technology development and evaluation.

Methods:A structured review of published literature in peer-reviewed journals was conducted.

Results:This literature review revealed that the main benefits of user involvement were an increased access to user needs, experiences, and ideas; improvements in medical device designs and user interfaces; and an increase in the functionality, usability, and quality of the devices. On the other hand, resource issues, particularly those of time and money were found the key impediments to involving users in the development and evaluation of medical device technologies. This study also has categorized both the benefits of and barriers to user involvement.

Conclusions:The involvement of users in medical device technology development and evaluation requires resources, which are limited; however, this involvement is essential from both users and manufacturers perspectives.
Voices from beyond: Verdi's Don Carlos and the modern stage
Authors: KREUZER GUNDULA
Published: January 2007

It has often been suggested that a renewed fascination with Verdi’s Don Carlos coincided with the advent of Regieoper (or radically revisionist staging) in Germany over the past few decades. However, Don Carlos already counted among the most frequently revived operas in German-language theatres during the first half of the twentieth century. This article argues that neglect of this rich performance tradition is linked both to a German-centred narrative of the history of operatic production, which constructs the 1930s and 1940s as a gap in the development of ‘avant-garde’ direction, and to an over-emphasis on the visual side in recent academic discourse on operatic staging. These attitudes are challenged by a close look at selected German productions of Don Carlos from the 1920s to 1940s. Treatment of the opera's most difficult scenes – the mystical elements of the auto-da-fé finale and the dénouement – reveals striking continuities between the Weimar and Nazi eras, as well as conceptual affinities to some of the most acclaimed recent stagings. These findings call for a more historically grounded approach to operatic production.
The Soviet opera project: Ivan Dzerzhinsky vs. Ivan Susanin
Authors: FROLOVA-WALKER MARINA
Published: January 2007

The subject of this article is the failure of the Stalinist Soviet opera project. Although similar proposals had appeared years before, the project was inaugurated in 1936, and its realisation was placed in the hands of the State Committee for Artistic Affairs. The archival materials discussed in the article (including transcripts of the Committee's meetings) demonstrate that even publicly acclaimed productions were seen as failures by these senior bureaucrats. On the one hand, there were demands for realism and contemporary topics, and on the other, for monumentality and elevated musical language; these demands proved to be in deep conflict with each other. In addition to this crippling problem, it soon became apparent that any treatment of a contemporary topic was bound to become unacceptable before long, given the ever-shifting political landscape. While novels and films were certainly under close scrutiny, many operas were subjected to so many demands for revision that they never saw production at all. The article's central claim is that the 1939 Soviet reworking of Glinka's A Life for the Tsar as Ivan Susanin fulfilled the state's needs much better than any newly created Soviet opera could have, resulting in the effective curtailment of the project by 1946.