bluuebunny/crossref_metadata_2025_split huggingface dataset:
Updated Variable‐Radius Measures of Hospital Competition
Authors: Gresenz Carole Roan , Rogowski Jeannette , Escarce José J. 
Published: February 2004

Objective. To calculate variable‐radius measures of hospital market size and create measures of competition for hospitals' markets.Data Sources. Discharge abstracts from the 1997 State Inpatient Databases of the Healthcare Cost and Utilization Project (HCUP) linked with the American Hospital Association (AHA) Annual Survey, Area Resource File (ARF), InterStudy Regional Market Analysis database, and Medicare's Prospective Payment System Impact Files.Study Design. Hospital radii capturing 75 and 90 percent of hospital admissions regressed against hospital and health care market characteristics and other local area characteristics, where the specification was designed to maximize predictive ability. The number of competing hospitals and the Herfindahl‐Hirschman index (HHI) of competition were calculated for each hospital's market.Data Collection Methods. Discharge abstracts were used to create actual radii for hospitals in nine states. These data were linked with other data describing hospital, health care market, and other characteristics.Principal Findings. We explained 44.7 and 9.6 percent of the variation among urban and rural hospitals, respectively, in radii that capture 90 percent of patients, and slightly less of the variation in radii that capture 75 percent of patients. Population density; number of other hospitals in the local area; and hospital characteristics such as medical school affiliation, percentage of admissions that are Medicaid, case mix, and service offerings are important correlates of a hospital's market size.Conclusions. Predicted radii and associated competition measures were created (matched to AHA hospital identifiers) for all nonfederal, short‐term, general medical/surgical hospitals in the continental United States for which complete data were available in 1997 (N=4,806) and are available from the authors.
Nonstationary Brand Variables in Category Management: A Cointegration Perspective
Authors: Jiang James J. , Zhong Maosen , Klein Gary , Chen H. G. 
Published: February 2004

ABSTRACTCategory‐management models serve to assist in the development of plans for pricing and promotions of individual brands. Techniques to solve the models can have problems of accuracy and interpretability because they are susceptible to spurious regression problems due to nonstationary time‐series data. Improperly stated nonstationary systems can reduce the accuracy of the forecasts and undermine the interpretation of the results. This is problematic because recent studies indicate that sales are often a nonstationary time‐series. Newly developed correction techniques can account for nonstationarity by incorporating error‐correction terms into the model when using a Bayesian Vector Error‐Correction Model. The benefit of using such a technique is that shocks to control variates can be separated into permanent and temporary effects and allow cointegration of series for analysis purposes. Analysis of a brand data set indicates that this is important even at the brand level. Thus, additional information is generated that allows a decision maker to examine controllable variables in terms of whether they influence sales over a short or long duration. Only products that are nonstationary in sales volume can be manipulated for long‐term profit gain, and promotions must be cointegrated with brand sales volume. The brand data set is used to explore the capabilities and interpretation of cointegration.
The Effect of Lead Time Uncertainty on Safety Stocks
Authors: Chopra Sunil , Reinhardt Gilles , Dada Maqbool 
Published: February 2004

ABSTRACTThe pressure to reduce inventory investments in supply chains has increased as competition expands and product variety grows. Managers are looking for areas they can improve to reduce inventories without hurting the level of service provided. Two areas that managers focus on are the reduction of the replenishment lead time from suppliers and the variability of this lead time. The normal approximation of lead time demand distribution indicates that both actions reduce inventories for cycle service levels above 50%. The normal approximation also indicates that reducing lead time variability tends to have a greater impact than reducing lead times, especially when lead time variability is large. We build on the work of Eppen and Martin (1988) to show that the conclusions from the normal approximation are flawed, especially in the range of service levels where most companies operate. We show the existence of a service‐level threshold greater than 50% below which reorder points increase with a decrease in lead time variability. Thus, for a firm operating just below this threshold, reducing lead times decreases reorder points, whereas reducing lead time variability increases reorder points. For firms operating at these service levels, decreasing lead time is the right lever if they want to cut inventories, not reducing lead time variability.
Branch‐and‐Price Methods for Prescribing Profitable Upgrades of High‐Technology Products with Stochastic Demands*
Authors: Damodaran Purushothaman , Wilhelm Wilbert E. 
Published: February 2004

ABSTRACTThis paper develops a model that can be used as a decision support aid, helping manufacturers make profitable decisions in upgrading the features of a family of high‐technology products over its life cycle. The model integrates various organizations in the enterprise: product design, marketing, manufacturing, production planning, and supply chain management. Customer demand is assumed random and this uncertainty is addressed using scenario analysis. A branch‐and‐price (B&P) solution approach is devised to optimize the stochastic problem effectively. Sets of random instances are generated to evaluate the effectiveness of our solution approach in comparison with that of commercial software on the basis of run time. Computational results indicate that our approach outperforms commercial software on all of our test problems and is capable of solving practical problems in reasonable run time. We present several examples to demonstrate how managers can use our models to answer “what if” questions.
A possible role of the cytochrome P450c17α gene (CYP17) polymorphism in the pathobiology of uterine leiomyomas from black South African women: a pilot study
Authors: Amant Frédéric , Dorfling Cecilia M. , De Brabanter Jos , Vandewalle Joos , Vergote Ignace , Lindeque B. G. , Van Rensburg Elizabeth J. 
Published: February 2004

Background.  To investigate the role of the CYP17 gene promoter polymorphism in the pathobiology of uterine leiomyomas in African and Caucasian women.Methods.  During a 6‐month period, 145 Caucasian and black South African women undergoing hysterectomy were included prospectively. Blood samples were obtained for DNA analysis. Factors modifying the risk for uterine leiomyoma growth such as age, parity, age at last birth, weight, body mass index, menopausal status, cigarette smoking and oral contraceptive use were determined.Results.  The risk for leiomyoma development among black South African homozygous carriers of the CYP17 A2 allele was shown to be significantly increased when compared to women homozygous for the CYP17 A1 allele or to heterozygous women. Logistic regression analysis disclosed age, parity and CYP17 polymorphism to have an impact on the presence of uterine leiomyomas (p‐values are, respectively, 0.0006, 0.0001 and 0.03) in black South African women. However, among Caucasian women, logistic regression analysis showed only intake of oral contraceptives to influence the formation of uterine leiomyomas (p = 0.03).Conclusion.  This exploratory trial suggests that among African women, homozygous carriers of the CYP17 A2 allele expose their myometrium to a stronger estrogenic stimulation contributing to the pathobiology of uterine leiomyomas.
DEFECTS ON THE DORSUM OF THE HAND — THE POSTERIOR INTEROSSEOUS FLAP AND ITS ALTERNATIVES
Authors: Koch H. , Kursumovic A. , Hubmer M. , Seibert F. J. , Haas F. , Scharnagl E. 
Published: February 2004

There are conditions that preclude the use of the posterior interosseous flap for reconstruction of the dorsum of the hand. Based on a series of 34 cases, these conditions are outlined and alternative solutions discussed. The posterior interosseous flap was employed for closure in 30 cases. In four cases different methods were used due to severe trauma to the wrist and distal forearm with potential impairment of the pedicle, a complex defect requiring a composite flap and an anatomical variation. Thin free flaps were employed alternatively. All flaps survived but there was marginal flap necrosis in two posterior interosseous flaps. The posterior interosseous flap proved its usefulness and reliability in reconstruction of the hand in this series. In four cases, free lateral arm and temporoparietal fascial flaps were employed. Flaps based on the main vessels of the forearm were not used due to their significant donor site morbidity.
AN ANATOMICAL STUDY OF THE LIGAMENTS OF THE ULNAR COMPARTMENT OF THE WRIST
Authors: Sasao Saburo , Beppu Moroe , Kihara Hitoshi , Hirata Kazuaki , Takagi Masayuki 
Published: February 2004

The ligamentous structures of the triangular fibrocartilage complex (TFCC) and their attachments were examined anatomically and histologically using fresh and embalmed cadavers. The TFCC was observed to have a three-dimensional structure consisting of three palmar ligaments — the short radiolunate (SRL), ulnolunate (UL), and ulnotriquetral (UT) ligaments. In addition, the attachment site of the ulnocarpal ligament (UC), which had been previously unknown, was identified. The dorsal components of the TFCC have been previously reported to consist solely of the extensor carpi ulnaris (ECU) subsheath; however, the ligamentous components running from the ulnar styloid process to the triquetrum were found at a layer deeper than the floor of the ECU subsheath.The UC has been reported previously as a two-dimensional structure, but there has been some disagreement as to its attachment sites.2–6,14,15It is suggested that the dorsal UT ligament should be considered as a separate ligament, based on its different direction and distal attachment site as compared with those of the ulnar collateral ligament (UCL) and ECU subsheath.
Predictors of Early Neurological Deterioration after Ischaemic Stroke: A Case-Control Study
Authors: Barber Mark , Wright Fiona , Stott David J. , Langhorne Peter 
Published: February 2004

<i>Background:</i> Early neurological deterioration after ischaemic stroke (stroke in progression) is reported to be common and associated with poor outcome or death. The causes of progressing stroke are, however, uncertain. <i>Objective:</i> To determine whether prior drug treatment (with anticoagulant or antiplatelet agents) or early adverse physiological features (pyrexia, hypoxia, dehydration or hyperglycaemia) are associated with progressing ischaemic stroke. <i>Methods:</i> The study used a case-control design. From a database of 873 consecutive acute stroke admissions, 196 cases of progressing ischaemic stroke (defined by point deterioration in components of the Scandinavian Stroke Scale or death over the first 72 h after hospital admission) were matched to 196 controls on the basis of age and stroke type. Univariate and conditional logistic regression techniques were used to explore predictors of progressing stroke. <i>Results:</i> Cases and controls were well matched for baseline stroke severity. Warfarin use prior to admission was associated with a reduced risk of progressing stroke [odds ratio (OR) 0.10, p = 0.005]. Prior antiplatelet use was not related. A previous history of diabetes (OR 2.11, p = 0.039) and elevated systolic blood pressure on admission (OR 1.01 for each 1 mm Hg rise, p = 0.017) predicted progressing stroke. Although there were no differences in time to presentation or to brain imaging, a visible causative lesion on CT scanning was more common in the progressing stroke group (OR 2.30, p = 0.022). We found no evidence that adverse physiological features were associated with progressing stroke. Outcomes were worse in the progressing stroke group with 70% being dead or dependent by 30 days compared to 55% in the control group (p = 0.002). <i>Conclusion:</i> Prior warfarin use may be protective against progressing ischaemic stroke. A previous history of diabetes along with elevated admission systolic blood pressure predict deterioration. We found no evidence for an association between adverse physiological features and progressing stroke.
Intravesical Vanilloids and Neurogenic Incontinence: Ten Years Experience
Authors: Lazzeri Massimo , Spinelli Michele , Zanollo Alberto , Turini Damiano 
Published: February 2004

<i>Introduction:</i> In this study we critically review our ‘10-year’ experience with intravesical vanilloids (capsaicin and resiniferatoxin) in the treatment of neurogenic incontinence, addressing the issue of their introduction into daily clinical practice. <i>Materials and Methods:</i> From July 1992 to June 2001, 54 patients suffering from detrusor hyperreflexia, due to spinal cord injuries, received intravesical instillation of capsaicin, and from January 1995 to June 2001, 47 patients received intravesical instillation of resiniferatoxin (RTX) in order to treat bladder dysfunction and symptoms. All patients presented detrusor hyperreflexia refractory to oral and/or intravesical oxibutynin and they displayed high-voiding pressure associated with frequent urine leakage. Capsaicin was used at a concentration of 10 m<i>M;</i> RTX was tested in two different concentrations: 10 n<i>M</i> and 10 µ<i>M</i>. The outcome was considered according to simple parameters: (i) the number of patients who reported an improvement in clinical status (patient dry between clean intermittent catheterization) and urodynamic status (a bladder capacity 50% higher than pretreatment capacity, lasting more than 3 months after the instillation); (ii) the number of patients who continued intravesical therapy; (iii) the number of instillations they received; (iv) the length of the interval between 2 consecutive instillations, and (v) alternative therapies when vanilloids failed. <i>Results:</i> The topical intravesical instillation of capsaicin produced an improvement in symptoms and urodynamic parameters, in 29 patients (53.7%) after 3 months. In these 29 patients only 7 (24.13%) continued to received capsaicin in June 2001. The mean follow-up was 32.28 ± 14.20 (range 8–52) months, the mean number of instillations was 6.14 ± 2.54 (range 2–10) and the mean interval between the 2 consecutive instillations was 7.14 ± 2.60 (range 4–12) months. The topical intravesical instillation of RTX produced an improvement in symptoms and urodynamic parameters in 73.33% of patients (a total of 45 patients) who received 10 µ<i>M. </i>18 of them (54.54%) continued to received RTX in June 2001. The mean follow-up was 27.88 ± 10.95 (range 11–49) months, the mean number of instillations was 4.33 ± 1.60 (range 2–8). The mean interval between 2 consecutive instillations was 9.61 ± 2.99 (ranged 4–16) months. <i>Conclusion:</i> The results obtained using RTX seem to be very promising with regard to efficacy and tolerance, particularly in comparison with capsaicin. Even if the number of patients who received capsaicin and RTX remains small, the intravesical vanilloid receptor agonist RTX could offer an attractive alternative to oral medications in the treatment of neurogenic incontinence.
Recombinant factor VIIa partially reverses the inhibitory effect of fondaparinux on thrombin generation after tissue factor activation in platelet rich plasma and whole blood
Authors: Depasse François , Chakroun Tahar , Samama Meyer , Elalamy Ismail , Gerotziafas Grigoris 
Published: February 2004

SummaryFondaparinux (Arixtra®), a specific AT-dependent FXa inhibitor, is effective and safe in the prevention and treatment of venous thromboembolism, but some major hemorrhagic events may occur. No specific antidote to fondaparinux has been proposed. Recombinant FVIIa (Novoseven®) could be used as an haemostatic treatment, but this option has not been well documented. We studied the effect of rFVIIa (1 µg/ml) on the inhibition of thrombin generation induced by fondaparinux (0.1µg/ml to 1 µg/ml). Coagulation was triggered in platelet rich plasma (PRP) or in whole blood by recalcification in the presence of diluted thromboplastin. In PRP thrombin generation was assessed using the thrombinoscope assay. In whole blood, prothrombin activation was assessed by measuring the kinetics of F1+2
formation using an ELISA assay. Fondaparinux at concentrations equal or greater than 0.5 µg/ml prolonged the initiation phase of thrombin generation, and reduced the velocity of prothrombin activation. It also decreased by 60% the endogenous thrombin potential. In the presence of fondaparinux (0.5 µg/ml to 1 µg/ml) rFVIIa accelerated the initiation phase of thrombin generation, but it did not significantly increase the endogenous thrombin potential. However, rFVIIa did not completely reverse the inhibitory effect of fondaparinux on the parameters of thrombin generation and prothrombin activation. This study shows that rFVIIa accelerates thrombin generation, but does not completely reverse the inhibitory effect of fondaparinux on thrombin generation. The potential clinical use of rFVIIa as haemostatic treatment of major bleedings related to fondaparinux has to be evaluated.
The 'Teachers' of Mani in the Acta Archelai and Simon Magus
Authors: Spät Eszter 
Published: February 2004

AbstractThis paper aims to prove that the biography of Mani in the Acta Archelae of Hegemonius, which contains a great number of completely fictitious elements, was in fact drawn up on the file of Simon Magus, pater omnium haereticorum, using the works of heresiologists and the apocryphal acts, especially the Pseudo-Clementine Recognitiones, as a model and source. There are a great number of elements in this Vita Manis that bear a strong resemblance to the well known motives of Simon's life. Projecting Simon's life over that of Mani serves as tool to reinforce the image of Mani that Hegemonius tried to convey: that of just another 'run of the mill' heretic, one in the long line of the disciples of Simon, and a fraud and devoid of any originality.
In Quest of the Third Heaven: Paul & his Apocalyptic Imitators
Authors: Harrison J.R. 
Published: February 2004

AbstractIt is an irony of history that by late antiquity Paul had become the authority figure he never was during his lifetime. However, by the subapostolic and patristic periods Paul's apostolic authority was no longer considered quite so controversial. From 200 AD onwards Paul's letters were regularly cited alongside the Gospels and the Old Testament as 'Scripture'. It is therefore no surprise that the premier apocalyptic theologian of the New Testament would spawn several apocalyptic imitators. Two 'Apocalypses of Paul' have come down to us from antiquity, one gnostic, the other Christian. After discussing each work, the article asks to what extent the historical Paul would have agreed with these later works written in his name. The article will demonstrate how differing ecclesiastical traditions appropriated Paul for their own theological and social agendas instead of allowing the apostle to the Gentiles to speak to his first-century context
The Good Samaritan in Ancient Christianity
Authors: Roukema Riemer 
Published: February 2004

AbstractFor modern readers the parable of the Good Samaritan clearly has an ethical meaning. Although in ancient Christianity this tenor was not fully neglected, the parable was usually interpreted allegorically, the Samaritan being seen as Christ the Saviour of sinners, who had been robbed by the devil. The present article gives a survey of the various interpretations and elaborations of Irenaeus, Clement of Alexandria, an anonymous presbyter, Origen, Gregory Thaumaturgus, the Gospel of Philip, Ambrose, Augustine, and Ephrem the Syrian. It concludes with some remarks on Christian charity in the first centuries C.E. which may in part have provided the hermeneutical context of the allegorization of the parable. It is argued that before Christians were ready to identify themselves with the Samaritan, they first, before their conversion, had identified themselves with the wounded man helped by the Samaritan, who was represented by other Christians.
Force production and flow structure of the leading edge vortex on flapping wings at high and low Reynolds numbers
Authors: Birch James M. , Dickson William B. , Dickinson Michael H. 
Published: February 2004

SUMMARYThe elevated aerodynamic performance of insects has been attributed in part to the generation and maintenance of a stable region of vorticity known as the leading edge vortex (LEV). One explanation for the stability of the LEV is that spiraling axial flow within the vortex core drains energy into the tip vortex, forming a leading-edge spiral vortex analogous to the flow structure generated by delta wing aircraft. However, whereas spiral flow is a conspicuous feature of flapping wings at Reynolds numbers (Re) of 5000, similar experiments at Re=100 failed to identify a comparable structure. We used a dynamically scaled robot to investigate both the forces and the flows created by a wing undergoing identical motion at Re of∼120 and ∼1400. In both cases, motion at constant angular velocity and fixed angle of attack generated a stable LEV with no evidence of shedding. At Re=1400, flow visualization indicated an intense narrow region of spanwise flow within the core of the LEV, a feature conspicuously absent at Re=120. The results suggest that the transport of vorticity from the leading edge to the wake that permits prolonged vortex attachment takes different forms at different Re.
Central control of electric signaling behavior in the mormyridBrienomyrus brachyistius: segregation of behavior-specific inputs and the role of modifiable recurrent inhibition
Authors: Carlson Bruce A. , Hopkins Carl D. 
Published: February 2004

SUMMARYLike all mormyrid fish, Brienomyrus brachyistius produces an electric organ discharge (EOD) with a constant waveform and variable sequence of pulse intervals (SPI). Periodic bursts fall into two display categories termed `scallops' and `accelerations', with a third category termed `rasps'that appears to combine the two. The medullary EOD command nucleus (CN)receives excitatory input from the midbrain precommand nucleus (PCN) and the thalamic dorsal posterior nucleus (DP), both of which are regulated by a recurrent inhibitory projection from the ventroposterior nucleus of the torus semicircularis (VP). We tested the following hypotheses: (1) PCN and DP are responsible for generating different burst types (scallops and accelerations,respectively), (2) differences in the strength of recurrent inhibition are related to physiological differences between PCN and DP and (3) recurrent inhibition regulates the resting electromotor rhythm, while disinhibition releases PCN and DP, allowing them to generate bursts. Iontophoresis of the excitatory neurotransmitter l-glutamate (l-Glu) into DP led to acceleration-like output patterns, while in PCN it led to scallop-like output patterns. Iontophoresis of the inhibitory neurotransmitterγ-amino-butyric acid (GABA) into DP and PCN led to an elongation of intervals, as did iontophoresis of l-Glu into VP. Iontophoresis of the GABAA receptor blocker bicuculline methiodide (BMI) into DP and PCN induced repetitive bursting behavior and eliminated differences in the effects of l-Glu iontophoresis in the two nuclei. These results support our three hypotheses, suggesting that production of different communication behaviors may be regulated by spatially distinct groups of neurons, and recurrent inhibition and disinhibition may play an active role in driving and shaping such behaviors.