bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced Fitness Landscape Analysis and the Performance of Memetic Algorithms
Authors: Merz Peter 
Published: August 2004

Memetic algorithms (MAs) have demonstrated very effective in combinatorial optimization. This paper offers explanations as to why this is so by investigating the performance of MAs in terms of efficiency and effectiveness. A special class of MAs is used to discuss efficiency and effectiveness for local search and evolutionary meta-search. It is shown that the efficiency of MAs can be increased drastically with the use of domain knowledge. However, effectiveness highly depends on the structure of the problem. As is well-known, identifying this structure is made easier with the notion of fitness landscapes: the local properties of the fitness landscape strongly influence the effectiveness of the local search while the global properties strongly influence the effectiveness of the evolutionary meta-search. This paper also introduces new techniques for analyzing the fitness landscapes of combinatorial problems; these techniques focus on the investigation of random walks in the fitness landscape starting at locally optimal solutions as well as on the escape from the basins of attractions of current local optima. It is shown for NK-landscapes and landscapes of the unconstrained binary quadratic programming problem (BQP) that a random walk to another local optimum can be used to explain the efficiency of recombination in comparison to mutation. Moreover, the paper shows that other aspects like the size of the basins of attractions of local optima are important for the efficiency of MAs and a local search escape analysis is proposed. These simple analysis techniques have several advantages over previously proposed statistical measures and provide valuable insight into the behaviour of MAs on different kinds of landscapes.
Reproductive Health in the Context of Economic and Democratic Development
Authors: Wang Guang-Zhen 
Published: August 2004

AbstractThis paper proposes a model of women's reproductive health in the context of economic and democratic development. Gender equality and reproductive rights were used as intervening factors. The analysis was done in three stages. First, a comparison of the mean values of the variables was conducted. Second, the parameters of the measurement model were assessed, in particular the reliability of the variables and the factor loadings on the constructs. Finally, the estimates of the structural parameters of the model were determined. Data used for this study were obtained from 129 developing countries. Empirical findings indicate the importance of economic development, gender equality, and personal marriage and divorce rights in predicting reproductive health. The path coefficients are high and statistically significant. The relationship between democracy and gender equality is positive and statistically significant as proposed. The results of this study throw some light on several long-standing concerns with regard to the role of economic development, democracy, gender equality, and reproductive rights in predicting women's reproductive health. Limitations of the study are discussed.
Does Human Capital Strongly Affect Economic Growth Rates? Yes, But Only If Assessed Properly
Authors: Weede Erich 
Published: August 2004

AbstractAlthough modern growth theories regard human capital endowment as a determinant of economic growth rates, econometric research does not consistently support this view by empirical evidence. In principle, this discrepancy might arise either from misleading theories or from poor measurement of human capital endowment. Here, it is argued that poor measurement is the culprit, and that one should substitute results from psychological testing, i.e.IQ, for widely accepted measures based on schooling. In order to demonstrate both the superiority of IQ over schooling derived measures as well as the robustness of IQ effects on growth, the new measure is entered in the Mankiw, Romer and Weil and the De Long and Summers frameworks which differ in the specification of growth equations and, in particular, in their treatment of investment. It is demonstrated that IQ effects are at least about equally strong and robust determinants of growth as catch-up opportunities, whether investment is included or excluded, narrowly or broadly defined. If investment is included, its effects are in the same order of magnitude as those of catch-up opportunities or IQ. Since IQ is correlated with state antiquity, since state antiquity might offer
From Social Class and Religious Identity to Status Incongruence in Post-Industrial Societies
Authors: Dogan Mattei 
Published: August 2004

AbstractIn political behaviour, religion has played the role of a barrier against the lower social classes, at such a degree that in most democracies, the vertical cleavages (ethnicity, religion, language, race) have been stronger than the horizontal cleavage (income, education, professional status). Social changes in the last few decades have generated a decline of the social class as well as of the religious factor in the interpretation of political alignments. The concept of status incongruence appears to be a better explanation of contemporary social attitudes and political behaviour. Status imbalances are frequent in advanced pluralist societies, and rare in traditional societies of the Third World. For this reason, this analysis focuses on Western countries. Key words: social status, working class, decline of religious beliefs, status inconsistency, status crystallization, criss-crossing cleavages, downward mobility, individualization.
The Hollowing-out of Hong Kong Electronics: Organizational Inertia and Industrial Restructuring in the 1990s
Authors: Chiu Stephen , Wong Ka -Chung 
Published: August 2004

AbstractThis paper aims to enrich the literature on East Asian development by focusing on one critical difference between Hong Kong and the other NIEs – Hong Kong's rapid deindustrialization since the mid-1980s. We shall argue that while global restructuring gives rise to upgrading opportunities for various localities, it is the process of capability formation associated with the local business model that determines whether or not a locality is likely to benefit from these opportunities. We focus on the electronics industry as a crucial case and based on archival data and case interviews. We show that a strategic inertia associated with the "subcontractor model" locks Hong Kong firms in the OEM role within the buyer-driven global chain. Analyzing the evolution of local firms clearly illustrates the "imprinting" effect of the start-up environment on internal organizational structure and subsequent strategic choice. We conclude from this restructuring experience that sustainability
A prospective randomized controlled trial of point-of-care testing on the coronary care unit
Authors: Collinson PO , John C , Lynch S , Rao A , Canepa-Anson R , Carson E , Cramp D 
Published: August 2004

Background: We report the results of a prospective randomized controlled trial comparing point-of-care testing (POCT) with central laboratory testing (CLT) in a six-bed coronary care unit in a district general hospital. Methods: 263 consecutive admissions with chest pain and suspected acute coronary syndrome were randomized to measurement of cardiac troponin T by POCT or CLT only. Patient management was according to a pre-specified protocol utilizing clinical features, electrocardiographic changes and cardiac biomarkers (creatine kinase and cardiac troponin T) to define management. Outcome measures were diagnostic accuracy compared with CLT as 'gold standard', result turnaround time, mortality and length of stay in all patients and those with a protocol-driven early discharge policy. Results: Diagnostic accuracy and mortality was equivalent in the POCT and CLT arm. Overall there was no difference in length of stay. In the pre-specified early discharge group ( n = 64) there was a significant reduction in median length of non-coronary care unit stay (145.3 h versus 79.5 h) and overall hospital stay (209.3 h versus 149.9 h) in those randomized to POCT. Conclusion: A combination of rapid biochemical diagnosis and structured decisionmaking reduces length of hospital stay.
Diagnostic value of heart fatty acid binding protein and myoglobin in patients admitted with chest pain
Authors: Alansari Salwa E , Croal Bernard L 
Published: August 2004

Introduction: Patients presenting with chest pain do so at varying times following its onset. In addition, their histories can be unreliable, making the interpretation of time-dependent biochemical markers difficult. Patients are therefore subsequently managed according to measurements of specific markers, such as troponin, taken many hours following their admission. Earlier markers such as myoglobin and heart fatty acid binding protein (hFABP) may provide information earlier; however, the true role of such markers remains unclear when applied to real life patient cohorts. We aimed to evaluate and compare the diagnostic accuracy of the early markers hFABP and myoglobin (in terms of area under ROC curves, sensitivity and specificity) to troponin I (cTnI) in a pragmatic group of patients presenting with chest pain. Methods: 302 patients presenting with chest pain had blood samples withdrawn both on admission and 12 h later. These were analysed for cTnI, myoglobin and hFABP. Standard clinical and electrocardiographic data were also obtained. Only the cTnI results were reported back to the clinicians and hence only they would have affected clinical care. Patients were grouped clinically according to both the American College of Cardiology/European Society of Cardiology new definition of myocardial infarction (MI) and by clinicians' diagnosis of MI. Results: Median time from onset of symptoms to admission was 5.0 h (IQR 3.0-12 h). Greater ROC curve areas for the diagnosis of MI by both sets of criteria were obtained for cTnI over both myoglobin and hFABP. ROC curve areas for myoglobin and hFABP were also no better than that for cTnI in those patients presenting less than 4 h after the onset of chest pain. Both myoglobin and hFABP also performed poorly in those patients who were cTnI negative on admission. Conclusion: Myoglobin and hFABP provide little clinical value when measured on admission in patients presenting with chest pain.
Objective determination of appropriate reporting intervals
Authors: Badrick Tony , Wilson Susan R , Dimeski Goce , Hickman Peter E 
Published: August 2004

Background: The reporting interval is the incremental value chosen in reporting analyte concentration. Reporting intervals for different analytes are often inappropriately narrow, when analytical imprecision and biological variability are considered. Methods: We have used statistical techniques to determine intervals for individual analytes at which there is 50% or 95% confidence that two results are analytically different, and compared these with the reporting intervals in use for a range of general chemistry analytes and analytes usually measured by immunoassay. Results: No analytes met the criteria for 95% confidence that the results are analytically different. Even at the 50% confidence level, 24 of 46 analytes failed at all concentrations examined. For some analytes, particularly hormones at high concentration, the reporting interval increment should be increased by a factor of at least ten. Conclusions: The majority of analytes are inappropriately reported when analytical precision alone is considered. The concept of the 'uncertainty of measurement' has not been adequately addressed. A consensus should be reached and implemented on appropriate reporting intervals for all analytes.
Point-of-care test to monitor adherence to anti-tuberculous treatment
Authors: Whitfield Ruth , Cope Graham F 
Published: August 2004

Background: In the fight against the global tuberculosis epidemic, it is essential to ensure that patients adhere to the treatment prescribed. As the treatment is given for a minimum of 6 months it is common for patients not to take their drugs regularly. Strategies are therefore needed to assess adherence to treatment. One established method is to examine the patient's urine for the presence of drug metabolites. A rapid point-of-care test would overcome some of the drawbacks associated with currently available methods. Method: A rapid, safe point-of-care test for isoniazid metabolites (IsoScreen, Surescreen Diagnostics Limited, Derby, UK) has been developed and used to help assess adherence to treatment in a busy clinic for tuberculosis patients in South London. Results: Urine samples were examined from 191 patients receiving isoniazid, usually in combination with rifampicin and other anti-tuberculous drugs. Isoscreen was positive in 93.2% of patients, suggesting that 6.8% might be poorly adhering to treatment. By contrast, examining the same urine samples for evidence of rifampicin ingestion gave positive results in only 43.5%, due to the fact that this test is only positive for a few hours after drug ingestion. Conclusion: IsoScreen has been shown to provide a rapid and safe point-of-care test, which contributes to the detection of non-adherence in patients with tuberculosis.
Morning salivary cortisol versus short Synacthen test as a test of adrenal suppression
Authors: Patel Rajan S , Shaw Steve R , McIntyre Halena E , McGarry Gerald W , Wallace A Michael 
Published: August 2004

Background: The short Synacthen test (SST) is the most commonly used test for the assessment of adrenal suppression. We investigated the potential of a simpler and more cost-effective procedure [morning salivary cortisol (MSC)] as an outpatient screening tool to detect adrenal suppression in patients using topical intranasal corticosteroids for rhinosinusitis. Method: Forty-eight patients who were using topical corticosteroids underwent adrenal function assessment by way of SST and MSC measurement. Results: Sixteen of the 48 patients had impaired MSCs. Of these 16 patients, 15 had an impaired SST (sensitivity 100%) and one had a normal SST. All patients with normal MSCs also had normal SSTs (specificity 97%). Conclusion: The morning salivary cortisol measurement is a useful screening tool for adrenal suppression in this setting.
An audit of tumour marker requests in Northern Ireland
Authors: McDonnell Margaret 
Published: August 2004

Background: An audit of tumour marker requests was carried out in Northern Ireland. The aims were to establish the extent of inappropriate requesting, to effect change in request practice if required, and to standardize laboratory reports for tumour markers. Methods: A baseline audit was conducted to investigate the appropriateness of tumour marker requesting patterns in Northern Ireland. Information booklets containing guidelines for tumour markers were then distributed to all clinicians and a post-intervention audit was carried out. Results: At baseline, 80% of requests for tumour markers were appropriate for the source of the tumour; however, 54% of clinicians used tumour markers to screen for malignancy and there was a low index of suspicion in 35% of these. Requests for more than two tumour markers were received for 5% of request forms. The postintervention survey showed no change in requesting practice. Comments were returned by requestors for 55% of questionnaires. They appeared to be appropriate in 72% of cases. Conclusions: There is a low level of inappropriate requesting of tumour markers in Northern Ireland. Audit and feedback combined with circulation of guidelines were unsuccessful interventions in improving the appropriateness of request practice for these tests.
A population-based study of primary care predictors of non-attendance for cervical screening
Authors: Webb R , Richardson J , Pickles A 
Published: August 2004

Objective: To identify and estimate the population impact of primary care service delivery factors that independently predict non-attendance for cervical screening. Setting: Screening records of all eligible women aged 30 years and over and resident in the former Manchester Health Authority area were analysed (n=72,613). Methods: Practice-level and GP-level explanatory variables, along with area-level covariates, were obtained and merged to the study data set. Logistic regression models were used to identify factors associated with having no recorded history of attending NHS cervical screening services. A multivariate model was created to identify independent predictors of non-attendance with comprehensive adjustment for women's age, area-level socio-demographic factors, and other primary care factors. Attributable fraction estimates were used to assess the population impact of the independent predictors. Results: Large practice size (>4,000 patients), single-handed practice, South Asian male GP, part-time GP employment status, older age and birthplace overseas, and area-level measures of deprivation and transience independently predicted non-attendance. Women born overseas and registered at larger practices were especially unlikely to have ever attended. The combined population attributable fraction estimate for the independent predictors reflecting primary care service delivery was almost 40%, and that for all variables in the final model was over 70%. Conclusions: Independent predictors of non-attendance reflecting general practice structure, workload and GP characteristics were identified. Although relative risks were modest, the collective population impact of these factors was considerable, which has implications for the implementation of informed targeting and the development of new screening services by Primary Care Trusts.
Number needed to screen: lives saved over 20 years of follow-up in mammographic screening
Authors: Tabar L , Vitak B , Yen MFA , Chen HHT , Smith RA , Duffy SW 
Published: August 2004

Objective: To estimate the number needed to screen with mammography to save one life, based on a stated amount of screening activity and long-term follow-up for breast cancer death. Setting: A randomised controlled trial of mammographic screening for breast cancer, with 77,080 women invited to screening and 55,985 not invited. The invited group was offered screening for seven years. Follow-up continued for a total of just over 20 years. Methods: Number needed to screen for seven years to save one life over 20 years was calculated by dividing the number screened (not the number invited) by the total number of lives saved. Similarly, we calculated the number of mammographic examinations required to save one life. Results: We estimate that the number of women needed to screen for seven years to save one life over 20 years is 465 (95% CI 324–819). The number of mammographic examinations needed to save one life was 1499 (95% CI 1046–2642). Conclusions: The number needed to screen to save one life is smaller than has been reported in the past. Mammographic screening is effective in absolute terms as well as relative. Long-term follow-up allowed us to estimate the absolute benefit with greater accuracy.
Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening
Authors: Dinis-Ribeiro M , Yamaki G , Miki K , Costa-Pereira A , Matsukawa M , Kurihara M 
Published: August 2004

Aim: To assess the validity of the measurement of pepsinogen I and II as a screening test for gastric cancer and pre-malignant lesions, namely low-grade dysplasia, both in the general population and in selected groups of patients. Methods: A meta-analysis of sensitivity and specificity results from individual papers on the use of the pepsinogen test. An intrinsic cut-off effect was assumed and a random effect model was used for pooling. Results: Forty-two data sets were included: 27 (64%) population-based screening studies (n=296,553) and 15 (36%) sets of selected individuals (n=4385). Homogenous sensitivity and diagnostic odds ratio (DOR) estimates were found in studies using both pepsinogen I levels and pepsinogen I/II ratio calculations. Pooled pairs of sensitivity and false positive rates (FPr) for pepsinogen I ≤ 70; pepsinogen I/II ratio ≤ 3, pepsinogen I ≤50; pepsinogen I/II ratio ≤ 3, and pepsinogen I ≤ 30; pepsinogen I/II ratio ≤ 2, were sensitivity 77%/FPr 27%, sensitivity 68%/FPr 31%, and sensitivity 52%/FPr 84%, respectively. Positive predictive values (PPV) varied between 0.77% and 1.25%, and negative predictive values (NPV) varied between 99.08% and 99.90%. In selected groups, pooling was only possible when considering pepsinogen I ≤ 70; pepsinogen I/II ratio ≤ 3: giving sensitivity 57%, specificity 80%, PPV 15% and NPV 83%. As for the diagnosis of dysplasia, studies considering pepsinogen I <50; pepsinogen I/II ratio <3 obtained sensitivity 65% and specificity ranging from 74%–85%, both with NPV >95%. Conclusion: Pepsinogen test definition should include pepsinogen I/II ratio as consistency was obtained, both in population based studies and in selected groups for those studies that used pepsinogen I serum levels together with pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Further studies of this test in the management of high-risk patients seem to be worthwhile.
Screening for physical and psychological illness in the British Armed Forces: I: The acceptability of the programme
Authors: Rona RJ , Jones M , French C , Hooper R , Wessely S 
Published: August 2004

Objectives: To assess the response to a self-administered questionnaire and attendance of a medical centre for physical and psychological health screening. Methods: 4500 men and women from the three services were randomly selected to receive either a full or abridged screening questionnaire. The full questionnaire included the General Health Questionnaire-12 (GHQ-12) and Post-traumatic Stress Disorder (PTSD) checklist, 15 symptoms, a self-assessed health status question and three questions on alcohol behaviour (WHO Audit). The abridged questionnaire included GHQ-4, a slightly shortened PTSD checklist and five symptoms, but excluded questions on alcohol behaviour. All 'screen-positive' and a random 'screen-negative' sample were invited to attend a medical centre. Results: 67.1% of the servicemen completed a questionnaire; slightly but significantly more the abridged than the full questionnaire (4.9%, 95% confidence interval 2.3–7.4%). Of those receiving a full or abridged questionnaire, 32% and 22.5% respectively were 'screen-positives', most of the difference (7.5%) attributable to alcohol behaviour. Less than 30% of the servicemen invited to attend a medical centre accepted the invitation, even fewer during the preparation for deployment to Iraq. Those who fulfilled the criteria for PTSD, alcohol behaviour or multi-criteria 'screen-positive' were more reluctant than controls to attend. Conclusions: Screening for psychological illness has little support among servicemen, perhaps because they may not wish to share concerns with a military doctor. Avoidance behaviour among those with a psychological condition may also selectively reduce willingness to attend a medical centre. Screening during pre-deployment periods has even less support than at other times.