Short Software Descriptions

This paper briefly presents the software for interactive decision support that was developed in 1990-1991 within the Contracted Study Agreement between the System and Decision Sciences Program at IIASA and several Polish scientific institutions, namely: Institute of Automatic Control (Warsaw University of Technology); Institute of Computing Science (Technical University of Poznaii); Institute of Informatics (Warsaw University); and Systems Research Institute of the Polish Academy of Sciences. This Contracted Study Agreement has been a continuation of the same type of activity conducted since 1985. Therefore many of the software packages are actually improved versions of the programs developed in 1985-1989. The theoretical part of the results developed within this scientific activity is presented in the IIASA Collaborative Paper CP-90-008 by A. Ruszczynski, T. Rogowski and A.P. Wierzbicki entitled "Contributions to Methodology and Techniques of Decision Analysis (First Stage)." Detailed descriptions of the methodology and the user guide for each particular software package are published in separate Collaborative Papers. Each software package described here is available in executable form for non-profit educational and scientific purposes, however, any profit-oriented or commercial application requires a written agreement with IIASA. Inquires about the software should be directed to the System and Decision Sciences Program at IIASA, Methodology of Decisions Analysis Project

The Health Effects of Medicare for the Near-Elderly Uninsured

We study how the trajectory of health for the near-elderly uninsured changes upon enrolling into Medicare at the age of 65. We find that Medicare increases the probability of the previously uninsured having excellent or very good health, decreases their probability of being in good health, and has no discernable effects at lower health levels. Surprisingly, we found Medicare had a similar effect on health for the previously insured. This suggests that Medicare helps the relatively healthy 65 year olds, but does little for those who are already in declining health once they reach the age of 65. The improvement in health between the uninsured and insured were not statistically different from each other. The stability of insurance coverage afforded by Medicare may be the source of the health benefit suggesting that universal coverage at other ages may have similar health effects.

Strain and dynamic measurements using fiber optic sensors embedded into graphite/epoxy tubes

Graphite/epoxy tubes were fabricated with embedded optical fibers to evaluate the feasibility of monitoring strains with a fiber optic technique. Resistance strain gauges were attached to the tubes to measure strain at four locations along the tube for comparison with the fiber optic sensors. Both static and dynamic strain measurements were made with excellent agreement between the embedded fiber optic strain sensor and the strain gauges. Strain measurements of 10(exp -7) can be detected with the optical phase locked loop (OPLL) system using optical fiber. Because of their light weight, compatibility with composites, immunity to electromagnetic interference, and based on the static and dynamic results obtained, fiber optic sensors embedded in composites may be useful as the sensing component of smart structures

The Missing Course: An Introduction to College Teaching for Graduate Instructors

A book review of David Gooblar’s book, The Missing Course: Everything they Never Taught You About College Teaching

Human rights and ethical reasoning : capabilities, conventions and spheres of public action

This interdisciplinary article argues that human rights must be understood in terms of opportunities for social participation and that social and economic rights are integral to any discussion of the subject. We offer both a social constructionist and a normative framework for a sociology of human rights which reaches beyond liberal individualism, combining insights from the work of Amartya Sen and from French convention theory. Following Sen, we argue that human rights are founded on the promotion of human capabilities as ethical demands shaped by public reasoning. Using French convention theory, we show how the terms of such deliberation are shaped by different constructions of collectively held values and the compromises reached between them. We conclude by demonstrating how our approach offers a new perspective on spheres of public action and the role these should play in promoting social cohesion, individual capabilities and human rights

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness.

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management

173. Does the correlation between chemotherapy-induced leukopenia with response in locally advanced breast cancer exist?

PurposeThe correlation between chemotherapy-induced toxicity and treatment outcome in cancer patients has not been thoroughly studied. Our aim was to evaluate whether leukopenia following primary chemotherapy may be predictive for response in patients with locally advanced breast cancer.Patients and MethodsThe records of 164 breast cancer patients administered primary chemotherapy between 1985 and 1995 were analysed. Most of the patients presented with locally advanced disease, however included were also patients with large operable tumours. Chemotherapy included one of the three combinations: CMF; modified Cooper regimen (CMFVP); 31 patients (19%), anthracycline-based regimens (FAC and FEC); 16 patients (10%) and 118 patients (71%).ResultsThe objective response rate in the entire group was 58%; 75% in patients who developed grade 2–3 leukopenia during induction chemotherapy, and 52% in those who had no or grade 1 leukopenia (p < 0.01, multivariate analysis). No other patient- or treatment-related factor including age, performance status, T stage, N stage, supraclavicular Iymph node involvement, inflammatory carcinoma or chemotherapy regimen correlated with response to chemotherapy. There was no correlation between treatment-induced leukopenia and overall survival.ConclusionsThese findings suggest a relationship between chemotherapy induced leukopenia and tumour response in patients with locally advanced breast cancer. The prognostic impact of leukopenia is negliglble

Unraveling the complexity of protein backbone dynamics with combined 13C and 15N solid-state NMR relaxation measurements

Typically, protein dynamics involve a complex hierarchy of motions occurring on different time scales between conformations separated by a range of different energy barriers. NMR relaxation can in principle provide a site-specific picture of both the time scales and amplitudes of these motions, but independent relaxation rates sensitive to fluctuations in different time scale ranges are required to obtain a faithful representation of the underlying dynamic complexity. This is especially pertinent for relaxation measurements in the solid state, which report on dynamics in a broader window of time scales by more than 3 orders of magnitudes compared to solution NMR relaxation. To aid in unraveling the intricacies of biomolecular dynamics we introduce 13C spin–lattice relaxation in the rotating frame (R1ρ) as a probe of backbone nanosecond-microsecond motions in proteins in the solid state. We present measurements of 13C′ R1ρ rates in fully protonated crystalline protein GB1 at 600 and 850 MHz 1H Larmor frequencies and compare them to 13C′ R1, 15N R1 and R1ρ measured under the same conditions. The addition of carbon relaxation data to the model free analysis of nitrogen relaxation data leads to greatly improved characterization of time scales of protein backbone motions, minimizing the occurrence of fitting artifacts that may be present when 15N data is used alone. We also discuss how internal motions characterized by different time scales contribute to 15N and 13C relaxation rates in the solid state and solution state, leading to fundamental differences between them, as well as phenomena such as underestimation of picosecond-range motions in the solid state and nanosecond-range motions in solution

First uses of HAART 300 rings for aortic valve repair in Poland – 4 case studies

Introduction: Aortic valve reconstructions using geometric an- nuloplasty rings HAART 300/200 open new era in aortic valve surgery. The HAART technology resizes, reshapes, stabilizes and simplifies aortic valve repair. The HAART aortic repair rings are designed to be implanted directly into aortic annulus (un- der aortic valve leaflets). Aim: We present first in Poland 4 cases of aortic valve recon- structions using geometric annuloplasty rings HAART 300. Material and methods: Two patients had type IA aortic insuf- ficiency (due to El-Khoury classification) – they were treated by HAART 300 ring insertion and ascending aorta prosthesis implantation. Third patient, Marfan with type IB aortic insuf- ficiency was repaired by HAART 300 ring implantation followed by remodeling (Yacoub) procedure. Fourth patient with type II aortic insufficiency (due to RCC prolapse) was repaired by HAART 300 implantation and cusp plication. Results: All patients shows good results on 6 months postop- erative 3D TTE examinations. Conclusions: Presented technique is reproducible and simplify aortic valve reconstructions