240 research outputs found
Using Feedback to Mitigate Coordination and Threshold Problems in Iterative Combinatorial Auctions
Package bids, i.e., bids on sets of items, are an essential aspect of combinatorial auctions. They can allow bidders to accurately express their preferences. However, bidders on packages consisting of few items are often unable to outbid provisionally winning bids on large packages. To resolve this, both coordination as well as cooperation are needed. Coordination, since smaller bidders need to bid on packages that are disjoint; cooperation, since typically bid increases from more than one bidder are required to overcome the threshold to outbid a larger package bid. The authors design an information system that supports the implementation of an iterative combinatorial auction; this system is specifically aimed at helping bidders overcome coordination and threshold problems. They study the effect of information feedback on the behavior of bidders in different auction settings. The authors test this in an experimental setting using human bidders, varying feedback from very basic information about provisionally winning bids/prices, to providing more advanced concepts such as winning and deadness levels, and coalitional feedback. The experiment indicates that coalitional feedback has a positive impact on economic efficiency in cases where difficult threshold problems arise; however, it appears to have an adverse effect when threshold problems are easy
Patient Education and Counseling 56 (2005) 240-248 Long-term efficacy of a checklist to improve patient education in cardiology
Abstract In a randomised controlled trial a Frequently Asked Questions (FAQ) checklist intended to prepare coronary artery disease (CAD) outpatients for a medical check-up visit at the cardiologist was evaluated. The checklist was mailed to patients in preparation to their visits after 1, 4 and 10 months following patients' discharge from hospitalisation for CAD. It was hypothesised that the intervention would result in lower state anxiety, better patient-doctor communication, more knowledge of CAD and greater patient satisfaction, while it would not result in longer visits. Repeated measurements analyses of covariance showed that experimental patients (N = 46) were less anxious before the first visit. This visit was shorter than in the controls, though the third visit was longer. Control patients (N = 59) showed more CAD knowledge than experimental patients at the first and third visit. Experimental patients found the checklist useful, though its value diminished at subsequent visits. Using the checklist thus decreased anxiety prior to the first visit and the duration of that visit, while negatively affecting knowledge. No conclusions about long-term effects could be drawn, due to the likelihood of type II and type III errors. Process evaluation indicated that the approach used is not sufficiently stimulating for patients to use as a preparation to every visit
SNP-Based Typing: A Useful Tool to Study Bordetella pertussis Populations
To monitor changes in Bordetella pertussis populations, mainly two typing methods are used; Pulsed-Field Gel Electrophoresis (PFGE) and Multiple-Locus Variable-Number Tandem Repeat Analysis (MLVA). In this study, a single nucleotide polymorphism (SNP) typing method, based on 87 SNPs, was developed and compared with PFGE and MLVA. The discriminatory indices of SNP typing, PFGE and MLVA were found to be 0.85, 0.95 and 0.83, respectively. Phylogenetic analysis, using SNP typing as Gold Standard, revealed false homoplasies in the PFGE and MLVA trees. Further, in contrast to the SNP-based tree, the PFGE- and MLVA-based trees did not reveal a positive correlation between root-to-tip distance and the isolation year of strains. Thus PFGE and MLVA do not allow an estimation of the relative age of the selected strains. In conclusion, SNP typing was found to be phylogenetically more informative than PFGE and more discriminative than MLVA. Further, in contrast to PFGE, it is readily standardized allowing interlaboratory comparisons. We applied SNP typing to study strains with a novel allele for the pertussis toxin promoter, ptxP3, which have a worldwide distribution and which have replaced the resident ptxP1 strains in the last 20 years. Previously, we showed that ptxP3 strains showed increased pertussis toxin expression and that their emergence was associated with increased notification in the Netherlands. SNP typing showed that the ptxP3 strains isolated in the Americas, Asia, Australia and Europe formed a monophyletic branch which recently diverged from ptxP1 strains. Two predominant ptxP3 SNP types were identified which spread worldwide. The widespread use of SNP typing will enhance our understanding of the evolution and global epidemiology of B. pertussis
Factor V Leiden mutation, prothrombin gene mutation, and deficiencies in coagulation inhibitors associated with Budd-Chiari syndrome and portal vein thrombosis: results of a case-control study
In a collaborative multicenter case-control study, we investigated the
effect of factor V Leiden mutation, prothrombin gene mutation, and
inherited deficiencies of protein C, protein S, and antithrombin on the
risk of Budd-Chiari syndrome (BCS) and portal vein thrombosis (PVT). We
compared 43 BCS patients and 92 PVT patients with 474 population-based
controls. The relative risk of BCS was 11.3 (95% CI 4.8-26.5) for
individuals with factor V Leiden mutation, 2.1(95% CI 0.4-9.6) for those
with prothrombin gene mutation, and 6.8 (95% CI 1.9-24.4) for those with
protein C deficiency. The relative risk of PVT was 2.7 (95% CI 1.1-6.9)
for individuals with factor V Leiden mutation, 1.4 (95% CI 0.4-5.2) fo
EFO-LCI: A New Life Cycle Inventory Database of Forestry Operations in Europe
Life cycle assessment (LCA) has become a common methodology to analyze environmental impacts of forestry systems. Although LCA has been widely applied to forestry since the 90s, the LCAs are still often based on generic Life Cycle Inventory (LCI). With the purpose of improving LCA practices in the forestry sector, we developed a European Life Cycle Inventory of Forestry Operations (EFO-LCI) and analyzed the available information to check if within the European forestry sector national differences really exist. We classified the European forests on the basis of "Forest Units" (combinations of tree species and silvicultural practices). For each Forest Unit, we constructed the LCI of their forest management practices on the basis of a questionnaire filled out by national silvicultural experts. We analyzed the data reported to evaluate how they vary over Europe and how they affect LCA results and made freely available the inventory data collected for future use. The study shows important variability in rotation length, type of regeneration, amount and assortments of wood products harvested, and machinery used due to the differences in management practices. The existing variability on these activities sensibly affect LCA results of forestry practices and raw wood production. Although it is practically unfeasible to collect site-specific data for all the LCAs involving forest-based products, the use of less generic LCI data of forestry practice is desirable to improve the reliability of the studies. With the release of EFO-LCI we made a step toward the construction of regionalized LCI for the European forestry sector
Acute recoordination rather than functional hemodynamic improvement determines reverse remodelling by cardiac resynchronisation therapy
Purpose: Cardiac resynchronisation therapy (CRT) improves left ventricular (LV) function acutely, with further improvements and reverse remodelling during chronic CRT. The current study investigated the relation between acute improvement of LV systolic function, acute mechanical recoordination, and long-term reverse remodelling after CRT. Methods: In 35 patients, LV speckle tracking longitudinal strain, LV volumes & ejection fraction (LVEF) were assessed by echocardiography before, acutely within three days, and 6 months after CRT. A subgroup of 25 patients underwent invasive assessment of the maximal rate of LV pressure rise (dP/dt max,) during CRT-implantation. The acute change in dP/dt max, LVEF, systolic discoordination (internal stretch fraction [ISF] and LV systolic rebound stretch [SRSlv]) and systolic dyssynchrony (standard deviation of peak strain times [2DS-SD18]) was studied, and their association with long-term reverse remodelling were determined. Results: CRT induced acute and ongoing recoordination (ISF from 45 ± 18 to 27 ± 11 and 23 ± 12%, p < 0.001; SRS from 2.27 ± 1.33 to 0.74 ± 0.50 and 0.71 ± 0.43%, p < 0.001) and improved LV function (dP/dt max 668 ± 185 vs. 817 ± 198 mmHg/s, p < 0.001; stroke volume 46 ± 15 vs. 54 ± 20 and 52 ± 16 ml; LVEF 19 ± 7 vs. 23 ± 8 and 27 ± 10%, p < 0.001). Acute recoordination related to reverse remodelling (r = 0.601 and r = 0.765 for ISF & SRSlv, respectively, p < 0.001). Acute functional improvements of LV systolic function however, neither related to reverse remodelling nor to the extent of acute recoordination. Conclusion: Long-term reverse remodelling after CRT is likely determined by (acute) recoordination rather than by acute hemodynamic improvements. Discoordination may therefore be a more important CRT-substrate that can be assessed and, acutely restored
Distinct fecal and oral microbiota composition in human type 1 diabetes, an observational study
Objective Environmental factors driving the development of type 1 diabetes (T1D) are still largely unknown. Both animal and human studies have shown an association between altered fecal microbiota composition, impaired production of short-chain fatty acids (SCFA) and T1D onset. However, observational evidence on SCFA and fecal and oral microbiota in adults with longstanding T1D vs healthy controls (HC) is lacking. Research design and methods We included 53 T1D patients without complications or medication and 50 HC matched for age, sex and BMI. Oral and fecal microbiota, fecal and plasma SCFA levels, markers of intestinal inflammation (fecal IgA and calprotectin) and markers of low-grade systemic inflammation were measured. Results Oral microbiota were markedly different in T1D (eg abundance of Streptococci) compared to HC. Fecal analysis showed decreased butyrate producing species in T1D and less butyryl-CoA transferase genes. Also, plasma levels of acetate and propionate were lower in T1D, with similar fecal SCFA. Finally, fecal strains Christensenella and Subdoligranulum correlated with glycemic control, inflammatory parameters and SCFA. Conclusions We conclude that T1D patients harbor a different amount of intestinal SCFA (butyrate) producers and different plasma acetate and propionate levels. Future research should disentangle cause and effect and whether supplementation of SCFA-producing bacteria or SCFA alone can have disease-modifying effects in T1D.Peer reviewe
Bordetella pertussis Strains with Increased Toxin Production Associated with Pertussis Resurgence
A more virulent strain of the disease is emerging
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