Showing papers by "Columbia University published in 2002"

Cardiac Resynchronization in Chronic Heart Failure

Abstract: Background Previous studies have suggested that cardiac resynchronization achieved through atrial-synchronized biventricular pacing produces clinical benefits in patients with heart failure who have an intraventricular conduction delay. We conducted a double-blind trial to evaluate this therapeutic approach. Methods Four hundred fifty-three patients with moderate-to-severe symptoms of heart failure associated with an ejection fraction of 35 percent or less and a QRS interval of 130 msec or more were randomly assigned to a cardiac-resynchronization group (228 patients) or to a control group (225 patients) for six months, while conventional therapy for heart failure was maintained. The primary end points were the New York Heart Association functional class, quality of life, and the distance walked in six minutes. Results As compared with the control group, patients assigned to cardiac resynchronization experienced an improvement in the distance walked in six minutes (+39 vs. +10 m, P=0.005), functional clas...

Propensity score-matching methods for nonexperimental causal studies

Abstract: This paper considers causal inference and sample selection bias in nonexperimental settings in which (i) few units in the nonexperimental comparison group are comparable to the treatment units, and (ii) selecting a subset of comparison units similar to the treatment units is difficult because units must be compared across a high-dimensional set of pre-treatment characteristics. We discuss the use of propensity score-matching methods, and implement them using data from the National Supported Work experiment. Following LaLonde (1986), we pair the experimental treated units with nonexperimental comparison units from the CPS and PSID, and compare the estimates of the treatment effect obtained using our methods to the benchmark results from the experiment. For both comparison groups, we show that the methods succeed in focusing attention on the small subset of the comparison units comparable to the treated units and, hence, in alleviating the bias due to systematic differences between the treated and compariso...

Multi-Ethnic Study of Atherosclerosis: Objectives and Design

Abstract: The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years. The cohort will be selected from six US field centers. Approximately 38% of the cohort will be White, 28% African-American, 23% Hispanic, and 11% Asian (of Chinese descent). Baseline measurements will include measurement of coronary calcium using computed tomography; measurement of ventricular mass and function using cardiac magnetic resonance imaging; measurement of flow-mediated brachial artery endothelial vasodilation, carotid intimal-medial wall thickness, and distensibility of the carotid arteries using ultrasonography; measurement of peripheral vascular disease using ankle and brachial blood pressures; electrocardiography; and assessments of microalbuminuria, standard CVD risk factors, sociodemographic factors, life habits, and psychosocial factors. Blood samples will be assayed for putative biochemical risk factors and stored for use in nested case-control studies. DNA will be extracted and lymphocytes will be immortalized for genetic studies. Measurement of selected subclinical disease indicators and risk factors will be repeated for the study of progression over 7 years. Participants will be followed through 2008 for identification and characterization of CVD events, including acute myocardial infarction and other coronary heart disease, stroke, peripheral vascular disease, and congestive heart failure; therapeutic interventions for CVD; and mortality.

What is cognitive reserve? Theory and research application of the reserve concept.

Abstract: The idea of reserve against brain damage stems from the repeated observation that there does not appear to be a direct relationship between the degree of brain pathology or brain damage and the clinical manifestation of that damage. This paper attempts to develop a coherent theoretical account of reserve. One convenient subdivision of reserve models revolves around whether they envision reserve as a passive process, such as in brain reserve or threshold, or see the brain as actively attempting to cope with or compensate for pathology, as in cognitive reserve. Cognitive reserve may be based on more efficient utilization of brain networks or of enhanced ability to recruit alternate brain networks as needed. A distinction is suggested between reserve, the ability to optimize or maximize normal performance, and compensation, an attempt to maximize performance in the face of brain damage by using brain structures or networks not engaged when the brain is not damaged. Epidemiologic and imaging data that help to develop and support the concept of reserve are presented.

Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability.

Abstract: OBJECTIVES: To establish the prevalence of sarcopenia in older Americans and to test the hypothesis that sarcope- nia is related to functional impairment and physical dis- ability in older persons. DESIGN: Cross-sectional survey. SETTING: Nationally representative cross-sectional sur- vey using data from the Third National Health and Nutri- tion Examination Survey (NHANES III). PARTICIPANTS: Fourteen thousand eight hundred eigh- teen adult NHANES III participants aged 18 and older. MEASUREMENTS: The presence of sarcopenia and the relationship between sarcopenia and functional impairment and disability were examined in 4,504 adults aged 60 and older. Skeletal muscle mass was estimated from bioimped- ance analysis measurements and expressed as skeletal mus- cle mass index (SMIskeletal muscle mass/body mass � 100). Subjects were considered to have a normal SMI if their SMI was greater than -one standard deviation above the sex-specific mean for young adults (aged 18-39). Class I sarcopenia was considered present in subjects whose SMI was within -one to -two standard deviations of young adult values, and class II sarcopenia was present in subjects whose SMI was below -two standard deviations of young adult values. RESULTS: The prevalence of class I and class II sarcope- nia increased from the third to sixth decades but remained relatively constant thereafter. The prevalence of class I (59% vs 45%) and class II (10% vs 7%) sarcopenia was greater in the older ( � 60 years) women than in the older men ( P � .001). The likelihood of functional impairment and disability was approximately two times greater in the older men and three times greater in the older women with class II sarcopenia than in the older men and women with a normal SMI, respectively. Some of the associations be- tween class II sarcopenia and functional impairment re- mained significant after adjustment for age, race, body mass index, health behaviors, and comorbidity. CONCLUSIONS: Reduced relative skeletal muscle mass in older Americans is a common occurrence that is signifi- cantly and independently associated with functional im- pairment and disability, particularly in older women. These observations provide strong support for the prevailing view that sarcopenia may be an important and potentially re- versible cause of morbidity and mortality in older persons. J Am Geriatr Soc 50:889-896, 2002.

The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms.

Abstract: OBJECTIVE Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and not widely used. Therefore, we examined the validity of a brief measure of the severity of somatic symptoms. METHODS The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-15 comprises 15 somatic symptoms from the PHQ, each symptom scored from 0 ("not bothered at all") to 2 ("bothered a lot"). The PHQ-15 was administered to 6000 patients in eight general internal medicine and family practice clinics and seven obstetrics-gynecology clinics. Outcomes included functional status as assessed by the 20-item Short-Form General Health Survey (SF-20), self-reported sick days and clinic visits, and symptom-related difficulty. RESULTS As PHQ-15 somatic symptom severity increased, there was a substantial stepwise decrement in functional status on all six SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. PHQ-15 scores of 5, 10, 15, represented cutoff points for low, medium, and high somatic symptom severity, respectively. Somatic and depressive symptom severity had differential effects on outcomes. Results were similar in the primary care and obstetrics-gynecology samples. CONCLUSIONS The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.

A simple model of global cascades on random networks

Abstract: The origin of large but rare cascades that are triggered by small initial shocks is a phenomenon that manifests itself as diversely as cultural fads, collective action, the diffusion of norms and innovations, and cascading failures in infrastructure and organizational networks. This paper presents a possible explanation of this phenomenon in terms of a sparse, random network of interacting agents whose decisions are determined by the actions of their neighbors according to a simple threshold rule. Two regimes are identified in which the network is susceptible to very large cascades—herein called global cascades—that occur very rarely. When cascade propagation is limited by the connectivity of the network, a power law distribution of cascade sizes is observed, analogous to the cluster size distribution in standard percolation theory and avalanches in self-organized criticality. But when the network is highly connected, cascade propagation is limited instead by the local stability of the nodes themselves, and the size distribution of cascades is bimodal, implying a more extreme kind of instability that is correspondingly harder to anticipate. In the first regime, where the distribution of network neighbors is highly skewed, it is found that the most connected nodes are far more likely than average nodes to trigger cascades, but not in the second regime. Finally, it is shown that heterogeneity plays an ambiguous role in determining a system's stability: increasingly heterogeneous thresholds make the system more vulnerable to global cascades; but an increasingly heterogeneous degree distribution makes it less vulnerable.

Corporate reputation and sustained superior financial performance

Abstract: Good corporate reputations are critical because of their potential for value creation, but also because their intangible character makes replication by competing firms considerably more difficult. Existing empirical research confirms that there is a positive relationship between reputation and financial performance. This paper complements these findings by showing that firms with relatively good reputations are better able to sustain superior profit outcomes over time. In particular, we undertake an analysis of the relationship between corporate reputation and the dynamics of financial performance using two complementary dynamic models. We also decompose overall reputation into a component that is predicted by previous financial performance, and that which is ‘left over’, and find that each (orthogonal) element supports the persistence of above-average profits over time. Copyright © 2002 John Wiley & Sons, Ltd.

A Domain-Specific Risk-Attitude Scale: Measuring Risk Perceptions and Risk Behaviors

Abstract: We present a psychometric scale that assesses risk taking in five content domains: financial decisions (separately for investing versus gambling), health/safety, recreational, ethical, and social decisions. Respondents rate the likelihood that they would engage in domain-specific risky activities (Part I). An optional Part II assesses respondents’ perceptions of the magnitude of the risks and expected benefits of the activities judged in Part I. The scale’s construct validity and consistency is evaluated for a sample of American undergraduate students. As expected, respondents’ degree of risk taking was highly domain-specific, i.e. not consistently risk-averse or consistently risk-seeking across all content domains. Women appeared to be more risk-averse in all domains except social risk. A regression of risk taking (likelihood of engaging in the risky activity) on expected benefits and perceived risks suggests that gender and content domain differences in apparent risk taking are associated with differences in the perception of the activities’ benefits and risk, rather than with differences in attitude towards perceived risk.

Counseling the Culturally Diverse: Theory and Practice

Abstract: Preface About the Authors Section One the Multiple Dimensions of Multicultural Counseling and Therapy Part I: The Affective and Conceptual Dimensions of Multicultural Counseling and Therapy Chapter 1 Obstacles to Cultural Competence: Understanding Resistance to Multicultural Training Emotional Self-Revelations and Fears: Majority Group Members Emotional Invalidation versus Affirmation: For Marginalized Group Members A Word of Caution Recognizing and Understanding Resistance to Multicultural Training: For Trainees and Trainers Cognitive Resistance Denial Emotional Resistance Behavioral Resistance Conclusions Summary References Chapter 2 The Superordinate Nature of Multicultural Counseling and Therapy Culture Universal (Etic) versus Culture Specific (Emic) Formulations The Nature of Multicultural Counseling Competence A Tripartite Framework for Understanding the Multiple Dimensions of Identity Individual and Universal Biases in Psychology and Mental Health The Impact of Group Identities on Counseling and Psychotherapy What Is Multicultural Counseling/Therapy? What Is Cultural Competence? Cultural Humility and Cultural Competence Social Justice and Cultural Competence Summary References Chapter 3 Multicultural Counseling Competence for Counselors and Therapists of Marginalized Groups Counselors from Marginalized Groups Working with Majority and Other Marginalized Group Clients The Politics of Interethnic and Interracial Bias and Discrimination The Historical and Political Relationships between Groups of Color Differences between Racial/Ethnic Groups Counselors of Color and Dyadic Combinations Summary References Part II The Political Dimensions of Mental Health Practice Chapter 4 The Political and Social Justice Implications of Counseling and Psychotherapy The Education and Training of Mental Health Professionals Definitions of Mental Health Counseling and Mental Health Literature Need to Treat Social Problems Social Justice Counseling The Foci of Therapeutic Interventions: Individual, Professional, Organizational and Societal Social Justice Counseling Summary References Chapter 5 Impact of Systemic Oppression Therapist Credibility and Client Worldviews The Rest of the Story Therapist Credibility and Attractiveness Formation of Individual and Systemic Worldviews Formation of Worldviews Summary References Chapter 6 Microaggressions in Counseling and Psychotherapy Contemporary Forms of Oppression Evolution of the Isms : Microaggressions The Dynamics and Dilemmas of Microaggressions Therapeutic Implications Summary Part III The Practice Dimensions of Multicultural Counseling/Therapy Chapter 7 Barriers to Multicultural Counseling and Therapy: Individual and Family Perspectives Identifying Multicultural Therapeutic Issues Generic Characteristics of Counseling/Therapy Culture-Bound Values Class-Bound Values Language Barriers Patterns of American Cultural Assumptions and Multicultural Family Counseling/Therapy Conclusions Summary References Chapter 8 Culturally Appropriate Intervention Skills and Strategies Cultural Expression of Mental Disorders Communication Styles Sociopolitical Facets of Nonverbal Communication Counseling and Therapy as Communication Style Summary References Chapter 9 Multicultural Evidence-Based Practice Evidence-Based Practice and Multiculturalism Evidence-Based Practice and Diversity Issues in Therapy Summary References Chapter 10 Non-Western Indigenous Methods of Healing: Implications for Multicultural Counseling and Therapy Legitimacy of Culture-Bound Syndromes: Nightmare Deaths and the Hmong Sudden Death Phenomenon The Principles of Indigenous Healing Conclusion Summary References Part IV Racial/Cultural Identity Development in Multicultural Counseling and Therapy Chapter 11 Racial/Cultural Identity Development in People of Color: Therapeutic Implications Racial Awakening Racial/Cultural Identity Development Models A Racial/Cultural Identity Development Model Therapeutic Implications of the R/ CID Model Conclusions Summary References Chapter 12 White Racial Identity Development: Therapeutic Implications What Does It Mean to Be White? The Invisible Whiteness of Being Understanding the Dynamics of Whiteness Models of White Racial Identity Development The Process of White Racial Identity Development: A Descriptive Model Developing a Nonracist and Antiracist White Identity Summary Section Two Multicultural Counseling and Specific Populations Part V Understanding Specific Populations Chapter 13 Culturally Competent Assessment Therapist Variables Affecting Diagnosis Cultural Competence and Preventing Diagnostic Errors Contextual and Collaborative Assessment Infusing Cultural Competence into Standard Clinical Assessments References Part VI Counseling and Therapy with Racial/Ethnic Minority Group Populations Chapter 14 Counseling African Americans Characteristics and Strengths Specific Challenges References Chapter 15 Counseling American Indians and Alaska Natives Characteristics and Strengths Specific Challenges Alcohol and Substance Abuse References Chapter 16 Counseling Asian Americans and Pacific Islanders Characteristics and Strengths Specific Challenges References Chapter 17 Counseling Latinos Characteristics and Strengths Specific Challenges References Chapter 18 Counseling Individuals of Multiracial Descent Multiracialism in the United States Specific Challenges A Multiracial Bill of Rights Multiracial Strengths References Part VII Counseling and Special Circumstances Involving Racial/Ethnic Populations Chapter 19 Counseling Arab and Muslim Americans Arab Americans Muslim Americans Characteristics and Strengths Specific Challenges References Chapter 20 Counseling Jewish Americans Characteristics and Strengths Specific Challenges References Chapter 21 Counseling Immigrants and Refugees Challenges and Strengths Counseling Refugees References Part VIII Counseling and Therapy with Other Multicultural Populations Chapter 22 Counseling LGBT Individuals Understanding Sexual Minorities Specific Challenges References Chapter 23 Counseling Older Adult Clients Characteristics and Strengths Specific Challenges of Older Adults References Chapter 24 Counseling Women Specific Challenges Embracing Gender Strengths References Chapter 25 Counseling and Poverty Demographics: Who Are the Poor? Strengths of People Living in Poverty Suggested Guidelines for Counselors References Chapter 26 Counseling Persons with Disabilities Understanding Disabilities The Americans with Disabilities Act Specific Challenges Supports for Individuals with Disabilities Counseling Issues with Individuals with Disabilities References Author Index Subject Index

Migrant “Illegality” and Deportability in Everyday Life

Abstract: ▪ Abstract This article strives to meet two challenges. As a review, it provides a critical discussion of the scholarship concerning undocumented migration, with a special emphasis on ethnographically informed works that foreground significant aspects of the everyday life of undocumented migrants. But another key concern here is to formulate more precisely the theoretical status of migrant “illegality” and deportability in order that further research related to undocumented migration may be conceptualized more rigorously. This review considers the study of migrant “illegality” as an epistemological, methodological, and political problem, in order to then formulate it as a theoretical problem. The article argues that it is insufficient to examine the “illegality” of undocumented migration only in terms of its consequences and that it is necessary also to produce historically informed accounts of the sociopolitical processes of “illegalization” themselves, which can be characterized as the legal production ...

Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and theoretical review.

Abstract: Although the merits of parents using corporal punishment to discipline children have been argued for decades, a thorough understanding of whether and how corporal punishment affects children has not been reached. Toward this end, the author first presents the results of meta-analyses of the association between parental corporal punishment and 11 child behaviors and experiences. Parental corporal punishment was associated with all child constructs, including higher levels of immediate compliance and aggression and lower levels of moral internalization and mental health. The author then presents a process– context model to explain how parental corporal punishment might cause particular child outcomes and considers alternative explanations. The article concludes by identifying 7 major remaining issues for future

Climate Effects of Black Carbon Aerosols in China and India

Abstract: In recent decades, there has been a tendency toward increased summer floods in south China, increased drought in north China, and moderate cooling in China and India while most of the world has been warming. We used a global climate model to investigate possible aerosol contributions to these trends. We found precipitation and temperature changes in the model that were comparable to those observed if the aerosols included a large proportion of absorbing black carbon ("soot"), similar to observed amounts. Absorbing aerosols heat the air, alter regional atmospheric stability and vertical motions, and affect the large-scale circulation and hydrologic cycle with significant regional climate effects.

A domain-specific risk-attitude scale: measuring risk perceptions and risk behaviors

Abstract: We present a psychometric scale that assesses risk taking in five content domains: financial decisions (separately for investing versus gambling), health/safety, recreational, ethical, and social decisions. Respondents rate the likelihood that they would engage in domain-specific risky activities (Part I). An optional Part II assesses respondents' perceptions of the magnitude of the risks and expected benefits of the activities judged in Part I. The scale's construct validity and consistency is evaluated for a sample of American undergraduate students. As expected, respondents' degree of risk taking was highly domain-specific, i.e. not consistently risk-averse or consistently risk-seeking across all content domains. Women appeared to be more risk-averse in all domains except social risk. A regression of risk taking (likelihood of engaging in the risky activity) on expected benefits and perceived risks suggests that gender and content domain differences in apparent risk taking are associated with differences in the perception of the activities' benefits and risk, rather than with differences in attitude towards perceived risk. Copyright © 2002 John Wiley & Sons, Ltd.

Addiction to Oncogenes—the Achilles Heal of Cancer

Abstract: A series of recent studies are providing tantalizing hints of new therapeutic approaches for combating cancer. In his Perspective, Weinstein discusses new work ( Jain et al.) demonstrating that even brief inactivation of an oncogene can permanently reverse the malignant phenotype of some types of tumor.

Wnt/β-Catenin/Tcf Signaling Induces the Transcription of Axin2, a Negative Regulator of the Signaling Pathway

Abstract: Axin2/Conductin/Axil and its ortholog Axin are negative regulators of the Wnt signaling pathway, which promote the phosphorylation and degradation of beta-catenin. While Axin is expressed ubiquitously, Axin2 mRNA was seen in a restricted pattern during mouse embryogenesis and organogenesis. Because many sites of Axin2 expression overlapped with those of several Wnt genes, we tested whether Axin2 was induced by Wnt signaling. Endogenous Axin2 mRNA and protein expression could be rapidly induced by activation of the Wnt pathway, and Axin2 reporter constructs, containing a 5.6-kb DNA fragment including the promoter and first intron, were also induced. This genomic region contains eight Tcf/LEF consensus binding sites, five of which are located within longer, highly conserved noncoding sequences. The mutation or deletion of these Tcf/LEF sites greatly diminished induction by beta-catenin, and mutation of the Tcf/LEF site T2 abolished protein binding in an electrophoretic mobility shift assay. These results strongly suggest that Axin2 is a direct target of the Wnt pathway, mediated through Tcf/LEF factors. The 5.6-kb genomic sequence was sufficient to direct the tissue-specific expression of d2EGFP in transgenic embryos, consistent with a role for the Tcf/LEF sites and surrounding conserved sequences in the in vivo expression pattern of Axin2. Our results suggest that Axin2 participates in a negative feedback loop, which could serve to limit the duration or intensity of a Wnt-initiated signal.

World Poverty and Human Rights

Abstract: Despite a high and growing global average income, billions of human beings are still condemned to life long severe poverty, with all its attendant evils of low life expectancy, social exclusion, ill health, illiteracy, dependency, and effective enslavement. The annual death toll from poverty-related causes is around 18 million, or one-third of all human deaths, which adds up to approximately 270 million deaths since the end of the Cold War.

Do Muslim Women Really Need Saving? Anthropological Reflections on Cultural Relativism and Its Others

Abstract: This article explores the ethics of the current "War on Terrorism, asking whether anthropology, the discipline devoted to understanding and dealing with cultural difference, can provide us with critical purchase on the justifications made for American intervention in Afghanistan in terms of liberating, or saving, Afghan women. I look first at the dangers of reifying culture, apparent in the tendencies to plaster neat cultural icons like the Muslim woman over messy historical and political dynamics. Then, calling attention to the resonances of contemporary discourses on equality, freedom, and rights with earlier colonial and missionary rhetoric on Muslim women, I argue that we need to develop, instead, a serious appreciation of differences among women in the world—as products of different histories, expressions of different circumstances, and manifestations of differently structured desires. Further, I argue that rather than seeking to "save" others (with the superiority it implies and the violences it would entail) we might better think in terms of (1) working with them in situations that we recognize as always subject to historical transformation and (2) considering our own larger responsibilities to address the forms of global injustice that are powerful shapers of the worlds in which they find themselves. I develop many of these arguments about the limits of "cultural relativism" through a consideration of the burqa and the many meanings of veiling in the Muslim world. [Keywords: cultural relativism, Muslim women, Afghanistan war, freedom, global injustice, colonialism]

Risperidone in Children with Autism and Serious Behavioral Problems

Abstract: Background Atypical antipsychotic agents, which block postsynaptic dopamine and serotonin receptors, have advantages over traditional antipsychotic medications in the treatment of adults with schizophrenia and may be beneficial in children with autistic disorder who have serious behavioral disturbances. However, data on the safety and efficacy of atypical antipsychotic agents in children are limited. Methods We conducted a multisite, randomized, double-blind trial of risperidone as compared with placebo for the treatment of autistic disorder accompanied by severe tantrums, aggression, or self-injurious behavior in children 5 to 17 years old. The primary outcome measures were the score on the Irritability subscale of the Aberrant Behavior Checklist and the rating on the Clinical Global Impressions — Improvement (CGI-I) scale at eight weeks. Results A total of 101 children (82 boys and 19 girls; mean [±SD] age, 8.8±2.7 years) were randomly assigned to receive risperidone (49 children) or placebo (52). Treat...

A Jump-Diffusion Model for Option Pricing

Abstract: Brownian motion and normal distribution have been widely used in the Black--Scholes option-pricing framework to model the return of assets. However, two puzzles emerge from many empirical investigations: the leptokurtic feature that the return distribution of assets may have a higher peak and two (asymmetric) heavier tails than those of the normal distribution, and an empirical phenomenon called "volatility smile" in option markets. To incorporate both of them and to strike a balance between reality and tractability, this paper proposes, for the purpose of option pricing, a double exponential jump-diffusion model. In particular, the model is simple enough to produce analytical solutions for a variety of option-pricing problems, including call and put options, interest rate derivatives, and path-dependent options. Equilibrium analysis and a psychological interpretation of the model are also presented.

Vision and the Atmosphere

Abstract: Current vision systems are designed to perform in clear weather. Needless to say, in any outdoor application, there is no escape from “bad” weather. Ultimately, computer vision systems must include mechanisms that enable them to function (even if somewhat less reliably) in the presence of haze, fog, rain, hail and snow. We begin by studying the visual manifestations of different weather conditions. For this, we draw on what is already known about atmospheric optics, and identify effects caused by bad weather that can be turned to our advantage. Since the atmosphere modulates the information carried from a scene point to the observer, it can be viewed as a mechanism of visual information coding. We exploit two fundamental scattering models and develop methods for recovering pertinent scene properties, such as three-dimensional structure, from one or two images taken under poor weather conditions. Next, we model the chromatic effects of the atmospheric scattering and verify it for fog and haze. Based on this chromatic model we derive several geometric constraints on scene color changes caused by varying atmospheric conditions. Finally, using these constraints we develop algorithms for computing fog or haze color, depth segmentation, extracting three-dimensional structure, and recovering “clear day” scene colors, from two or more images taken under different but unknown weather conditions.

Sertraline Treatment of Major Depression in Patients With Acute MI or Unstable Angina

Abstract: Results Sertraline had no significant effect on mean (SD) LVEF (sertraline: baseline, 54% [10%]; week 16, 54% [11%]; placebo: baseline, 52% [13%]; week 16, 53% [13%]), treatment-emergent increase in ventricular premature complex (VPC) runs (sertraline: 13.1%; placebo: 12.9%), QTc interval greater than 450 milliseconds at end point (sertraline: 12%; placebo: 13%), or other cardiac measures. All comparisons were statistically nonsignificant (P.05). The incidence of severe cardiovascular adverse events was 14.5% with sertraline and 22.4% with placebo. In the total randomized sample, the CGI-I (P=.049), but not the HAM-D (P=.14), favored sertraline. The CGI-I responder rates for sertraline were significantly higher than for placebo in the total sample (67% vs 53%; P=.01), in the group with at least 1 prior episode of depression (72% vs 51%; P=.003), and in the more severe MDD group (78% vs 45%; P=.001). In the latter 2 groups, both CGI-I and HAM-D measures were significantly better in those assigned to sertraline. Conclusion Our results suggest that sertraline is a safe and effective treatment for recurrent depression in patients with recent MI or unstable angina and without other life-threatening medical conditions. JAMA. 2002;288:701-709 www.jama.com

Effect of Carvedilol on the Morbidity of Patients With Severe Chronic Heart Failure Results of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Study

Abstract: Background— β-Blocking agents improve functional status and reduce morbidity in mild-to-moderate heart failure, but it is not known whether they produce such benefits in severe heart failure. Methods and Results— We randomly assigned 2289 patients with symptoms of heart failure at rest or on minimal exertion and with an ejection fraction <25% (but not volume-overloaded) to double-blind treatment with either placebo (n=1133) or carvedilol (n=1156) for an average of 10.4 months. Carvedilol reduced the combined risk of death or hospitalization for a cardiovascular reason by 27% (P=0.00002) and the combined risk of death or hospitalization for heart failure by 31% (P=0.000004). Patients in the carvedilol group also spent 27% fewer days in the hospital for any reason (P=0.0005) and 40% fewer days in the hospital for heart failure (P<0.0001). These differences were as a result of both a decrease in the number of hospitalizations and a shorter duration of each admission. More patients felt improved and fewer pat...

Blockade of Microglial Activation Is Neuroprotective in the 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine Mouse Model of Parkinson Disease

Abstract: 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) damages the nigrostriatal dopaminergic pathway as seen in Parkinson's disease (PD), a common neurodegenerative disorder with no effective protective treatment. Consistent with a role of glial cells in PD neurodegeneration, here we show that minocycline, an approved tetracycline derivative that inhibits microglial activation independently of its antimicrobial properties, mitigates both the demise of nigrostriatal dopaminergic neurons and the formation of nitrotyrosine produced by MPTP. In addition, we show that minocycline not only prevents MPTP-induced activation of microglia but also the formation of mature interleukin-1beta and the activation of NADPH-oxidase and inducible nitric oxide synthase (iNOS), three key microglial-derived cytotoxic mediators. Previously, we demonstrated that ablation of iNOS attenuates MPTP-induced neurotoxicity. Now, we demonstrate that iNOS is not the only microglial-related culprit implicated in MPTP-induced toxicity because mutant iNOS-deficient mice treated with minocycline are more resistant to this neurotoxin than iNOS-deficient mice not treated with minocycline. This study demonstrates that microglial-related inflammatory events play a significant role in the MPTP neurotoxic process and suggests that minocycline may be a valuable neuroprotective agent for the treatment of PD.

2001 Consensus Guidelines for the Management of Women With Cervical Cytological Abnormalities

Abstract: ObjectiveTo provide evidence-based consensus guidelines for the management of women with cervical cytological abnormalities and cervical cancer precursors.ParticipantsA panel of 121 experts in the diagnosis and management of cervical cancer precursors, including representatives from 29 professional organizations, federal agencies, and national and international health organizations, were invited to participate in a consensus conference sponsored by the American Society for Colposcopy and Cervical Pathology (ASCCP).Evidence and Consensus ProcessGuidelines for the management of women with cervical cytological abnormalities were developed through a multistep process. Starting 6 months before the conference, working groups developed draft management guidelines based on formal literature reviews of English-language articles published in 1988-2001, as well as input from the professional community at large, obtained using interactive Internet-based bulletin boards. On September 6-8, 2001, the ASCCP Consensus Conference was held in Bethesda, Md. Guidelines with supporting evidence were presented and underwent discussion, revision, and voting.ConclusionsManagement of women with atypical squamous cells (ASC) depends on whether the Papanicolaou test is subcategorized as of undetermined significance (ASC-US) or as cannot exclude high-grade squamous intraepithelial lesion (HSIL) (ASC-H). Women with ASC-US should be managed using a program of 2 repeat cytology tests, immediate colposcopy, or DNA testing for high-risk types of human papillomavirus (HPV). Testing for HPV DNA is the preferred approach when liquid-based cytology is used for screening. In most instances, women with ASC-H, low-grade squamous intraepithelial lesion, HSIL, and atypical glandular cells should be referred for immediate colposcopic evaluation.

Anti-CD3 Monoclonal Antibody in New-Onset Type 1 Diabetes Mellitus

Abstract: Background Type 1 diabetes mellitus is a chronic autoimmune disease caused by the pathogenic action of T lymphocytes on insulin-producing beta cells. Previous clinical studies have shown that continuous immune suppression temporarily slows the loss of insulin production. Preclinical studies suggested that a monoclonal antibody against CD3 could reverse hyperglycemia at presentation and induce tolerance to recurrent disease. Methods We studied the effects of a nonactivating humanized monoclonal antibody against CD3 — hOKT3γ1(Ala-Ala) — on the loss of insulin production in patients with type 1 diabetes mellitus. Within 6 weeks after diagnosis, 24 patients were randomly assigned to receive either a single 14-day course of treatment with the monoclonal antibody or no antibody and were studied during the first year of disease. Results Treatment with the monoclonal antibody maintained or improved insulin production after one year in 9 of the 12 patients in the treatment group, whereas only 2 of the 12 controls ...