Pub Date : 2014-04-01DOI: 10.5824/1309-1581.2014.2.005.x
Berna Çağlar
Bu calismada; elektronik ticaret sektorunde marka sadakati saglamak amaciyla algilanan lojistik hizmet performansi ile markayla ilgili cesitli yapilarin arasindaki iliski incelenmektedir. Bu amacla; Anadolu Bil Meslek Yuksekokulu ogrencileri uzerinde kantitatif arastirma teknikleri kullanilarak arastirma yapilmistir. Arastirma surecinde elde edilmis olan veriler, SPSS 21.0 paket programi ile degerlendirmeye tabi tutulmustur. Arastirma hipotezlerinin analizinde guvenilirlik, faktor ve korelasyon analizleri kullanilmistir. Bu arastirmanin sonucunda; elektronik ticaret sektorunde algilanan lojistik hizmet performansi ile marka sadakati ve markayla ilgili cesitli yapilarin gostergeleri arasinda anlamli iliskilere ulasilmistir. Ayrica; isletmelerin elektronik ticaret uygulamalarina iliskin algilanan lojistik hizmet performanslarini arttirmalari sayesinde marka sadakati gostergelerinde elde edecekleri faydalar konusunda onerilere yer verilmistir.
{"title":"E-Ticaret Sektöründe Algılanan Lojistik Hizmet Performansı ile Marka Sadakati Ve Marka Güveni Arasındaki İlişki: Meslek Yüksekokulu Öğrencileri Üzerinde Bir Araştırma","authors":"Berna Çağlar","doi":"10.5824/1309-1581.2014.2.005.x","DOIUrl":"https://doi.org/10.5824/1309-1581.2014.2.005.x","url":null,"abstract":"Bu calismada; elektronik ticaret sektorunde marka sadakati saglamak amaciyla algilanan lojistik hizmet performansi ile markayla ilgili cesitli yapilarin arasindaki iliski incelenmektedir. Bu amacla; Anadolu Bil Meslek Yuksekokulu ogrencileri uzerinde kantitatif arastirma teknikleri kullanilarak arastirma yapilmistir. Arastirma surecinde elde edilmis olan veriler, SPSS 21.0 paket programi ile degerlendirmeye tabi tutulmustur. Arastirma hipotezlerinin analizinde guvenilirlik, faktor ve korelasyon analizleri kullanilmistir. Bu arastirmanin sonucunda; elektronik ticaret sektorunde algilanan lojistik hizmet performansi ile marka sadakati ve markayla ilgili cesitli yapilarin gostergeleri arasinda anlamli iliskilere ulasilmistir. Ayrica; isletmelerin elektronik ticaret uygulamalarina iliskin algilanan lojistik hizmet performanslarini arttirmalari sayesinde marka sadakati gostergelerinde elde edecekleri faydalar konusunda onerilere yer verilmistir.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"19 2 1","pages":"75-88"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82564471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-02-21DOI: 10.15420/USC.2012.9.1.57
G. Mentzer, A. Auseon
of the primary prevention of cardiovascular (CV) disease. However, more emphasis needs to be placed on physicians identifying those at risk of HF who require intensified primary prevention practices and advanced therapies to prevent progression. In addition, this would need to include an assessment of exercise capacity, with each patient given a specific exercise prescription. 7 This could range from a conversation during an office visit to more advanced screening for high-risk individuals, with the selection of an exercise test to further assess functional capacity and the need for therapy. Physicians also need to be aware of the patient’s current level of conditioning, factors that predict safety in exercising, and proven methods to increase exercise adherence among patients. In the evaluation of HF, clinical assessment of dyspnea, fatigue, and exertional symptoms have been used for diagnosis and staging. 2 Exercise capacity has also been used to determine prognosis because it can be quantified objectively with a six-minute walk test, treadmill or cycle stress test, and cardiopulmonary exercise testing (CPET). 8–13 The limiting component in exercise capacity for those with HF is impaired Abstract Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. Clinically, there is acceptance that exercise is safe in HF and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. Specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for HF patients in exercise testing and therapy to provide comprehensive cardiac care. It is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from HF.
{"title":"Exercise Capacity in Chronic Heart Failure","authors":"G. Mentzer, A. Auseon","doi":"10.15420/USC.2012.9.1.57","DOIUrl":"https://doi.org/10.15420/USC.2012.9.1.57","url":null,"abstract":"of the primary prevention of cardiovascular (CV) disease. However, more emphasis needs to be placed on physicians identifying those at risk of HF who require intensified primary prevention practices and advanced therapies to prevent progression. In addition, this would need to include an assessment of exercise capacity, with each patient given a specific exercise prescription. 7 This could range from a conversation during an office visit to more advanced screening for high-risk individuals, with the selection of an exercise test to further assess functional capacity and the need for therapy. Physicians also need to be aware of the patient’s current level of conditioning, factors that predict safety in exercising, and proven methods to increase exercise adherence among patients. In the evaluation of HF, clinical assessment of dyspnea, fatigue, and exertional symptoms have been used for diagnosis and staging. 2 Exercise capacity has also been used to determine prognosis because it can be quantified objectively with a six-minute walk test, treadmill or cycle stress test, and cardiopulmonary exercise testing (CPET). 8–13 The limiting component in exercise capacity for those with HF is impaired Abstract Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. Clinically, there is acceptance that exercise is safe in HF and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. Specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for HF patients in exercise testing and therapy to provide comprehensive cardiac care. It is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from HF.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"30 1","pages":"57-60"},"PeriodicalIF":0.0,"publicationDate":"2012-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88970619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-01-05DOI: 10.15420/USC.2012.9.1.66
N. Glusenkamp, W. Oetgen, B. Mullen
• Blood pressure control remains elusive for many hypertensive people: 33.5 % of adults who are 20 years or older in the US have high blood pressure; 80 % are aware of their condition but less than half have their condition under control. • Decades of public health campaigns have produced considerable successes, but tobacco-use rates could be reduced still further: 23.1 % of men and 18.1 % of women are cigarette-smokers. More alarmingly, 19.5 % of students in grades 9–12 report current tobacco use. • A significant minority of US adults have high cholesterol: 15 % of people who are 20 years or older have total serum cholesterol levels of 240 mg/dl or higher. • Diabetes, a key risk factor, already afflicts many people, and there is the potential for this population to grow significantly: 8 % of adults have been diagnosed with diabetes mellitus; 36.8 % of adults are pre-diabetic. • Lastly, more than 67 % of adults in the US are overweight.
{"title":"The Million Hearts Initiative—Targeting Key Drivers of Cardiovascular Mortality from a Medical Specialty Society Perspective","authors":"N. Glusenkamp, W. Oetgen, B. Mullen","doi":"10.15420/USC.2012.9.1.66","DOIUrl":"https://doi.org/10.15420/USC.2012.9.1.66","url":null,"abstract":"• Blood pressure control remains elusive for many hypertensive people: 33.5 % of adults who are 20 years or older in the US have high blood pressure; 80 % are aware of their condition but less than half have their condition under control. • Decades of public health campaigns have produced considerable successes, but tobacco-use rates could be reduced still further: 23.1 % of men and 18.1 % of women are cigarette-smokers. More alarmingly, 19.5 % of students in grades 9–12 report current tobacco use. • A significant minority of US adults have high cholesterol: 15 % of people who are 20 years or older have total serum cholesterol levels of 240 mg/dl or higher. • Diabetes, a key risk factor, already afflicts many people, and there is the potential for this population to grow significantly: 8 % of adults have been diagnosed with diabetes mellitus; 36.8 % of adults are pre-diabetic. • Lastly, more than 67 % of adults in the US are overweight.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"9 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2012-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85313319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-01-04DOI: 10.15420/USC.2012.9.1.12
L. Allen, John S Rumsfield
This unpredictability limits our understanding of the main drivers of readmission and hampers our ability to triage resource-intensive post-discharge care to those patients most likely to be readmitted. Third, the degree to which readmissions can and should be reduced is controversial. The proportion of readmissions that are preventable and, therefore, unnecessary, has been estimated to be as high as 75 % 4 and as low as 19 %. 9 finally, efforts to positively impact readmission rates are likely to be complex and Abstract hospital to home (h2h) is a national quality improvement initiative designed to support efforts to reduce unnecessary cardiovascular-related hospital readmissions. Launched in 2009 by the American college of cardiology and the institute for healthcare improvement, h2h acts as a clearinghouse for clinical providers and healthcare institutions to share strategies for optimizing transitions of care from the inpatient to the outpatient setting. The program centers around three core concepts: patient understanding of, and access to, medications; routine early follow-up with a healthcare provider following discharge; and comprehension of signs and symptoms that require medical attention, and how to seek urgent care in a timely manner. h2h has begun to offer toolkits, instructional webinars, and surveys to further develop these core concepts; it is also launching ‘challenge projects’ such as ‘Mind Your Meds’ or ‘see You in 7’. To date, there are more than 1,000 unique hospitals enrolled from all 50 states. individuals and institutions can learn more by registering online (at www.h2hquality.org). for &
这种不可预测性限制了我们对再入院的主要驱动因素的理解，并阻碍了我们对那些最有可能再入院的患者进行资源密集型出院后护理的能力。第三，在多大程度上可以而且应该减少重新接纳是有争议的。据估计，可预防和因此不必要的再入院比例高达75% 4，低至19%。最后，积极影响再入院率的努力可能是复杂的，摘要医院到家(h2h)是一项国家质量改进倡议，旨在支持减少不必要的心血管相关医院再入院的努力。h2h于2009年由美国心脏病学会(American college of cardiology)和医疗保健改善研究所(institute for healthcare improvement)推出，它是临床提供者和医疗保健机构的交流中心，可以分享优化从住院病人到门诊病人护理过渡的策略。该项目围绕着三个核心概念:患者对药物的理解和获取;出院后与医疗保健提供者进行常规早期随访;了解需要医疗护理的体征和症状，以及如何及时寻求紧急护理。H2h已经开始提供工具包、教学网络研讨会和调查，以进一步发展这些核心概念;该公司还推出了“挑战项目”，如“注意服药”或“7点见”。迄今为止，已有来自所有50个州的1000多家独特的医院注册。个人和机构可以通过在线注册(www.h2hquality.org)了解更多信息。为&
{"title":"The Hospital to Home Quality Improvement Initiative","authors":"L. Allen, John S Rumsfield","doi":"10.15420/USC.2012.9.1.12","DOIUrl":"https://doi.org/10.15420/USC.2012.9.1.12","url":null,"abstract":"This unpredictability limits our understanding of the main drivers of readmission and hampers our ability to triage resource-intensive post-discharge care to those patients most likely to be readmitted. Third, the degree to which readmissions can and should be reduced is controversial. The proportion of readmissions that are preventable and, therefore, unnecessary, has been estimated to be as high as 75 % 4 and as low as 19 %. 9 finally, efforts to positively impact readmission rates are likely to be complex and Abstract hospital to home (h2h) is a national quality improvement initiative designed to support efforts to reduce unnecessary cardiovascular-related hospital readmissions. Launched in 2009 by the American college of cardiology and the institute for healthcare improvement, h2h acts as a clearinghouse for clinical providers and healthcare institutions to share strategies for optimizing transitions of care from the inpatient to the outpatient setting. The program centers around three core concepts: patient understanding of, and access to, medications; routine early follow-up with a healthcare provider following discharge; and comprehension of signs and symptoms that require medical attention, and how to seek urgent care in a timely manner. h2h has begun to offer toolkits, instructional webinars, and surveys to further develop these core concepts; it is also launching ‘challenge projects’ such as ‘Mind Your Meds’ or ‘see You in 7’. To date, there are more than 1,000 unique hospitals enrolled from all 50 states. individuals and institutions can learn more by registering online (at www.h2hquality.org). for &","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"16 1","pages":"12-15"},"PeriodicalIF":0.0,"publicationDate":"2012-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86468430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-01-03DOI: 10.15420/USC.2012.9.1.26
C. Eshelbrenner, K. Vásquez, L. Yanze, R. Oliveros, R. Chilton
coronary disease. Other studies that support a strong relationship between elevated and increased cardiovascular disease the Chicago heart study, 4 the UK prospective diabetes study Abstract Evidence-based medicine is key to the cardiologist’s role in the management of type 2 diabetes. Proven therapies that reduce cardiovascular (CV) events with few off-target effects are imperative. Evidence from epidemiology studies supports the concept that increased blood sugar is correlated with increased CV events. Unfortunately, the lowering of glucose with current agents shows limited benefit in reducing CV events. Metformin in the obese individual reduced CV events and is currently first-line therapy in most clinical practice guidelines. Recently, a meta-analysis reported that current hypoglycemic agents did not improve CV outcomes and were possibly harmful. Possible exceptions come from the Prospective pioglitazone clinical trial in macrovascular events (PROactive), a secondary prevention trial in patients with prior myocardial infarction in which pioglitazone was found to reduce CV events. Glucagon-like peptide-1 (GLP-1) agonists appear to be the most exciting new CV agents, but a dipeptidyl peptidase-4 (DPP4) inhibitor (sitagliptin) combined with a high-dose angiotensin-converting enzyme inhibitor (ACEI) (enalapril) may increase blood pressure and heart rate. Lifestyle modification and proven global risk reduction are still the number one ways to reduce CV events in type 2 diabetes.
{"title":"The cardiologist's role in the management of type 2 diabetes-a review","authors":"C. Eshelbrenner, K. Vásquez, L. Yanze, R. Oliveros, R. Chilton","doi":"10.15420/USC.2012.9.1.26","DOIUrl":"https://doi.org/10.15420/USC.2012.9.1.26","url":null,"abstract":"coronary disease. Other studies that support a strong relationship between elevated and increased cardiovascular disease the Chicago heart study, 4 the UK prospective diabetes study Abstract Evidence-based medicine is key to the cardiologist’s role in the management of type 2 diabetes. Proven therapies that reduce cardiovascular (CV) events with few off-target effects are imperative. Evidence from epidemiology studies supports the concept that increased blood sugar is correlated with increased CV events. Unfortunately, the lowering of glucose with current agents shows limited benefit in reducing CV events. Metformin in the obese individual reduced CV events and is currently first-line therapy in most clinical practice guidelines. Recently, a meta-analysis reported that current hypoglycemic agents did not improve CV outcomes and were possibly harmful. Possible exceptions come from the Prospective pioglitazone clinical trial in macrovascular events (PROactive), a secondary prevention trial in patients with prior myocardial infarction in which pioglitazone was found to reduce CV events. Glucagon-like peptide-1 (GLP-1) agonists appear to be the most exciting new CV agents, but a dipeptidyl peptidase-4 (DPP4) inhibitor (sitagliptin) combined with a high-dose angiotensin-converting enzyme inhibitor (ACEI) (enalapril) may increase blood pressure and heart rate. Lifestyle modification and proven global risk reduction are still the number one ways to reduce CV events in type 2 diabetes.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"10 1","pages":"26-29"},"PeriodicalIF":0.0,"publicationDate":"2012-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85732179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-01-03DOI: 10.15420/USC.2012.9.1.35
Harshal R. Patil, M. Main
a previously unmet clinical need: at least 10–15 % of echocardiograms in the US are ‘technically difficult,’ usually because of patient-related factors, including lung disease and obesity. 21 Such examinations are usually salvaged with the administration of a UCA. This prevents downstream testing, lowers healthcare costs, and results in more timely and accurate diagnoses. 22 DEFINITY was contraindicated at product approval in two patient subsets: those with known hypersensitivity to octafluoropropane (perflutren, the constituent gas within the DEFINITY microbubble), and those with known cardiac shunts. Additionally, product labeling specifically contraindicated intra-arterial injection and use in patients with prior hypersensitivity reactions to perflutren. The contraindication in patients with shunts and the prohibition of intra-arterial injection are related to a theoretical concern regarding the potential for systemic embolization. Although the diameter of a DEFINITY microbubble ranges from 1.1 μ m to 3.3 μ m, about 2 % of these microbubbles are >10 μ m, with a maximum diameter of 20 μ m. 1 Although, under normal conditions, this small subset of microbubbles >10 μ m are filtered by the pulmonary microvasculature, larger microbubbles could access the systemic circulation in patients with intracardiac shunts (or following direct intra-arterial injection) and Abstract DEFINITY ® (Perflutren Lipid Microsphere Injectable Suspension, Lantheus Medical Imaging, North Billerica, MA) was approved by the US Food and Drug Administration in 2001 for “opacification of the left ventricular border in patients with technically difficult echocardiograms”. Since then, product labeling has been substantially revised on three occasions, initially due to safety concerns, and more recently to reflect a large body of literature which supports the excellent risk–benefit profile of this agent. This article describes in detail the substantive modifications of the product labeling for DEFINITY since 2001, and the associated supportive scientific data and public regulatory meetings.
{"title":"The History of Product Label Changes for DEFINITY® in the US","authors":"Harshal R. Patil, M. Main","doi":"10.15420/USC.2012.9.1.35","DOIUrl":"https://doi.org/10.15420/USC.2012.9.1.35","url":null,"abstract":"a previously unmet clinical need: at least 10–15 % of echocardiograms in the US are ‘technically difficult,’ usually because of patient-related factors, including lung disease and obesity. 21 Such examinations are usually salvaged with the administration of a UCA. This prevents downstream testing, lowers healthcare costs, and results in more timely and accurate diagnoses. 22 DEFINITY was contraindicated at product approval in two patient subsets: those with known hypersensitivity to octafluoropropane (perflutren, the constituent gas within the DEFINITY microbubble), and those with known cardiac shunts. Additionally, product labeling specifically contraindicated intra-arterial injection and use in patients with prior hypersensitivity reactions to perflutren. The contraindication in patients with shunts and the prohibition of intra-arterial injection are related to a theoretical concern regarding the potential for systemic embolization. Although the diameter of a DEFINITY microbubble ranges from 1.1 μ m to 3.3 μ m, about 2 % of these microbubbles are >10 μ m, with a maximum diameter of 20 μ m. 1 Although, under normal conditions, this small subset of microbubbles >10 μ m are filtered by the pulmonary microvasculature, larger microbubbles could access the systemic circulation in patients with intracardiac shunts (or following direct intra-arterial injection) and Abstract DEFINITY ® (Perflutren Lipid Microsphere Injectable Suspension, Lantheus Medical Imaging, North Billerica, MA) was approved by the US Food and Drug Administration in 2001 for “opacification of the left ventricular border in patients with technically difficult echocardiograms”. Since then, product labeling has been substantially revised on three occasions, initially due to safety concerns, and more recently to reflect a large body of literature which supports the excellent risk–benefit profile of this agent. This article describes in detail the substantive modifications of the product labeling for DEFINITY since 2001, and the associated supportive scientific data and public regulatory meetings.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"28 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2012-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76169280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-15DOI: 10.15420/USC.2012.9.1.47
S. Samii, J. Banchs
The concept of using an implantable device to manage arrhythmias and heart failure started over 50 years ago. Since then, we have seen these devices improve patient outcomes from bradyarrhythmias, atrial fibrillation, ventricular arrhythmias, and heart failure. These devices are now standard of care in the management of patients and include pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) or combination devices. The future may hold expansion of the indications for these devices, with careful examination of the outcomes of today’s patients. In addition, there is very exciting new technology that may further advance the management of arrhythmias and heart failure.
{"title":"Implantable cardiac devices in the treatment of arrhythmias and congestive heart failure","authors":"S. Samii, J. Banchs","doi":"10.15420/USC.2012.9.1.47","DOIUrl":"https://doi.org/10.15420/USC.2012.9.1.47","url":null,"abstract":"The concept of using an implantable device to manage arrhythmias and heart failure started over 50 years ago. Since then, we have seen these devices improve patient outcomes from bradyarrhythmias, atrial fibrillation, ventricular arrhythmias, and heart failure. These devices are now standard of care in the management of patients and include pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) or combination devices. The future may hold expansion of the indications for these devices, with careful examination of the outcomes of today’s patients. In addition, there is very exciting new technology that may further advance the management of arrhythmias and heart failure.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"22 1","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2011-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79541594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-12DOI: 10.15420/USC.2012.9.2.105
A. Johri, Matthew I Crerar, A. Sanfilippo
IOV in the assessment of LVEF. Galema et al. showed that, in a cohort of patients who had recently undergone primary angioplasty for the treatment of acute myocardial infarction, both intra-observer variability and IOV in the assessment of LVEF were significantly reduced after left ventricular (LV) opacification through the administration of a bolus of contrast agent. 1 Comparison with the mean LVEF results of experienced cardiologists demonstrated that Abstract The assessment of left ventricular ejection fraction is a key clinical investigation guiding the diagnosis, management and prognosis of cardiology patients. Echocardiography is an inexpensive, safe, and portable method commonly used to provide this information. Improvement in the quality of assessment provided by echocardiography continues to be the subject of current clinical programs and investigations. Contrast-enhanced echocardiography is an established method to reduce both inter- and intra-observer variability in the echocardiography lab. The implementation of teaching interventions has also been shown to reduce variability in the qualitative and quantitative assessment of ejection fraction. Newer investigative methods, such as 3D imaging and speckle tracking, show promise as tools to further enhance the quality of left ventricular ejection fraction assessment in the echocardiography lab.
{"title":"Enhancing the Quality of Left Ventricular Ejection Fraction Assessment by Echocardiography","authors":"A. Johri, Matthew I Crerar, A. Sanfilippo","doi":"10.15420/USC.2012.9.2.105","DOIUrl":"https://doi.org/10.15420/USC.2012.9.2.105","url":null,"abstract":"IOV in the assessment of LVEF. Galema et al. showed that, in a cohort of patients who had recently undergone primary angioplasty for the treatment of acute myocardial infarction, both intra-observer variability and IOV in the assessment of LVEF were significantly reduced after left ventricular (LV) opacification through the administration of a bolus of contrast agent. 1 Comparison with the mean LVEF results of experienced cardiologists demonstrated that Abstract The assessment of left ventricular ejection fraction is a key clinical investigation guiding the diagnosis, management and prognosis of cardiology patients. Echocardiography is an inexpensive, safe, and portable method commonly used to provide this information. Improvement in the quality of assessment provided by echocardiography continues to be the subject of current clinical programs and investigations. Contrast-enhanced echocardiography is an established method to reduce both inter- and intra-observer variability in the echocardiography lab. The implementation of teaching interventions has also been shown to reduce variability in the qualitative and quantitative assessment of ejection fraction. Newer investigative methods, such as 3D imaging and speckle tracking, show promise as tools to further enhance the quality of left ventricular ejection fraction assessment in the echocardiography lab.","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"1 1","pages":"105-107"},"PeriodicalIF":0.0,"publicationDate":"2011-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88559606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Insect-mediated self-pollination evolved from outcrossing in two species of Calyptridium. Plants of C. umbellatum are selfpollinated by insects. Most populations of C. monospermum are outcrossing, but those sympatric with C. umbellatum have a complex of floral adaptations that encourage insect-mediated self-pollination very similar to that of C. umbellatum. Allopatric populations of C. umbellatum and C. monospermum have consistent and distinctive chromatographic patterns, but sympatric populations may have varied combinations of the chromatographic patterns of both species. These two species are separated by strong incompatibility barriers, but these barriers are weaker or even rarely nonexistent in some sympatric populations. Data from 35 populations suggest that, although C. umbellatum and C. monospermum. are mostly reproductively isolated from one another, introgression played an important role in the evolution of the many floral modifications inivolved in a change to insect-mediated selfpollination in C. monospermum. Calyptridium unbellatum (Torrey) Greene and C. monospermum Greene are closely related and partly sympatric rosette-forming perennial herbs of montane western North America (Hinton, 1975). Although both species have a basic flower morphology that could have evolved only as an adaptation for insect cross-pollination, the flowers of C. umbellatum have modifications that encourage insect-mediated self-pollination (Hinton, 1976). This species, characterized by flowers with white petals, yellow to red anthers, and a strong odor, is primarily pollinated by butterflies, flies, or beetles. Calyptridium monospermum is an outcrosser over most of its range. The flowers have rose-colored petals and anthers and a faint or undetectable odor and are primarily pollinated by bumblebees. However, in areas of sympatry with the selfing C. umbellatum, C. monospermum includes populations with white petals and a strong floral odor. These populations of C. monspermum are visited by much the same pollinators as C. umbellatum and have a complex of floral modifications that promote inbreeding, highly similar to that of C. umbellatum (Hinton, 1976). These similar floral modifications include: a reorientation of the styles and stamens bringing anthers and stigma within a flower closer together; anthesis over a shorter period of time, resulting in an inflorescence more crowded with 1 This paper is part of a doctoral dissertation submitted to the University of California, Berkeley. I am deeply grateful to Robert Ornduff, Lincoln Constance, and Grady Webster for help. 2iBiology, George Mason University, Fairfax VA 22030. This content downloaded from 157.55.39.153 on Mon, 19 Sep 2016 04:45:39 UTC All use subject to http://about.jstor.org/terms 86 SYSTEMATIC BOTANY [Volume 1 open flowers; a great increase in stigmatic surface area; increased pollen production; and greater synchrony between pollen presentation and stigma receptiveness. All these modifications incre
{"title":"Introgression and the evolution of selfing in Calyptridium monospermum (Portulacaceae)","authors":"W. Hinton","doi":"10.2307/2418841","DOIUrl":"https://doi.org/10.2307/2418841","url":null,"abstract":"Insect-mediated self-pollination evolved from outcrossing in two species of Calyptridium. Plants of C. umbellatum are selfpollinated by insects. Most populations of C. monospermum are outcrossing, but those sympatric with C. umbellatum have a complex of floral adaptations that encourage insect-mediated self-pollination very similar to that of C. umbellatum. Allopatric populations of C. umbellatum and C. monospermum have consistent and distinctive chromatographic patterns, but sympatric populations may have varied combinations of the chromatographic patterns of both species. These two species are separated by strong incompatibility barriers, but these barriers are weaker or even rarely nonexistent in some sympatric populations. Data from 35 populations suggest that, although C. umbellatum and C. monospermum. are mostly reproductively isolated from one another, introgression played an important role in the evolution of the many floral modifications inivolved in a change to insect-mediated selfpollination in C. monospermum. Calyptridium unbellatum (Torrey) Greene and C. monospermum Greene are closely related and partly sympatric rosette-forming perennial herbs of montane western North America (Hinton, 1975). Although both species have a basic flower morphology that could have evolved only as an adaptation for insect cross-pollination, the flowers of C. umbellatum have modifications that encourage insect-mediated self-pollination (Hinton, 1976). This species, characterized by flowers with white petals, yellow to red anthers, and a strong odor, is primarily pollinated by butterflies, flies, or beetles. Calyptridium monospermum is an outcrosser over most of its range. The flowers have rose-colored petals and anthers and a faint or undetectable odor and are primarily pollinated by bumblebees. However, in areas of sympatry with the selfing C. umbellatum, C. monospermum includes populations with white petals and a strong floral odor. These populations of C. monspermum are visited by much the same pollinators as C. umbellatum and have a complex of floral modifications that promote inbreeding, highly similar to that of C. umbellatum (Hinton, 1976). These similar floral modifications include: a reorientation of the styles and stamens bringing anthers and stigma within a flower closer together; anthesis over a shorter period of time, resulting in an inflorescence more crowded with 1 This paper is part of a doctoral dissertation submitted to the University of California, Berkeley. I am deeply grateful to Robert Ornduff, Lincoln Constance, and Grady Webster for help. 2iBiology, George Mason University, Fairfax VA 22030. This content downloaded from 157.55.39.153 on Mon, 19 Sep 2016 04:45:39 UTC All use subject to http://about.jstor.org/terms 86 SYSTEMATIC BOTANY [Volume 1 open flowers; a great increase in stigmatic surface area; increased pollen production; and greater synchrony between pollen presentation and stigma receptiveness. All these modifications incre","PeriodicalId":74859,"journal":{"name":"Spring simulation conference (SpringSim)","volume":"23 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"1976-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91420112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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