Physician Financial Incentives and Cesarean Section Delivery

The 'induced demand' model states that in the face of negative income shocks physicians may exploit their agency relationship with patients by providing excessive care in order to maintain their incomes. We test this model by exploiting an exogenous change in the financial environment facing obstetrician/gynecologists during the 1970s: declining fertility in the U.S. We argue that the 13.5% fall in fertility over the 1970-1982 period increased the income pressure on ob/gyns, and led them to substitute from normal childbirth towards a more highly reimbursed alternative, cesarean delivery. Using a nationally representative micro-data set for this period, we show that there is a strong correlation between within state declines in fertility and within state increases in cesarean utilization. This correlation is robust to consideration of a variety of alternative hypotheses, and appears to be symmetric with respect to periods of fertility decline and fertility increase.

First human study in treatment of unresectable liver metastases from colorectal cancer with irinotecan-loaded beads (DEBIRI)

The objective of this pilot clinical study was to assess the safety, technical feasibility, pharmacokinetic (PK) profile and tumour response of DC Bead™ with irinotecan (DEBIRI™) delivered by intra-arterial embolisation for the treatment of metastatic colorectal cancer. Eleven patients with unresectable liver metastases from CRC, tumour burden <30% of liver volume, adequate haematological, liver and renal function, performance status of <2 were included in this study. Patients received up to 4 sessions of TACE with DEBIRI at 3-week intervals. Feasibility of the procedure, safety and tumour response were assessed after each cycle. PK was measured after the first cycle. Patients were followed up to 24 weeks. Only mild to moderate adverse events were observed. DEBIRI is a technically feasibile procedure; no technical complications were observed. Average Cmax for irinotecan and SN-38 was 194 ng/ml and 16.7 ng/ml, respectively, with average t½ of 4.6 h and 12.4 h following administration of DEBIRI. Best overall response during the study showed disease control in 9 patients (2 patients with partial response and 7 with stable disease, overall response rate of 18%). Our study shows that transarterial chemoembolisation with irinotecan-loaded DC beads (DEBIRI) is safe, technically feasible and effective with a good PK profile

Erwerbsorientierung und Erwerbstätigkeit ost- und westdeutscher Frauen unter veränderten gesellschaftlichen Rahmenbedingungen (Employment orientation and economic activity of women in eastern and western Germany under changed basic social conditions)

"The number of western German women who wish to work has increased continuously since the mid-sixties irrespective of the economic development. In eastern Germany it remained at a high level in spite of continuously high unemployment. With the crisis on the labour market in the early nineties, however, it also became increasingly difficult for western German women to realise their wishes regarding employment, and in eastern Germany the competition on the labour market intensified at the expense of the women. The result was a stagnating labour force participation of women in western Germany compared with the 1980s, with an increasing shift from full-time to part-time work, high unemployment, and the decline in the employment of women in eastern Germany almost to the level in western Germany. These are the results of a survey carried out by the IAB in 1995 which included 4,059 women in western Germany and 2,683 in eastern Germany. In addition it could be seen that the higher labour force participation of better qualified women which was ascertained as early as the 1980s stabilised in all age groups in western Germany in the 1990s. As a result of the above-average sudden drops in employment among women without a vocational qualification and among those with skilled or semi-skilled worker qualifications, the employment opportunities of eastern German women were even more strongly determined by the level of vocational qualifications. The consequence of this was that eastern German women from lower income groups, whose financial necessity to work is the highest, succeed less and less in finding employment again.With the improved basic legal conditions since the beginning of 1991, the number of women on childcare leave increased clearly, especially in western Germany. The 'voluntary' retreat from working life in this phase of life was, however, frequently of a temporary nature: the vast majority of western German women and virtually all eastern German women wished to return to work following the period of childcare leave. Whereas to a large extent western German women succeeded in returning to work after childcare leave, more than a quarter of the eastern German women who gave up work between 1990 and 1992 in order to care for children were unemployed or seeking work at the time of the survey. Women in western Germany also more frequently had possibilities to maintain contact to their company via part-time or temporary work during their childcare leave than did women in eastern Germany." (Author's abstract, IAB-Doku) ((en))Frauen, Erwerbsbeteiligung, Arbeitsmarktchancen, Arbeitszeitwunsch, Erwerbsmotivation, Berufsverlauf, regionaler Vergleich, Erwerbsunterbrechung, Erziehungsurlaub, berufliche Reintegration, Arbeitslosigkeit, Ehefrauen, Erwerbsquote, berufliche Flexibilität, erwerbstätige Frauen, Altersstruktur, Qualifikationsstruktur, Stellung im Beruf, Westdeutschland, Ostdeutschland, Bundesrepublik Deutschland

Fetal functional imaging portrays heterogeneous development of emerging human brain networks

The functional connectivity architecture of the adult human brain enables complex cognitive processes, and exhibits a remarkably complex structure shared across individuals. We are only beginning to understand its heterogeneous structure, ranging from a strongly hierarchical organization in sensorimotor areas to widely distributed networks in areas such as the parieto-frontal cortex. Our study relied on the functional magnetic resonance imaging (fMRI) data of 32 fetuses with no detectable morphological abnormalities. After adapting functional magnetic resonance acquisition, motion correction, and nuisance signal reduction procedures of resting-state functional data analysis to fetuses, we extracted neural activity information for major cortical and subcortical structures. Resting fMRI networks were observed for increasing regional functional connectivity from 21st to 38th gestational weeks (GWs) with a network-based statistical inference approach. The overall connectivity network, short range, and interhemispheric connections showed sigmoid expansion curve peaking at the 26–29 GW. In contrast, long-range connections exhibited linear increase with no periods of peaking development. Region-specific increase of functional signal synchrony followed a sequence of occipital (peak: 24.8 GW), temporal (peak: 26 GW), frontal (peak: 26.4 GW), and parietal expansion (peak: 27.5 GW). We successfully adapted functional neuroimaging and image post-processing approaches to correlate macroscopical scale activations in the fetal brain with gestational age. This in vivo study reflects the fact that the mid-fetal period hosts events that cause the architecture of the brain circuitry to mature, which presumably manifests in increasing strength of intra- and interhemispheric functional macro connectivity.Seventh Framework Programme (European Commission) (KHRESMOI Project

An Evaluation of the Effect Of Degradation on IrisPlex SNPs

The information from short tandem repeats (STRs), the current standard forensic DNA typing technology, does not always result in identification. In these cases, there are other informative markers in DNA that can be used to help generate investigative leads, one of which is single nucleotide polymorphisms (SNPs). One of the uses of SNPs is for phenotype determination. Among the phenotypic characteristics that can be predicted is eye color. A commonly used tool for eye color prediction is the free, online statistical prediction model IrisPlex, which includes 6 SNPs known to control eye color. While SNPs can be useful, they, like all DNA, are susceptible to degradation. Research on the effect of degradation on SNPs has already been done, but much of it uses massively parallel sequencing (MPS), which is not currently feasible for most crime labs. A stronger consensus is needed regarding the value of SNPs with instrumentation and techniques available to crime labs, such as real-time PCR. Because SNPs are such small fragments, they will be highly resistant to the effects of degradation. Buccal swabs from 3 donors were degraded using two methods: UV exposure and burial in soil. Modern teeth and ancient remains found in the Gobi Desert were also analyzed to represent more natural degradation. DNA was extracted and quantified, and the degradation index was assessed. SNP profiles were generated using qPCR and input into IrisPlex to get an eye color prediction. The SNPs were found to be resistant to degradation and the degradation index was not an indicator of SNP assay success or IrisPlex prediction accuracy. The intermediate eye colors did not produce as many accurate predictions as the brown eyes, which reinforces the need to focus on improving prediction accuracy for intermediate eye colors. The TaqMan assays are an option to generate the SNP data; however, there are other methods that likely work better, such as sequencing via capillary electrophoresis

Automatising the learning of lexical patterns: An application to the enrichment of WordNet by extracting semantic relationships from Wikipedia

This is the author’s version of a work that was accepted for publication in Journal Data & Knowledge Engineering. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal Data & Knowledge Engineering, 61, 3, (2007) DOI: 10.1016/j.datak.2006.06.011This paper describes an automatic approach to identify lexical patterns that represent semantic relationships between concepts in an on-line encyclopedia. Next, these patterns can be applied to extend existing ontologies or semantic networks with new relations. The experiments have been performed with the Simple English Wikipedia and WordNet 1.7. A new algorithm has been devised for automatically generalising the lexical patterns found in the encyclopedia entries. We have found general patterns for the hyperonymy, hyponymy, holonymy and meronymy relations and, using them, we have extracted more than 2600 new relationships that did not appear in WordNet originally. The precision of these relationships depends on the degree of generality chosen for the patterns and the type of relation, being around 60-70% for the best combinations proposed.This work has been sponsored by MEC, project number TIN-2005-0688

Erstellung eines förderungsorientierten Diagnosemodells für arbeitslose Jugendliche mit besonderem Schwerpunkt auf deren Arbeitshaltungen

In dieser Studie wurde versucht, durch Bezugnahme auf das „Wiener Diagnosemodell zum Hochleistungspotenzial“ von Holocher-Ertl (2008a), ein Diagnosemodell zur förderungsorientierten Diagnostik für arbeitslose Jugendliche zu erstellen. Im Speziellen wurde jeweils ein Test aus dem Bereich „Persönlichkeit“ („Arbeitshaltungen“, AHA, Kubinger & Ebenhöh, 1996) und „Kognitive Fähigkeiten“ („Adaptiver Matrizentest“, AMT, Hornke, Etzel & Rettig, 1999) ausgewählt (Holocher-Ertl 2008a). Als Stichprobe wurden arbeitslose Jugendliche ausgewählt die Teilnehmer der Berufsorientierungs- und Coachingmaßnahmen“ des österreichischen Arbeitsmarktservice (AMS) waren. Ziel dieser Studie war es, herauszufinden, ob die ausgewählten Verfahren innerhalb der „Berufsorientierungs- und Coachingmaßnahmen“ des österreichischen Arbeitsmarktservice (AMS) differenzieren können. Durch diesen substantiellen Informationsgewinn könnten die Trainer bereits frühzeitig intervenieren und die Jugendlichen fördern. Insgesamt wurden 110 Jugendliche aus der Steiermark und aus Wien getestet, die an einer „Berufsorientierungs- und Coachingmaßnahme“ des AMS teilnahmen. Die Ergebnisse zeigten, dass nur die Variable „Frustrationstoleranz“ (Kubinger & Ebenhöh, 1996) innerhalb der Gruppe arbeitsloser Jugendlicher differenzieren kann. Diese Ergebnisse lassen vermuten, dass man dem AMS beziehungsweise den Trainern nicht eindeutig empfehlen kann diese diagnostischen Verfahren direkt zu Kursbeginn anzuwenden. Nur der Test „Arbeitshaltungen“ (Kubinger & Ebenhöh, 1996) mit seiner Variable Frustrationstoleranz scheint anwendbar um unmittelbar eine erste Einschätzung der Kursteilnehmer zu erhalten und um frühzeitig intervenieren und fördern zu können.In reference to the “Viennese diagnostic model of high achievement potential“ (Holocher-Ertl, 2008a) the following study tried to develop a diagnostic model for the advancement of unemployed adolescents. The test “Adaptiver Matrizentest“ (AMT, Hornke, Etzel & Rettig, 1999) was chosen to cover the field “Intellectual Abilities“ and the diagnostic test “Arbeitshaltungen“ (AHA, Kubinger & Ebenhöh, 1996) was chosen to cover the field “Personality Traits“ (Holocher-Ertl, 2008a). The goal of this study was to investigate whether the named diagnostic tests are able to differentiate within the “Job Orientation and Coaching Courses“ of the Public Employment Service Austria (AMS). If this is the case, then the coaches of the AMS would already gain substantial information at an early stage, which then could be used for effectively supporting the adolescents. 110 unemployed adolescents from Styria and from Vienna who participated at the “Job Orientation and Coaching Courses“ were tested. The results of the study suggest that only the variable “Frustration Tolerance” (Kubinger & Ebenhöh, 1996) can differentiate within the “Job Orientation and Coaching Courses“. Based on the results of this study it is suggested, that the AMS and its coaches can only use the diagnostic tests “Arbeitshaltungen“ with its variable “Frustration Tolerance” (Kubinger & Ebenhöh, 1996) directly at the beginning of the “Job Orientation and Coaching Courses“ for effectively supporting the adolescents