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Full-Text Articles in Physical Sciences and Mathematics

A Critical Review Of Endometriosis Pathology, Brittany Lauren Cureton Jan 2013

A Critical Review Of Endometriosis Pathology, Brittany Lauren Cureton

Theses and Dissertations

Endometriosis is a complex, multifactorial, reproductive disorder present in approximately 10-15% of adult women between the ages of 25-35. This disorder occurs when endometrial glands and stroma grow ectopically on the surface of the ovaries, pelvic peritoneum, fallopian tubes, and the uterus. Endometriosis causes varying degrees of painful symptoms and infertility in infected individuals. Three main theories of endometrial accumulation attempt to explain the etiology of this elusive disease. There have been various staging of endometriosis symptoms that attempt to standardize classification as well as predict pain and infertility. Angiogenesis, necessary to the survival of endometrial tissue, along with immune …


The Reproductive Ecology Of Plethodontid Salamanders In The South Carolina Inner Coastal Plain, Heather Rena Oswald Jan 2013

The Reproductive Ecology Of Plethodontid Salamanders In The South Carolina Inner Coastal Plain, Heather Rena Oswald

Theses and Dissertations

Nest- site selection is a critical process in the life history of amphibians, directly influencing offspring survival and parental fitness. When and where an amphibian chooses to nest is strongly influenced by a range of environmental cues. We monitored plethodontid salamander breeding behavior in seepage wetlands in the South Carolina inner Coastal Plain. Seepage wetlands are ideal for monitoring semiaquatic salamander breeding, because they provide habitat for both larval and adult salamanders while having relatively predictable, constant water temperatures and presence year round. We observed the breeding phenology of three sympatric salamanders (Eurycea cirrigera, Desmognathus auriculatus, and Pseudotriton ruber) in …


A Comparison Of Raman, Ftir And Atr-Ftir Micro Spectroscopy For Imaging Human Skin Tissue Sections., Syed Mehmood Ali, Franck Bonnier, Helen Lambkin, Kathleen Flynn, V Mcdonagh, Claragh Healy, T C. Lee, Fiona Lyng, Hugh Byrne Jan 2013

A Comparison Of Raman, Ftir And Atr-Ftir Micro Spectroscopy For Imaging Human Skin Tissue Sections., Syed Mehmood Ali, Franck Bonnier, Helen Lambkin, Kathleen Flynn, V Mcdonagh, Claragh Healy, T C. Lee, Fiona Lyng, Hugh Byrne

Articles

Raman and Infrared absorption spectroscopies are compared for the analysis of human hand skin tissue sections. The tissue sections have been formalin fixed and paraffin processed, and subsequently dewaxed. Fourier Transform infrared (FTIR) spectra are preprocessed using the resonant Mie – extended multiplicative scattering algorithm to remove spectral artefacts. FTIR images of resolution 4cm-1, analysed using K-means cluster analysis, reveal the double layer structure of the dermis and epidermis, but no further layer differentiation is achieved using the higher spatial resolution of the Attenuated Total Reflection imaging or improved spectral resolution of 2cm-1. At comparable spectral …


Raman Spectroscopy In Nanomedicine: Current Status And Future Perspectives, Hugh Byrne, Mark Keating Jan 2013

Raman Spectroscopy In Nanomedicine: Current Status And Future Perspectives, Hugh Byrne, Mark Keating

Articles

Raman spectroscopy is a branch of vibration spectroscopy which is capable of probing the chemical composition of materials. Recent advances in Raman microscopy have added significantly to the range of applications which now extend from medical diagnostics to exploring interfaces between biological organisms and nanomaterials. In this review, Raman is introduced in a general context, highlighting some of the areas in which the technique has found success in the past, as well as some of the potential benefits it offers over other analytical modalities. The subset of Raman techniques which specifically probe the nanoscale, namely Surface Enhanced and Tip Enhanced …


Raman Micro Spectroscopy Study Of The Interaction Of Vincristine With A549 Cells Supported By Expression Analysis Of Bcl-2 Protein, Haq Nawaz, Amaya Garcia, Aidan Meade, Fiona Lyng, Hugh Byrne Jan 2013

Raman Micro Spectroscopy Study Of The Interaction Of Vincristine With A549 Cells Supported By Expression Analysis Of Bcl-2 Protein, Haq Nawaz, Amaya Garcia, Aidan Meade, Fiona Lyng, Hugh Byrne

Articles

Understanding the interaction of anticancer drugs with model cell lines is important to elucidate the mode of action of these drugs as well as to develop cost effective and rapid screening methods. Raman spectroscopy has been demonstrated to be a valuable technique for high throughput, noninvasive analysis. The interaction of vincristine with a human lung adenocarcinoma cell line (A549)was investigated using Raman micro spectroscopy. The results were correlated with parallel measurements from the MTT cytotoxicity assay, which yielded an IC50 value of 0.10 ± 0.03 μM. The Raman spectral data acquired from vincristine treated A549 cells was analysed to …


Electric Field Standing Wave Effects In Ft-Ir Transflection Spectra Of Biological Tissue Sections: Simulated Models Of Experimental Variability, Tomasz P. Wrobel, Barbara Wajnchold, Hugh Byrne, Malgorzata Baranska Jan 2013

Electric Field Standing Wave Effects In Ft-Ir Transflection Spectra Of Biological Tissue Sections: Simulated Models Of Experimental Variability, Tomasz P. Wrobel, Barbara Wajnchold, Hugh Byrne, Malgorzata Baranska

Articles

The so-called electric field standing wave effect (EFSW) has recently been demonstrated to significantly distort FT-IR spectra acquired in a transflection mode, both experimentally and in simulated models, bringing into question the appropriateness of the technique for sample characterization, particularly in the field of spectroscopy of biological materials. The predicted effects are most notable in the regime where the sample thickness is comparable to the source wavelength. In this work, the model is extended to sample thicknesses more representative of biological tissue sections and to include typical experimental factors which are demonstrated to reduce the predicted effects. These include integration …


Provenance Framework For Mhealth, Aarathi Prasad, Ronald Peterson, Shrirang Mare, Jacob Sorber, Kolin Paul, David Kotz Jan 2013

Provenance Framework For Mhealth, Aarathi Prasad, Ronald Peterson, Shrirang Mare, Jacob Sorber, Kolin Paul, David Kotz

Dartmouth Scholarship

Mobile health technologies allow patients to collect their health information outside the hospital and share this information with others. But how can data consumers know whether to trust the sensor-collected and human-entered data they receive? Data consumers might be able to verify the accuracy and authenticity of the data if they have information about its origin and about changes made to it, i.e., the \emphprovenance\/ of the data. We propose a provenance framework for mHealth devices, to collect and share provenance metadata and help the data consumer verify whether certain provenance properties are satisfied by the data they receive. This …


Santa Clara Magazine, Volume 54 Number 3, Winter 2013, Santa Clara University Jan 2013

Santa Clara Magazine, Volume 54 Number 3, Winter 2013, Santa Clara University

Santa Clara Magazine

16 - TO CATCH A THIEF by Vince Beiser. Mathematician George Mohler has helped equip police in Santa Cruz and L.A. with an algorithm that predicts where crimes might happen next. Is this the future of policing?

22 - HOW TO PREVENT A BONFIRE OF THE HUMANITIES by Michael S. Malone '75, MBA '77. A veteran chronicler of Silicon Valley looks at why the high-tech industry needs-and wants-folks who know how to tell a story.

26 - A POEM, A PRAYER, AND A MARTINI FOR THE RHINO Two conversations with Chancellor William J. Rewak, S.J.-who's just published his first collection …


Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman Dec 2012

Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman

Edward H. Kennedy

Use of the electronic health record (EHR) is expected to increase rapidly in the near future, yet little research exists on whether analyzing internal EHR data using flexible, adaptive statistical methods could improve clinical risk prediction. Extensive implementation of EHR in the Veterans Health Administration provides an opportunity for exploration. Our objective was to compare the performance of various approaches for predicting risk of cerebrovascular and cardiovascular (CCV) death, using traditional risk predictors versus more comprehensive EHR data. Regression methods outperformed the Framingham risk score, even with the same predictors (AUC increased from 71% to 73% and calibration also improved). …


Hyaluronic Acid Based Self-Assembling Nanosystems For Cd44 Target Mediated Sirna Delivery To Solid Tumors., Arun Iyer Dec 2012

Hyaluronic Acid Based Self-Assembling Nanosystems For Cd44 Target Mediated Sirna Delivery To Solid Tumors., Arun Iyer

Arun Iyer

Anticancer therapeutics employing RNA interference mechanism holds promising potentials for sequence-specific silencing of target genes. However targeted delivery of siRNAs to tumor tissues and cells and more importantly, their intracellular release at sites of interest still remains a major challenge that needs to be addressed before this technique could become a clinically viable option. In the current study, we have engineered and screened a series of CD44 targeting hyaluronic acid (HA) based self-assembling nanosystems for targeted siRNA delivery. The HA polymer was functionalized with lipids of varying carbon chain lengths/nitrogen content, as well as polyamines for assessing siRNA encapsulation. From …


A Case-Control Study Of Physical Activity Patterns And Risk Of Non-Fatal Myocardial Infarction, Jian Gong, Hannia Campos, Mark Fiecas, Stephen Mcgarvey, Robert Goldberg, Caroline Richardson, Ana Baylin Dec 2012

A Case-Control Study Of Physical Activity Patterns And Risk Of Non-Fatal Myocardial Infarction, Jian Gong, Hannia Campos, Mark Fiecas, Stephen Mcgarvey, Robert Goldberg, Caroline Richardson, Ana Baylin

Mark Fiecas

Background The interactive effects of different types of physical activity on cardiovascular disease (CVD) risk have not been fully considered in previous studies. We aimed to identify physical activity patterns that take into account combinations of physical activities and examine the association between derived physical activity patterns and risk of acute myocardial infarction (AMI). Methods We examined the relationship between physical activity patterns, identified by principal component analysis (PCA), and AMI risk in a case-control study of myocardial infarction in Costa Rica (N=4172), 1994-2004. The component scores derived from PCA and total METS were used in natural cubic spline models …


Hydraphiles: A Rigorously Studied Class Of Synthetic Channel Compounds With In Vivo Activity, Saeedeh Negin, Bryan A. Smith, Alexandra Unger, W. Matthew Leevy, George W. Gokel Dec 2012

Hydraphiles: A Rigorously Studied Class Of Synthetic Channel Compounds With In Vivo Activity, Saeedeh Negin, Bryan A. Smith, Alexandra Unger, W. Matthew Leevy, George W. Gokel

George Gokel

No abstract provided.


Varying-Smoother Models For Functional Responses, Philip T. Reiss, Lei Huang, Huaihou Chen, Stan Colcombe Dec 2012

Varying-Smoother Models For Functional Responses, Philip T. Reiss, Lei Huang, Huaihou Chen, Stan Colcombe

Philip T. Reiss

This paper studies estimation of a smooth function f(x,v) when we are given functional responses of the form f(x, ·) + error, but scientific interest centers on the collection of functions f(·,v) for different v. The motivation comes from studies of human brain development, in which x denotes age whereas v refers to brain locations. Analogously to varying-coefficient models, in which the mean response is linear in x, the “varying-smoother” models that we consider exhibit nonlinear dependence on x that varies smoothly with v. We discuss three approaches to estimating varying-smoother models: (a) methods that employ a tensor product penalty; …


Progression From New Methicillin-Resistant Staphylococcus Aureus Colonisation To Infection: An Observational Study In A Hospital Cohort, Michelle Nd Balm, Andrew A. Lover, Sharon Salmon, Paul A. Tambyah, Dale A. Fisher Dec 2012

Progression From New Methicillin-Resistant Staphylococcus Aureus Colonisation To Infection: An Observational Study In A Hospital Cohort, Michelle Nd Balm, Andrew A. Lover, Sharon Salmon, Paul A. Tambyah, Dale A. Fisher

Andrew Lover

Background
Patients newly colonised with methicillin-resistant Staphylococcus aureus (MRSA) are at higher risk of clinical MRSA infection. At present, there are limited data on the duration or magnitude of this risk in a hospital population with a known time of MRSA acquisition.
Methods
A retrospective cohort study of 909 adult patients known to have newly identified MRSA colonisation during admission to National University Hospital, Singapore between 1 July 2007 and 30 June 2011 was undertaken. Patients were excluded if they had history of previous MRSA colonisation or infection, or if they had been a hospital inpatient in the preceding 12 …


Quantifying Effect Of Geographic Location On Epidemiology Of Plasmodium Vivax Malaria, Andrew A. Lover, Richard J. Coker Dec 2012

Quantifying Effect Of Geographic Location On Epidemiology Of Plasmodium Vivax Malaria, Andrew A. Lover, Richard J. Coker

Andrew Lover

Recent autochthonous transmission of Plasmodium vivax malaria in previously malaria-free temperate regions has generated renewed interest in the epidemiology of this disease. Accurate estimates of the incubation period and time to relapse are required for effective malaria surveillance; however, this information is currently lacking. By using historical data from experimental human infections with diverse P. vivax strains, survival analysis models were used to obtain quantitative estimates of the incubation period and time to first relapse for P. vivax malaria in broad geographic regions. Results show that Eurasian strains from temperate regions have longer incubation periods, and Western Hemisphere strains from …


Methods For Evaluating Prediction Performance Of Biomarkers And Tests, Margaret S. Pepe Phd, Holly Janes Phd Dec 2012

Methods For Evaluating Prediction Performance Of Biomarkers And Tests, Margaret S. Pepe Phd, Holly Janes Phd

Margaret S Pepe PhD

This chapter describes and critiques methods for evaluating the performance of markers to predict risk of a current or future clinical outcome. We consider three criteria that are important for evaluating a risk model: calibration, benefit for decision making and accurate classification. We also describe and discuss a variety of summary measures in common use for quantifying predictive information such as the area under the ROC curve and R-squared. The roles and problems with recently proposed risk reclassification approaches are discussed in detail.


Piscine Myocarditis Virus (Pmcv) In Wild Atlantic Salmon Salmo Salar, Torstein Tengs Dr. Dec 2012

Piscine Myocarditis Virus (Pmcv) In Wild Atlantic Salmon Salmo Salar, Torstein Tengs Dr.

Dr. Torstein Tengs

Cardiomyopathy syndrome (CMS) is a severe cardiac disease of sea-farmed Atlantic salmon Salmo salar L., but CMS-like lesions have also been found in wild Atlantic salmon. In 2010 a double-stranded RNA virus of the Totiviridae family, provisionally named piscine myocarditis virus (PMCV), was described as the causative agent of CMS. In the present paper we report the first detection of PMCV in wild Atlantic salmon. The study is based on screening of 797 wild Atlantic salmon by real-time RT-PCR. The samples were collected from 35 different rivers along the coast of Norway, and all individuals included in the study were …


An Assessment Of The Effects Of Desertification In Yobe State, Nigeria, Jibril Musa Phd Dec 2012

An Assessment Of The Effects Of Desertification In Yobe State, Nigeria, Jibril Musa Phd

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Desertification is one of the most serious environmental and socio-economic problems of our time. Desertification describes circumstances of land degradation in arid, semi-arid and dry sub-humid regions resulting from the climatic variation and human activities. The fundamental goal of this thesis was to assess the effects of desertification in Yobe State, Nigeria. The present threat of desertification in the sahel has reached an alarming stage where crops cultivation and animal rearing/grazing are no more productive, soil has lost its nutrient/fertility, various infrastructure had given way because of windstorm from the neighbouring Niger Republic and sand dunes had taken over. The …


Multiple Subject Barycentric Discriminant Analysis (Musubada): How To Assign Scans To Categories Without Using Spatial Normalization, Hervé Abdi, Lynne J. Williams, Andrew C. Connolly, M. Ida Gobbini Dec 2012

Multiple Subject Barycentric Discriminant Analysis (Musubada): How To Assign Scans To Categories Without Using Spatial Normalization, Hervé Abdi, Lynne J. Williams, Andrew C. Connolly, M. Ida Gobbini

Dartmouth Scholarship

We present a new discriminant analysis (DA) method called Multiple Subject Barycentric Discriminant Analysis (MUSUBADA) suited for analyzing fMRI data because it handles datasets with multiple participants that each provides different number of variables (i.e., voxels) that are themselves grouped into regions of interest (ROIs). Like DA, MUSUBADA (1) assigns observations to predefined categories, (2) gives factorial maps displaying observations and categories, and (3) optimally assigns observations to categories. MUSUBADA handles cases with more variables than observations and can project portions of the data table (e.g., subtables, which can represent participants or ROIs) on the factorial maps. Therefore MUSUBADA can …


Using Remote Sensing Data To Improve Rice Production In Kutigi, Niger State, Nigeria, Jibril Musa Phd, M B. Yunusa Dec 2012

Using Remote Sensing Data To Improve Rice Production In Kutigi, Niger State, Nigeria, Jibril Musa Phd, M B. Yunusa

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This research work looked in the used of Remote Sensing to improve Agricultural production in Kutigi, Niger State. The aim of the study is to use remote sensing to improve rice farming activities in Kutigi, Niger State. It is very important to identify such methods to improve Agricultural production because experts are always interested in new researches and findings to better the standard of living in any environment. In view of this, Remotely-sensed data could be used or employed to elevate most of these agricultural problems in Kutigi through the following objectives: Using Landsat imagery to assess the present landuse …


Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho Dec 2012

Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …


A Regionalized National Universal Kriging Model Using Partial Least Squares Regression For Estimating Annual Pm2.5 Concentrations In Epidemiology, Paul D. Sampson, Mark Richards, Adam A. Szpiro, Silas Bergen, Lianne Sheppard, Timothy V. Larson, Joel Kaufman Dec 2012

A Regionalized National Universal Kriging Model Using Partial Least Squares Regression For Estimating Annual Pm2.5 Concentrations In Epidemiology, Paul D. Sampson, Mark Richards, Adam A. Szpiro, Silas Bergen, Lianne Sheppard, Timothy V. Larson, Joel Kaufman

UW Biostatistics Working Paper Series

Many cohort studies in environmental epidemiology require accurate modeling and prediction of fine scale spatial variation in ambient air quality across the U.S. This modeling requires the use of small spatial scale geographic or “land use” regression covariates and some degree of spatial smoothing. Furthermore, the details of the prediction of air quality by land use regression and the spatial variation in ambient air quality not explained by this regression should be allowed to vary across the continent due to the large scale heterogeneity in topography, climate, and sources of air pollution. This paper introduces a regionalized national universal kriging …


Complex Adaptive Systems As A Model For Evaluating Organisational Change Caused By The Introduction Of Health Information Systems, Kieren Diment Mr, Ping Yu, K. Garrety Dec 2012

Complex Adaptive Systems As A Model For Evaluating Organisational Change Caused By The Introduction Of Health Information Systems, Kieren Diment Mr, Ping Yu, K. Garrety

Dr Ping Yu

This paper documents the preliminary development of a framework for evaluating organisational change processes during the implementation of an electronic nursing documentation system in residential aged care facilities. It starts with a brief outline of organisational change processes. This is followed by a more detailed exposition of the principles underlying complex adaptive systems (CAS) theory, where we explain how mathematical concepts can be used to illuminate qualitative research approaches. Finally we present some preliminary findings on the facilitators and barriers for the introduction of the electronic documentation system, explained with reference to the CAS theory, based on analysis of interviews …


Maternal Mortality: The Need To Work With Traditional Birth Attendants To Offset The Problem, Nat Quansah Dec 2012

Maternal Mortality: The Need To Work With Traditional Birth Attendants To Offset The Problem, Nat Quansah

Nat Quansah

The Reninjaza (Traditional Birth Attendant) is recognized as the professional of Traditional Medicine specializing in the provision of maternal and infant health care services just as the Midwife is recognized as the professional of Allopathic Medicine who specializes in the provision of maternal and infant health care services. Having these professionals of the two medical systems work in a complimentary manner, it is argued, will not only result in improving the gathering of information on maternal deaths, the accuracy of reporting and monitoring of maternal deaths but more importantly, will result in the reduction of maternal deaths. This is because …


Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert Dec 2012

Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert

Doctoral Dissertations

This dissertation concentrates on the introduction of Predictive Adaptive Radiation Therapy (PART) as a potential method to improve cancer treatment. PART is a novel technique that utilizes volumetric image-guided radiation therapy treatment (IGRT) data to actively predict the tumor response to therapy and estimate clinical outcomes during the course of treatment. To implement PART, a patient database containing IGRT image data for 40 lesions obtained from patients who were imaged and treated with helical tomotherapy was constructed. The data was then modeled using locally weighted regression. This model predicts future tumor volumes and masses and the associated confidence intervals based …


Data Mining Of Pancreatic Cancer Protein Databases, Peter Revesz, Christopher Assi Dec 2012

Data Mining Of Pancreatic Cancer Protein Databases, Peter Revesz, Christopher Assi

CSE Conference and Workshop Papers

Data mining of protein databases poses special challenges because many protein databases are non- relational whereas most data mining and machine learning algorithms assume the input data to be a type of rela- tional database that is also representable as an ARFF file. We developed a method to restructure protein databases so that they become amenable for various data mining and machine learning tools. Our restructuring method en- abled us to apply both decision tree and support vector machine classifiers to a pancreatic protein database. The SVM classifier that used both GO term and PFAM families to characterize proteins gave …


Progression Magazine, 2012-2013, Coastal Carolina University Dec 2012

Progression Magazine, 2012-2013, Coastal Carolina University

Progression Magazine

Magazine of the College of Science at Coastal Carolina University.


Complexity And Uncertainty In Human And Ecological Risk Assessment, Matthew Jordan Dellinger Dec 2012

Complexity And Uncertainty In Human And Ecological Risk Assessment, Matthew Jordan Dellinger

Theses and Dissertations

Multiple interacting stressors in the environment present increasingly complex risks to human health. Too often, however, the data required for traditional risk assessment are either lacking or unavailable at the necessary spatial or temporal scale. In addition, assessment practices and management policies need to move away from single factor approaches in order to accommodate the reality of complex chemical mixtures and environmental stressors. Recent literature suggests that a paradigm shift is under way. This points to a need for the development of new techniques both for rapid data collection and flexible risk assessment strategies that can adapt to make use …


Privacy And Security Issues In Iot Healthcare Applications For The Disabled Users A Survey, Wassnaa Al-Mawee Dec 2012

Privacy And Security Issues In Iot Healthcare Applications For The Disabled Users A Survey, Wassnaa Al-Mawee

Masters Theses

Aging of the population resulted in new challenges for the society and healthcare systems. Ambient Assisted Living (AAL) that depends on Internet of Things (IoT) provides assistance to the disabled people and supports their vital daily life activities. Affordability of and accessibility to AAL and the usage of IoT starts revolutionizing healthcare services. This Thesis is a survey of the privacy and security issues in IoT healthcare applications for the disabled users. Introduction includes definitions of privacy and security terms, and discusses their relationship. Then, it presents an overview of the IoT, including its architecture and components. Next, the Thesis …


The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon Dec 2012

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HRβ_biockers= 0.64, 95% CI 0.26-1.56 and HRACEi/ARB=0.50, …