{"markup":"\u003C?xml version=\u00221.0\u0022 encoding=\u0022UTF-8\u0022 ?\u003E\n    \u003Chtml version=\u0022HTML+RDFa+MathML 1.1\u0022\n    xmlns:content=\u0022http:\/\/purl.org\/rss\/1.0\/modules\/content\/\u0022\n    xmlns:dc=\u0022http:\/\/purl.org\/dc\/terms\/\u0022\n    xmlns:foaf=\u0022http:\/\/xmlns.com\/foaf\/0.1\/\u0022\n    xmlns:og=\u0022http:\/\/ogp.me\/ns#\u0022\n    xmlns:rdfs=\u0022http:\/\/www.w3.org\/2000\/01\/rdf-schema#\u0022\n    xmlns:sioc=\u0022http:\/\/rdfs.org\/sioc\/ns#\u0022\n    xmlns:sioct=\u0022http:\/\/rdfs.org\/sioc\/types#\u0022\n    xmlns:skos=\u0022http:\/\/www.w3.org\/2004\/02\/skos\/core#\u0022\n    xmlns:xsd=\u0022http:\/\/www.w3.org\/2001\/XMLSchema#\u0022\n    xmlns:mml=\u0022http:\/\/www.w3.org\/1998\/Math\/MathML\u0022\u003E\n  \u003Chead\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_itu2PgFdrjV-docKmLK8Jn5oXe_05RgvQh73eOhI_mE.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_at_symbol.js?nzm3r1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_article_reference_popup.js?nzm3r1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_I8yX6RYPZb7AtMcDUA3QKDZqVkvEn35ED11_1i7vVpc.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\n(function(i,s,o,g,r,a,m){i[\u0022GoogleAnalyticsObject\u0022]=r;i[r]=i[r]||function(){(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)})(window,document,\u0022script\u0022,\u0022\/\/www.google-analytics.com\/analytics.js\u0022,\u0022ga\u0022);ga(\u0022create\u0022, \u0022UA-15605596-27\u0022, {\u0022cookieDomain\u0022:\u0022auto\u0022});ga(\u0022set\u0022, \u0022page\u0022, location.pathname + location.search + location.hash);ga(\u0022send\u0022, \u0022pageview\u0022);ga(\u0027create\u0027, \u0027UA-189672-26\u0027, \u0027auto\u0027, {\u0027name\u0027: \u0027hwTracker\u0027});\r\nga(\u0027hwTracker.send\u0027, \u0027pageview\u0027);\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\njQuery.extend(Drupal.settings, {\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/4\\\/28\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/4\\\/28\u0022}],\u0022ac\u0022:{\u0022spmdc;14\\\/4\\\/28\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;14\\\/4\\\/28\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EA joint symposium of the Heart Failure Society of America (HFSA) and the American College of Cardiology was held to discuss the 2013 update to the American College of Cardiology Foundation (ACCF)\/American Heart Association (AHA) Guidelines for the management of HF [Yancy CW et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2013; \u003Cem\u003ECirculation\u003C\/em\u003E 2013]. Harmonization between the 2013 ACCF\/AHA Guidelines and the European Society of Cardiology (ESC) Guideline for the diagnosis and treatment of acute and chronic HF [McMurray JJ et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2012] and the HFSA 2010 comprehensive HF practice guideline [Lindenfeld J et al. \u003Cem\u003EJ Card Fail\u003C\/em\u003E 2010] were also discussed in the session.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart Failure\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Guidelines\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart Failure\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Guidelines\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EA joint symposium of the Heart Failure Society of America (HFSA) and the American College of Cardiology (ACC) was held to discuss the 2013 update to the American College of Cardiology Foundation (ACCF)\/American Heart Association (AHA) Guidelines for the management of HF [Yancy CW et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2013; \u003Cem\u003ECirculation\u003C\/em\u003E 2013]. The symposium began with an introduction by guideline writing committee chair, Clyde W. Yancy MD, MSc, Northwestern University Chicago, Illinois, USA. Harmonization between the 2013 ACCF\/AHA Guidelines and the European Society of Cardiology (ESC) Guideline for the diagnosis and treatment of acute and chronic HF [McMurray JJ et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2012] and the HFSA 2010 comprehensive HF practice guideline [Lindenfeld J et al. \u003Cem\u003EJ Card Fail\u003C\/em\u003E 2010] were also discussed in the session.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EDr. Yancy briefly discussed aspects of the 2013 ACCF\/AHA Guidelines. HF with reduced ejection fraction (HFrEF) has an EF cutoff \u226440%. HeF with preserved ejection fraction (HFpEF) has an EF cutoff \u226550%. HF with EF 41% to 49% is now termed HFpEF-\u003Cem\u003Eborderline.\u003C\/em\u003E A new recognition has also been made for patients with improved systolic function (EF increase to \u0026gt;40), termed, HFpEF-\u003Cem\u003Eimproved.\u003C\/em\u003E In addition, Stage C disease management is now divided into specific medical and device management for both HFpEF and HFrEF. A number of the available risk scores to help clinicians predict outcomes in HF have been added with hyperlinks to the online resources. The role of arginine vasopressin antagonists to treat hypervolemic hyponatremia in hospitalized HF patients is discussed. In addition, emphasis on transitioning care in the hospital and ambulatory settings, coordinating care for HF patients, and optimizing processes to improve care quality have received significant attention.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPharmacological therapy across the different HF guidelines was reviewed by Randall C. Starling, MD, MPH, Cleveland Clinic, Cleveland, Ohio, USA. Guideline-directed medical therapy (GDMT) is emphasized in the 2013 ACCF\/AHA Guideline. For patients with HFrEF, Class I indicated medical therapy includes ACE-inhibitors (ACE-I), angiotensin receptor blockers (if ACE-I intolerant), and \u03b2-blockers. For select patients with HFrEF, aldosterone antagonists, hydrazaline-nitrates, anticoagulation, and\/or diuretics should be added to the regimen. While the recommendations are largely consistent the latest ACCF\/AHA and ESC HF guidelines, Dr. Starling noted that the ESC includes use of ivabradine, a novel rate-lowering drug recommended for specific patients with HFrEF that is not available in the United States.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe 2013 ACCF\/AHA Guidelines give aldosterone antagonists a Class I with Level of Evidence (LOE) A recommendation, but with more strict guidelines for appropriate patient selection than the ESC Guidelines. Both guidelines are harmonized regarding the potential for harm when aldosterone antagonists are used inappropriately. Recommendations for hydralazine-isosorbide dinitrate are now harmonized in the 2013 ACCF\/AHA and HFSA Guidelines. Regarding HFpEF, a syndrome which remains poorly understood without any evidence-based targeted treatments, Dr. Starling stated \u201cthere\u0027s definitely a gap of evidence here. This is completely harmonized: all of the guidelines say treat the underlying disease. We don\u0027t have the evidence, and that\u0027s the state of where things are today.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EW. H. Wilson Tang, MD, Cleveland Clinic, Cleveland, Ohio, USA, gave an overview of device recommendations across the guidelines. The guidelines are largely harmonized with minor discrepancies primarily due to the large amount of new data published since 2010. One of the major developments has occurred in implantable cardioverter-defibrillator (ICD) programming. A great deal has been learned regarding device management, particularly in delaying the needed response for shock as learned in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy [MADIT-RIT; Moss AJ et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2012].\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EOther notable changes in the guidelines have occurred in cardiac resynchronization therapy (CRT). The benefit of CRT across the spectrum of symptomatic HF is now well established. One of the major changes to the ACCF\/AHA Guidelines for CRT is that the Class I indication is limited to patients with EF \u226435%, sinus rhythm, QRS duration \u2265150 ms and left bundle branch block (LBBB) and NYHA II, III, or ambulatory IV. Class IIa indications expand the use of CRT to those with non-LBBB patterns and QRS duration of 120 to 149 ms. \u201cThe evolution of the CRT indication really is a refinement of what we knew a few years. Clearly the emphasis now is longer QRS duration and LBBB morphology,\u201d summarized Dr. Tang. A recent comprehensive expert consensus statement from the Heart Rhythm Society provides further description regarding use of this technology including maximization of pacing, synchronization optimization, rhythm management, end-of-life considerations, device diagnostics, and remote monitoring.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EBiykem Bozkurt, MD, PhD, Baylor College of Medicine, Houston, Texas, USA, compared how the guidelines differ in regard to adjunct therapies, for example sodium restriction and fluid restriction. A comparison of the HFSA, ACCF\/AHA, and ESC guidelines regarding adjunctive therapies is presented in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E. In general, recommendations across these guidelines are more consistent when based on large well-conducted studies. \u201cThere are quite a few gaps in knowledge about the benefit of adjunct therapies that need further study with randomized controlled trials or high-quality observational studies, systematic reviews, or meta-analyses, especially in the areas of salt restriction, treatment of sleep disordered breathing weight loss in obesity, and percutaneous and other interventional approaches,\u201d concluded Dr. Bozkurt.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15857\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15857\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15857\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EComparison of Recommendations for Adjunct Therapies\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-11\u0022\u003EGregg C. Fonarow, MD, University of California, Los Angeles, Los Angeles, California, USA, concluded the symposium by addressing the beneficial impact of guideline adherence and highlighting questions requiring additional research, so called \u201cevidence gaps\u201d, that will need to be addressed in future guidelines (\u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E). Although unanswered questions remain, treatment strategies that follow the HF guidelines translate into better patient outcomes. Using the 2005 ACCF\/AHA Guidelines for the diagnosis and management of chronic HF in adults [Hunt SA et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2005; Hunt SA et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2005] and the 2009 Focused Update [Hunt SA et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2009; \u003Cem\u003ECirculation\u003C\/em\u003E 2009], each 10% improvement in composite care adherence of HF outpatients lowered the odds of 2-year mortality by 13% (adjusted OR, 0.87; 95% CI, 0.84 to 0.90; p\u0026lt;0.0001) [Fonarow GC et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2011]. \u201cThis gives us the impetus to further refine and improve our guidelines as our evidence base expands because its application in practice does indeed improve clinical outcomes,\u201d said Dr. Fonarow.\u003C\/p\u003E\u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15860\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15860\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15860\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n            \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003EHeart Failure Guideline Evidence Gaps\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/4\/28.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm3r1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzm3r1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}