bluuebunny/crossref_metadata_2025 huggingface dataset:
The Application of Virtual Reality to the Treatment of PTSD Following the WTC Attack
Authors: DIFEDE JOANN , CUKOR JUDITH , PATT IVY , GIOSAN CEZAR , HOFFMAN HUNTER
Published: August 2006

Abstract:  Recent research suggests that virtual reality (VR) enhanced exposure therapy may enhance the efficacy of treatment through increasing patient engagement in the exposure. This study evaluated the use of VR in the treatment of PTSD following the WTC attack of September 11, 2001. Individuals in a 14 session VR‐enhanced treatment (n=9) were compared to a waitlist (WL) control group (n=8). ANOVA showed a significant interaction of time by group (p<.01) with a large effect size of 1.53. The VR group showed significantly greater post‐treatment decline in CAPS scores compared to the WL. Our preliminary data suggests that VR is an effective tool for enhancing exposure therapy for both civilians and disaster workers who suffer from PTSD.
Pharmacotherapeutic Treatment of Nightmares and Insomnia in Posttraumatic Stress Disorder
Authors: VAN LIEMPT SASKIA , VERMETTEN ERIC , GEUZE ELBERT , WESTENBERG HERMAN
Published: August 2006

Abstract:  Sleep disturbances are hallmark symptoms of posttraumatic stress disorder (PTSD). Where the subjective experience of nightmares and insomnia in PTSD patients is very real indeed and demands treatment, objective research findings on disordered sleep architecture in PTSD are inconclusive and inconsistent. After reviewing the literature an insufficient number of controlled studies are published to formulate evidence‐based guidelines. Several studies have methodological limitations, such as small group sizes and heterogenic samples. Large randomized controlled trials (RCTs) need to be conducted in order to further develop adequate therapeutic interventions. Objective parameters for insomnia and nightmares need to be identified for understanding underlying mechanisms of disturbed sleep in PTSD, and for evaluating therapy.
Treatment of PTSD by Eye Movement Desensitization Reprocessing (EMDR) Improves Sleep Quality, Quality of life, and Perception of Stress
Authors: RABONI MARA REGINA , TUFIK SERGIO , SUCHECKI DEBORAH
Published: August 2006

Abstract:  The impact of posttraumatic stress disorder (PTSD) on the sleep of patients is widely reported. However, the parameters that can be altered are not the same for all patients. Some studies report an impairment of sleep maintenance and recurrent nightmares, while others failed to find such alterations. Among the many treatments, the eye movement desensitization reprocessing (EMDR) is a therapy used specifically to treat PTSD and general trauma. The purpose of this study was to examine whether EMDR treatment can improve PTSD symptoms, such as sleep, depression, anxiety, and poor quality of life.
Clinical Correlates of 24‐H Cortisol and Norepinephrine Excretion Among Subjects Seeking Treatment Following the World Trade Center Attacks on 9/11
Authors: BIERER LINDA M. , TISCHLER LISA , LABINSKY ELLEN , CAHILL SHAWN , FOA EDNA , YEHUDA RACHEL
Published: August 2006

Abstract:  Whereas trauma‐associated arousal has been linked fairly consistently with elevations in both glucocorticoids and catecholamines, neuroendocrine correlates of hyperarousal in the context of posttraumatic stress disorder (PTSD) have been more variable. Further, neuroendocrine predictors of the development of PTSD following trauma have been related to prior exposure, and data from several laboratories suggests that hyperarousal may develop in a neuroendocrine milieu of relatively diminished basal glucocorticoid secretion. Methods: In this article we examined 24‐h cortisol and norepinephrine excretion in 42 treatment‐seeking survivors of the 9/11 World Trade Center (WTC) attacks, 32 of whom met criteria for PTSD, and 15 of whom met criteria for major depression, at the time of evaluation; 14 of the 15 subjects meeting criteria for major depression also suffered from PTSD. Results: PTSD subjects' 24‐h cortisol excretion (46.3 ± 20.0 μL/dL) was lower than that of the non‐PTSD cohort (72.2 ± 22.4 μL/dL; t= 3.18, df= 37, P= 0.003), and 24‐h urinary cortisol was negatively correlated with the experience of the WTC attacks as a Criterion‐A event (r=−0.427, P= 0.007), and with self‐rated avoidance (r=−0.466, P= 0.003) and total score (r=−0.398, P= 0.012) on the PTSD Symptom Scale (PSS). In contrast, 24‐h norepinephrine excretion was not associated with the development of PTSD or with PTSD‐related symptoms, but was negatively correlated with days since 9/11 at the time of evaluation (r=−0.393, P= 0.015). Discussion: The latter finding suggests a relationship of norepinephrine to a dimension of stress‐related arousal not captured by the symptom‐rating scales chosen for this study to reflect symptoms related to PTSD and other neuropsychiatric disorders, but instead, of one to that of the sudden multidimensional life disruption suffered by the WTC survivors that applied for treatment. These data also confirm, in a naturalistic sample, the previously observed negative association of urinary cortisol excretion with development of PTSD in the aftermath of severe trauma exposure
Noradrenergic Signaling in the Amygdala Contributes to the Reconsolidation of Fear Memory
Authors: DȨBIEC JACEK , LeDOUX JOSEPH E.
Published: August 2006

Abstract:  Intrusive memories resulting from an emotional trauma are a defining feature of posttraumatic stress disorder (PTSD). Existing studies demonstrate that an increase of noradrenergic activity during a life‐threatening event contributes to strengthening or “overconsolidation” of the memory for trauma. The lateral nucleus of the amygdala (LA) is critical for fear learning. Using classical fear conditioning in rats, we have recently demonstrated that noradrenergic blockade in the LA following reactivation of fear memory by retrieval disrupts memory reconsolidation and lastingly impairs fear memory. This suggests that noradrenergic blockade may be useful in attenuating traumatic memories, even well‐consolidated old memories, in PTSD.
Maternal–Infant Response to Variable Foraging Demand in Nonhuman Primates
Authors: COPLAN JEREMY D. , SMITH ERIC L.P. , ALTEMUS MARGARET , MATHEW SANJAY J. , PERERA TARIQUE , KRAL JOHN G. , GORMAN JACK M. , OWENS MICHAEL J. , NEMEROFF CHARLES B. , ROSENBLUM LEONARD A.
Published: August 2006

Abstract:  The maternal stress response may vary as a function of infant developmental phase. Using a median split, 13 bonnet macaque (M. radiata) mother–infant dyads were exposed to early initiation of variable foraging demand (VFD), a prolonged stressor, whereas 11 dyads were exposed to late VFD onset. Cerebrospinal fluid (CSF) and plasma samples were obtained from mothers and infants prior to and following VFD. Increases in maternal CSF corticotropin‐releasing factor (CRF) concentrations were evident in response to late, but not early, VFD. Mothers exhibited either increased or decreased cortisol concentrations in response to VFD. However, absolute cortisol change was greater in early versus late VFD. Timing of the VFD stressor differentially affects maternal neuroendocrine response, with potential implications for the offspring's developmental trajectory.
Interleukin‐1β as a Mechanism for Stress‐Induced Startle Suppression in Females
Authors: BECK KEVIN D. , SERVATIUS RICHARD J.
Published: August 2006

Abstract:  Startle measures were taken 2 h following a systemic injection of interleukin‐1β (IL‐1β) (3 μg/kg) to intact or ovariectomy (OVX) female rats.
Changes in startle responsivity (reduced startle magnitude) were evident in intact IL‐1β‐treated rats, despite no significant effects on startle sensitivity (number of elicited startles). No significant changes in startle sensitivity or responsivity were evident in IL‐1β‐treated OVX rats. These results are discussed as a possible mechanism for stress‐induced suppression of startle responsivity seen in intact female rats.
Role of the Bed Nucleus of the Stria Terminalis (BST) in the Expression of Conditioned Fear
Authors: MELONI EDWARD G. , JACKSON ALEXANDRA , GERETY LYLE P. , COHEN BRUCE M. , CARLEZON WILLIAM A.
Published: August 2006

Abstract:  Male Sprague–Dawley rats were trained and tested in the fear‐potentiated startle (FPS) paradigm to examine the involvement of the bed nucleus of the stria terminalis (BST) in the expression of conditioned fear. Studies were designed to (a) detect physiological changes in the BST that might correlate with different levels of FPS expression and (b) determine if chemical inactivation of the BST with muscimol (1 ng) had any effect on FPS expression. The data suggest that the BST plays a role in the expression of conditioned fear and that GABA‐mediated inhibition at this level may influence the level of this expression.
Ghrelin Increases Neuropeptide Y and Agouti-Related Peptide Gene Expression in the Arcuate Nucleus in Rat Hypothalamic Organotypic Cultures
Authors: Goto Motomitsu , Arima Hiroshi , Watanabe Minemori , Hayashi Masayuki , Banno Ryouichi , Sato Ikuko , Nagasaki Hiroshi , Oiso Yutaka
Published: August 2006

Ghrelin, which was identified from the rat stomach, is a potent stimulant for food intake. Several lines of evidence suggest that the orexigenic action of ghrelin is mediated via the neuropeptide Y (NPY) neurons in the arcuate nucleus, although the detailed mechanisms by which ghrelin stimulates NPY neurons are not clear. In this study, we examined the gene regulation of NPY and agouti-related peptide (AGRP), another orexigenic peptide synthesized in the NPY neurons, in the arcuate nucleus by ghrelin in hypothalamic organotypic cultures. Incubation of the hypothalamic explants with ghrelin significantly increased NPY and AGRP mRNA expression in the presence, but not absence, of dexamethasone. Glucocorticoids were also necessary for ghrelin action in vivo because an intracerebroventricular injection of ghrelin significantly increased NPY and AGRP mRNA expression in the arcuate nucleus only in sham-operated, but not in adrenalectomized rats. The stimulatory effects of ghrelin on gene expression were not blocked by a sodium channel blocker tetrodotoxin in the organotypic cultures. Ghrelin also increased NPY heteronuclear (hn) RNA expression, the first transcript that has been used as an indicator for gene transcription. The stimulatory effects of ghrelin on NPY gene expression were abolished in the presence of cycloheximide, which blocks translation, suggesting that de novo protein synthesis is required for ghrelin action. These data suggest that ghrelin stimulates NPY and AGRP gene expression independently of action potentials only in the presence of glucocorticoids. Furthermore, our data demonstrate stimulatory action of ghrelin on NPY gene transcription, which requires de novo protein synthesis.
Neutral Endopeptidase Expressed by Decidualized Stromal Cells Suppresses Akt Phosphorylation and Deoxyribonucleic Acid Synthesis Induced by Endothelin-1 in Human Endometrium
Authors: Iwase Akira , Ando Hisao , Nagasaka Tetsuro , Shibata Daijiro , Harata Toko , Shimomura Yuji , Goto Maki , Kikkawa Fumitaka
Published: August 2006

Endothelin-1 (ET-1) in human endometrium has been proposed to have a potential paracrine role, for its receptors are also present within this tissue. In addition, the expression of ET-1 varies during the menstrual cycle, and therefore, ET-1 may be involved in the cyclic change of the human endometrium, such as proliferation and decidualization. However, neither the inactivation of ET-1 in the endometrium nor the paracrine effect of ET-1 on endometrial cells has been determined. We investigated the production of ET-1 and the presence of neutral endopeptidase (NEP), which cleaves and inactivates ET-1, in primary cultured human endometrial cells. We found primary cultured endometrial epithelial cells, not stromal cells, to be the major source of ET-1. Western blot analysis and RT-PCR demonstrated that NEP was predominantly expressed by endometrial stromal cells. We also demonstrated that ET-1 stimulated the phosphorylation of Akt and DNA synthesis in endometrial stromal cells via the ETA receptor and phospahtidylinositol-3 kinase signaling pathways. The effect of ET-1 was regulated by NEP expressed by stromal cells. We also found that conditioned medium containing ET-1 from endometrial epithelial cell culture stimulated phosphorylation of Akt via the ETA receptor. In conclusion, ET-1 has a paracrine effect of Akt phosphorylation and cell proliferation on endometrial stromal cells, which occurs via the ETA receptor and phospahtidylinositol-3 kinase signaling pathways, and is regulated by cell-surface NEP.
Sphingosine Regulates the Transcription of CYP17 by Binding to Steroidogenic Factor-1
Authors: Urs Aarti N. , Dammer Eric , Sewer Marion B.
Published: August 2006

Steroidogenic factor (SF1, Ad4BP, NR5A1) is a nuclear receptor that is essential for steroid hormone biosynthesis and endocrine development. Recent crystallographic studies have found that phospholipids are ligands for SF1. In the present study, our aim was to identify endogenous ligands for SF1 and characterize their functional significance in mediating cAMP-dependent transcription of human CYP17. Using tandem mass spectrometry, we show that in H295R adrenocortical cells, SF1 is bound to sphingosine (SPH) and lyso-sphingomyelin (lysoSM) under basal conditions and that cAMP stimulation decreases the amount of SPH and lysoSM bound to the receptor. Silencing both acid and neutral ceramidases using small interfering RNA induces CYP17 mRNA expression, suggesting that SPH acts as an inhibitory ligand. SPH antagonized the ability of cAMP and the coactivator steroid receptor coactivator-1 to increase CYP17 reporter gene activity. These studies demonstrate that SPH is a bonafide endogenous ligand for SF1 and a negative regulator of CYP17 gene expression.
Interleukin-1β Signals through a c-Jun N-Terminal Kinase-Dependent Inducible Nitric Oxide Synthase and Nitric Oxide Production Pathway in Sertoli Epithelial Cells
Authors: Ishikawa Tomomoto , Morris Patricia L.
Published: August 2006

Our recent Sertoli cell (SC) studies showed that the c-Jun N-terminal kinase (JNK) and inducible cyclooxygenase-2 (COX-2) pathways are key regulatory components of IL (IL-1α, IL-1β, and IL-6) expression and START-domain containing StARD1 and StARD5 proteins. IL-1β regulates SC autocrine/paracrine activities and subsequently influences developing germ cells and spermatogenesis. This study was designed to evaluate whether IL-1β mediates high-output inducible nitric oxide synthase (iNOS) expression and nitric oxide (NO) production in these specialized epithelial cells and characterize gonadotropin and cytokine-regulation of NO. Purified SCs were maintained in serum-free cultures and treated with FSH (100 ng–1 μg/ml) or IL-1β (10 ng/ml) in time-course studies. To determine obligatory intracellular pathways, treatments were conducted with or without activity inhibitors: COX-2 selective (NS-398, 10 μm) or JNK (SP600125, 10 μm) for 1, 3, 6, and 24 h. NOS mRNAs and proteins were evaluated by RT-PCR and Western analysis, respectively. NO and reactive oxygen species were measured by flow cytometry and ELISA. IL-1β transiently induces intracellular NO (30 min) but not reactive oxygen species. Subsequently, iNOS mRNA and protein expression (3–6 h) significantly increased after IL-1β but not FSH stimulation, and in time-dependent manner, markedly increased extracellular NO (24 h, 8-fold). No change in the constitutive endothelial NOS isoform was observed. Inhibition of JNK, but not COX-2, activity inhibits IL-1β-induced iNOS expression and NO production. Such findings suggest that intra- and extracellular NO within the tubule may alert SCs monitoring the microenvironment to an aberrant cytokine, triggering antioxidant and antiinflammatory activities to avoid disruption of spermatogenesis.
Prevention of Adipose Tissue Depletion during Food Deprivation in Angiotensin Type 2 Receptor-Deficient Mice
Authors: Yvan-Charvet Laurent , Even Patrick , Lamandé Noël , Ferré Pascal , Quignard-Boulangé Annie
Published: August 2006

Angiotensin (Ang) II is produced locally in various tissues, but its role in the regulation of tissue metabolism is still unclear. Recent studies have revealed the role of type 2 Ang II receptor (AT2R) in the control of energy homeostasis and lipid metabolism. The contribution of the AT2R to adaptation to starvation was tested using AT2R-deficient (AT2Ry/−) mice. Fasted AT2Ry/− mice exhibited a lower loss of adipose tissue weight associated to a decreased free fatty acid (FFA) release from stored lipids than the controls. In vitro studies show that Ang II causes an AT1R-mediated antilipolytic effect in isolated adipocytes. AT1R expression is up-regulated by fasting in both genotypes, but the increase is more pronounced in AT2Ry/− mice. In addition, the increased muscle β-oxidation displayed in AT2Ry/− mice on a fed state, persists after fasting compared with wild-type mice. In liver from fed mice, AT2R deficiency did not modify the expression of genes involved in fatty acid oxidation. However, in response to fasting, the large increase of the expression of this subset of genes exhibited by wild-type mice, was impaired in AT2Ry/− mice. Taken together, decreased lipolytic capacity and increased muscle fatty acid oxidation participate in the decreased plasma FFA observed in fasted AT2Ry/− mice and could account for the lower FFA metabolism in the liver. These data reveal an important physiological role of AT2R in metabolic adaptations to fasting.
DNA methylation is a primary mechanism for silencing postmigratory primordial germ cell genes in both germ cell and somatic cell lineages
Authors: Maatouk Danielle M. , Kellam Lori D. , Mann Mellissa R. W. , Lei Hong , Li En , Bartolomei Marisa S. , Resnick James L.
Published: August 2006

DNA methylation is necessary for the silencing of endogenous retrotransposons and the maintenance of monoallelic gene expression at imprinted loci and on the X chromosome. Dynamic changes in DNA methylation occur during the initial stages of primordial germ cell development; however,all consequences of this epigenetic reprogramming are not understood. DNA demethylation in postmigratory primordial germ cells coincides with erasure of genomic imprints and reactivation of the inactive X chromosome, as well as ongoing germ cell differentiation events. To investigate a possible role for DNA methylation changes in germ cell differentiation, we have studied several marker genes that initiate expression at this time. Here, we show that the postmigratory germ cell-specific genes Mvh, Dazl and Scp3are demethylated in germ cells, but not in somatic cells. Premature loss of genomic methylation in Dnmt1 mutant embryos leads to early expression of these genes as well as GCNA1, a widely used germ cell marker. In addition,GCNA1 is ectopically expressed by somatic cells in Dnmt1 mutants. These results provide in vivo evidence that postmigratory germ cell-specific genes are silenced by DNA methylation in both premigratory germ cells and somatic cells. This is the first example of ectopic gene activation in Dnmt1 mutant mice and suggests that dynamic changes in DNA methylation regulate tissue-specific gene expression of a set of primordial germ cell-specific genes.
The autophagy-related kinase UNC-51 and its binding partner UNC-14 regulate the subcellular localization of the Netrin receptor UNC-5 inCaenorhabditis elegans
Authors: Ogura Ken-ichi , Goshima Yoshio
Published: August 2006

UNC-51 and UNC-14 are required for the axon guidance of many neurons in Caenorhabditis elegans. UNC-51 is a serine/threonine kinase homologous to yeast Atg1, which is required for autophagy. The binding partner of UNC-51, UNC-14, contains a RUN domain that is predicted to play an important role in multiple Ras-like GTPase signaling pathways. How these molecules function in axon guidance is largely unknown. Here we observed that,in unc-51 and unc-14 mutants, UNC-5, the receptor for axon-guidance protein Netrin/UNC-6, abnormally localized in neuronal cell bodies. By contrast, the localization of many other proteins required for axon guidance was undisturbed. Moreover, UNC-5 localization was normal in animals with mutations in the genes for axon guidance proteins, several motor proteins, vesicle components and autophagy-related proteins. We also found that unc-5 and unc-6 interacted genetically with unc-51 and unc-14 to affect axon guidance, and that UNC-5 co-localized with UNC-51 and UNC-14 in neurons. These results suggest that UNC-51 and UNC-14 regulate the subcellular localization of the Netrin receptor UNC-5, and that UNC-5 uses a unique mechanism for its localization; the functionality of UNC-5 is probably regulated by this localization.
Dual function of theDrosophilaAlk1/Alk2 ortholog Saxophone shapes the Bmp activity gradient in the wing imaginal disc
Authors: Bangi Erdem , Wharton Kristi
Published: August 2006

Wing patterning in Drosophila requires a Bmp activity gradient created by two Bmp ligands, Gbb and Dpp, and two Bmp type I receptors, Sax and Tkv. Gbb provides long-range signaling, while Dpp signals preferentially to cells near its source along the anteroposterior (AP) boundary of the wing disc. How each receptor contributes to the signaling activity of each ligand is not well understood. Here, we show that while Tkv mediates signals from both Dpp and Gbb, Sax exhibits a novel function for a Bmp type I receptor: the ability to both promote and antagonize signaling. Given its high affinity for Gbb, this dual function of Sax impacts the function of Gbb in the Bmp activity gradient more profoundly than does Dpp. We propose that this dual function of Sax is dependent on its receptor partner. When complexed with Tkv, Sax facilitates Bmp signaling, but when alone, Sax fails to signal effectively and sequesters Gbb. Overall, our model proposes that the balance between antagonizing and promoting Bmp signaling varies across the wing pouch,modulating the level and effective range, and, thus, shaping the Bmp activity gradient. This previously unknown mechanism for modulating ligand availability and range raises important questions regarding the function of vertebrate Sax orthologs.
Requirement forMap2k1(Mek1) in extra-embryonic ectoderm during placentogenesis
Authors: Bissonauth Vickram , Roy Sophie , Gravel Mathieu , Guillemette Stéphanie , Charron Jean
Published: August 2006

Map2k1-/- embryos die at mid-gestation from abnormal development and hypovascularization of the placenta. We now show that this phenotype is associated with a decreased labyrinth cell proliferation and an augmented cell apoptosis. Although the activation of MAP2K1 and MAP2K2 is widespread in the labyrinthine region, MAPK1 and MAPK3 activation is restricted to the cells lining the maternal sinuses, suggesting an important role for the ERK/MAPK cascade in these cells. In Map2k1-/-placenta, ERK/MAPK cascade activation is perturbed. Abnormal localization of the syncytiotrophoblasts is also observed in Map2k1-/-placenta, even though this cell lineage is specified at the correct time during placentogenesis. The placental phenotype can be rescued in tetraploid experiments. In addition, Map2k1-specific deletion in the embryo leads to normal embryo development and to the birth of viable Map2k1-/- mice. Altogether, these data enlighten the essential role of Map2k1 in extra-embryonic ectoderm during placentogenesis. In the embryo, the Map2k1 gene function appears dispensable.
On Equivalent Target-Oriented Formulations for Multiattribute Utility
Authors: Tsetlin Ilia , Winkler Robert L.
Published: August 2006

Targets are used quite often as a management tool, and it has been argued that thinking in terms of targets may be more natural than thinking in terms of utilities. The standard expected-utility framework with a single attribute (such as money) and nondecreasing, bounded utility is equivalent to a target-oriented setting. A utility function, properly scaled, can be expressed as a cumulative distribution function (cdf) and related to the probability of meeting a target value. We consider whether the equivalence of the two approaches extends to the case of multiattribute utility. Our analysis shows that a multiattribute utility function cannot always be expressed in the form of a cumulative distribution function and, furthermore, cannot always be expressed in the form of a target-oriented utility function. However, in each case equivalence does hold for certain well-known classes of utility functions. In general, our results imply that although interpreting utility as a cdf and thinking about achieving targets works fine in the case of a single attribute, this approach should be used with caution in the multiattribute case, with cdf representations requiring more caution than target-oriented representations.
Comment on Influence Diagram Retrospective
Authors: Howard Ronald A. , Matheson James E. , Merkhofer Miley W. (Lee) , Miller Allen C. , North D. Warner
Published: August 2006

Influence diagrams were first used in 1973 as a way to model political conflicts in the Persian Gulf and measure the value of information collected by the Defense Intelligence Agency. The number of scenarios for events in the region was too large to be represented as a conventional decision tree model. Influence diagrams were initially conceived as a way to create smaller, coalesced decision trees that required fewer probability assessments. However we found that they also facilitated communication between analysts, experts, and policy makers. Influence diagrams later became the basis for new ways of solving decision models.
Should We Protect Commercial Airplanes Against Surface-to-Air Missile Attacks by Terrorists?
Authors: von Winterfeldt Detlof , O'Sullivan Terrence M.
Published: August 2006

This paper describes a decision tree analysis to assess the cost-effectiveness of MANPADS (Man-Portable Air Defense Systems) countermeasures. These countermeasures are electronic devices that can be installed on commercial airplanes to detect and deflect surface-to-air missiles (SAMs) fired by terrorists. The model considers a terrorist attempt to shoot down a commercial airplane with a heat-seeking SAM, and it evaluates the decision to install countermeasures, taking into account alternative modes of attack, probabilities of success, and consequences to the economy. All model variables were fully parameterized, using reasonable ranges based on open-source literature. Not surprisingly, the probability of an attack, the consequences of an attack to the economy, and the cost of countermeasures are the most important parameters. Surprisingly, some of the hotly disputed parameters, such as the probability of an airplane surviving a successful hit or the probability of a false alarm, have very little impact on the results. The analysis suggests that MANPADS countermeasures installed on planes can be cost-effective if the probability of such an attack is large (greater than about 0.40 in ten years), the economic losses are large (greater than about $75 billion), and the countermeasures are relatively inexpensive (smaller than about $15 billion). An economic analysis conducted as part of this analysis showed that the economic impacts can be as large as $250 billion, thus making countermeasures a possibly cost-effective option. More research is needed to determine the real costs of MANPADS countermeasures and how terrorists may shift their tactics, once countermeasures are installed.
A Multiple-Objective Decision Analysis for Terrorism Protection: Potassium Iodide Distribution in Nuclear Incidents
Authors: Feng Tianjun , Keller L. Robin
Published: August 2006

This paper presents a multiple-objective decision analysis approach to qualitatively and quantitatively evaluate different potassium iodide (KI) distribution plans for a hypothetical local region. We developed this approach for a U.S. National Research Council committee that was charged with figuring out the best means for protecting people against potential thyroid cancer resulting from the release of radioactive iodine from nuclear incidents occurring due to terrorism or accidents. We first identify an objectives hierarchy and then develop the single-attribute value functions and the weights for the objectives using a swing weight method. The identification of the largest value gaps between the status quo and the ideal situation helps to develop potential KI distribution plans. We then use an additive value function to assess the performance of these new alternatives, with the status quo as a benchmark, by computing their overall values. Finally, sensitivity analysis for the KI problem shows how this approach can create more key insights for the improvement of health and safety decision-making processes.
From the Editors …
Authors: Clemen Robert T. , Kleinmuntz Don N.
Published: August 2006

This issue contains two articles describing applications of decision analysis to counter-terrorism risk management. The article by von Winterfeldt and O'Sullivan analyzes the cost-effectiveness of countermeasures to prevent surface-to-air missile attacks on civilian aircraft, while the article by Feng and Keller analyzes alternative strategies for the distribution of potassium iodide in response to a nuclear incident. Three other contributions follow: Tsetlin and Winkler analyze the relationship between target-based approaches to decision making and multiattribute utility functions. Butler, Dyer, and Jia compare and evaluate alternative methods for analyzing preferences when the decision maker is presented with a prespecified list of attributes. Finally, Howard, Matheson, Merkhofer, Miller, and North provide a historical comment on the development of influence diagrams within the Decision Analysis Group at the Stanford Research Institute.
Muddy waters: evidence-based policy making, uncertainty and the ‘York review’ on water fluoridation
Authors: Wilson Paul M. , Sheldon Trevor A.
Published: August 2006

English

The systematic review has become widely recognised as an aid to evidence-based decision making in health care. Recently, there has been much interest around the value of systematic reviews in policy-making contexts. This article describes a relatively rare example of an explicit policy commitment to follow the findings of a systematic review, namely that of the efficacy and safety of the fluoridation of drinking water. We argue that although a policy-relevant systematic review may not be directly influential if its findings contradict prior beliefs and policy intent, it can be of value beyond the immediate policy response.
Deliberative processes and evidence-informed decision making in healthcare: do they work and how might we know?
Authors: Culyer Anthony J. , Lomas Jonathan
Published: August 2006

English

Evidence-informed decisions are conjectured to be better than un-evidenced ones. Evidence is classified into three types: context-free scientific, context-sensitive scientific and colloquial. A deliberative process provides guidance informed by relevant scientific evidence, interpreted in a relevant context wherever possible with context-sensitive scientific evidence and, where not, by the best available colloquial evidence. Some characteristics of an empirical approach to the evaluation of the impact of deliberative processes on the quality of decisions in healthcare are identified. These are centred on the selection of key outcomes, key characteristics and having explicit alternatives as comparator.
US state government and DARE: the story in four states
Authors: Petrosino Anthony , Birkeland Sarah , Hacsi Timothy A. , Murphy-Graham Erin , Weiss Carol Hirschon
Published: August 2006

English

In contrast to the widespread local popularity of the police-led Drug Abuse Resistance Education (DARE) school-based programme, evaluation studies have consistently questioned its sustained impact on adolescent drug use. Our focus in this article is on the role of state government in DARE policy. Semi-structured personal interviews were conducted with 30 people, including past or present state agency officials and external researchers. These cases are organised chronologically along three time periods: (1) the genesis and expansion of DARE; (2) the resiliency of the programme to negative evaluation evidence; and (3) the decline of DARE.
Research dissemination: actively bringing the research and policy worlds together
Authors: Lawrence Ruth
Published: August 2006

English

Several changes have posed increasing challenges for the active dissemination of research within the policy world: the evidence-based policy-making movement has led to a demand for the implications of research to be spelt out; rapid technological changes have offered new electronic methods for bringing research to the attention of policy makers, but have also created information overload; while modernisation of the policy process has led to an emphasis on outcomes and demonstrable effectiveness. This article provides a critique of three models of research dissemination; it concludes with some innovative examples and identifies key resources for planning and developing an active dissemination strategy.
Development impact evaluation: new trends and challenges
Authors: Fiszbein Ariel
Published: August 2006

English

This article explores the implications associated with the growing emphasis on the use of impact evaluation studies of interventions among the international development community. It argues that: (1) impact evaluations, particularly when structured and conducted within a comparative framework, can be a fundamental input for policy and programme design; (2) impact evaluations are international public goods and thus there are serious coordination issues that need to be addressed to achieve an optimal supply; and (3) there are complex challenges involved in setting up that coordination in such a way that it properly serves the interests and needs of developing countries.
Exploring the involvement and perceptions of professional stakeholders on NICE clinical guidelines
Authors: Ilott Irene , Mead Judy , Roberts Julia , Hammond Ralph , Pearmain Henny
Published: August 2006

English

This article gives an insight into the effectiveness of stakeholding from the perspective of 15 professional bodies for the allied health professions, health visiting, health scientists, midwifery and nursing in the development of National Institute for Clinical Excellence (NICE) clinical guidelines. The findings reveal that larger professional bodies had embedded stakeholder relations within business plans while smaller organisations, with minimal infrastructure and reliant on voluntary activity, had difficulty participating. Stakeholding highlighted the challenge for research-emergent professions of making their evidence count within guideline methodology. The recommendations about understanding the purpose and problems of stakeholding are likely to be transferable to other contexts.
Protease Inhibitor-Associated Dyslipidemia in HIV-Infected Patients Is Strongly Influenced by the APOA5–1131T→C Gene Variation
Authors: Guardiola Montse , Ferré Raimon , Salazar Juliana , Alonso-Villaverde Carlos , Coll Blai , Parra Sandra , Masana Lluís , Ribalta Josep
Published: August 2006

Background: Hyperlipidemia associated with the protease inhibitor (PI) component of highly active antiretrovial treatment can lead to accelerated atherosclerosis. The apolipoprotein A-V (APOA5) gene, which affects VLDL production and lipolysis, may play a role in PI-induced hyperlipidemia, particularly in individuals with the APOA5–1131T→C genotype.

Methods: We measured lipoprotein changes in HIV-positive patients (n = 229) who had been followed for 5 years. For statistical analyses, we segregated the patients with respect to PI treatment and APOA5–1131T→C genotype.

Results: The frequency of the C allele was 0.08, similar to that in the general population. We found a strong effect of the APOA5–1131T→C genotype among patients receiving PIs. Carriers of the C allele had consistently increased mean (SD) triglyceride concentrations compared with noncarriers after 1 year [2.11 (1.62) vs 3.71 (4.27) mmol/L; P = 0.009], 2 years [2.48 (2.09) vs 4.02 (4.05) mmol/L, P = 0.050], 3 years [2.32 (1.71) vs 4.13 (4.26) mmol/L; P = 0.013], 4 years [2.90 (2.95) vs 5.35 (7.12) mmol/L; P was not significant], and 5 years [4.25 (5.58) vs 9.23 (9.63) mmol/L; P was not significant]. We observed the same effect on total cholesterol concentrations: after 1 year [4.93 (1.31) vs 5.87 (1.66) mmol/L; P = 0.006], 2 years [5.03 (1.12) vs 6.42 (2.48) mmol/L; P = 0.001], 3 years [5.11 (1.17) vs 6.38 (2.43) mmol/L; P = 0.009], 4 years [5.49 (1.71) vs 6.78 (3.03) mmol/L; P was not significant], and 5 years [5.56 (1.75) vs 7.90 (3.60) mmol/L; P was not significant]. HDL cholesterol showed a progressive reduction, leading to a considerably higher cholesterol/HDL cholesterol ratio after 3 years.

Conclusion: Variability in the APOA5 gene predisposes patients with HIV, particularly those treated with PI, to severe hyperlipidemia.
Definition of an XML Markup Language for Clinical Laboratory Procedures and Comparison with Generic XML Markup
Authors: Saadawi Gilan M , Harrison James H
Published: August 2006

Background: Clinical laboratory procedure manuals are typically maintained as word processor files and are inefficient to store and search, require substantial effort for review and updating, and integrate poorly with other laboratory information. Electronic document management systems could improve procedure management and utility. As a first step toward building such systems, we have developed a prototype electronic format for laboratory procedures using Extensible Markup Language (XML).

Methods: Representative laboratory procedures were analyzed to identify document structure and data elements. This information was used to create a markup vocabulary, CLP-ML, expressed as an XML Document Type Definition (DTD). To determine whether this markup provided advantages over generic markup, we compared procedures structured with CLP-ML or with the vocabulary of the Health Level Seven, Inc. (HL7) Clinical Document Architecture (CDA) narrative block.

Results: CLP-ML includes 124 XML tags and supports a variety of procedure types across different laboratory sections. When compared with a general-purpose markup vocabulary (CDA narrative block), CLP-ML documents were easier to edit and read, less complex structurally, and simpler to traverse for searching and retrieval.

Conclusion: In combination with appropriate software, CLP-ML is designed to support electronic authoring, reviewing, distributing, and searching of clinical laboratory procedures from a central repository, decreasing procedure maintenance effort and increasing the utility of procedure information. A standard electronic procedure format could also allow laboratories and vendors to share procedures and procedure layouts, minimizing duplicative word processor editing. Our results suggest that laboratory-specific markup such as CLP-ML will provide greater benefit for such systems than generic markup.
Methods for Deriving p-y Curves from Instrumented Lateral Load Tests
Authors: Yang K , Liang R
Published: August 2006

With the developments of new deep foundation systems and construction techniques, such as high capacity micro-piles, large diameter piles or drilled shafts, existing p-y criteria that were developed previously for small diameter piles or shafts may no longer be adequate. Deriving p-y curves from lateral load tests on instrumented deep foundations is critical for further refinement or developing pertinent p-y criteria for these new applications. However, there is a lack of a consistent and well verified method for deducing the p-y curves from lateral load tests measurement data. Four existing methods are evaluated using the measured results of eight full-scale field tests on fully instrumented drilled shafts as well as four hypothetical numerical simulation results. It is found that the p-y curves deduced by the piecewise cubic polynomial curve fitting method, when input into the LPILE (or COM624P) computer program, provides the smallest error on the prediction of deflections of a drilled shaft under the applied lateral loads. A procedure for determining an optimum strain gage spacing for instrumentation in a lateral load test to derive representative p-y curves is recommended. Finally, a parametric study has shown that the errors of the deduced p-y curves are mainly due to inaccurate moment profiles from strain gage readings. Accurate estimate of moment-curvature relationship of a reinforced concrete shaft is therefore essential to the accuracy of the deduced p-y curves from strain data.
A Tracer Method to Determine Extremely Low Wear Rates of Ultrahigh Molecular Weight Polyethylene
Authors: Kunze J , Wimmer MA
Published: August 2006

Wear testing protocols of ultrahigh molecular weight polyethylene (UHMWPE), which rely on gravimetric or topographic measurements, or both, for wear determination, are usually complicated due to fluid absorption or creep, or both, of the polyethylene samples. In this study we report the feasibility of using a tracer material to quantify wear of polyethylene. Europium (Eu), a rare earth element, has been identified as a suitable tracer material. Eu can be quantified with ICP-MS. Nascent UHMWPE powder has been mixed with a solution of Eu-acetate. Different mixing techniques were tried to homogenize the tracer distribution before consolidation. After molding, the 10-mm diameter pins were worn on a pin-on-disk testing apparatus. In addition, lubricant samples were taken at regular time intervals. The Eu content was analyzed and the derived polyethylene wear rate was compared with the weight loss of the pins.
Experimental Studies of NiTi Self-expanding Stent Designs
Authors: Eaton-Evans J , Dulieu-Barton JM , Little EG , Brown IA
Published: August 2006

Preliminary investigations to apply thermoelastic stress analysis (TSA) to Nitinol self-expanding stents are described. Tests conducted at high resolution indicated that a viable thermoelastic signal can be obtained from the fine stent structure. It is shown that it is possible to digitally compensate for errors arising from motion at this high resolution. High variability in Nitinol's material properties with stress and temperature result in a complex thermoelastic response. Correction strategies are proposed to account for variation in material properties and to minimize errors due to thermal variations in order to derive calibration factors for the austenite and martensite material phases. The greatest challenge is identified as calibrating the thermoelastic response from the radially loaded stent structure where it is likely the material is highly inhomogeneous.
Measuring the Field Corrosion Activity of Bridge Decks Built with Bare and Epoxy Coated Steel
Authors: Ramniceanu A , Weyers RE , Anderson-Cook C , Brown MC
Published: August 2006

Epoxy coated steel became the prevalent corrosion protection methods starting in the early 1980s. Since then, studies have shown that epoxy coating does not prevent corrosion, but instead will debond from the steel reinforcement in as little as four years, allowing instead a much more insidious form of corrosion to take place under the coating. Therefore, it is important to determine if nondestructive corrosion activity detection methods are applicable to epoxy coated reinforcing steel as well as institute guidelines for interpreting the results. Based on comparisons of measurements distributions, this study shows that there is an indication that these nondestructive test methods may be applicable to structures reinforced with epoxy coated steel.
Mechanical Impact Testing: Data Review and Analysis
Authors: Engel CD , Herald SD , Davis SE
Published: August 2006

Since the 1950s, when first the Army and then NASA developed mechanical impact testing of materials, researchers have continued efforts to gain a better understanding of the chemical, mechanical, and thermodynamic nature of the phenomenon. The impact mechanism is a proven ignition mechanism, which must be considered and understood in the design of an oxygen system. The use of test data from this test method has been questioned because of the lack of a clear method of application of the data and variability found between tests, material batches, and facilities. This effort explores a large database, which has accumulated over a number of years, and its overall nature. Moreover, testing was performed to determine the statistical nature of the test procedure to help establish sample size guidelines for material characterization. The current practice of reporting reaction frequency data at dropped energy rather than energy the sample receives does not offer a way to compare data between facilities.
Using Nondestructive Testing Technologies to Assist in Selecting the Optimal Pavement Rehabilitation Strategy
Authors: Chen DH , Scullion T
Published: August 2006

A comprehensive evaluation of pavement condition and an understanding of the underlying causes of pavement distress is vital in selecting the optimal rehabilitation strategy. Three projects were investigated in this study to demonstrate the application of nondestructive testing technologies in this selection process. Ground Penetrating Radar (GPR), Falling Weight Deflectometer (FWD), and Dynamic Cone Penetrometers (DCP) were successfully used on these TxDOT projects. GPR was employed successfully to locate defects in the hot mix surface layer that were responsible for the chronic distress on US 69. This roadway was rehabilitated previously but the strategy used had not addressed the root cause of the pavement problem. FWD and DCP data were also used to determine the structural capacity or layer moduli of the pavement system that allows the designer to derive the overlay thickness. Coring and trenching were utilized to verify the defects detected in the GPR data. The advantage of nondestructive testing is that it provides a comprehensive evaluation of subsurface conditions throughout the entire project, not only at locations where coring and trenching are performed. Furthermore, GPR was employed to verify a rehab design of an old JCP pavement on SH 73. Originally, the plan called for pressure grouting to fill the subsurface voids. However, GPR found no voids under the JCP slab; this was validated in subsequent coring. Therefore the GPR results helped district personnel to eliminate the cost of the pressure grouting. For comparison purposes, GPR results from IH 45 and US 82 (where there were voids under JCP slabs) were utilized.
New Method for Testing Fiber-reinforced Polymer Rods Under Flexure
Authors: Zhang B , Masmoudi R , Benmokrane B
Published: August 2006

This paper provides a new test method to determine the flexural properties of FRP reinforcing rods for material specifications, research and development, quality assurance, and structural design and analysis. This test method specifies the requirements of four-point flexural tests on FRP rods used in place of steel reinforcement or prestressing tendon in concrete on the basis of the knowledge gained from research results. This test method follows the ASTM standard test methods with some modifications according to the intended purpose and easy realization of the tests. Furthermore, flexural verification tests have been conducted on six sizes of diameters of GFRP rods, from #3 to #8 and each having six specimens. The test results were discussed and compared with that obtained from the three-point flexural tests as specified by the ASTM standard test method for flexural properties of fiber reinforced pultruded plastic rods.