bluuebunny/crossref_metadata_2025 huggingface dataset:
Computational models for fibre-reinforced composites
Authors: Kompiš V. , Štiavnický M.
Published: February 2009

Composite materials reinforced by short fibres are considered to be the materials of the future because of their excellent electro-thermo-mechanical properties, when the fibres have much higher stiffness and thermal and electric conductivity than the matrix. Usually the aspect ratio of fibres is very high. The classical numerical methods cannot accurately simulate the interaction of fibre–fibre–matrix for complicated topology of such materials. The current paper presents a method that enables such problems to be solved efficiently and accurately for an elastic matrix with such inclusions. The method uses one-dimensional continuously distributed source functions (forces, dipoles and couples) along the fibre axis to simulate interaction of the fibre with matrix and neighbour fibres. Numerical results indicate the importance of the topology of reinforcing fibres (i.e. if the fibres are straight, imperfect straight or curved; if they are unidirectional; how they are distributed in the matrix) for the overall effect in the composite. Numerical results of the method are discussed.
A review of potential methods of determining critical effect size for designing environmental monitoring programs
Authors: Munkittrick Kelly R. , Arens Collin J. , Lowell Richard B. , Kaminski Greg P.
Published: February 2009

The effective design of field studies requires that sample size requirements be estimated for important endpoints before conducting assessments. This a priori calculation of sample size requires initial estimates for the variability of the endpoints of interest, decisions regarding significance levels and the power desired, and identification of an effect size to be detected. Although many programs have called for use of critical effect sizes (CES) in the design of monitoring programs, few attempts have been made to define them. This paper reviews approaches that have been or could be used to set specific CES. The ideal method for setting CES would be to define the level of protection that prevents ecologically relevant impacts and to set a warning level of change that would be more sensitive than that CES level to provide a margin of safety; however, few examples of this approach being applied exist. Program-specific CES could be developed through the use of numbers based on regulatory or detection limits, a number defined through stakeholder negotiation, estimates of the ranges of reference data, or calculation from the distribution of data using frequency plots or multivariate techniques. The CES that have been defined often are consistent with a CES of approximately 25%, or two standard deviations, for many biological or ecological monitoring endpoints, and this value appears to be reasonable for use in a wide variety of monitoring programs and with a wide variety of endpoints.
Lessons Learned From Chicago's Emergency Response to Mass Evacuations Caused by Hurricane Katrina
Authors: Broz Dita , Levin Elise C. , Mucha Amy P. , Pelzel Darlene , Wong William , Persky Victoria W. , Hershow Ronald C.
Published: February 2009

Objectives. We analyzed the response of the Chicago Department of Public Health with respect to its effectiveness in providing health care to Hurricane Katrina evacuees arriving in the city.

Methods. Between September 12 and October 21, 2005, we conducted a real-time qualitative assessment of a medical unit in Chicago's Hurricane Victim Welcome and Relief Center. A semistructured guide was used to interview 33 emergency responders in an effort to identify key operational successes and failures.

Results. The medical unit functioned at a relatively high level, primarily as a result of the flexibility, creativity, and dedication of its staff and the presence of strong leadership. Chronic health care services and prescription refills were the most commonly mentioned services provided, and collaboration with a national pharmacy proved instrumental in reconstructing medication histories. The lack of a comprehensive and well-communicated emergency response plan resulted in several preventable inefficiencies.

Conclusions. Our findings highlight the need for improved planning for care of evacuee populations after a major emergency event and the importance of ensuring continuity of care for the most vulnerable. We provide an emergency response preparedness checklist for local public health departments.
The Moral Justification for a Compulsory Human Papillomavirus Vaccination Program
Authors: Balog Joseph E.
Published: February 2009

Compulsory human papillomavirus (HPV) vaccination of young girls has been proposed as a public health intervention to reduce the threat of the disease. Such a program would entail a symbiotic relationship between scientific interests in reducing mortality and morbidity and philosophical interests in promoting morality. This proposal raises the issue of whether government should use its police powers to restrict liberty and parental autonomy for the purpose of preventing harm to young people. I reviewed the scientific literature that questions the value of a HPV vaccination. Applying a principle-based approach to moral reasoning, I concluded that compulsory HPV vaccinations can be justified on moral, scientific, and public health grounds.
Effects of Hydrodynamically Rough Grassed Waterways on Dissolved Reactive Phosphorus Loads Coming from Agricultural Watersheds
Authors: Fiener P. , Auerswald K.
Published: February 2009

A modified type of grassed waterway (GWW) with large hydrodynamic roughness has proven ability to reduce sediment load and surface runoff under conditions where best management practices on the delivering fields reduce sediment inputs that could otherwise damage the grass cover. It is unknown how such a GWW affects the loading of surface runoff with dissolved reactive phosphorus (DRP). The effect on DRP was tested in a landscape‐scale study where DRP concentrations and loads in surface runoff were measured in two watersheds in which GWWs were newly installed and increased in effectiveness over time. Both watersheds were compared with paired watersheds without GWW installation; all watersheds were continuously monitored over 5 yr (1993–1997). Additionally, DRP concentrations were measured in open field and throughfall precipitation under growing grass and crops in field experiments, and DRP concentrations in surface runoff from straw covered surfaces were determined with laboratory rainfall simulation experiments. Dissolved reactive P in throughfall for the different cover types was highly variable, and the highest concentrations (up to 2.8 mg L−1) occurred especially during flowering of the respective crop and after frost events. Dissolved reactive P concentrations in runoff from straw‐covered surfaces were slightly higher compared with those from bare soil. On average, there was a small difference in DRP concentrations between throughfall under growing crops and grass and in runoff from bare or straw covered soil surfaces. Hence, the introduction of a relatively small grassed area has little effect on the DRP concentration in surface runoff from the total watershed. This finding was supported by the watershed data, where watersheds with and without GWW showed similar DRP concentrations. No change in DRP concentrations occurred over the 5‐yr period. Such GWWs will thus reduce the DRP load analogously to the reduction in total surface runoff.
Relationships between Benthic Sediments and Water Column Phosphorus in Illinois Streams
Authors: McDaniel Marshall D. , David Mark B. , Royer Todd V.
Published: February 2009

Sediments can be important in regulating stream water P concentrations, and this has implications for establishing nutrient standards that have not been fully investigated. We evaluated abiotic and biotic processes to better understand the role of sediments in determining stream water dissolved P concentrations. Sediment and stream water samples were collected during low discharge from 105 streams across Illinois and analyzed for equilibrium P concentration at zero release or retention (EPC0), P sorption characteristics, stream water P concentration, and sediment particle size. In addition, four east‐central Illinois streams were repeatedly sampled to examine temporal patterns in sediment P retention and biotic processing of P. Median dissolved reactive P (DRP) and total P concentrations across the state were 0.081 and 0.168 mg L−1, respectively. Sediment EPC0 concentrations were related to stream water DRP concentrations (rs = 0.75). Sediment silt+clay (and co‐correlated organic matter) was related to sorbed P (rs = −0.49) and the reactive sediment pool of P (rs = 0.76). However, for most sites this pool was small given the coarse textures present (median silt+clay was 5.7%). Repeated sampling at the four intensive sites showed little variation in EPC0 values or alkaline phosphatase activity, suggesting overall stream conditions regulated the biotic processing. Biotic retention of P was 32% of short‐term P removal. We conclude that sediments in Illinois streams are a reflection of and partially affected by stream water P concentrations through both abiotic and biotic processes. Sediments seem unlikely to alter annual stream P loads, but may affect concentrations at low discharge.
Influence of Plant Communities on Denitrification in a Tidal Freshwater Marsh of the Potomac River, United States
Authors: Hopfensperger Kristine N. , Kaushal Sujay S. , Findlay Stuart E.G. , Cornwell Jeffrey C.
Published: February 2009

We investigated whether marsh surface elevation, plant community composition (annuals vs. perennials), and organic matter quantity/quality were associated with differences in denitrification rates in an urban tidal freshwater marsh of the Potomac River, United States. We measured denitrification rates using both denitrification enzyme activity (DEA) with acetylene inhibition (June:n= 38, 3234 ± 303; October:n= 38, 1557 ± 368 ng N g dry soil−1h−1) and direct N2flux measurements with membrane inlet mass spectrometry (MIMS) (November:n= 6, 147 ± 24 μmol m−2h−1). Organic carbon content and nitrate concentrations in soil, and plant community composition were correlated with elevation, but DEA rates did not differ across marsh surface elevation. Soil organic carbon was highest in plots dominated by perennial graminoids, but DEA rates did not differ across plant community types. The DEA rates increased with increasing soil ammonium concentrations and total N content, and DEA rates differed between summer and fall sampling. The MIMS rates did not differ across plant community types, but were correlated with soil organic N content. Denitrification rates suggest that potential N removal at the site could be substantial. In addition, denitrification rates measured in Dyke Marsh were higher than rates for sediments measured in the adjacent Potomac River. Tidal freshwater marshes can represent an important site for denitrification, and factors fostering denitrification should be considered when restoring urban tidal freshwater wetlands as they are faced with pressures from increasing land use change and sea level rise.
Dissolved Organic Nitrogen: An Overlooked Pathway of Nitrogen Loss from Agricultural Systems?
Authors: van Kessel Chris , Clough Tim , van Groenigen Jan Willem
Published: February 2009

Conventional wisdom postulates that leaching losses of N from agriculture systems are dominated by NO3− Although the export of dissolved organic nitrogen (DON) into the groundwater has been recognized for more than 100 yr, it is often ignored when total N budgets are constructed. Leaching of DON into stream and drinking water reservoirs leads to eutrophication and acidification, and can pose a potential risk to human health. The main objective of this review was to determine whether DON losses from agricultural systems are significant, and to what extent they pose a risk to human health and the environment. Dissolved organic N losses across agricultural systems varied widely with minimum losses of 0.3 kg DON ha−1yr−1 in a pasture to a maximum loss of 127 kg DON ha−1yr−1 in a grassland following the application of urine. The mean and median values for DON leaching losses were found to be 12.7 and 4.0 kg N ha−1yr−1, respectively. On average, DON losses accounted for 26% of the total soluble N (NO3− plus DON) losses, with a median value of 19%. With a few exceptions, DON concentrations exceeded the criteria recommendations for drinking water quality. The extent of DON losses increased with increasing precipitation/irrigation, higher total inputs of N, and increasing sand content. It is concluded that DON leaching can be an important N loss pathway from agricultural systems. Models used to simulate and predict N losses from agricultural systems should include DON losses.
Determination of Gypsum Content in Dryland Soils Exploiting the Gypsum–Bassanite Phase Change
Authors: Lebron I. , Herrero J. , Robinson D.A.
Published: February 2009

The presence of gypsum in soil, even in small amounts, is relevant from the genetic, taxonomic, and applied points of view. Moreover, those soils having gypsum as the main component, for example gypseous soils, host a number of rare and endangered organisms. Determining gypsum content in soils is crucial to understanding their behavior; however, current methods of determination are cumbersome or imprecise. This study was conducted to develop an accurate new method to determine soil gypsum content by reducing the inaccuracies or poor assumptions in previous methods. We determined gypsum content in samples using quartz sand and clay minerals mixed with gypsum reagent powder to 0 and approximately 2, 5, and 50% gypsum content; we also studied seven gypseous soil samples. Gypsum (CaSO4·2H2O), after heating at 105°C, dehydrates, losing the two water molecules of the gypsum crystal cell and becoming mostly anhydrite (CaSO4). Anhydrite is very hygroscopic, absorbing atmospheric water very quickly; this process has been found to occur even in desiccators where the relative humidity (RH) is between 12 and 20% depending on the desiccant. Anhydrite rehydrates under laboratory conditions to bassanite (CaSO4·0.5H2O), which is stable at RH values <100%. We propose exploiting this difference in mass between gypsum and bassanite to quantify the gypsum content of soils. We found that by equilibrating the soils at constant RH, e.g., 40%, before and after heating the samples, the clay water content is constant, eliminating a major error with other thermogravimetric methods. This simple, yet effective method determined gypsum content to within 1% in all the mineralogies studied, whereas other oven‐based methods overestimated gypsum content by as much as 36% in a pure Ca‐montmorillonite sample.
Phosphorus Source and Surface Fluid Band Spacing Effects on Irrigated Alfalfa
Authors: Koenig Richard , Winward Dean , Reid Chad , Barnhill James , Pace Mike , Heaton Kevin
Published: February 2009

Subsurface banding of P fertilizer is more effective than broadcast and incorporation for annual crops on P‐deficient sites. Subsurface banding in established alfalfa (Medicago sativa L.) may damage plants. This study compared spring‐applied, broadcast dry monoammonium phosphate (MAP) and fluid ammonium polyphosphate (APP), and APP applied in surface bands with 15‐, 30‐, or 60‐cm spacing, at rates equivalent to 0.5× and 1× the soil test recommendation for yield, tissue P concentration, and P uptake at six sites. There was no difference in soil test P measured after the first cutting between broadcast MAP or APP. Yield responses to P occurred at all sites and ranged from a low of 0.7 Mg ha−1 (7%) averaged across P rate, to 2.6 Mg ha−1 (46%) at the 0.5× rate and 5.4 Mg ha−1 (95%) at the 1× rate above the 0 kg P ha−1 treatment. Yield was higher with MAP than with APP for five of 19 individual harvests, while total yield was 1.0 Mg ha−1 higher with MAP than with APP at one site‐year. Phosphorus source effects on P concentration and uptake were similar to those on dry matter yield. There was a linear decrease in yield with increasing band spacing for one site‐year and a quadratic response for another. Responses to band spacing in tissue P concentration for nine harvests suggest that band spacing of 15 and 30 cm may enhance P availability relative to broadcast or 60‐cm spacing. In only one site‐year did we find a yield advantage of MAP over APP, or of surface band over broadcast APP.
On the Impact of Better Targeted Transfers on Poverty in Tunisia
Authors: Bibi Sami
Published: February 2009

This paper describes the effects of general food subsidies on poverty in Tunisia, as revealed by household survey data for 1990. The analysis indicates that the poorest certainly take advantage of this system, but at the price of considerable leakages to non-poor people and at a sizable economic efficiency loss resulting from relative price distortions. Further, nonparametric estimations suggest that there are no commodities predominantly consumed by the poor. This implies that targeting by commodities is not an effective way to fight against poverty and, thus, it is unlikely that restructuring the current scheme would improve significantly the living standards of the less well-off members of society. We then investigate the impact on poverty of a more targeted transfer scheme, based on proxy means tests, using an appropriate econometric technique for modeling. Simulations show that this design would be more effective in reducing poverty than the use of general food subsidies. Finally, dominance tests show that this design would first-order-dominate a food subsidies scheme within a range of poverty lines, including all those estimated and generally used for Tunisia.
The Problem of Interest and Islamic Banking in a Comparative Perspective: The Case of Egypt, Iran and Pakistan
Authors: Nomani Farhad
Published: February 2009

As a growing economic sector in many Muslim countries, Islamic banking has its roots in the application of the Sharia. This is because Islamic banking is, in principle, based on legally recognized financial contracts and transactions that should be free of riba and gharar, both of which are interpreted somewhat differently by major Sunni and Shii schools of law. The objective of this study is (a) to shed light on the development of the debate on riba among Sunni and Shii scholars and the position of governments on the problem of interest-free banking in the twentieth century in Egypt, Iran and Pakistan; and (b) to study the implications of this debate for Islamic financial contracts. It is concluded that the expansion of a modern and viable internationally orientated Islamic banking and finance depends mainly on the development of financial capital markets, more independent and transparent central banking in Muslim countries, and a more innovative and flexible approach to Sharia by different schools of law in Muslim countries.
Book Reviews
Authors: Djoundourian Salpie , Baroudi Sami E
Published: February 2009

The Economics of Women and Work in the Middle East and North Africa, edited by E. Mine Cinar (Elsevier Science B. V., 2001). Labor and the State in Egypt: Workers, Unions, and Economic Reconstructuring, by Marsha Pripstein Posusney (New York: Columbia University Press, 1997). 327 pp., bibliography, index, $US21.50 (paperback), ISBN 0-231-10693-9.
Explaining the Adjustment of Adolescents With Type 1 Diabetes
Authors: Malik Jamil A. , Koot Hans M.
Published: February 2009

OBJECTIVE

The aim of this study was to explain adjustment (diabetes-related quality of life, general well-being, and psychopathology) in adolescents with type 1 diabetes by testing the direct, mediating, and moderating effects of diabetes-specific and psychosocial factors, using an adapted version of the Disability-Stress-Coping model of Wallander and Varni.

RESEARCH DESIGN AND METHODS

A total of 437 adolescents (54.5% girls; age range 11–19 years) with type 1 diabetes (mean ± SD diabetes duration 6.13 ± 3.78 years) were recruited from 25 hospitals in the Netherlands. Questionnaires were completed by the adolescents and their family members. Metabolic control was assessed by measuring A1C in all participants in one laboratory.

RESULTS

Diabetes stress mediated between A1C and adjustment, after controlling for protective factors, and explained an additional 16% variance in quality of life and a 15% variance in general well-being, whereas a 19% additional variance in psychopathology was explained by both diabetes-related and general stress. No moderating effects were identified after controlling for the main effects of all risk and protective factors in the model.

CONCLUSIONS

Both diabetes-related and general stress are critical predictors of the adjustment of adolescents with type 1 diabetes. Protective factors such as self-worth and social support may mediate the effects of generic stress and thus should be encouraged. Diabetes-related stress has the potential to displace the effects of protective factors and thus may play a critical role in the development of maladjustment in adolescents with type 1 diabetes.
Renal Hyperfiltration and the Development of Microalbuminuria in Type 1 Diabetes
Authors: Ficociello Linda H. , Perkins Bruce A. , Roshan Bijan , Weinberg Janice M. , Aschengrau Ann , Warram James H. , Krolewski Andrzej S.
Published: February 2009

OBJECTIVE

The purpose of this study was to examine prospectively whether renal hyperfiltration is associated with the development of microalbuminuria in patients with type 1 diabetes, after taking into account known risk factors.

RESEARCH DESIGN AND METHODS

The study group comprised 426 participants with normoalbuminuria from the First Joslin Kidney Study, followed for 15 years. Glomerular filtration rate was estimated by serum cystatin C, and hyperfiltration was defined as exceeding the 97.5th percentile of the sex-specific distribution of a similarly aged, nondiabetic population (134 and 149 ml/min per 1.73 m2 for men and women, respectively). The outcome was time to microalbuminuria development (multiple albumin excretion rate >30 μg/min). Hazard ratios (HRs) for microalbuminuria were calculated at 5, 10, and 15 years.

RESULTS

Renal hyperfiltration was present in 24% of the study group and did not increase the risk of developing microalbuminuria. The unadjusted HR for microalbuminuria comparing those with and without hyperfiltration at baseline was 0.8 (95% CI 0.4–1.7) during the first 5 years, 1.0 (0.6–1.7) during the first 10 years, and 0.8 (0.5–1.4) during 15 years of follow-up. The model adjusted for baseline known risk factors including A1C, age at diagnosis of diabetes, diabetes duration, and cigarette smoking resulted in similar HRs. In addition, incorporating changes in hyperfiltration status during follow-up had minimal impact on the HRs for microalbuminuria.

CONCLUSIONS

Renal hyperfiltration does not have an impact on the development of microalbuminuria in type 1 diabetes during 5, 10, or 15 years of follow-up.
Prediction of Type 2 Diabetes Using Alternate Anthropometric Measures in a Multi-Ethnic Cohort
Authors: MacKay Meredith F. , Haffner Steven M. , Wagenknecht Lynne E. , D'Agostino Ralph B. , Hanley Anthony J.G.
Published: February 2009

OBJECTIVE

To compare different anthropometric measures in terms of their ability to predict type 2 diabetes and to determine whether predictive ability was modified by ethnicity.

RESEARCH DESIGN AND METHODS

Anthropometry was measured at baseline for 1,073 non-Hispanic white (nHW), African American (AA), and Hispanic (HA) subjects, of whom 146 developed type 2 diabetes after 5.2 years. Logistic regression models were used with areas under the receiver operator characteristic curve (AROCs) comparing the prediction of models.

RESULTS

Waist-to-height ratio (AROC 0.678) was the most predictive measure, followed by BMI (AROC 0.674). Results were similar in nHW and HA subjects, although in AA subjects, central adiposity measures appeared to best predict type 2 diabetes.

CONCLUSIONS

Measures of central and overall adiposity predicted type 2 diabetes to a similar degree, except in AA subjects, for whom results suggested that central measures were more predictive.
Effects of Type 2 Diabetes on Insulin Secretion, Insulin Action, Glucose Effectiveness, and Postprandial Glucose Metabolism
Authors: Basu Ananda , Dalla Man Chiara , Basu Rita , Toffolo Gianna , Cobelli Claudio , Rizza Robert A.
Published: February 2009

OBJECTIVE

In this study, we sought to determine whether postprandial insulin secretion, insulin action, glucose effectiveness, and glucose turnover were abnormal in type 2 diabetes.

RESEARCH DESIGN AND METHODS

Fourteen subjects with type 2 diabetes and 11 nondiabetic subjects matched for age, weight, and BMI underwent a mixed-meal test using the triple-tracer technique. Indexes of insulin secretion, insulin action, and glucose effectiveness were assessed using the oral “minimal” and C-peptide models.

RESULTS

Fasting and postprandial glucose concentrations were higher in the diabetic than nondiabetic subjects. Although peak insulin secretion was delayed (P < 0.001) and lower (P < 0.05) in type 2 diabetes, the integrated total postprandial insulin response did not differ between groups. Insulin action, insulin secretion, disposition indexes, and glucose effectiveness all were lower (P < 0.05) in diabetic than in nondiabetic subjects. Whereas the rate of meal glucose appearance did not differ between groups, the percent suppression of endogenous glucose production (EGP) was slightly delayed and the increment in glucose disappearance was substantially lower (P < 0.01) in diabetic subjects during the first 3 h after meal ingestion. Together, these defects resulted in an excessive rise in postprandial glucose concentrations in the diabetic subjects.

CONCLUSIONS

When measured using methods that avoid non–steady-state error, the rate of appearance of ingested glucose was normal and suppression of EGP was only minimally impaired. However, when considered in light of the prevailing glucose concentration, both were abnormal. In contrast, rates of postprandial glucose disappearance were substantially decreased due to defects in insulin secretion, insulin action, and glucose effectiveness.
Impaired Distal Thermoregulation in Diabetes and Diabetic Polyneuropathy
Authors: Rutkove Seward B. , Veves Aristidis , Mitsa Theophano , Nie Rui , Fogerson Patricia M. , Garmirian Lindsay P. , Nardin Rachel A.
Published: February 2009

OBJECTIVE

To determine how thermoregulation of the feet is affected by diabetes and diabetic polyneuropathy in both wakefulness and sleep.

RESEARCH DESIGN AND METHODS

Normal subjects, diabetic subjects without neuropathy, diabetic subjects with small-fiber diabetic polyneuropathy, and those with advanced diabetic polyneuropathy were categorized based on neurological examination, nerve conduction studies, and quantitative sensory testing. Subjects underwent foot temperature monitoring using an iButton device attached to the foot and a second iButton for recording of ambient temperature. Socks and footwear were standardized, and subjects maintained an activity diary. Data were collected over a 32-h period and analyzed.

RESULTS

A total of 39 normal subjects, 28 patients with diabetes but without diabetic polyneuropathy, 14 patients with isolated small-fiber diabetic polyneuropathy, and 27 patients with more advanced diabetic polyneuropathy participated. No consistent differences in foot temperature regulation between the four groups were identified during wakefulness. During sleep, however, multiple metrics revealed significant abnormalities in the diabetic patients. These included reduced mean foot temperature (P < 0.001), reduced maximal temperature (P < 0.001), increased rate of cooling (P < 0.001), as well as increased frequency of variation (P = 0.005), supporting that patients with diabetic polyneuropathy and even those with only diabetes but no diabetic polyneuropathy have impaired nocturnal thermoregulation.

CONCLUSIONS

Nocturnal foot thermoregulation is impaired in patients with diabetes and diabetic polyneuropathy. Because neurons are highly temperature sensitive and because foot warming is part of the normal biology of sleep onset and maintenance, these findings suggest new potentially treatable mechanisms of diabetes-associated nocturnal pain and sleep disturbance.
Exercise Capacity and All-Cause Mortality in African American and Caucasian Men With Type 2 Diabetes
Authors: Kokkinos Peter , Myers Jonathan , Nylen Eric , Panagiotakos Demosthenes B. , Manolis Athanasios , Pittaras Andreas , Blackman Marc R. , Jacob-Issac Roshney , Faselis Charles , Abella Joshua , Singh Steven
Published: February 2009

OBJECTIVE

The purpose of this study was to assess the association between exercise capacity and mortality in African Americans and Caucasians with type 2 diabetes and to explore racial differences regarding this relationship.

RESEARCH DESIGN AND METHODS

African American (n = 1,703; aged 60 ± 10 years) and Caucasian (n = 1,445; aged 62 ± 10 years) men with type 2 diabetes completed a maximal exercise test between 1986 and 2007 at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, California. Three fitness categories were established (low-, moderate-, and high-fit) based on peak METs achieved. Subjects were followed for all-cause mortality for 7.3 ± 4.7 years.

RESULTS

The adjusted mortality risk was 23% higher in African Americans than in Caucasians (hazard ratio 1.23 [95% CI 1.1–1.4]). A graded reduction in mortality risk was noted with increased exercise capacity for both races. There was a significant interaction between race and METs (P < 0.001) and among race and fitness categories (P < 0.001). The association was stronger for Caucasians. Each 1-MET increase in exercise capacity yielded a 19% lower risk for Caucasians and 14% for African Americans (P < 0.001). Similarly, the risk was 43% lower (0.57 [0.44–0.73]) for moderate-fit and 67% lower (0.33 [0.22–0.48]) for high-fit Caucasians. The comparable reductions in African Americans were 34% (0.66 [0.55–0.80]) and 46% (0.54 [0.39–0.73]), respectively.

CONCLUSIONS

Exercise capacity is a strong predictor of all-cause mortality in African American and Caucasian men with type 2 diabetes. The exercise capacity-related reduction in mortality appears to be stronger and more graded for Caucasians than for African Americans.
Metabolic Syndrome as a Risk Factor for Cardiovascular Disease, Mortality, and Progression of Diabetic Nephropathy in Type 1 Diabetes
Authors: Thorn Lena M. , Forsblom Carol , Wadén Johan , Saraheimo Markku , Tolonen Nina , Hietala Kustaa , Groop Per-Henrik ,   for the Finnish Diabetic Nephropathy (FinnDiane) Study Group
Published: February 2009

OBJECTIVE

To assess the predictive value of the metabolic syndrome in patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS

Patients were from the prospective Finnish Diabetic Nephropathy (FinnDiane) Study (n = 3,783): mean age 37 ± 12 years and diabetes duration 23 ± 12 years. Metabolic syndrome was defined according to World Health Organization (WHO), National Cholesterol Education Program (NCEP), and International Diabetes Federation (IDF) definitions. Follow-up time was median 5.5 years (interquartile range 3.7–6.7). Mortality data were complete, whereas morbidity data were available in 69% of the patients.

RESULTS

The WHO definition was associated with a 2.1-fold increased risk of cardiovascular events and a 2.5-fold increased risk of cardiovascular- and diabetes-related mortality, after adjustment for traditional risk factors and diabetic nephropathy. The NCEP definition did not predict outcomes when adjusted for nephropathy but markedly added to the risk associated with elevated albuminuria alone (P < 0.001). The IDF definition did not predict outcomes.

CONCLUSIONS

The metabolic syndrome is a risk factor, beyond albuminuria, for cardiovascular morbidity and diabetes-related mortality in type 1 diabetes.
A strategy for new macrocycle magnetic materials synthesis
Authors: Mroziński Jerzy , Bieńko Alina
Published: February 2009

A study of a series of new types of copper(II) and rhenium(IV) macrocyclic complexes, important macrocyclic molecular magnets, is reported. A detailed description of crystal structure and magnetic behavior of mononuclear copper(II) macrocyclic compounds: CuL1(ClO4)2 (L1 = N-d-2,4,4,9,11,11-hexamethyl-1,5,8,12-tetraazacyclotetradeca-2,9-diene), CuL2(ClO4)2 (L2 = N-d-7,14-diisopropyl-5,12-dimethyl-1,4,8,11-tetraazacyclotetradeca-4,11-diene) and of heteropolynuclear complexes: [CuL1][ReCl4(ox)] · DMF and [(CuL2)(ox)ReCl4] is presented. The results indicate that all compounds behave as weak interacting magnets.
Application of isotachophoretic and conductometric methods for neomycin trisulphate determination
Authors: Kurzawa Marzanna , Jastrzębska Aneta , Szłyk Edward
Published: February 2009

Determination of neomycin trisulphate (NMS) in a dosage form (Neox and Neosol) was carried out by capillary isotachophoresis (cITP) with conductometric detection. The following electrolytes: leading: 10 mmol dm−3 sodium acetate + 0.08 % hydroxyethylcelulose (HEC) and acetic acid to pH = 5.5, and terminating: 10 mmol dm−3 β-alanine were tested for isotachophoretic separation of NMS. The calibration curve was linear over the range of 10.00 mg dm−3 to 100.00 mg dm−3 with LOD = 5.69 mg dm−3 and LOQ = 18.96 mg dm−3. The results were compared to the conductometric determination of NMS with: ammonium molybdate (VI), silver nitrate (V) and Reinecke salt. Good accuracy was obtained from conductometric titration of NMS with Reinecke salt, the recoveries being as follows: 100 % (RSD = 1.99 %); 96.17 % (RSD = 2.10 %) and 95.22 % (RSD = 1.55 %) for NMS in pure form, Neosol and Neox, respectively.
N2O catalytic decomposition — effect of pelleting pressure on activity of Co-Mn-Al mixed oxide catalysts
Authors: Galejová Kateřina , Obalová Lucie , Jirátová Květuše , Pacultová Kateřina , Kovanda František
Published: February 2009

The effect of pelleting pressure (0–10 MPa) during the preparation of Co-Mn-Al mixed oxide catalyst on its texture and activity for N2O catalytic decomposition was examined for small grain sizes used in laboratory experiments, and for model industry catalyst particles. Adsorption/desorption measurements of nitrogen, mercury porosimetry and helium pycnometry were used for detail characterization of porous structure. A volume of micropores of about 20 mm3 g−1 was evaluated using modified BET equation. This value did practically not change with the increasing pelletization pressure except that of the sample formed at the pressure of 10 MPa. Although an increase of pelleting pressure caused an increase in bulk density and a decrease in pore size and pore volume of the prepared catalyst (resulting in lower values of N2O effective diffusion coefficient), no direct correlation between pelleting pressure used and catalyst activity has been found. In contrary, estimation of the internal diffusion limitation according to the Weisz-Prater criterion indicated that even laboratory experimental data obtained for catalyst grains with particle size lower than 0.315 mm pelletized at higher pressures could be influenced by internal diffusion. Estimation of the internal mass transfer limitation in industrial catalyst particles described by the effectiveness factor showed that effectiveness factor of about 0.07 and 0.2 can be obtained for spheres with the radius of 1.5 mm and 0.5 mm, respectively, if pelleting pressure of about 6 MPa was used for the catalyst preparation.
Does Sleep Promote Motor Learning? Implications for Physical Rehabilitation
Authors: Siengsukon Catherine F , Boyd Lara A
Published: February 2009

Sleep following motor skill practice has repeatedly been demonstrated to enhance motor skill learning off-line (continued overnight improvements in motor skill that are not associated with additional physical practice) for young people who are healthy. Mounting evidence suggests that older people who are healthy fail to demonstrate sleep-dependent off-line motor learning. However, little is known regarding the influence of sleep on motor skill enhancement following damage to the brain. Emerging evidence suggests that individuals with brain damage, particularly following stroke, do benefit from sleep to promote off-line motor skill learning. Because rehabilitation following stroke requires learning new, and re-learning old, motor skills, awareness that individuals with stroke benefit from a period of sleep following motor skill practice to enhance skill learning could affect physical therapist practice. The objective of this article is to present the evidence demonstrating sleep-dependent off-line motor learning in young people who are healthy and the variables that may influence this beneficial sleep-dependent skill enhancement. In young people who are healthy, these variables include the stages of memory formation, the type of memory, the type of instruction provided (implicit versus explicit learning), and the task utilized. The neural mechanisms thought to be associated with sleep-dependent off-line motor learning also are considered. Research examining whether older adults who are healthy show the same benefits of sleep as do younger adults is discussed. The data suggest that older adults who are healthy do not benefit from sleep to promote off-line skill enhancement. A possible explanation for the apparent lack of sleep-dependent off-line motor learning by older adults who are healthy is presented. Last, emerging evidence showing that individuals with chronic stroke demonstrate sleep-dependent off-line motor skill learning and some of the possible mechanisms for this effect are considered.
Anatomical feasibility of transferring supinator motor branches to the posterior interosseous nerve in C7–T1 brachial plexus palsies
Authors: Bertelli Jayme Augusto , Kechele Paulo Roberto , Santos Marcos Antonio , Besen Bruno Adler Maccagnan Pinheiro , Duarte Hamilton
Published: February 2009

Object

In C7–T1 palsies of the brachial plexus, shoulder and elbow function is preserved, but finger motion is absent. Finger flexion has been reconstructed using tendon or nerve transfers. Finger extension has been restored ineffectively by attaching the extensor tendons to the distal side of the dorsal radius (that is, tenodesis). In these types of nerve palsy, supinator muscle function is preserved because innervation stems from the C-6 root. In the present study, the authors investigated the anatomy and the feasibility of transferring the supinator motor branches to the posterior interosseous nerve. Sacrifice of the supinator motor branches does not abolish supination because biceps muscle function is preserved in lower-type injuries of the brachial plexus.

Methods

The posterior interosseous nerve was dissected in 20 formalin-fixed forearms. Through posterior forearm access, the posterior interosseous nerve and its motor branches to the supinator muscle were dissected. Specimens were removed for histological study.

Results

In the vicinity of the supinator muscle's proximal margin (that is, the Frohse arcade), 2 nerve branches arose laterally and medially from the posterior interosseous nerve to innervate the superficial and deep heads of the supinator muscle, respectively. The supinator motor nerves, when divided, could be coapted directly to the posterior interosseous nerve. The number of myelinated fibers in the supinator motor branches corresponded to 70% that of the posterior interosseous nerve.

Conclusions

The supinator motor nerves can be transferred directly to the posterior interosseous nerve to restore thumb and finger extension in patients with C7–T1 brachial plexus lesions.
Clinical and angiographic long-term outcomes of vertebral artery–subclavian artery transposition to treat symptomatic stenosis of vertebral artery origin
Authors: Kakino Shunsuke , Ogasawara Kuniaki , Kubo Yoshitaka , Kashimura Hiroshi , Konno Hiromu , Sugawara Atsushi , Kobayashi Masakazu , Sasaki Makoto , Ogawa Akira
Published: February 2009

Object

Although angioplasty and stent placement for vertebral artery (VA)–origin stenosis have been performed using endovascular techniques, a high likelihood of restenosis has been observed in the long term. Therefore, the authors assessed the long-term clinical and angiographic outcomes in patients after VA–subclavian artery (SA) transposition.

Methods

Thirty-six patients (31 men, 5 women; mean age 64.3 years, range 46–76 years) underwent clinical evaluation (modified Rankin Scale [mRS]) and cervical angiographic evaluation preoperatively and within 1 month of and 6 months after VA-SA transposition undertaken to treat symptomatic stenosis of VA origin.

Results

Postoperative neurological deficits due to intraoperative brain ischemia did not occur, and MR imaging demonstrated no new postoperative ischemic lesions in any of the patients. One patient died of acute myocardial infarction 2 months after surgery and another developed a left thalamic hemorrhage (mRS score of 5) at 42 months postsurgery. None of the remaining 34 patients experienced further ischemic events, and the mRS score in all of these patients remained unchanged during a mean follow-up period of 54 months. The degree of VA-origin stenosis (preoperative mean 84%) was reduced to ≤ 30% after surgery (mean 2%). Long-term follow-up angiography in 29 patients (81%) revealed the absence of restenosis, defined as > 50% luminal narrowing, in all of them.

Conclusions

The clinical and angiographic long-term outcomes demonstrated here suggest that VA-SA transposition will be useful in patients with symptomatic stenosis of VA origin.
Knee Joint Tuberculosis Presenting as Immune Thrombocytopenia
Authors: Khan Mohammad Abdullah Az Zubayer , Mohammed Fazle Rabbi , Shams Md Ziaus , Sarker Shaymal , Alam Md Billal
Published: February 2009

Tuberculosis (TB) is a major public health problem of increasing proportions in Bangladesh for last several decades. A total of 350,641 cases were reported in Bangladesh in 2006 representing an incidence of 225 per 100,000 population for that year. Many hematological derangements such as anaemia, leukocytosis or pancytopenia can occur in association with TB. However isolated thrombocytopenia is rare and most commonly occur via a non immune mechanism in the setting of pancytopenia that develop secondary to granulomatous infiltration of the bone marrow. Â However immune thrombocytopenic purpura (ITP) in a patient with TB is exceedingly a rare event. Here we report a case of ITP associated with TB of knee joint in whom thrombocytopenia and TB were successfully treated. A casual association between joint TB and ITP is extraordinarily rare and to our knowledge this is the first such case documentation in Bangladesh, although a few case reports citing association of TB and ITP are found in literature. Â  doi:10.3329/jom.v10i1.2001 J Medicine 2009; 10: 28-30
Hypothyroidism and Nephrotic Syndrome- A Rare Association
Authors: Uddin Md Julhash , Alam Kazi Monjurul , Mohammed Fazle Rabbi , Alam Md Billal
Published: February 2009

Hypothyroidism may coexist with different renal pathologies. Several cases of glomerular diseases have been associated with thyroid diseases of which the most frequent lesion described is membranous glomerulopathy, presented as a nephrotic syndrome. Although pseudohypothyroidism is well-known in nephrotic pathophysiology, actual hypothyroidism are uncommon. We report here an unusual association of hypothyroidism due to Hashimoto's disease with nephrotic syndrome due to membranoproliferative glumerulonephritis which were revealed by hormone & antibody assay and renal biopsy respectively. Â  doi:10.3329/jom.v10i1.2003 J Medicine 2009; 10: 34-35
Dengue Haemorrhagic Fever with Bradycardia
Authors: Arif SM , Ahmed H , Khokon KZ , Azad AK , Faiz MA
Published: February 2009

Dengue fever (DF) and dengue hemorrhagic fever (DHF) is a viral disease, caused by dengue (DEN) virus and transmitted by bites of Aedes aegypti mosquito. There are four serotypes of dengue viruses- DEN-1, DEN-2, DEN-3 and DEN-4.In Bangladesh dengue has started as epidemic & has created panic among the people since the year 2000 and as per the sero-survey findings, 3 sero-types of the virus circulating.2 Here we describe a case of DHF with subsequent cardiac complication, treated in Dhaka Medial College Hospital (DMCH). Â  doi:10.3329/jom.v10i1.2004 J Medicine 2009; 10: 36-37
Doctor in the Dock
Authors: Mathew Biju C , Daniel Reji Susan , Bordom Jamal Al Baylool , Campbell Ian W
Published: February 2009

Tobacco smoking is one of the greatest threats to human health. The global epidemic of tobacco killed 100 million in the 20th century, and if not dealt with on a war- footing shall entice and kill another one billion in this century. In the society , physicians play a leading role as ambassadors of promoting issues related to health. They play a vital role in helping patients to stop smoking as they occupy an important position as tobacco control exemplars. Unfortunately, the rate of smoking in the medical profession in some developed countries and newly-developing countries is still high. Considering the staggering cost of smoking in terms of human lives, physicians should not rest until they have successfully kicked the habit. Tobacco-related issues are to be included in the medical school curricula, as medical students can play decisive roles in tobacco-prevention programs. Â  doi:10.3329/jom.v10i3.2013 J Medicine 2009; 10 (Supplement 1): 27-31
Upper Body Hypertension with Gross Atherosclerotic Narrowing and Diffuse Calcification of the Descending and Abdominal Aorta
Authors: Hilaly Shah Mahboob Rashid , Sarma Apurba Kumar , Hussain M Zakir
Published: February 2009

Of the hypertensive patients presenting to the primary care providers, 95-99% have essential hypertension. Remaining 1-5% have an underlying diagnosis.1 Narrowing of the aorta distal to the origin of the arteries to the head, neck & upper limbs causes upper body hypertension. Coarctation of the aorta, a congenital narrowing of the aorta just distal to the insertion of ductus arteriosus, is the major cause of upper body hypertension. Gross atherosclerotic narrowing & diffuse calcification of the descending & abdominal aorta rarely emulates the features of coarctation of the aorta. We report a case of upper body hypertension due to gross atherosclerotic narrowing & diffuse calcification of the descending & abdominal aorta after extensive medline search we have not come across of such reports yet. Â  doi:10.3329/jom.v10i3.2014 Â  J Medicine 2009; 10 (Supplement 1): 32-35