bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality Among Men and Women in Same-Sex Marriage: A National Cohort Study of 8333 Danes
Authors: Frisch Morten , Brønnum-Hansen Henrik
Published: November 2008

Objectives. We studied overall mortality in a demographically defined, complete cohort of gay men and lesbians to address recent claims of markedly shorter life spans among homosexual persons.

Methods. We calculated standardized mortality ratios (SMRs) starting 1 year after the date of same-sex marriage for 4914 men and 3419 women in Denmark who married a same-sex partner between 1989 and 2004.

Results. Mortality was markedly increased in the first decade after same-sex marriage for men who married between 1989 and 1995 (SMR = 2.25; 95% confidence interval [CI] = 2.01, 2.50), but much less so for men who married after 1995, when efficient HIV/AIDS therapies were available (SMR = 1.33; 95% CI = 1.04, 1.68). For women who married their same-sex partner between 1989 and 2004, mortality was 34% higher than was mortality in the general female population (SMR = 1.34; 95% CI = 1.09, 1.63). For women, and for men marrying after 1995, the significant excess mortality was limited to the period 1 to 3 years after the marriage.

Conclusions. Despite recent marked reduction in mortality among gay men, Danish men and women in same-sex marriages still have mortality rates that exceed those of the general population. The excess mortality is restricted to the first few years after a marriage, presumably reflecting preexisting illness at the time of marriage. Although further study is needed, the claims of drastically increased overall mortality in gay men and lesbians appear unjustified.
Effects of a Community-Based, Professionally Supervised Intervention on Physical Activity Levels Among Residents of Recife, Brazil
Authors: Simoes Eduardo J. , Hallal Pedro , Pratt Michael , Ramos Luiz , Munk Marcia , Damascena Wilson , Parra Perez Diana , Hoehner Christine M. , Gilbertz David , Malta Deborah Carvalho , Brownson Ross C.
Published: November 2008

Objectives. We evaluated the effects of a community-based intervention, the Academia da Cidade program (ACP), on increasing leisure-time physical activity among residents of Recife, Brazil.

Methods. We used the International Physical Activity Questionnaire to assess leisure-time physical activity and transport physical activity (i.e., activities involved in traveling from place to place) levels in a random sample of 2047 Recife residents surveyed in 2007. We also examined factors related to exposure to ACP (participation in the intervention, residing near an intervention site, hearing about or seeing intervention activities). We estimated prevalence odds ratios (ORs) of moderate to high leisure-time and transport physical activity levels via intervention exposures adjusted for sociodemographic, health, and environmental variables.

Results. Prevalence ORs for moderate to high levels of leisure-time physical activity were higher among former (prevalence OR = 2.0; 95% confidence interval [CI] = 1.0, 3.9) and current (prevalence OR = 11.3; 95% CI = 3.5, 35.9) intervention participants and those who had heard about or seen an intervention activity (prevalence OR = 1.8; 95% CI = 1.3, 2.5). Transport physical activity levels were inversely associated with residing near an ACP site.

Conclusions. The ACP program appears to be an effective public health strategy to increase population-level physical activity in urban developing settings.
Letter: Paying for a Dirty and Leaky Bucket: Further Comments on the Bailout
Authors: Barbier Edward B
Published: November 2008

Edward Barbier of the University of Wyoming elaborates on the relevance of the polluter pays principle for the Paulson bailout plan.
Glucose and Pharmacological Modulators of ATP-Sensitive K+ Channels Control [Ca2+]c by Different Mechanisms in Isolated Mouse α-Cells
Authors: Quoix Nicolas , Cheng-Xue Rui , Mattart Laurine , Zeinoun Ziad , Guiot Yves , Beauvois Mélanie C. , Henquin Jean-Claude , Gilon Patrick
Published: November 2008

OBJECTIVE—We studied how glucose and ATP-sensitive K+ (KATP) channel modulators affect α-cell [Ca2+]c.

RESEARCH DESIGN AND METHODS—GYY mice (expressing enhanced yellow fluorescent protein in α-cells) and NMRI mice were used. [Ca2+]c, the KATP current (IKATP, perforated mode) and cell metabolism [NAD(P)H fluorescence] were monitored in single α-cells and, for comparison, in single β-cells.

RESULTS—In 0.5 mmol/l glucose, [Ca2+]c oscillated in some α-cells and was basal in the others. Increasing glucose to 15 mmol/l decreased [Ca2+]c by ∼30% in oscillating cells and was ineffective in the others. α-Cell IKATP was inhibited by tolbutamide and activated by diazoxide or the mitochondrial poison azide, as in β-cells. Tolbutamide increased α-cell [Ca2+]c, whereas diazoxide and azide abolished [Ca2+]c oscillations. Increasing glucose from 0.5 to 15 mmol/l did not change IKATP and NAD(P)H fluorescence in α-cells in contrast to β-cells. The use of nimodipine showed that L-type Ca2+ channels are the main conduits for Ca2+ influx in α-cells. γ-Aminobutyric acid and zinc did not decrease α-cell [Ca2+]c, and insulin, although lowering [Ca2+]c very modestly, did not affect glucagon secretion.

CONCLUSIONS—α-Cells display similarities with β-cells: KATP channels control Ca2+ influx mainly through L-type Ca2+ channels. However, α-cells have distinct features from β-cells: Most KATP channels are already closed at low glucose, glucose does not affect cell metabolism and IKATP, and it slightly decreases [Ca2+]c. Hence, glucose and KATP channel modulators exert distinct effects on α-cell [Ca2+]c. The direct small glucose-induced drop in α-cell [Ca2+]c contributes likely only partly to the strong glucose-induced inhibition of glucagon secretion in islets.
Association Analysis of Variation in/NearFTO,CDKAL1,SLC30A8,HHEX,EXT2,IGF2BP2,LOC387761, andCDKN2BWith Type 2 Diabetes and Related Quantitative Traits in Pima Indians
Authors: Rong Rong , Hanson Robert L. , Ortiz Daniel , Wiedrich Christopher , Kobes Sayuko , Knowler William C. , Bogardus Clifton , Baier Leslie J.
Published: November 2008

OBJECTIVE—In recent genome-wide association studies, variants in CDKAL1, SLC30A8, HHEX, EXT2, IGF2BP2, CDKN2B, LOC387761, and FTO were associated with risk for type 2 diabetes in Caucasians. We investigated the association of these single nucleotide polymorphisms (SNPs) and some additional tag SNPs with type 2 diabetes and related quantitative traits in Pima Indians.

RESEARCH DESIGN AND METHODS—Forty-seven SNPs were genotyped in 3,501 Pima Indians informative for type 2 diabetes and BMI, among whom 370 had measures of quantitative traits.

RESULTS— FTO provided the strongest evidence for replication, where SNPs were associated with type 2 diabetes (odds ratio = 1.20 per copy of the risk allele, P = 0.03) and BMI (P = 0.002). None of the other previously reported SNPs were associated with type 2 diabetes; however, associations were found between CDKAL1 and HHEX variants and acute insulin response (AIR), where the Caucasian risk alleles for type 2 diabetes were associated with reduced insulin secretion in normoglycemic Pima Indians. Multiallelic analyses of carrying risk alleles for multiple genes showed correlations between number of risk alleles and type 2 diabetes and impaired insulin secretion in normoglycemic subjects (P = 0.006 and 0.0001 for type 2 diabetes and AIR, respectively), supporting the hypothesis that many of these genes influence diabetes risk by affecting insulin secretion.

CONCLUSIONS—Variation in FTO impacts BMI, but the implicated common variants in the other genes did not confer a significant risk for type 2 diabetes in Pima Indians. However, confidence intervals for their estimated effects were consistent with the small effects reported in Caucasians, and the multiallelic “genetic risk profile” identified in Caucasians is associated with diminished early insulin secretion in Pima Indians.
Management of Inpatient Hyperglycemia in Noncritically Ill Patients
Authors: Lansang M. Cecilia , Umpierrez Guillermo E.
Published: November 2008

In Brief

Hyperglycemia in hospitalized patients is associated with increased morbidity, mortality, and length of hospital stay. Insulin counteracts the damaging processes caused by hyperglycemia and is therefore a logical choice in treating inpatient hyperglycemia. This article emphasizes the importance of using a physiological (basal-bolus) insulin regimen for noncritically ill hospitalized patients, discusses protocols for initiating and titrating insulin doses and for transitioning from insulin infusion to a subcutaneous regimen, and recommends insulin teaching as part of discharge planning for patients who were not on insulin before admission.
Inpatient Care Coordination for Patients With Diabetes
Authors: Rogers Susan
Published: November 2008

In Brief

Focus on transition of care from outpatient to inpatient and back to an outpatient setting should be a priority in the fragmented health care system. Inpatient care coordinators, along with an interdisciplinary team from varying settings along the care continuum, can be instrumental in ensuring smooth,safe, and quality transitions. This, in turn, provides an avenue to ensure that patients are educated, adherent, and involved in their own health along the continuum of diabetes care.
Physical Therapist Management of Acute and Chronic Low Back Pain Using the World Health Organization's International Classification of Functioning, Disability and Health
Authors: Rundell Sean D , Davenport Todd E , Wagner Tracey
Published: November 2008

Background and Purpose

The World Health Organization's Classification of Functioning, Disability and Health (WHO-ICF) model was developed to describe, classify, and measure function in health care practice and research. Recently, this model has been promoted as a successor to the Nagi model by some authors in the physical therapy literature. However, conceptual work in demonstrating use of the WHO-ICF model in physical therapist management of individual patients remains sparse. The purpose of this case report series is to demonstrate the application of the WHO-ICF model in clinical reasoning and physical therapist management of acute and chronic low back pain.

Case Description

Two patients, 1 with acute low back pain and 1 with chronic low back pain, were treated pragmatically using the WHO-ICF model and other applicable models of clinical reasoning.

Intervention

Manual therapy, exercise, and education interventions were directed toward relevant body structure and function impairments, activity limitations, and contextual factors based on their hypothesized contribution to functioning and disability.

Outcome

Both patients demonstrated clinically significant improvements in measures of pain, disability, and psychosocial factors after 3 weeks and 10 weeks of intervention, respectively.

Discussion

The WHO-ICF model appears to provide an effective framework for physical therapists to better understand each person's experience with his or her disablement and assists in prioritizing treatment selection. The explicit acknowledgment of personal and environmental factors aids in addressing potential barriers. The WHO-ICF model integrates well with other models of practice such as Sackett's principles of evidence-based practice, the rehabilitation cycle, and Edwards and colleagues’ clinical reasoning model. Future research should examine outcomes associated with the use of the WHO-ICF model using adequately designed clinical trials.
Ruptured cerebral fusiform aneurysm with mucopolysaccharide deposits in the tunica media in a patient with Marfan syndrome
Authors: Kubo Yoshitaka , Ogasawara Kuniaki , Kurose Akira , Kakino Shunsuke , Tomitsuka Nobuhiko , Ogawa Akira
Published: November 2008

Although aortic or cardiac complications are common in patients with Marfan syndrome, the presence of an intracranial aneurysm is comparatively rare. In this study, the authors report on their experience with resection of a ruptured fusiform aneurysm of the posterior cerebral artery in a 30-year-old woman with Marfan syndrome. Microscopic examination of the resected tissue showed many Alcian blue–staining deposits, consistent with the presence of mucopolysaccharide in the tunica media and focal fragmentation of the internal elastic lamina.
Infratentorial angioleiomyoma: a new location for a rare neoplastic entity
Authors: Gasco Jaime , Franklin Brodus , Rangel-Castilla Leonardo , Campbell Gerald A. , Eltorky Mahmoud , Salinas Paul
Published: November 2008

Angioleiomyomas are benign neoplasms most often located in the subcutaneous tissue of middle-aged individuals and usually confined to the subcuticular and deep dermal layers of the lower extremities. An intracranial site for this tumor is exceedingly rare, with very few reports documenting locations in the neuraxis. To the authors' knowledge the present case represents the first reported instance of an infratentorial angioleiomyoma. The authors conducted a review of selected English-language papers published since 1960 describing well-documented cases of intracranial vascular leiomyomas, with detailed information on the clinical presentation, radiology, pathology, and particulars of surgical management in each case.
Survival with good outcome after cerebral herniation and Duret hemorrhage caused by traumatic brain injury
Authors: Stiver Shirley I. , Gean Alisa D. , Manley Geoffrey T.
Published: November 2008

Brainstem hemorrhage can occur as a primary or secondary event in traumatic brain injury (TBI). Secondary brainstem hemorrhage that evolves from raised intracranial pressure and transtentorial herniation is referred to as Duret hemorrhage. Duret hemorrhage following TBI has been considered an irreversible and terminal event. The authors report on the case of a young adult patient with TBI who presented with a low Glasgow Coma Scale score and advanced signs of cerebral herniation. She underwent an urgent decompressive hemicraniectomy for evacuation of an acute epidural hematoma and developed a Duret hemorrhage postoperatively. In accordance with the family's wishes, aggressive TBI monitoring and treatment in the intensive care unit was continued even though the anticipated outcome was poor. After a lengthy hospital course, the patient improved dramatically and was discharged ambulatory, with good cognitive functioning and a Glasgow Outcome Scale score of 4. Duret hemorrhage secondary to raised intracranial pressure is not always a terminal event, and by itself should not trigger a decision to withdraw care. Aggressive intracranial monitoring and treatment of a Duret hemorrhage arising secondary to cerebral herniation may enable a good recovery in selected patients after severe TBI.
A stereotactic near-infrared probe for localization during functional neurosurgical procedures: further experience
Authors: Giller Cole A. , Liu Hanli , German Dwight C. , Kashyap Dheerendra , Dewey Richard B.
Published: November 2008

Object

The authors previously developed an optical stereotactic probe employing near-infrared (NIR) spectroscopy to provide intraoperative localization by distinguishing gray matter from white matter. In the current study they extend and further validate this technology.

Methods

Near-infrared probes were inserted 203 times during 138 procedures for movement disorders. Detailed validation with postoperative imaging was obtained for 121 of these procedures and with microelectrode recording (MER) for 30 procedures. Probes were constructed to interrogate tissue perpendicular to the probe path and to incorporate hollow channels for microelectrodes, deep brain stimulation (DBS) electrodes, and other payloads.

Results

The NIR data were highly correlated to imaging and MER recordings for thalamic targets. The NIR data were highly sensitive but less specific relative to imaging for subthalamic targets, confirming the ability to detect the subthalamic nucleus and to provide warnings of inaccurate localization. The difference between the NIR- and MER-detected midpoints of the subthalamic nucleus along the chosen tracks was 1.1 ± 1.2 mm (SD). Data obtained during insertion and withdrawal of the NIR probe suggested that DBS electrodes may push their targets ahead of their paths. There was one symptomatic morbidity. Detailed NIR data could be obtained from a 7-cm track in less than 10 minutes.

Conclusions

The NIR probe is a straightforward, quick, and robust tool for intraoperative localization during functional neurosurgery. Potential future applications include localization of targets for epilepsy and psychiatric disorders, and incorporation of NIR guidance into probes designed to convey various payloads.
Significant headache improvement after transsphenoidal surgery in patients with small sellar lesions
Authors: Fleseriu Maria , Yedinak Christine , Campbell Caitlin , Delashaw Johnny B.
Published: November 2008

Object

Pituitary adenomas represent a large proportion of brain tumors that are increasing in incidence because of improved imaging techniques. Headache is the primary symptom in patients with large tumors (macroadenomas), but is also a symptom in patients with small tumors (microadenomas, tumors < 1.0 cm). The prevalence and optimal treatment of headaches associated with pituitary tumors is still unclear, particularly in cases of microadenoma. If conventional medical management fails, transsphenoidal surgery (TSS) may be considered as an alternative treatment for intractable headaches.

Methods

The authors conducted a retrospective review of 512 patients who underwent TSS at Oregon Health & Science University between 2001 and 2007; patients with Cushing disease were excluded. The authors identified 41 patients with small pituitary tumors who underwent TSS, and retrospectively evaluated the resolution and/or treatment of headache.

Results

Ninety percent of patients who presented with nonfunctioning microadenomas and Rathke cleft cysts experienced resolution or improvement in their headaches after TSS, and 56% of patients who presented with hyperfunctioning pituitary microadenomas had improvement in their headaches. There were no postoperative complications.

Conclusions

In this retrospective study, the authors demonstrate the efficacy of TSS in the treatment of intractable headaches in patients who present with pituitary microadenomas (nonsecreting and hypersecretory) and Rathke cleft cysts.
Fenestrated vertebrobasilar junction aneurysm: diagnostic and therapeutic considerations
Authors: Albanese Erminia , Russo Antonino , Ulm Arthur J.
Published: November 2008

Vertebrobasilar junction (VBJ) aneurysms are uncommon and are often found in association with basilar artery (BA) fenestration. The complex anatomical environment of the VBJ, and the complicated geometry of the fenestration make clipping of these aneurysms difficult. Therefore, endovascular treatment of these aneurysms is now widely accepted.

The authors describe the case of a 43-year-old woman with sickle cell anemia. She presented with subarachnoid hemorrhage. Digital subtraction angiography was performed and depicted multiple intracranial aneurysms. The patient had a left superior hypophysial artery aneurysm, a right superior cerebellar artery–posterior cerebral artery aneurysm, and a VBJ aneurysm associated with a fenestration of the BA. The VBJ aneurysm was not identified on the initial angiogram and was only revealed after 3D rotational angiography was performed. The 3D reconstruction was critical to the understanding of the complex geometry associated with the fenestrated BA. The VBJ was reconstructed using a combination endovascular technique. The dominant limb of the fenestration was stented and balloon-assisted coiling was performed, followed by sacrifice of the nondominant vertebral artery using coils and the embolic agent Onyx. Postoperative angiography demonstrated successful occlusion of the aneurysm with reconstruction of the VBJ.

To the authors' knowledge, this is the first report of a fenestrated VBJ aneurysm treated with the combination of stenting, balloon remodeling, coiling, and vessel sacrifice. Three-dimensional angiography was critical in making the correct diagnosis of the source of the subarachnoid hemorrhage and with operative planning.
De novo intracranial aneurysm formation after Gamma Knife radiosurgery for vestibular schwannoma
Authors: Park Keun Young , Ahn Jung Yong , Lee Jae Whan , Chang Jong Hee , Huh Seung Kon
Published: November 2008

Vascular complications, including vessel occlusion and hemorrhage, can arise after radiosurgery; however, hemorrhage due to a ruptured de novo aneurysm after Gamma Knife radiosurgery (GKS) for tumor is extremely rare. To the authors' knowledge, only a single case of de novo aneurysm formation after GKS for vestibular schwannoma has been previously reported. In this study, they describe their experience with the treatment of a 74-year-old woman with subarachnoid hemorrhage limited to the cerebellopontine cistern, who had undergone GKS for vestibular schwannoma 5 years earlier. Cerebral angiography demonstrated a left distal anterior inferior cerebellar artery aneurysm; coil embolization was attempted and failed. However, self-resolution of the aneurysm was revealed on follow-up angiography.
A comparative analysis of lexical bundles in academic history writing in English and Spanish
Authors: Cortes Viviana
Published: November 2008

This paper reports the findings of a study that analysed the use of lexical bundles in two corpora of academic history writing. One corpus consisted of history articles written in English and published in American journals, and the other was made up of history articles written in Spanish from Argentinian publications. The most frequent four-word lexical bundles were identified in each corpus and classified structurally and functionally. Then, the use of these bundles was compared across languages. The analyses showed that the bundles identified in each language had many features in common. While one group of bundles could be regarded as the result of direct translation, a second group of bundles showed structural characteristics that are closely related to bundles frequently found in academic writing in both languages (phrasal bundles). Finally, a functional classification showed that some bundles from both languages shared functions connected with academic prose and with the essence of the discipline, as well as to the topics discussed in the publications from which the texts had been extracted.
The identification of stages in diachronic data: variability-based neighbour clustering
Authors: Th. Gries Stefan , Hilpert Martin
Published: November 2008

In this paper, we introduce a data-driven bottom-up clustering method for the identification of stages in diachronic corpus data that differ from each other quantitatively. Much like regular approaches to hierarchical clustering, it is based on identifying and merging the most cohesive groups of data points, but, unlike regular approaches to clustering, it allows for the merging of temporally adjacent data, thus, in effect, preserving the chronological order. We exemplify the method with two case studies, one on verbal complementation of shall, the other on the development of the perfect in English.
Use of Liquid Chromatography with Electrochemical Detection for the Determination of Antioxidants in Less Common Fruits
Authors: Gazdik Zbynek , Reznicek Vojtech , Adam Vojtech , Zitka Ondrej , Jurikova Tunde , Krska Boris , Matuskovic Jan , Plsek Jan , Saloun Jan , Horna Ales , Kizek Rene
Published: November 2008

Neurodegenerative disorders (NDD) have become the common global health burden over the last several decades. According to World Health Organization (WHO), a staggering 30 million people will be affected by Alzheimer’s disease in Europe and the USA by 2050. Effective therapies in this complex field considering the multitude of symptoms associated with NDD indications, have not been found yet. Based on the results of NDD related studies, prevention appears to be the promise alternative. Antioxidative and anti-inflammatory properties are hypothesized for natural phenolics, a group of plant secondary products that may positively impact neurodegenerative diseases. In these studies, phenolic-rich extracts from less common fruit species: Blue honeysuckle (Lonicera edulis, Turcz. ex. Freyn), Saskatoon berry (Amelanchier alnifolia Nutt.), and Chinese hawthorn (Crateagus pinnatifida Bunge) were obtained and analyzed to detect neuroprotective substances content and establish a potential therapeutic value. High performance liquid chromatography with electrochemical detection was optimized and further applied on analysis of the extracts of less common fruit species. It was observed that Chinese hawthorn and Blue honeysuckle extracts are potent source of neuroprotective phenolic antioxidants. In accordance the results, it appears that the fruit or formulated products may have the potential for the prevention of neurodegenerative diseases.
Multifunctional Polypeptide EQCN Sensors: Probing the Cysteamine-Glutathione Film Permeability with Hg(II) Ions
Authors: Hepel Maria , Dallas Julia
Published: November 2008

Multifunctional films are the basis of biosensors and play an important role in the emerging field of nanobioelectronics. In this work, films of a tripeptide glutathione (GSH) immobilized on a self-assembled monolayer of cysteamine (CA-SAM) on a quartz crystal Au piezosensor have been synthesized and characterized using electrochemical quartz crystal nanogravimetry (EQCN) with a Hg(II) ion probe. It has been found that in contrast to previously studied Au/GSH films, the Au/CA-GSH films strongly hinder the formation of Hg0 with bulk properties while still allowing for relatively easy permeation by Hg(II) ions. This results in complete disappearance of the sharp Hg0 electrodissolution peak which is observed on bare Au and Au/GSH piezosensors. The multiple-peak anodic behavior of Au/CA and bare Au is replaced by a single high-field anodic peak of mercury reoxidation in the case of Au/CA-GSH sensors. The mass-to-charge plots indicate predominant ingress/egress of Hg(II) to/from the film. The strong hindrance of CA-SAM to bulk-Hg0 formation is attributed to film-stabilizing formation of surface (CA)2Hg2+ complexes with conformation evaluated by ab initio quantum mechanical calculations of electronic structure using Hartree-Fock methods. The associates CA-GSH provide an additional functionality of the side sulfhydryl group which is free for interactions, e.g. with heavy metals. It is proposed that in the film, the CA-GSH molecules can assume open (extended) conformation or bent hydrogen-bonded conformation with up to four possible internal hydrogen bonds.
Microwave Imaging of Cotton Bales
Authors: Pelletier Mathew G. , Barnes Edward M.
Published: November 2008

Modern moisture restoration systems are increasingly capable of adding water to cotton bales. However, research has identified large variations in internal moisture within bales that are not readily monitored by current systems. While microwave moisture sensing systems can measure average bale moisture, this can be deceptive where water is unevenly distributed. In some cases, localized internal moisture levels exceed 7.5%, the upper safe limit for cotton bale storage, as determined by the USDA, as above this level, bales degrade and lose value. A high proportion of stored bales containing excess moisture have been discovered throughout the US in increasing numbers over the past several seasons, making the detection and prevention of this occurrence a critical goal. Previous research by the authors resulted in the development of microwave moisture-sensing technology. The current study examines an extension to this technology to allow for detailed cotton bale moisture imaging. The new technique incorporates a narrow beam imaging antenna coupled to a tomographic imaging algorithm. The imaging technique was able to resolve small (< 1 cm) high-permittivity structures against a low permittivity background. Moreover, the system was able to identify structures of known permittivity with high accuracy (coefficient of determination (r2) > 0.99). In preliminary testing on a wet commercial UD bale, the technique was able to accurately image and resolve the location of the pre-placed internal wet layer.
A Mobile Sensor Network System for Monitoring of Unfriendly Environments
Authors: Song Guangming , Zhou Yaoxin , Ding Fei , Song Aiguo
Published: November 2008

Observing microclimate changes is one of the most popular applications of wireless sensor networks. However, some target environments are often too dangerous or inaccessible to humans or large robots and there are many challenges for deploying and maintaining wireless sensor networks in those unfriendly environments. This paper presents a mobile sensor network system for solving this problem. The system architecture, the mobile node design, the basic behaviors and advanced network capabilities have been investigated respectively. A wheel-based robotic node architecture is proposed here that can add controlled mobility to wireless sensor networks. A testbed including some prototype nodes has also been created for validating the basic functions of the proposed mobile sensor network system. Motion performance tests have been done to get the positioning errors and power consumption model of the mobile nodes. Results of the autonomous deployment experiment show that the mobile nodes can be distributed evenly into the previously unknown environments. It provides powerful support for network deployment and maintenance and can ensure that the sensor network will work properly in unfriendly environments.
Thrombosis in Systemic Lupus Erythematosus and Other Autoimmune Diseases of Recent Onset
Authors: ROMERO-DÍAZ JUANITA , GARCÍA-SOSA ICELLINI , SÁNCHEZ-GUERRERO JORGE
Published: November 2008

Objective

To determine the risk of thrombosis in patients with systemic lupus erythematosus (SLE) and other autoimmune diseases of recent onset.

Methods

A retrospective cohort of 482 patients, mean age 28.3 years, with SLE or other autoimmune diseases was analyzed. Followup started at diagnosis or first appointment within 12 months since diagnosis until the development of thrombosis, end of study, loss to followup, or death. Thromboses were diagnosed upon clinical manifestations and confirmed by appropriate studies. Clinical variables were retrieved from the medical records, and SLE activity was assessed from the medical notes at onset of thrombosis, or at a dummy date for thrombosis, using the SLE Disease Activity Index-2K.

Results

During 2936 patient-years of followup, thromboses occurred in 49 patients (20.3%) with SLE and 6 patients (2.5%) with other autoimmune diseases. The incidence rate of thrombosis was 36.3 and 3.8 per 1000 patient-years in SLE and in other autoimmune diseases, respectively; relative risk 9.6 (95% CI 4.1–27.4, p < 0.0001). Throughout the disease course, the risk of thrombosis remained high in the SLE group, while in patients with other autoimmune diseases this risk was lower. The incidence of venous and arterial thrombosis was similar among SLE patients and patients with other autoimmune diseases. SLE and venous insufficiency were associated with thromboses in the total study population, and with venous insufficiency, vasculitis, and disease activity in the SLE group.

Conclusion

Patients with autoimmune diseases, particularly SLE, are at an increased risk of thrombosis. In patients with SLE, the risk remains elevated throughout the course of the disease.
Is Diabetes Associated with Shoulder Pain or Stiffness? Results from a Population Based Study
Authors: COLE ANTONIA , GILL TIFFANY K. , SHANAHAN E. MICHAEL , PHILLIPS PATRICK , TAYLOR ANNE W. , HILL CATHERINE L.
Published: November 2008

Objectives.

To assess the association of shoulder pain and/or stiffness and diabetes mellitus in a population based cohort.

Methods.

Participants were randomly recruited from the North West Adelaide Health Study, a longitudinal, population based study. In the second stage, 3128 participants were assessed for diabetes mellitus and shoulder complaints via questionnaires, the Shoulder Pain and Disability Index (SPADI), physical assessment, blood sampling for fasting plasma glucose, and HbA1c levels.

Results.

Overall, 682 (21.8%) participants experienced shoulder pain and/or stiffness and 221 participants (7.1%) fulfilled criteria for diabetes mellitus. Those with diabetes had a higher prevalence of shoulder pain and/or stiffness (27.9% vs 21.3%; p = 0.025), and poorer SPADI disability subscore (p = 0.01) and total SPADI score (p = 0.02). After controlling for age, sex, obesity, and current smoking, the prevalence of shoulder pain and/or stiffness did not differ significantly between those with diabetes and those without (OR 1.05, 95% CI 0.76–1.45), nor were there significant differences in the SPADI disability subscore (p = 0.39) or total SPADI score (p = 0.32) between the 2 groups. After adjustment for covariates, there was no association between higher levels of HbA1c and shoulder pain and/or stiffness (p > 0.8). Range of shoulder movement was significantly reduced in those with diabetes (p < 0.05).

Conclusions.

There is a higher prevalence of shoulder pain and/or stiffness in people with diabetes mellitus. The differences observed between those with diabetes and those without can largely be explained by the confounding factors of age, sex, obesity, and current smoking.
The Role of Traditional Cardiovascular Risk Factors Among Patients with Rheumatoid Arthritis
Authors: BRADY SHARMAYNE R.E. , de COURTEN BARBORA , REID CHRISTOPHER M. , CICUTTINI FLAVIA M. , de COURTEN MAXIMILIAN P.J. , LIEW DANNY
Published: November 2008

Objective

People with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) compared with the general population. We investigated the relative contribution of traditional cardiovascular risk factors to this elevated risk.

Methods

Fifty RA subjects and 150 age and sex matched controls attended a cardiovascular risk assessment clinic betweenMarch and July 2006. Traditional cardiovascular risk factors and the absolute risks of CVD (calculated from application of a Framingham risk equation) were compared between the 2 groups.

Results

Compared with the controls, RA subjects were more likely to smoke (p < 0.001), be physically inactive (p = 0.006), and have higher mean measurements of body mass index (p = 0.040) and waist circumference (p = 0.049). No significant differences were found in mean levels of plasma lipid or glucose, or in the prevalences of diabetes and hypertension. Overall, the mean absolute risk of CVD was higher in the RA group, even after excluding smokers (p = 0.036).

Conclusion

Smoking and physical inactivity are important risk factors in the management of cardiovascular risk among patients with RA. Subjects with RA seem to have higher absolute risks of CVD compared with controls, even independently of smoking. This highlights the importance of treating all modifiable risk factors in those with RA although, individually, few may be conspicuous.
Common Measures and Analytic Techniques Provide Flawed Assessments of Pain: Modeled Data, and Hip Replacement Study
Authors: SMYTHE HUGH A. , BOGOCH EARL R.
Published: November 2008

Objective

To examine commonly used measures and analytic techniques of pain outcomes, using (1) a synthetic model, and (2) a cohort of patients who underwent total hip replacement.

Methods

(1) A synthetic data set was constructed with 110 visual analog scale (VAS) values, 10 for each integer from zero to 10. Random noise was added to simulate measurement variations. Drift through time and a therapeutic trial were simulated. (2) Eighty-six patients were studied before and a mean of 17 months after total hip replacement. Assessments included a VAS pain scale, the Western Ontario and McMaster Universities Osteoarthritis Index, Harris Hip Score, and SF-36 scores.

Results

The clinical study mirrored the model. Correlation coefficients among treatment differences measured by the pain subscales of 4 instruments varied from 0.53 to 0.22. Floor effects obscured benefit. “Percentage improvement” created a directional bias, and had a hyperbolic distribution that invalidated means, variances, and related statistics. The best outcomes were undervalued when postoperative pain measures approached zero. Standardized means enabled pooling of data from the different instruments and facilitated measurement of the variations due to treatment, methods, and subjects, and other factors.

Conclusion

Outcome measures and analytic techniques are often flawed because of floor and ceiling effects, non-normal distributions, and other problems. Outcomes expressed as “percentage improvement” are inappropriate; changes should be reported in the observed units. Revisions of standard outcome measures to relate pain with activity can better document outcomes, especially favorable results.
Limited Utility of Rapamycin in Severe, Refractory Wegener’s Granulomatosis
Authors: KOENING CURRY L. , HERNÁNDEZ-RODRÍGUEZ JOSÉ , MOLLOY EAMONN S. , CLARK TIFFANY M. , HOFFMAN GARY S.
Published: November 2008

Objective

We report our experience using rapamycin in patients with Wegener’s granulomatosis (WG) who failed to achieve remission with conventional treatment.

Methods

Eight patients received rapamycin for severe, refractory WG. Clinical outcomes were reviewed retrospectively.

Results

Four patients treated with rapamycin sustained remissions of at least 6 months’ duration while receiving prednisone ≤ 10 mg/day; 2 relapsed during followup. Five patients discontinued rapamycin due to continued disease activity, cancer, or adverse events.

Conclusion

Toxicities due to rapamycin were numerous; consistent proof of efficacy in this pilot experience with WG was not seen.
Relationship between Job Dissatisfaction and Physical and Psychological Health among Filipino Immigrants
Authors: de Castro A. B. , Gee Gilbert C. , Takeuchi David
Published: November 2008

This study investigated the relationship between job dissatisfaction and psychological and physical health among Filipino immigrants in the United States. Cross-sectional data from the Filipino American Community Epidemiological Study were analyzed for 1,381 Filipino immigrants. The primary independent variable of interest was job dissatisfaction. Linear and negative binomial regression analyses were conducted to determine separate associations between job dissatisfaction and the outcomes of psychological distress and physical health conditions, respectively. Job dissatisfaction was positively associated with both psychological distress (β = 0.32, p < .001) and physical health conditions (β = 0.42, p < .001), controlling for sociodemographic variables such as age, gender, education, income, and job category. This community-based study demonstrated that job dissatisfaction has implications for health and well-being among an understudied, immigrant group of workers. Findings also suggest that job-related experiences should be considered when examining disparate health for immigrant, minority populations.
Bayesian Networks
Authors: Buede Dennis , Mahoney Suzanne M. , Tatman Joseph A.
Published: November 2008

This contribution describes Bayesian networks (BNs), their applications including their potential application to homeland security problems, and BNs research being done and needing to be done. The graphical elements of a BNs provide a convenient model structuring tool for enhancing communication when working with experts or decision makers. These models can be built from data or with expert opinion or some combination. The computational elements of a BNs permit computations that were unthinkable in 1985. A survey of current research topics is provided along with research funding organizations worldwide. Critical needs that BNs can address for homeland security are described with illustrations and suggestions. Examples of problem categories for which BNs would be very valuable are warning for a terrorist attack, assessment of risks and vulnerabilities, and tracking and assessing people and organizations. Future research directions important for making BNs especially useful for application to homeland security topics include structuring, computation, and packaging.
Using Risk Analysis to Inform Intelligence Analysis
Authors: Willis Henry H.
Published: November 2008

The study and application of risk analysis provides a set of tools with a strong methodological foundation. This article describes how risk analysis can be integrated into the intelligence cycle for producing terrorism threat assessments and warnings. Intelligence professionals can use the risk analyst's toolbox to sharpen conclusions that are made in intelligence products by providing support for identification of scenarios of greatest concern. Risk analysis can also be used to focus future collection efforts on information that appears to be most relevant to refining existing estimates of terrorism risks. However, risk analysis must be conducted to meet challenges of information availability, matching resolution of results to the problem, reflecting risk as the social construct that it is, and not ignoring the possibility of surprise.
Social and Psychological Aspects
Authors: Moghaddam Fathali M. , Lee Naomi
Published: November 2008

A staircase metaphor is used to examine the social and psychological processes underlying terrorist attacks, and the consequences of such attacks on victims. The focus of the discussion is terrorism emanating from Islamic societies, because this constitutes the greatest global threat in the foreseeable future. The ground floor is occupied by about 1.2 billion Muslims, most of whom do not move up the staircase despite the high level of dissatisfaction with despotic regimes. But some individuals move up the staircase, primarily searching for ways to change their perceived situation. As individuals move up the staircase, they become more radicalized, eventually becoming engaged with moralities supportive of terrorism, and on the final floor become psychologically equipped to carry out terrible acts. Deradicalization programs need to be specially designed to impact individuals depending on the particular floor they have reached on the staircase to terrorism. The social psychological consequences of terrorism for society are discussed.
Defeating Surprise Through Threat Anticipation and Possibility Management
Authors: McGill William L. , Ayyub Bilal M.
Published: November 2008

This article discusses the menacing problem of surprise in the context of critical infrastructure protection and proposes several strategies for defeating the potential for and effects of surprise. It is suggested that adversaries achieve surprise by exploiting ignorance and lack of preparedness, and that defeating surprise requires new approaches to thinking about terrorism risk. In particular, this article advocates two complementary approaches for defeating surprise: threat anticipation aimed at increasing awareness of plausible threat scenarios and possibility management aimed at improving preparedness to deal with loss irrespective of its cause.
High Consequence Events: Nuclear Explosions
Authors: Shipbaugh Calvin , Frankel Michael J.
Published: November 2008

The risk posed by a potential terrorist nuclear event is determined by a combination of threat, vulnerability, and consequences, all of which are subject to uncertainties. Effects of nuclear weapon described in standard references give detailed outcomes for specific thresholds and targets, and provide insight into the consequences of such events. Numerous studies have analyzed particular scenarios and contributed estimates useful for understanding the scope of the problem.

This article considers the risk of a low yield—1 to 20 kt nuclear explosion scenario in an urban setting. It considers the nature of the threat, the vulnerability of our urban circumstance, and the likely consequences of the spectrum of nuclear effects. It also discusses the uncertainties in such estimates, especially for low yield devices, and makes recommendation for their reduction. Reduction of uncertainties is seen as a component of a risk management response to reduce the probability of a successful attack in the foreseeable future, and to reduce the consequences of a potential event.
Less‐Lethal Payloads for Robotic and Automated Response Systems
Authors: Everett Hobart Ray , Kogut Greg , Drymon Larry , Sights Brandon , Grant Kelly
Published: November 2008

This article reviews the various problems encountered in controlling less‐lethal weapon payloads on unmanned ground vehicles (UGVs) and provides an overview of ongoing efforts to address those challenges. Examples of near‐term field‐ready candidates (automated and robotic) include thenetworked remotely operated weapon system (NROWS)and themobile detection assessment response system (MDARS). A brief treatment of future capabilities is presented at the end.
The Nation's Transportation System as a Security Challenge
Authors: Meyer Michael D.
Published: November 2008

By its very nature, the transportation system is vulnerable to disruption that can result in significant economic costs. This article examines several characteristics of a transportation system, which present challenges from a security perspective. These characteristics include the extent of the system and thus its vulnerability to attack; the network characteristics of travel paths, critical links and choke points, and the time lag associated with infusion of biological agents inserted into passenger flows that result in a widespread diffusion throughout the system; transportation facilities acting as ports of entry to international passenger and freight flows; the important linkages between transportation use and other societal goals, such as economic development, environmental quality, and public health; the long time to recover from major disruptions due to the infrastructure focus of network design; the dependency on command and control systems to manage system operations; and the institutional complexity associated with all of the different agencies and groups involved with decision making and system management. The Atlanta metropolitan area is used as an example to illustrate these characteristics of the transportation system. The article concludes that the transportation system is too vulnerable to hope for 100% security; however, through rigorous vulnerability and risk assessment efforts, the most important parts of this system can be protected. The challenge to transportation and security officials is to develop a collaborative process for developing and using a security‐conscious approach toward transportation planning and decision making.
Biosurveillance Tradecraft
Authors: Wilson James M. , Walters Ronald A. , Kiebler Craig , Davies‐Cole John
Published: November 2008

This article focuses on an overview of the emerging analytic discipline of biosurveillance. Here we discuss basic organizational principles, biological event evolution, targeting of biological event features, data sources, social networking implications in validating information, and parallels to existing meteorological warning systems.
North Carolina Biosurveillance System
Authors: Waller Anna E. , Ising Amy I. , Deyneka Lana
Published: November 2008

The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) was established to serve the needs of North Carolina in better positioning itself against natural and intentional events of public health significance. The system, built upon health care customer needs, has matured and is integral to the daily activity of the North Carolina Division of Public Health, as well as local and regional public health and hospital officials. As NC DETECT has grown, the principles have remained constant: the creation of a secure, user‐centered, robust, flexible system that can provide comprehensive, timely information to public health decision‐makers throughout North Carolina.