Energy Transformation: Examining How Nuclear and Solar Power Could Enhance Stability in the Middle East Region and Implications for U.S. Policy

The U.S. Department of Energy projects that rapid growth in population and access to domestic resources will cause the Middle East\u27s energy consumption to increase by 95% from 2012 to 2040. Currently, Jordan, Saudi Arabia, and the United Arab Emirates do not have enough installed power capacity to handle this increase in consumption. Due to this, these states are looking to solar and nuclear power to diversify their energy sectors. This thesis\u27 focus is to examine the impending energy demand crisis that will affect Saudi Arabia, the United Arab Emirates (UAE), and Jordan. I argue that solar and nuclear power must play a vital role in these states\u27 energy sectors to stave off future power shortages, decrease reliance on domestic hydrocarbons and imported energy, and reduce CO2 emissions to lessen the effects of climate change. As nuclear energy capabilities for civilian use expand, so does the threat of nuclear terrorism or the possibility for countries to edge closer towards nuclear proliferation. The United States has a vested interest in stemming the proliferation of nuclear weapons and will need to be prepared to address this in the region in the future. Additionally, foreign powers are investing considerable resources and technology in the energy sectors in these states, which could erode U.S. influence in the region going forward

AGE AND GENDER DIFFERENCES IN THE IMPACT OF PSORIASIS ON QUALITY OF LIFE

Background. The impact of psoriasis upon the quality of life contributes significantly to the overall morbidity associated with the disease. An older age at onset of psoriasis and being a man have been associated previously with lower psychosocial morbidity. In order to further evaluate these potentially important mitigating factors, we examined the relation of age and gender on some aspects of psoriasis-related psychosocial morbidity. Methods. Two hundred and fifteen consenting psoriasis patients, representing a wide range of disease severity, were studied. They included 110 men and 105 women, age range 19–87 years (age: mean ± SD: 48·0 ± 15·9 years); all endorsed a list of 30 items (by checking a “Yes” or “No”) pertaining to life events related to psoriasis that they had experienced in the previous one month. The patients self-rated the severity of their psoriasis. The patients were categorized into four age groups of 18–29 years (N = 28), 30–45 years (N = 77), 46–65 years (N = 76), and > 65 years (N = 34), respectively, for the statistical analyses. Results. No age or gender differences in the severity of psoriasis were observed. Patients of both sexes in the 18 to 29 and 30 to 45 year age groups reported more frequent (P < 0·05) problems related to both appearance/socialization and occupation/finances, in contrast to patients in the 46–65 and over-65-year age groups. No gender differences (P < 0·05) were observed in the frequency of items related to appearance and socialization; however, men reported greater work-related stresses. Conclusion. Psoriasis has a greater impact upon the quality of life of patients in the 18 to 45 year age range and affects the socialization of both sexes equally. Men face greater work-related stresses as a result of their psoriasis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65194/1/j.1365-4362.1995.tb04656.x.pd

Abnormal Leg Muscle Latencies and Relationship to Dyscoordination and Walking Disability after Stroke

The purpose was to determine timing characteristics of leg muscle latencies for patients following stroke (>12 months) who had persistent coordination and gait deficits, and to determine the relationships among abnormal latencies, dyscoordination, and gait deficits. We compared nine healthy controls and 27 stroke survivors. Surface electromyography measured activation and deactivation latencies of knee flexor and extensor muscles during a ballistic knee flexion task, consistency of latencies across repetitions, and close coupling between agonist and antagonist muscle latencies. We measured Fugl-Meyer (FM) coordination and the functional gait measure, six minute walk test (6MWT). For stroke subjects, there were significant delays of muscle activation and deactivation, abnormal inconsistency, and abnormal decoupled agonist and antagonist activations. There was good correlation between activation latencies and FM and 6MWT. Results suggest abnormal timing characteristics underlie coordination impairment and dysfunctional gait. These abnormal muscle activation and deactivation timing characteristics are important targets for rehabilitation

Local Land-Use Planning and Natural Hazards in Coastal North Carolina

The North Carolina Coastal Area Management Act (CAMA) of 1974 was designed to protect coastal resources. This legislation required local governments in the coastal region to develop land-use plans to guide development. While many saw a strong need to control growth in the region, few local governments managed land use. Proponents of the law believed that local land-use planning could protect the environment from unwise growth, while still allowing local control of development. To determine CAMA's impact after more than a decade, we interviewed thirty local governments in North Carolina. This research was part of a larger National Science Foundation-sponsored study of land-use planning in North Carolina and four other states. The results from these interviews and additional surveys indicate that CAMA has played a critical role in shaping land-use planning in the coastal region. Furthermore, the evidence suggests that, while the mandate is still necessary to ensure local land-use planning in most communities, CAMA has increased support for planning and may be playing a long-term educational role. In this article, we provide a brief history of CAMA and its land-use planning requirements, particularly those related to natural hazards. We then examine the findings from our interviews and their implications for the future

Capability of 2 Gait Measures for Detecting Response to Gait Training in Stroke Survivors: Gait Assessment and Intervention Tool and The Tinetti Gait Scale

Zimbelman J, Daly JJ, Roenigk KL, Butler K, Burdsall R, Holcomb JP. Capability of 2 gait measures for detecting response to gait training in stroke survivors: Gait Assessment and Intervention Tool and the Tinetti Gait Scale. Objective:To characterize the performance of 2 observational gait measures, the Tinetti Gait Scale (TGS) and the Gait Assessment and Intervention Tool (G.A.I.T.), in identifying improvement in gait in response to gait training. Design: In secondary analysis from a larger study of multimodal gait training for stroke survivors, we measured gait at pre-, mid-, and posttreatment according to G.A.I.T. and TGS, assessing their capability to capture recovery of coordinated gait components. Setting: Large medical center. Participants: Cohort of stroke survivors (N=44) greater than 6 months after stroke. Interventions: All subjects received 48 sessions of a multimodal gait-training protocol. Treatment consisted of 1.5 hours per session, 4 sessions per week for 12 weeks, receiving these 3 treatment aspects: (1) coordination exercise, (2) body weight–supported treadmill training, and (3) overground gait training, with 46% of subjects receiving functional electrical stimulation. Main Outcome Measures: All subjects were evaluated with the G.A.I.T. and TGS before and after completing the 48-session intervention. An additional evaluation was performed at midtreatment (after session 24). Results: For the total subject sample, there were significant pre-/post-, pre-/mid-, and mid-/posttreatment gains for both the G.A.I.T. and the TGS. According to the G.A.I.T., 40 subjects (91%) showed improved scores, 2 (4%) no change, and 2 (4%) a worsening score. According to the TGS, only 26 subjects (59%) showed improved scores, 16 (36%) no change, and 1 (2%) a worsening score. For 1 treatment group of chronic stroke survivors, the TGS failed to identify a significant treatment response to gait training, whereas the G.A.I.T. measure was successful. Conclusions: The G.A.I.T. is more sensitive than the TGS for individual patients and group treatment response in identifying recovery of volitional control of gait components in response to gait training

Development and Testing of The Gait Assessment and Intervention Tool (G.A.I.T.): A Measure of Coordinated Gait Components

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (\u3e12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC = .98, p = .0001, 95% CI = .95, .99; ICC = .83, p = .007, 95% CI = .32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC = .99 (p = .0001, CI = .97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z = −2.93, p = .003); and comprehensive gait training plus functional electrical stimulation (FES; z = −3.3, p = .001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate = 1.72, p = .021; CI, .25, 3.1)

Development and Testing of The Gait Assessment and Intervention Tool (G.A.I.T.): A Measure of Coordinated Gait Components

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (\u3e12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC = .98, p = .0001, 95% CI = .95, .99; ICC = .83, p = .007, 95% CI = .32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC = .99 (p = .0001, CI = .97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z = −2.93, p = .003); and comprehensive gait training plus functional electrical stimulation (FES; z = −3.3, p = .001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate = 1.72, p = .021; CI, .25, 3.1)

A Case of Cutaneous Side Effect of Methotrexate Mimicking Behçet's Disease

Methotrexate (MTX) is an antimetabolite which interferes with DNA synthesis, and it is used for the treatment of moderate to severe psoriasis, atopic dermatitis and a wide variety of cutaneous diseases. Although many adverse effects of MTX, including cutaneous ulcerations, have been documented, multifocal mucosal ulceration mimicking Behçet's disease has not been reported. In our case, a 63-year-old female presented with oral, vaginal ulcer and multiple purpuric patches on both legs. Considering patient's clinical course and histopathologic findings, we presumed that these reactions may be the side effect of MTX administered for treatment of necrotizing scleritis. Herein we report the cutaneous side effect of MTX that manifested clinically like Behçet's disease