Post- and peritraumatic stress in disaster survivors: An explorative study about the influence of individual and event characteristics across different types of disasters

Background: Examination of existing research on posttraumatic adjustment after disasters suggests that survivors’ posttraumatic stress levels might be better understood by investigating the influence of the characteristics of the event experienced on how people thought and felt, during the event as well as afterwards. Objective: To compare survivors’ perceived post- and peritraumatic emotional and cognitive reactions across different types of disasters. Additionally, to investigate individual and event characteristics. Design: In a European multi-centre study, 102 survivors of different disasters terror attack, flood, fire and collapse of a building were interviewed about their responses during the event. Survivors’ perceived posttraumatic stress levels were assessed with the Impact of Event Scale-Revised (IES-R). Peritraumatic emotional stress and risk perception were rated retrospectively. Influences of individual characteristics, such as socio-demographic data, and event characteristics, such as time and exposure factors, on post- and peritraumatic outcomes were analyzed. Results: Levels of reported post- and peritraumatic outcomes differed significantly between types of disasters. Type of disaster was a significant predictor of all three outcome variables but the factors gender, education, time since event, injuries and fatalities were only significant for certain outcomes. Conclusion: Results support the hypothesis that there are differences in perceived post- and peritraumatic emotional and cognitive reactions after experiencing different types of disasters. However, it should be noted that these findings were not only explained by the type of disaster itself but also by individual and event characteristics. As the study followed an explorative approach, further research paths are discussed to better understand the relationships between variables

Atorvastatin combined to interferon to verify the efficacy (ACTIVE) in relapsing-remitting active multiple sclerosis patients: a longitudinal controlled trial of combination therapy.

A large body of evidence suggests that, besides their cholesterol-lowering effect, statins exert anti-inflammatory action. Consequently, statins may have therapeutic potential in immune-mediated disorders such as multiple sclerosis. Our objectives were to determine safety, tolerability and efficacy of low-dose atorvastatin plus high-dose interferon beta-1a in multiple sclerosis patients responding poorly to interferon beta-1a alone. Relapsing–remitting multiple sclerosis patients, aged 18–50 years, with contrast-enhanced lesions or relapses while on therapy with interferon beta-1a 44 mg (three times weekly) for 12 months, were randomized to combination therapy (interferon+atorvastatin 20mg per day; group A) or interferon alone (group B) for 24 months. Patients underwent blood analysis and clinical assessment with the Expanded Disability Status Scale every 3 months, and brain gadolinium-enhanced magnetic resonance imaging at screening, and 12 and 24 months thereafter. Primary outcome measure was contrast-enhanced lesion number. Secondary outcome measures were number of relapses, EDSS variation and safety laboratory data. Forty-five patients were randomized to group A (n 1⁄4 21) or B (n 1⁄4 24). At 24 months, group A had significantly fewer contrast-enhanced lesions versus baseline (p 1⁄4 0.007) and significantly fewer relapses versus the two pre-randomization years (p < 0.001). At survival analysis, the risk for a 1-point EDSS increase was slightly higher in group B than in group A (p 1⁄4 0.053). Low-dose atorvastatin may be beneficial, as add-on therapy, in poor responders to high-dose interferon beta-1a alone

Frequency encoding for simultaneous display of multimodality images.

An original method for simultaneous display of functional and anatomic images, based on frequency encoding (FE), merges color PET with T1-weighted MR brain images, and grayscale PET with multispectral color MR images. A comparison with two other methods reported in the literature for image fusion (averaging and intensity modulation techniques) was performed. Methods: For FE, the Fourier transform of the merged image was obtained summing the low frequencies of the PET image and the high frequencies of the MR image. For image averaging, the merged image was obtained as a weighted average of the intensities of the two images to be merged. For intensity modulation, the red, green and blue components of the color image were multiplied on a pixel- by-pixel basis by the grayscale image. A comparison of the performances of the three techniques was made by three independent observers assessing the conspicuity of specific MRI and PET information in the merged images. For evaluation purposes, images from seven patients and a computer-simulated MRI/PET phantom were used. Data were compared with a chi-square test applied to ranks. Results: For the depiction of MRI and PET information when merging color PET and T1-weighted MR images, FE was rated superior to intensity modulation and averaging techniques in a significant number of comparisons. For merging grayscale PET with multispectral color MR images, FE and intensity modulation were rated superior to image averaging in terms of both MRI and PET information. Conclusion: The data suggest that improved simultaneous evaluation of MRI and PET information can be achieved with a method based on FE

Simulating Dynamical Features of Escape Panic

One of the most disastrous forms of collective human behaviour is the kind of crowd stampede induced by panic, often leading to fatalities as people are crushed or trampled. Sometimes this behaviour is triggered in life-threatening situations such as fires in crowded buildings; at other times, stampedes can arise from the rush for seats or seemingly without causes. Tragic examples within recent months include the panics in Harare, Zimbabwe, and at the Roskilde rock concert in Denmark. Although engineers are finding ways to alleviate the scale of such disasters, their frequency seems to be increasing with the number and size of mass events. Yet, systematic studies of panic behaviour, and quantitative theories capable of predicting such crowd dynamics, are rare. Here we show that simulations based on a model of pedestrian behaviour can provide valuable insights into the mechanisms of and preconditions for panic and jamming by incoordination. Our results suggest practical ways of minimising the harmful consequences of such events and the existence of an optimal escape strategy, corresponding to a suitable mixture of individualistic and collective behaviour.Comment: For related information see http://angel.elte.hu/~panic, http://www.helbing.org, http://angel.elte.hu/~fij, and http://angel.elte.hu/~vicse

Imatinib mesylate therapy in chronic myeloid leukemia patients in stable complete cytogenetic response after interferon-alpha results in any high complete molecular response.

To determine the impact on minimal residual disease by switching to imatinib chronic phase chronic myeloid leukaemia (CP-CML) patients responsive to interferon-alpha (IFNα), in stable complete cytogenetic response (CCR) but with persistent PCR positivity. Twenty-six Philadelphia positive (Ph+) CML patients in stable CCR after IFNα but persistently positive at PCR analysis during this treatment, were given imatinib mesylate at standard dose. At enrolment into the study, median IFN treatment and CCR duration were 88 months (range 15–202) and 73 months (range 10–148), respectively. Imatinib treatment resulted in a progressive and consistent decline of the residual disease as measured by quantitative PCR (RQ-PCR) in all but one of the 26 patients; at the end of follow-up, after a median of 32 months (range 21–49) of treatment, a major molecular response (BCR/ABL levels <0.1) was reached in 20 patients (77%), and BCR/ABL transcripts were undetectable in 13 (50%). The achievement of molecular response was significantly correlated with post-IFN baseline transcript level (mean 1.194 for patients achieving complete molecular response versus 18.97 for those who did not; p < 0.001), but not with other clinical/biological disease characteristics. These results indicate that patients induced into CCR by IFN treatment represent a subset with very favourable prognosis, which can significantly improve molecular response with imatinib and further support investigative treatment schedules combining these two drugs

A randomized clinical trial of lithium in multiple system atrophy.

The aim of our study was to test the safety and tolerability of lithium in multiple system atrophy (MSA). The study was randomized, placebo-controlled, and double-blind. The primary endpoint of the study was safety and tolerability. An interim analysis, performed 1 year after the first patient was randomized, showed a higher proportion of trial abandon (P < 0.01) and a higher number of adverse events (P < 0.02) in the lithium group. The trial was stopped by the Data Monitoring Committee. Overall, lithium was not well tolerated, and we do not encourage future studies with lithium in MSA patients

Pedestrian, Crowd, and Evacuation Dynamics

This contribution describes efforts to model the behavior of individual pedestrians and their interactions in crowds, which generate certain kinds of self-organized patterns of motion. Moreover, this article focusses on the dynamics of crowds in panic or evacuation situations, methods to optimize building designs for egress, and factors potentially causing the breakdown of orderly motion.Comment: This is a review paper. For related work see http://www.soms.ethz.c

"In vivo" and "in vitro" degradability of diets for Parmigiano Reggiano cheese production

"In vitro" Dry Matter (IVDMD) and fiber degradability (IVNDFD) dynamics were determined for Total Mixed Rations (TMR) typical of Parmigiano Reggiano cheese area. The same parameters were estimated on some of these ration also "in vivo" on a group of fresh cows. "In vivo" trial showed values of 62.21 and 44.82% for DMD and NDFD respectively, while average IVDMD was 67.48 and 74.33% at 24 and 48 hours respectively. At the same intervals IVNDFD was of 49.32 and 62.61%, indicating an high fiber digestibility of fresh cow. Based on the "in vitro" equations and the "in vivo" values, the ruminal retention time was estimated to be of about 21 hours for DMD and of 19 hours for NDFD

Determination of the optimal priming interval of rumen fluids used as inocula for the in vitro digestibility trials through radial enzyme diffusion method

Context: Determination of the neutral detergent fibre digestibility is one of the important parameters to consider when formulating diets. However, the in vitro determination shows low repeatability because of the source of rumen-fluid inoculum. Priming of the rumen fluid inocula, obtained through an oesophageal probe, has been proposed to overcome this issue. Aim: The objective of the study was to investigate the evolution of the microbial enzymatic activities of different rumen fluids during a priming procedure, to establish the fermentation interval that minimises the differences among rumen-fluid degradative potentials. Methods: Three farms for each type of diet were involved in the study. Rumen fluids were obtained from dry and lactating cows fed the following four diet types: 100% hay or a diet with 80: 20 forage: Concentrate ratio (F: C) as dry-cow diets, and ad libitum hay and concentrate, or a total mixed ration (both at 60: 40 F: C) as lactating-cow diets. On each farm, rumen fluid was collected from three Holstein cows by using an oesophageal probe, and mixed. Two aliquots of each rumen fluid mix were added to the medium containing the same priming substrate in an in vitro batch-fermentation system. During the incubation, the fermentation fluids were sampled in duplicate at 0-, 1-, 2-, 4-, 8-, 24- A nd 48-h intervals. Enzymatic activities of amylase, cellulase and xylanase were determined by radial enzyme diffusion method. Key results: Initial enzymatic activities were quite variable and increased with an increasing incubation time. By 24 h, amylase showed similar values among high-concentrate diet fermentation fluids, and a lower data dispersion in comparison to the other intervals cellulase was characterised by similar values in all the fermentation fluids derived from diets including concentrates, and xylanase showed similar activity in the fermentation fluids derived from high-concentrate diets. Development of the enzymatic activity of the fermentation fluids derived from the 100% hay diet differed from the others. Conclusions: A 24-h priming procedure was needed to stabilise and equalise the enzymatic activity of the rumen fluid from cows fed high-concentrate diets. This was not observed in rumen fluid from cows fed hay-based diets. Implications: The 24-h-primed rumen fluid can be used to increase the repeatability of neutral detergent fibre digestibility determination