Source: http://www.auditpaper.com/audit-trail/251020882.shtml
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Monday, November 26, 2012
Design and Partial Realization of the China Arrow Information ...
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Gastric bypass surgery helps diabetes but doesn't cure it, study suggests
ScienceDaily (Nov. 26, 2012) ? After gastric bypass surgery, diabetes goes away for some people -- often even before they lose much weight. So does that mean gastric surgery "cures" diabetes? Not necessarily, according to the largest community-based study of long-term diabetes outcomes after bariatric surgery. For most people in the study, e-published in advance of print in Obesity Surgery, diabetes either never remitted after gastric surgery or relapsed within five years.
Among the two thirds of the study's patients whose diabetes at first went away, more than a third re-developed diabetes again within five years after gastric surgery. After adding in the one quarter of patients whose diabetes never remitted after surgery, most (56 percent) of the study's patients had no long-lasting remission of their diabetes following gastric surgery. However, when diabetes did go away, the research team extrapolated, it stayed away for a median of eight years.
Which kinds of obese people with type 2 diabetes are likely to get the most benefit from gastric surgery? "Our results suggest that, after gastric surgery, diabetes stays away for longer in those people whose diabetes was less severe and at an earlier stage at the time of surgery," said principal investigator David E. Arterburn, MD, MPH, a general internist and associate investigator at Group Health Research Institute. "Gastric surgery isn't for everyone," he said. "But this evidence suggests that, once you have diabetes and are severely obese, you should strongly consider it, even though it doesn't seem to be a cure for most patients."
The multi-site study tracked 4,434 adults at Kaiser Permanente Northern California, Kaiser Permanente Southern California, and HealthPartners for 14 years: from 1995 to 2008. The research arms of all three of these integrated health care delivery systems -- and Group Health Research Institute, where the study's results were analyzed -- belong to the HMO Research Network. The patients had type 2 diabetes that was either controlled with medication or else uncontrolled, and they were also obese enough to be candidates for gastric bypass surgery.
"Diabetes is an increasingly common disease that tends to keep getting worse relentlessly," Dr. Arterburn said. More than 25 million American adults have diabetes -- and as populations age and keep gaining weight, 50 million are predicted to have it by 2050. Already, diabetes accounts for 5 percent of all U.S. health care spending. And it raises the risk of blindness, kidney disease, heart attacks, strokes, and deaths.
"Prevention is by far the best medicine for diabetes," Dr. Arterburn said. "Once you have diabetes, it's really hard to get rid of. Attempts to treat it with intensive lifestyle changes and medical management have been disappointing." For instance, the National Institutes of Health recently halted the Look AHEAD study of intensive lifestyle changes for people with diabetes. Despite improvements in risk factors like body weight, fitness, and blood pressure, sugar, and lipids, that study showed lifestyle changes did not lower the outcomes that matter most: heart attacks, strokes, and deaths.
"No wonder so many were excited to learn that diabetes can remit after gastric surgery -- even, in some cases, before any significant weight loss -- and many were hoping that gastric surgery might be a 'cure' for diabetes," Dr. Arterburn said. "Our study is the first major evidence that diabetes often recurs after gastric bypass surgery." Still, he added, even after diabetes comes back, having had a long period of post-surgery remission is likely to have many positive effects, such as fewer complications of diabetes: less damage to eyes and kidneys, and fewer heart attacks, strokes, and deaths. The researchers are now funded by the National Institutes of Health to study that possibility in this same population. Dr. Arterburn is also leading a randomized controlled pilot trial of intensive behavioral treatment vs. gastric surgery at Group Health with colleagues from the University of Washington.
It's still not clear whether diabetes relapse happens because of gaining weight back or because of underlying the progression of diabetes. But patients' weight -- before and after surgery -- was not strongly correlated with remission or relapse of diabetes in this population.
As part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program, the Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services funded this project under contract HHSA290-2005-0033-I-TO10-WA1, led by Dr. Arterburn.
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The above story is reprinted from materials provided by Group Health Research Institute.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Journal Reference:
- David E. Arterburn, Andy Bogart, Nancy E. Sherwood, Stephen Sidney, Karen J. Coleman, Sebastien Haneuse, Patrick J. O?Connor, Mary Kay Theis, Guilherme M. Campos, David McCulloch, Joe Selby. A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass. Obesity Surgery, 2012; DOI: 10.1007/s11695-012-0802-1
Note: If no author is given, the source is cited instead.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.
Source: http://feeds.sciencedaily.com/~r/sciencedaily/top_news/~3/rmyeHWJJJb0/121126142957.htm
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Police reports turn up as Macy's parade confetti
By Isolde Raftery, NBC News
At least they recycle. Along?the Macy?s Thanksgiving Parade route in New York on Thursday, long, white strips of confetti blew into the crowd. On one was a Social Security number. Other strips fluttered about ? and on them were bits of information ? some seemingly trivial, others possibly sensitive. ?
Ethan Finkelstein, 18, told WPIX that a strip landed on his friend?s jacket at West 65th Street?and Central Park West. Finkelstein, a New Yorker, is a freshman at Tufts University near Boston. ?
?It landed on her shoulder, and she looked and it and it says, SSN and there?s a number that?s written like a Social Security number,? Finkelstein told WPIX. ?And we?re like, that?s really bizarre.?
There were phone numbers, license plate numbers of undercover detectives ? even information about former GOP presidential candidate Mitt Romney?s motorcade as he left Hofstra University, where he and President Barack Obama sparred at a town hall debate.
A partial seal on one of the confetti strips indicated that the records came from the Nassau County Police Department. ?
"The Nassau County Police Department is very concerned about this situation," police spokesman Insp. Kenneth Lack said in a statement, according to Newsday. "We will be conducting an investigation into this matter as well as reviewing our procedures for the disposing of sensitive documents."
Also of note: The confetti, a Macy's official told WPIX, is not official Macy?s Thanksgiving Day Parade confetti, which is more festive ? although just about anything might be more cheery than a shredded police report. ?
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Disobedience
If enough people deem what has happened to you as unjust, something might be done via a small-scale revolution. If not enough people agree with you, society has deemed you deserving of whatever happens.
Alternatively, if you don't like the idea of following the laws of the country you currently reside in, either move or refuse every right and opportunity it provides you. It's not right to just take all the benefits of a contract, which is what citizenship is, and then decide that you don't want to hold up your end of it. If no country's laws strike your fancy, because none of them are absolutely perfect, than I'm sure there are some backwoods you could go live in, or Antarctica.
Source: http://feedproxy.google.com/~r/RolePlayGateway/~3/UDropT3Ez88/viewtopic.php
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Algeria scandals mask high level power struggle
ALGIERS, Algeria (AP) ? Nearly a week from regional elections, Algerians are less interested in the public vote than an intensifying behind-the-scenes power struggle ? one that is playing out through a flurry of corruption probes.
Though ostensibly a democracy, Algeria is really ruled by a powerful president and a shadowy collection of military generals and intelligence chiefs, making figuring out who has real power a constant preoccupation.
Thursday's local elections, like last May's legislative ones, mean little to people who know that real power lies with officials that have been appointed, not elected.
Aging President Abdelaziz Bouteflika has said he will retire in April 2014 after three terms and 15 years in power, setting the stage for a wide open presidential contest for the first time in the country's history.
Voters expect to have little direct say in the outcome.
Like the rest of North Africa, Algeria was shaken by protests calling for reform in the wake of Tunisia's dramatic overthrow of its long-ruling dictator in January 2011.
But in this North African country of 35 million, the protests never truly caught fire and were crushed by a combination of ruthless security forces and public sector salary increases, as well as lingering fears of instability after a decade-long civil war in the 1990s that claimed more than 200,000 lives.
The stakes are high for the presidential elections for not only this oil-rich nation, but for the region as a whole: Algeria has the strongest military in North Africa and neighbors unstable Libya and even more fragile Mali, where al-Qaida appears to control much of the north.
When a new daily newspaper began printing stories last week about three prominent politicians with close ties to Bouteflika taking bribes, it was widely taken as an opening salvo ahead of the presidential polls.
"These revelations are directly related to current politics and the upcoming 2014 presidential elections," said Rachid Tlemcani, a politics professor at Algiers University. "Corruption has reached grotesque proportions in Algeria, but rather than being fought with the law, it is unfortunately used as a weapon by the different clans in the system fighting among themselves since the war for succession to Bouteflika has opened."
That fight involves control over billions of dollars.
Algeria is awash in oil and natural gas money and has foreign reserves of almost $200 billion. It has embarked on a string high profile infrastructure projects ? and accusations are rife that foreign companies have been paying massive bribes to secure contracts. That has all contributed to Algeria's ranking of 112 out of 183 countries on Transparency International's 2011 corruption index.
The head of the ruling party, Abdelaziz Belkhadem, the minister of public works, Amar Ghoul, and well as the minister of industry, Cherif Rahmani, have all been accused by Algerie News of taking bribes to influence bids for the $12 billion East-West highway project (won by a Chinese-Japanese consortium), the Algiers metro and an extension of the tramway.
Belkhaddem and Ghoul are both close to the 75-year-old Bouteflika and are seen as possible candidates for the 2014 elections.
While Ghoul, for his part, has denied the allegations, the other two have remained silent ? as has the Ministry of Justice.
Noureddine Benissad, the president of the Algerian League to Defend Human Rights, expressed outrage over the ministry's lack of action. "The Ministry of Justice should order a judicial investigation," he said, lamenting the lack of independence of the ministry from the executive.
After his appointment in September, Bouteflika's new prime minister, Abdelmalek Sellal, like many Algerian leaders before him, promised to lead the fight against corruption. Yet just last week the daily El Watan also published a four page expose over the misuse of public funds, including fancy cars for ministers and the construction of new seaside villas for them from public money.
Algerie News has said it has confidential files in its possession and more corruption revelations are expected ? suggesting it is being fed by the feared "Research and Security Department" or DRS, as the intelligence service is known.
The military and security services are meanwhile reportedly backing Ahmed Ouyahia for the presidency, a former prime minister and head of the other main party in the ruling coalition.
Ouyahia coexisted uneasily with Bouteflika for years, but after May's elections and the overwhelming victory of the president's National Liberation Front, he was not asked back as prime minister.
Members of his own party, the National Democratic Rally, have even criticized Ouyahia for using the party to further his presidential ambitions.
According to political expert Mohammed Said, the fact that the revelations involve two politicians close to the president could also be the military's way of warning Bouteflika against harboring any ideas of staying in power.
"It is a likely a warning shot to discourage him from running for a fourth term," he said.
The president, who is rumored to be ailing, had already said that he would not run again and just a week before the May parliamentary elections, he made a landmark speech in which he said that the mission of his generation, the generation that fought the war of independence from France in 1962 and had ruled the country ever since, was over.
He also announced a series of reforms and promised to rewrite the constitution during the start of 2013.
On Tuesday, however, Interior Minister Dahou Ould Kablia said that the constitution reform process had been postponed ? indefinitely.
Columnist Ihsane el-Kadi has suggested that the reform and talk of other candidates is all a smoke screen for Bouteflika's own continuing presidential ambitions.
"For several months, he's been pushing the idea that if there is no agreement on his successor, it should be him," he said in the online news site Maghreb Emergent. "I sincerely doubt he ever thought it wouldn't be him."
___
Schemm reported from Rabat, Morocco.
Source: http://news.yahoo.com/algeria-scandals-mask-high-level-power-struggle-091106216.html
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1 employee, 2 employers and health benefits: How many W-2s ...
Question: How do we report an employee?s health benefits if he transferred between two divisions of the same company, and each division has its own Employer Identification Number? Must each division report separately, or can we combine this information and report it on one W-2?
Answer: The IRS isn?t too choosy about this, since this reporting is for informational purposes only. As long as the employers are related, you can report the aggregate cost on one W-2 or split reporting between the benefits provided by each division. But whatever method you choose, use it to report health benefits for all employees who transferred between divisions this year.
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Sunday, November 25, 2012
Birdlike Dinos Had Tough Time Flying
Some of the first birdlike creatures to emerge during the age of the dinosaurs probably couldn't get their heavy wings to take them off the ground, and they likely opted for gliding over flying, new research shows.
Modern flying birds have a single primary layer of easily separated long feathers covered with short ones ? a design that helps them overcome drag when taking flight. A new analysis of the fossils of two of their ancestors shows that the arrangement of feathers for primitive birds was quite different.
The birdlike dinosaurs Anchiornis huxley and Archaeopteryx lithographica had dense overlapping layers of wing feathers that were likely difficult to separate, the researchers found. Instead of lifting off from the ground, these creatures probably climbed trees and used their wings to glide from a height, the scientists said.
What's more, differences in the wing feathers of Archaeopteryx and Anchiornis appear to represent early evolutionary experiments in wing design, according to the researchers. For example, Archaeopteryx had multiple layers of long feathers, while Anchiornis had an abundance of simple feathers that overlapped like a penguin's, said study researcher Nicholas R. Longrich, a postdoctoral fellow at Yale.
Longrich's colleague Jakob Vinther, a former Yale doctoral student, now with the University of Bristol in the United Kingdom, said the fossil analyses add to an intricate picture of how feathers and modern birds evolved.
"We now seem to see that feathers evolved initially for insulation," Vinther explained in a statement. "More complex vaned or pinnate feathers evolved for display. These display feathers turned out to be excellent membranes that could have been utilized for aerial locomotion, which only very late in bird evolution became what we consider flapping flight."
The research was detailed today (Nov. 21) online in the journal Current Biology.
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Copyright 2012 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Source: http://news.yahoo.com/birdlike-dinos-had-tough-time-flying-151041148.html
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