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The bridge : the building of the Verrazano-Narrows Bridge
Toward the end of 1964, the Verrazano Narrows Bridge--linking the New York City boroughs of Brooklyn and Staten Island--was completed. Fifty years later, it remains an engineering marvel. At 13,700 feet (more than two and a half miles), it is still the longest suspension bridge in the United States and the sixth longest in the world. Gay Talese, then early in his career at the New York Times, closely followed the construction, and soon after the opening of this marvel of human ingenuity and engineering, he chronicled the human drama of its completion--from the construction workers high on the beams to the backroom dealing that displaced whole neighborhoods to make way for the bridge. Now in a new, beautifully packaged edition featuring dozens of breathtaking photos and architectural drawings, The Bridge remains both a riveting narrative of politics and courage and a demonstration of Talese's consummate skills as a reporter and storyteller. His memorable narrative will help celebrate the bridge's fiftieth anniversary and captivate a new generation of readers.
Book
Disease activity influences the reclassification of rheumatoid arthritis into very high cardiovascular risk
Background
Previous studies have shown that risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the actual cardiovascular (CV) risk of patients with rheumatoid arthritis (RA). In contrast, carotid ultrasound was found to be useful to identify RA patients at high CV. In the present study, we aimed to determine if specific disease features influence the CV risk reclassification of RA patients assessed by SCORE risk charts and carotid ultrasound.
Methods
1279 RA patients without previous CV events, diabetes, or chronic kidney disease were studied. Disease characteristics including disease activity scores, CV comorbidity, SCORE calculation, and the presence of carotid plaque by carotid ultrasound were assessed. A multivariable regression analysis was performed to evaluate if the reclassification into very high CV risk category was independently associated with specific features of the disease including disease activity. Additionally, a prediction model for reclassification was constructed in RA patients.
Results
After carotid ultrasound assessments, 54% of the patients had carotid plaque and consequently fulfilled definition for very high CV risk. Disease activity was statistically significantly associated with reclassification after fully multivariable analysis. A predictive model containing the presence of dyslipidemia and hypertension, an age exceeding 54 years, and a DAS28-ESR score equal or higher than 2.6 yielded the highest discrimination for reclassification.
Conclusion
Reclassification into very high CV risk after carotid ultrasound assessment occurs in more than the half of patients with RA. This reclassification can be independently explained by the activity of the disease.
Journal Article
Teaching To and Through Cultural Diversity
This discussion examines some of the major issues and attributes of culturally responsive teaching. It begins with explaining my views of culturally responsive teaching and how I incorporate cultural responsiveness in my writing to teach readers what it means. These general conceptual frameworks are followed by a discussion of some specific actions essential to its implementation. They are restructuring teacher attitudes and beliefs about cultural, ethnic, and racial diversity; resisting resistance to cultural diversity in teacher education and classroom instruction; centering culture and difference in the teaching process; and establishing pedagogical connections between culturally responsive teaching and subjects and skills routinely taught in schools. Excerpts from samples of my own and others' scholarship are woven throughout to exemplify general patterns, themes, and principles of culturally responsive teaching.
Journal Article
Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis
Obesity is one of the most important risk factors of knee osteoarthritis (KOA), but its impact on clinical and functional consequences is less clear. The main objective of this cross-sectional study was to describe the relation between body mass index (BMI) and clinical expression of KOA. Participants with BMI >/= 25 kg/m(2) and KOA completed anonymous self-administered questionnaires. They were classified according to BMI in three groups: overweight (BMI 25-30 kg/m(2)), stage I obesity (BMI 30-35 kg/m(2)) and stage II/III obesity (BMI >/= 35 kg/m(2)). The groups were compared in terms of pain, physical disability, level of physical activity (PA) and fears and beliefs concerning KOA. Among the 391 individuals included, 57.0% were overweight, 28.4% had stage I obesity and 14.6% had stage II/III obesity. Mean pain score on a 10-point visual analog scale was 4.3 (SD 2.4), 5.0 (SD 2.6) and 5.2 (SD 2.3) with overweight, stage I and stage II/III obesity, respectively (p = 0.0367). The mean WOMAC function score (out of 100) was 36.2 (SD 20.1), 39.5 (SD 21.4) and 45.6 (SD 18.4), respectively (p = 0.0409). The Knee Osteoarthritis Fears and Beliefs Questionnaire total score (KOFBEQ), daily activity score and physician score significantly differed among BMI groups (p = 0.0204, p = 0.0389 and p = 0.0413, respectively), and the PA level significantly differed (p = 0.0219). We found a dose-response relation between BMI and the clinical consequences of KOA. Strategies to treat KOA should differ by obesity severity. High PA level was associated with low BMI and contributes to preventing the clinical consequences of KOA.
Journal Article
Do you know what to eat?
\"Discusses the difficulties facing those with problems eating, including history, symptoms, treatments, nutrition, and ways to help\"-- Provided by publisher.
Book
Transforming growth factor beta 1 is associated with subclinical carotid atherosclerosis in patients with systemic lupus erythematosus
Background
Transforming growth factor beta (TGF-β1) is a multifunctional cytokine that has anti-inflammatory and immunosuppressive effects. TGF-β1 has been linked to cardiovascular disease in the general population. The immunosuppressive effect of TGF-β1 is believed to be dysregulated in patients with systemic lupus erythematosus (SLE). In the present work, we aimed to study the relationship of serum levels of TGF-β1 with subclinical carotid atherosclerosis in patients with SLE.
Methods
The study included 284 patients with SLE. Serum levels of TGF-β1 and subclinical carotid atherosclerosis (by carotid ultrasonography) were evaluated. In addition, the complete lipid profile and insulin resistance were analyzed. Multivariable linear and logistic regression analysis was performed to establish the relationship of TGF-β1 with carotid subclinical atherosclerosis adjusting for traditional cardiovascular risk factors that included lipid profile and insulin resistance.
Results
Circulating TGF-β1 was positively and significantly associated with higher levels of LDL:HDL cholesterol ratio and atherogenic index. TGF-β1 was also associated with significantly lower levels of HDL cholesterol and apolipoprotein A1. Remarkably, TGF-β1 was associated with the presence of carotid plaque not only after adjustment for demographics (age, sex, body mass index, diabetes, hypertension, and aspirin use) but also after adjustment for relationships of TGF-β1 with lipid profile molecules, insulin resistance, and SLEDAI disease score (odds ratio 1.14 [95% confidence interval 1.003–1.30],
p
= 0.045).
Conclusion
TGF-β1 serum levels are positively and independently associated with the presence of subclinical atherosclerosis disease in patients with SLE.
Journal Article