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[ Barriers to Bioweapons ] is a must-read for nonproliferation experts and should be a standard text for understanding biological weapons development for some time to come. ―David W. Kearn, Perspectives on Politics In both the popular imagination and among lawmakers and national security experts, there exists the belief that with sufficient motivation and material resources, states or terrorist groups can produce bioweapons easily, cheaply, and successfully. In Barriers to Bioweapons , Sonia Ben Ouagrham-Gormley challenges this perception by showing that bioweapons development is a difficult, protracted, and expensive endeavor, rarely achieving the expected results whatever the magnitude of investment. Her findings are based on extensive interviews she conducted with former U.S. and Soviet-era bioweapons scientists and on careful analysis of archival data and other historical documents related to various state and terrorist bioweapons programs. Bioweapons development relies on living organisms that are sensitive to their environment and handling conditions, and therefore behave unpredictably. These features place a greater premium on specialized knowledge. Ben Ouagrham-Gormley posits that lack of access to such intellectual capital constitutes the greatest barrier to the making of bioweapons. She integrates theories drawn from economics, the sociology of science, organization, and management with her empirical research. The resulting theoretical framework rests on the idea that the pace and success of a bioweapons development program can be measured by its ability to ensure the creation and transfer of scientific and technical knowledge. The specific organizational, managerial, social, political, and economic conditions necessary for success are difficult to achieve, particularly in covert programs where the need to prevent detection imposes managerial and organizational conditions that conflict with knowledge production. In both the popular imagination and among lawmakers and national security experts, there exists the belief that with sufficient motivation and material resources, states or terrorist groups can produce bioweapons easily, cheaply, and successfully. In Barriers to Bioweapons , Sonia Ben Ouagrham-Gormley challenges this perception by showing that bioweapons development is a difficult, protracted, and expensive endeavor, rarely achieving the expected results whatever the magnitude of investment. Her findings are based on extensive interviews she conducted with former U.S. and Soviet-era bioweapons scientists and on careful analysis of archival data and other historical documents related to various state and terrorist bioweapons programs.Bioweapons development relies on living organisms that are sensitive to their environment and handling conditions, and therefore behave unpredictably. These features place a greater premium on specialized knowledge. Ben Ouagrham-Gormley posits that lack of access to such intellectual capital constitutes the greatest barrier to the making of bioweapons. She integrates theories drawn from economics, the sociology of science, organization, and management with her empirical research. The resulting theoretical framework rests on the idea that the pace and success of a bioweapons development program can be measured by its ability to ensure the creation and transfer of scientific and technical knowledge. The specific organizational, managerial, social, political, and economic conditions necessary for success are difficult to achieve, particularly in covert programs where the need to prevent detection imposes managerial and organizational conditions that conflict with knowledge production.

In response to a request from the U.S. Congress, this book examines how the unique experience and extensive capabilities of the Department of Defense (DOD) can be extended to reduce the threat of bioterrorism within developing countries outside the former Soviet Union (FSU). During the past 12 years, DOD has invested $800 million in reducing the risk from bioterrorism with roots in the states of the FSU. The program's accomplishments are many fold. The risk of bioterrorism in other countries is too great for DOD not to be among the leaders in addressing threats beyond the FSU. Taking into account possible sensitivities about a U.S. military presence, DOD should engage interested governments in about ten developing countries outside the FSU in biological threat reduction programs during the next five years. Whenever possible, DOD should partner with other organizations that have well established humanitarian reputations in the countries of interest. For example, the U.S. Agency for International Development, the Centers for Disease Control and Prevention, and the World Health Organization should be considered as potential partners.

Objectives. We examined the burden of disability resulting from traumatic brain injuries (TBIs) among children younger than 18 years. Methods. We derived our data from a cohort study of children residing in King County, Washington, who were treated in an emergency department for a TBI or for an arm injury during 2007–2008. Disabilities 12 months after injury were assessed according to need for specialized educational and community-based services and scores on standardized measures of adaptive functioning and social–community participation. Results. The incidence of children receiving new services at 12 months was about 10-fold higher among those with a mild TBI than among those with a moderate or severe TBI. The population incidence of disability (defined according to scores below the norm means on the outcome measures included) was also consistently much larger (2.8-fold to 28-fold) for mild TBIs than for severe TBIs. Conclusions. The burden of disability caused by TBIs among children is primarily accounted for by mild injuries. Efforts to prevent these injuries as well as to decrease levels of disability following TBIs are warranted.

During the summer of 2018, U.S. diplomacy related to the North Atlantic Treaty Organization (NATO) and Russia took sharp twists and turns. President Trump's statements at a pair of diplomatic events abroad in July sowed confusion regarding the continued U.S. commitment to NATO and the nature of the relationship between the White House and the Kremlin. Yet despite some wariness regarding NATO and a desire to have “a very good relationship with Russia,” Trump joined a robust NATO summit declaration that emphasized Russian malfeasance and reaffirmed the importance of the North Atlantic Alliance. Several weeks later, the U.S. State Department announced the imposition of new sanctions on Russia pursuant to the Chemical and Biological Weapons Control and Warfare Elimination Act of 1991.

Objectives. We identified risk factors for pregnancy-associated homicide (women who died as a result of homicide during or within 1 year of pregnancy) in the United States from 1991 to 1999. Methods. Pregnancy-associated homicides were analyzed with data from the Pregnancy Mortality Surveillance System at the Centers for Disease Control and Prevention. Results. Six hundred seventeen (8.4%) homicide deaths were reported to the Pregnancy Mortality Surveillance System. The pregnancy-associated homicide ratio was 1.7 per 100000 live births. Risk factors included age younger than 20 years, Black race, and late or no prenatal care. Firearms were the leading mechanism for homicide (56.6%). Conclusions. Homicide is a leading cause of pregnancy-associated injury deaths.

Objective: To investigate whether, there is an association between consumption of fruit and vegetables and dietary antioxidants and the risk of developing inflammatory polyarthritis (IP). Methods: In a prospective, population based, nested case-control study of residents of Norfolk, UK, men and women aged 45–74 years were recruited, between 1993 and 1997 through general practice age-sex registers to the Norfolk arm of the European Prospective Investigation of Cancer (EPIC-Norfolk). Dietary intake was assessed at baseline using 7 day diet diaries. Seventy three participants who went on to develop IP between 1993 and 2001 and were registered by the Norfolk Arthritis Register (NOAR) were identified. Incident cases of IP, assessed by general practitioners, fulfilled the criteria of two or more swollen joints, persisting for a minimum of 4 weeks. Each case of IP was matched for age and sex with two controls free of IP. Results: Lower intakes of fruit and vegetables, and vitamin C were associated with an increased risk of developing IP. Those in the lowest category of vitamin C intake, compared with the highest, increased their risk of developing IP more than threefold, adjusted odds ratio (OR) with 95% confidence intervals (CI) 3.3 (95% CI 1.4 to 7.9). Weak inverse associations between vitamin E and β-carotene intake and IP risk were found. Conclusion: Patients with IP (cases) consumed less fruit and vitamin C than matched controls, which appeared to increase their risk of developing IP. The mechanism for this effect is uncertain. Thus similar studies are necessary to confirm these results.

The successor states of the former Soviet Union have enormous stocks of weapons-usable nuclear material and other militarily significant commodities and technologies. Preventing the flow of such items to countries of proliferation concern and to terrorist groups is a major objective of U.S. national security policy. This book reviews the effectiveness of two U.S. programs directed to this objective. These programs have supported the efforts of Russia, Ukraine, Belarus, and Kazakstan in upgrading the physical protection, control, and accountability of highly enriched uranium and plutonium and strengthening systems to control the export of many types of militarily sensitive items.

These Lipid Association of India (LAI) recommendations refer to specific patient populations. They follow the previously published LAI part 1 recommendations. These part 2 LAI recommendations focus on specific patient groups. These include patients with heart failure, chronic kidney disease, non-alcoholic fatty liver disease, cerebrovascular disease, thyroid disorders, inflammatory joint diseases, familial hypercholesterolaemia and human immunodeficiency virus infection. We also consider women, the elderly and post-transplantation patients. The current recommendations are based, as much as possible, on available data from Indian populations.

In 1993, the affluent Washington D.C. neighborhood of Spring Valley was unaware of what lurked beneath their carefully manicured lawns and million-dollar homes. Contractors hired by a resident to build an inground pool suddenly found themselves short of breath and half the crew had to be rushed to the hospital suffering respiratory distress, internal blistering of the lungs, and vision problems. The symptoms they exhibited matched all the characteristics of the World War I era blister agent lewisite. This thesis is an environmental study of chemical weapons that aims to contribute to the overall history of these weapons and their disposal by looking beyond diplomacy and development and focusing on how production and disposal of chemical weapons have affected ecosystems, impacting both human and non-human actors in significant ways. Spring Valley is just one of the more prominent examples of negligent chemical weapons disposal by the military. Numerous other incidents have occurred across the United States since 1993 including a host of chemical agents produced both during and after the Great War including sulfur mustard, chloropicrin, phosgene, and VX gas. By looking at the deep and expansive footprint left by the American chemical weapons program, this study will show how disposal methods used during the twentieth century and continuing through the twenty-first century contributed to the disruption of delicate ecosystems and the continued marginalization of classes of citizens who have been denied agency in decisions regarding the locations and methods used for destruction of America’s aging chemical weapons arsenal.