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        <p>rE AE cE<lb /><lb />7<lb />Petre tet) ee a ee monterey<lb /><lb />oe Sean Gee<lb /><lb /><lb /><lb />SPRING 1999<lb /><lb />Small-town boy/<lb />big-time surgeon<lb /><lb />New understanding<lb />of obesity, diabetes<lb /><lb /></p>
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        <p>edge<lb />East Carolina University<lb />Spring 1999<lb /><lb />www.ecu.edu/research/edge<lb /><lb />publisher<lb />Dr. THOMAS L. FELDBUSH<lb /><lb />Vice CHANCELLOR, RESEARCH AND GRADUATE STUDIES<lb /><lb />executive editor<lb />JOHN DURHAM<lb /><lb />Director, NEWS AND COMMUNICATIONS SERVICES<lb /><lb />yeliaelat-|meler-lae<lb />TOM FORTNER<lb /><lb />Director, MEDICAL CENTER NEWS AND INFORMATION<lb /><lb />JOANNE KOLLAR<lb /><lb />DirECTOR, UNIVERSITY PUBLICATIONS<lb /><lb />Dr. ALAN A. SCHREIER<lb /><lb />DirECTOR, OFFICE OF SPONSORED PROGRAMS<lb /><lb />Dr. Emitie S. KANE<lb /><lb />ASSOCIATE Director, OFFICE OF SPONSORED PROGRAMS<lb /><lb />rveliaels<lb /><lb />GARNET BASS<lb /><lb />designer<lb />DANA Ezzett Gay<lb /><lb />UNIVERSITY PUBLICATIONS<lb /><lb />elalel cele le-] elalig<lb />CuiFF HOLLIS<lb /><lb />News AND COMMUNICATIONS SERVICES<lb /><lb />TONY RUMPLE<lb /><lb />News AND COMMUNICATIONS SERVICES<lb /><lb />edge is published by the Division of Research<lb /><lb />and Graduate Studies at East Carolina University.<lb /><lb />Any written portion of this publication may be<lb />reprinted with appropriate credit.<lb /><lb />Comments or questions should be addressed to<lb /><lb />olatam 2leisar-ias<lb /><lb />East Carolina University<lb /><lb />News and Communications Services<lb />Howard House<lb /><lb />Greenville, NC 27858-4353<lb />252-328-6481<lb /><lb />durhamj@mail.ecu.edu<lb /><lb />© 1999 by East Carolina University<lb /><lb />U.P. 99-044 &amp; Printed on recycled paper<lb /><lb />cw eet iv.e<lb /><lb />the next big thing<lb /><lb />Waa<lb /><lb />THE LAST YEAR HAS BEEN AN IMPRESSIVE ONE FOR EAST CAROLINA.<lb />WeTve received formal designation as a doctoral institution. WeTve<lb />dedicated the greatly expanded and fabulously renovated Joyner<lb />Library and its companion Sonic Plaza. WeTve completed design work<lb />for the new Science and Technology Building, which now awaits<lb />complete funding from the North Carolina General Assembly to<lb />become a reality. And weTve become a member of UCAID"University<lb />Corporation for Advanced Internet Development"the association of<lb />universities working to build the next-generation Internet.<lb /><lb />The future is equally exciting. This spring the university expects<lb />to take over the 594-acre site that formerly housed the Voice of<lb />America facilities just west of Greenville. It will immediately become<lb />home to the North Carolina Institute for Health and Safety in<lb />Agriculture, Forestry and Fisheries (see page 6).<lb /><lb />But the site, now occupied chiefly by antenna towers, will be<lb />much more than that. As a third campus for East Carolina"the<lb />Millennium Campus, if you will"it will open up an unbelievable<lb />array Of opportunities for us. Among the proposals are medical<lb />clinics, an emeritus village� providing a learning and teaching<lb />environment for retired professors, a wetlands preservation area and<lb />a university golf course. The new campus will help us handle an<lb />expected enrollment boom in the next decade as the high school<lb />graduate pool adds an extra 50,000 students to the 16-campus<lb />University of North Carolina.<lb /><lb />At the same time that weTre planning a new bricks-and-mortar<lb />campus, weTre hard at work on a Virtual University that will embrace<lb />the digital revolution to make East Carolina faculty and instructional<lb />prowess available worldwide. The challenge is to use the Internet and<lb />other information technologies to deliver ECU courses to any student<lb />at literally, any place on the globe.<lb /><lb />The essence of these developments, both completed and planned,<lb />is simply this"East Carolina is a different place, doing business in a<lb />different way. We have always had confidence in the future, now we<lb />are helping invent it. Some of our most exciting work is reported in<lb />these pages. " Dr. Thomas L. Feldbush, Vice Chancellor for Research<lb />and Graduate Studies<lb /><lb />wet ivi Cy<lb /><lb />4*<lb /><lb />18<lb /><lb />22<lb /><lb />24<lb />26<lb /><lb />29<lb /><lb />12<lb /><lb />y<lb /><lb />The geometry of sound<lb />Will physics show the way to build<lb /><lb />a better violin?<lb /><lb />Walden pond and beyond<lb />English professor Ronald Hoag explores<lb /><lb />the many facets of the Thoreau legacy.<lb /><lb />Obesity and diabetes<lb /><lb />Research yields startling clues to the complex<lb /><lb />connections between two deadly conditions.<lb />The diabetes/obesity connection<lb /><lb />Clinical trials advance treatment<lb />of diabetes and its complications<lb /><lb />It takes two<lb />Part Odd Couple, part Dynamic Duo,<lb />ECU social scientists make the most<lb /><lb />of complementary talents.<lb /><lb />One smooth operator<lb />Randolph Chitwood never forgets his roots<lb /><lb />as he builds an international reputation as<lb /><lb />a cardiovascular surgeon.<lb /><lb />A finger on the pulse of<lb />farmersT stress<lb />When a child testifies<lb />Tracking the first North Carolinians<lb />Nursing solutions<lb />Topsoil gone with the wind, rain<lb />At the top of their math class<lb />An office for clinical trials<lb />A parable for the ~90s<lb /><lb />28<lb /><lb />32<lb /><lb />34<lb /><lb />36<lb /><lb />39<lb /><lb />Space age<lb />NASA technology proves a good fit for<lb /><lb />interior design.<lb /><lb />Quality care<lb /><lb />Early studies show telemedicine compares<lb /><lb />well with doctorTs visit.<lb /><lb />Upbeat<lb /><lb />For marimbist Mark Ford, making music<lb /><lb />means having fun.<lb /><lb />Seamless<lb /><lb />Emotionally disturbed children benefit as<lb /><lb />new approach to care takes hold.<lb /><lb />Partnership to investigate issues<lb />in welfare reform<lb /><lb />Biomedical physics admits first<lb />Ph.D. students<lb /><lb />Technologies move closer to market<lb /><lb />ECU implements state-of-the-art<lb /><lb />research administration<lb /><lb />Grant and contract activity increases<lb /><lb />on the cover<lb /><lb />Front: Dr. George Bissinger readies equipment to measure the<lb /><lb />sound and vibration of a violin. (Photo by Cliff Hollis.)<lb /><lb />Back: Walden Pond. (Photo courtesy of the Thoreau Society.)<lb /><lb />Cover DESIGN By DANA EzzELL GAy<lb /><lb />|<lb />|<lb />|<lb />|<lb /><lb /><lb /></p>
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          <lb />2<lb /><lb />'<lb /><lb />|<lb /><lb />violin, a fateful step for this amateur musician and<lb />former nuclear physicist. ITve really spent all the<lb />25 years since then trying to understand why, if<lb />you build it all the right way with all the right<lb />stuff, it still doesnTt turn out so good"the tradi-<lb />tional problems with making a violin,� he said.<lb />Today, Bissinger is poised to unite science and<lb />art, employing the fundamental principles of vibra-<lb />tion to help violin makers build good violins<lb />consistently. He uses geometry"such things as<lb />shape, stiffness and density"to predict vibration,<lb />which in turn predicts sound. There is no way,<lb />prior to the work ITm doing, anybody could pre-<lb />dict the acoustic output of a violin from mechani-<lb />cal measurements,� he said. The approach has<lb />attracted the interest of violin makers and the sci-<lb />entific community alike. One violin maker called<lb />BissingerTs technology the tool violin makers dream<lb />of.� And the National Science Foundation has award-<lb />ed him and three colleagues"Drs. Robert Chin,<lb />Hamid Khan and Biwu Yang of industrial technolo-<lb />gy"a $370,000 grant to advance their research.<lb />Bissinger, who directed ECUTs particle accelerator<lb />lab from 1973 to 1992, learned to play the violin,<lb />somewhat grudgingly, as a child and took up the<lb />instrument again while finishing his doctoral<lb /><lb />work at the University of Notre Dame. He built his<lb /><lb />A<lb /><lb />violin under the tutelage of musical acoustics<lb />expert Carleen Hutchins while he was on a post-<lb />doctoral appointment at Rutgers University. Years<lb />later, he heard a talk about normal mode analysis<lb />on the violin at a meeting of the Acoustical<lb />Society of America. Being in physics, I realized<lb />that if you had the normal modes of an instru-<lb />ment, you literally knew everything possible there<lb />was to know about that instrument and all you<lb />had to do was figure out how all the individual<lb />modes get put together,� he said.<lb /><lb />Normal modes, in this case, amount to a collec-<lb />tion of individually unique physical responses<lb />gathered by tapping at discrete points on the body<lb />of the violin while measuring the response at a<lb />given point (or vice versa). Bissinger calls them the<lb />building blocks of vibration. You hit it in a cer-<lb />tain place and some modes will be excited strongly<lb /><lb />and some will not,� he said. You hit it in a differ-<lb /><lb />edge<lb /><lb />ent place, and different modes will be excited<lb />strongly. Any way that a violin can vibrate, no<lb />matter how you hit it, bang it, tweak it, bounce<lb />it, drop it on the ground, anything you do, you<lb />can figure out how itTs going to respond to the<lb />force that you apply if you have the normal modes.�<lb />Sound flows from vibration. If it vibrates, itTs<lb />pushing the air around so itTs going to radiate sound.<lb />So if you know how it vibrates, you can figure out<lb />how it radiates"even the direction in which it will<lb />radiate, and once youTve got that, you have the<lb />essence of really understanding a musical instrument.�<lb />The difficulty comes in applying the concept. There<lb />are an infinite number of normal modes, but less than<lb />a thousand in the range of hearing, and every violin<lb />will be different. Wood, shape, components, even glues<lb />and worm holes can affect the normal modes. What<lb />Bissinger must do is figure out which normal modes are<lb /><lb />important to the sound quality of the violin. <lb /><lb />PHYSICS SHOW THE way ®&amp;<lb />TO BUILD 2a<lb /><lb />ae<lb /><lb />A computer rendering of a violin takes music back<lb /><lb />to its source: pinpoint responses to applied force.<lb /><lb /></p>
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        <p>His tools include an echo-less small room equipped with a<lb />rotatable semi-circular arc of microphones and a laser scan-<lb />ning system. A violin is suspended in the center of the arc,<lb /><lb />SOUND Fiows<lb /><lb />FROM VIBRATION.<lb />ie iT VIBRATES,<lb /><lb />ITTS PUSHING<lb /><lb />and a carefully calibrated hammer taps on the bridge of<lb />the instrument. The laser measures the resulting vibra-<lb />tion at 270 different points on the violin, one point<lb /><lb />at a time. As mechanical energy is converted to<lb />acoustic energy, the microphones measure the<lb />direction and volume of the sound. With the<lb />cooperation of the Leo Jenkins Cancer Center<lb /><lb />at Pitt County Memorial Hospital, each violin<lb /><lb />THE AIR AROUND also will undergo a computerized tomo-<lb /><lb />graphic, or CT, scan to reveal its structure,<lb />from the shape of components to the<lb /><lb />SO ITTS GOING TO<lb />RADIATE sounb.<lb /><lb />SO IF YOU KNOW<lb /><lb />thickness of the wood. Start to finish,<lb />measurements on a single violin take<lb />about 12 hours.<lb /><lb />These quantitative measurements,<lb />however, cannot tell whether a violin<lb />sounds good or bad. For a qualitative<lb /><lb />assessment, Bissinger will draw on<lb /><lb />PRA gy te<lb />ret 4<lb /><lb />ia ay ie<lb /><lb />HOW IT VIBRATES,<lb /><lb />the expertise of violinists at the<lb />ECU School of Music. Then all of<lb /><lb />YOU CAN FIGURE : " pe oi Be eee ec E 3 : 3 a the information will be entered<lb />BS vere tae� * gitar me, : | : into an advanced statistical analy-<lb /><lb />OUT HOW IT<lb />SAND] PANE he<lb />EVEN THE<lb /><lb />DIRECTION<lb /><lb />IN WHICH IT WILL<lb /><lb />sis computer program that will<lb />help sort out the correlations.<lb />Before he can reach definitive<lb />conclusions, Bissinger needs to<lb />obtain measurements on hundreds<lb />of violins, from the worst sounding<lb />to the best. So far, a dozen violin<lb />makers have promised to provide<lb />instruments for him. He also hopes<lb />to measure some classic violins, even<lb />if it means transporting his equip-<lb />RADIATE, INNipe) (a: ment to such places as the Smith-<lb /><lb />sonian and Library of Congress or to<lb />Europe to test museum instruments.<lb /><lb />YOU VE GOT THAT,<lb /><lb />The overall sound of the violin<lb /><lb />relates to two independent factors, how<lb /><lb />YOU HAVE THE effectively the vibrating string energy is<lb />transferred to the normal modes of the<lb />body and how well each normal mode of the<lb /><lb />body radiates this energy in the form of<lb /><lb />sound. As youTre bowing a string, youTve got<lb /><lb />all these string harmonics and theyTre moving<lb /><lb />back and forth frequency-wise across normal modes<lb /><lb />of the body of the violin,� Bissinger said. The loud-<lb /><lb />est sounds come when they cross the normal modes<lb />that radiate well. One of the things that makes the violin<lb /><lb />sO appealing is that it changes so much mode to mode.�<lb /><lb />ESSENCE OF REALLY<lb /><lb />UNDERSTANDING<lb /><lb />A MUSICAL<lb />INSTRUMENT.�<lb /><lb />BissingerTs current anechoic, or echo-less chamber,<lb /><lb />has evolved from this earlier model.<lb /><lb />This relationship also means that a computer<lb />will be able to simulate the sound of the violin<lb />based on the measurements Bissinger has taken.<lb />ItTs not that itTs going to make real good violin<lb />sound,� he said. The important thing will be the<lb />trend. If you make a modification and the sound<lb />goes from a to b, you listen before and after and<lb />decide if you want to go in the other direction.<lb />With the computer, you can add just as well as<lb />subtract. In the real world, unfortunately, once<lb />youTve shaved the wood off, itTs difficult to get it<lb />back on, so things donTt reverse so well.�<lb /><lb />The prospect excites Joseph Curtin, a renowned<lb />violin maker in Ann Arbor, Mich., who wrote a let-<lb />ter in support of BissingerTs NSF grant. Here is a<lb />way of both understanding what existing violins<lb />actually do when they are played and predicting<lb />how carefully specified changes in material and<lb />design might affect the performance of a new instru-<lb />ment,� Curtin wrote. This is a tool violin makers<lb />dream of, and if it becomes a reality, I will be first<lb />in line to use it! It should greatly reduce the time<lb />needed to develop new instruments and contribute<lb />enormously to our understanding of old ones.�<lb /><lb />This will be a considerable change from the<lb />centuries-old approach to making and improving<lb />violins. ItTs a really tough job because itTs empiri-<lb />cal,� Bissinger explained. You have to work with<lb />someone who knows how to do it. They have to do<lb />it and show you, and you have to hear it and feel<lb />it yourself. Typically, by the time the really good<lb />ones get really good, they die, and then some-<lb />bodyTs got to learn from scratch again. ThatTs part<lb />of the reason why weTre no better now than were<lb />Antonio Stradavari and all the really great violin<lb />makers who are gone.�<lb /><lb />Bissinger is working closely with the violin<lb />makers to assure that his work will translate into<lb />useful knowledge. Peter Zaret, a violin maker from<lb />Norfolk, Va., has patented a modification for the<lb />bass bar and will supply violins before and after he<lb />has modified them so Bissinger can measure the<lb />resulting changes.<lb /><lb />Zaret is confident of the outcome. ItTs scien-<lb />tific confirmation of what I already know,� he said.<lb />T feel itTs the best-sounding violin made.�<lb /><lb />Of course, determining the best shape for a<lb />violin is quite different from making music by<lb />applying bow to strings. As Bissinger figures it, this<lb />will be a perfect contribution to music for nerdy<lb /><lb />people who would love to be able to play a *<lb />musical instrument really well but canTt.�<lb /><lb /></p>
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          <lb />S<lb /><lb />PW ilive (sme am carom ole] iyo<lb />of farmersT stress<lb /><lb />Memory is a constructed, dynamic process,� says<lb />Agricultural and medical professionals The four universities are organiz- 1998. The program may soon evolve<lb /><lb />Dr. Robert Nida, a specialist in childrenTs ability<lb /><lb /> FS 8 fee wey a) ar ivercities j y = he re ive Tr? ol we 4 j 2 tee ti ae » e<lb />wt ECU and three other universities ing a cooperative program to track eh com estes Oru beh iaiaticcmco)ms ale liesme tare bias eet<lb /><lb />are cooperating to help farm families stress indicators and mobilize inter- Safety in Agriculture, Forestry and<lb />cope with stresses related to depressed vention programs to head off wide- Fisheries. The UNC General Adminis-<lb />pork prices, the statesT tobacco settle- spread problems. Three of the univer- tration is expected to approve the<lb />ment and recent tobacco allotment sities"ECU, N.C. State University and establishment of the institute in 1999.<lb />cutbacks. N.C. A&amp;T State University"already are Under the universitiesT agreement,<lb /><lb />During the farm crisis of the partners in the N.C. Agromedicine ECU will take the administrative lead<lb />1980s, we saw an increase in the num- Program. The fourth, the University for the institute. If negotiations with<lb />ber of suicides, incidents of family of Kentucky, serves the countryTs No. the U.S. Department of Education are<lb />violence and highway accidents, espe- 2 tobacco-producing state. North successful, the core institute will be<lb />cially in the Midwest, where the crisis Carolina is the leading tobacco-pro- housed at the former Voice of<lb />hit particularly hard,� said Dr. Byron ducing state and the second major America site just west of Greenville.<lb />Burlingham, chair of the N.C. Agro- hog-producing state. The 28,000-square-foot building sits<lb />medicine Program steering committee The occupational stress project is on nearly 600 acres near the ECU<lb />and professor of microbiology and one of the latest projects of the School of Medicine. Burlingham said<lb />immunology at the ECU School of Agromedicine Program, which was the building could be renovated to<lb />Medicine. WeTre in nervous anticipation established in 1989 as a cooperative house the instituteTs administrative<lb />that tobacco and hog farmers may venture by ECU and NCSU. N.C. A&amp;T offices, research facilities and clinics. <lb /><lb />be in for the same stress responses.� signed on as a full partner in October<lb /><lb />PHOTO BY GEORGE THREEWITTS<lb /><lb /><lb /><lb />Dr. Byron Burlingham leads a<lb />tour of the Voice of America<lb />site, future home of the N.C.<lb />Institute for Health and Safety<lb />in Agriculture, Forestry and<lb /><lb />Fisheries.<lb /><lb />When a child testifies<lb /><lb />Since 1992, Central PrisonTs death row has been home for a<lb />Greenville man convicted of rape and murder. The key evidence link-<lb />ing him to the crime was the testimony of a child who was 3 1/2<lb />years old at the time of the killing. The manTs<lb />attorneys are seeking a retrial.<lb /><lb />For Dr. Robert Nida, associate professor in the<lb />Department of Child Development and Family<lb />Relations, this case and others involving childrenTs<lb />testimony raise a red flag. We just donTt know<lb />how accurate childrenTs long-term memory is,� he<lb />said. We need more information on the accuracy<lb />of memory, the individual differences involved in<lb />the ability to recall and issues related to suscepti-<lb />bility to suggestion. ItTs a very tricky issue.�<lb /><lb />Nida has been studying the ability of children to<lb />give accurate court testimony for more than 10<lb />years, first during postdoctoral studies at the<lb />University of North Carolina at Chapel Hill and<lb />now with further research at ECU. His research<lb />has focused on memory and suggestibility.<lb /><lb />At Chapel Hill, Nida assisted in a series of stud-<lb />ies looking into childrenTs memory of events they<lb />personally experienced. Using the pediatric physical<lb />examination as a point of reference, the researchers<lb />interviewed children ages 3 to 7 immediately after<lb />the exam and at intervals of up to 12 weeks to see<lb />how well they could remember details of the exam<lb />and whether they could correctly deny misleading questions.<lb /><lb />The researchers found that even the youngest children could<lb />remember the bulk of their physical exams, but they forgot more<lb />over time and were more susceptible to suggestion than were older<lb />children. The older children also were able to recall more specifics in<lb />response to open-ended questions. The children came mostly from<lb />middle- to upper-class white families.<lb /><lb />Since coming to ECU, Nida has tried to replicate those studies<lb />with African-American children from low-income households.<lb />Although he found similarities in the ability to recall experiences,<lb />children in this study were more susceptible to suggestion. More<lb />research will be needed to explain the differences in suggestibility,<lb />he said.<lb /><lb />Meanwhile, he said, other research has shown that interviewer<lb />bias can distort the reports of young children prone to susceptibility.<lb />Intervening events also may have a profound effect. ThereTs a lot of<lb />work that shows intervening experiences become integrated into<lb />memory,� he said. Memory is a constructed, dynamic process.�<lb /><lb />edge<lb /><lb />7<lb /><lb /></p>
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          <lb />bi ef s<lb /><lb />Tracking the first North Carolinians<lb />The trail is cold, but Dr. I. Randolph Daniel Jr.,<lb />assistant professor of anthropology, hopes<lb />ancient stone tools will point him toward sites<lb />inhabited by the first North Carolinians.<lb /><lb />People often think of history in North<lb />Carolina as beginning with the Lost Colony,�<lb />he said, but people lived here 10 millennia<lb />before Virginia Dare was born. So much more<lb />happened before European settlement thatTs<lb />equally interesting and that has a lot to say<lb />about life in North Carolina.�<lb /><lb />Anthropologists call those earliest settlers<lb />Paleoindians, for the Paleolithic era in which ~<lb />they first ventured onto the North American .<lb />continent. Eventually, Daniel wants to decipher<lb />how North CarolinaTs Paleoindians lived. First,<lb />heTs trying to find where they settled.<lb /><lb />Dr. Randolph Daniel notes #�,� $ize, shape<lb /><lb />and composition of tools that Paleoindians<lb />Daniel has been combing public and private collections to create<lb /><lb />a comprehensive record of fluted points"stones flaked into an elon-<lb />gated point with a groove across the base"that have been found<lb />here. He photographs each point that appears to date to the right<lb /><lb />period (10,000 to 12,000 years ago), logs details about its shape and<lb />composition, and plots where it was found.<lb /><lb />left behind in North Carolina.<lb /><lb />Stone type gives an important clue to mobility. Hunters and<lb />gatherers have to move a lot according to where resources are avail-<lb />able,� Daniel said, but stone for hunting may not be available where<lb />the deer are. We have evidence they planned for these contingen-<lb />cies.� Whenever they found a good source of stone, the Paleoindians<lb />apparently packed tool kits, pieces of stone suitable for shaping into<lb />Spear points and other tools, that they carried with them whenever<lb />they moved on. Rhyolite from North CarolinaTs Morrow Mountain,<lb />for example, has been found in South Carolina.<lb /><lb />Already, Daniel is beginning to draw conclusions about dispersal<lb />patterns. For example, based on the large number of points found in<lb />the Piedmont, he theorizes that the high quality of stone in the<lb />region may have determined the location of the first settlements. (In<lb />a new book, Daniel argues that Uwharrie Mountain stone outcrops<lb />were the main factor in the settlement of a previously discovered<lb />site. See page 38.) Distribution patterns also will help Daniel narrow<lb />his search for an undisturbed settlement site. If he finds it, he said,<lb />he expects it will be at the fall line of a major river, buried under<lb />several feet of deposits.<lb /><lb />In the meantime, the current study will fill a gap in information<lb />elololeian loo beret lemernienloleielesemlemestanvelliesle-CitospmOliccemic lic mn ill<lb />studies have been completed in Virginia, South Carolina and Georgia.<lb /><lb />Nursing solutions<lb /><lb />Lying in one position without move-<lb />ment for long periods can cause pres-<lb />sure ulcers commonly known as bed<lb />sores. A study led by nursing professor<lb />Dr. Marie E. Pokorny is testing whether<lb />a strict regimen of care will prevent<lb />ulcer development in susceptible car-<lb />diac surgery patients. The nursing staff<lb />at Pitt County Memorial Hospital is<lb />collaborating on the project.<lb /><lb />The effort began in 1996 at the<lb />request of critical-care nurses in the<lb />cardiac surgery units of the hospital.<lb />According to national studies, pres-<lb />sure ulcers occur in about 15 percent<lb />of intensive-care patients. PokornyTs<lb />first task was to analyze which<lb />patients were at risk of developing<lb />ulcers. With bed sores, you think of<lb />people who are immobilized, such as<lb />elderly patients in nursing homes or<lb />people who are paralyzed,� she said.<lb />Among cardiac surgery patients who<lb />developed ulcers, she found a range of<lb />ailments that compromised circulation.<lb />Blood flow nourishes the skin and<lb />keeps it healthy. Most were over 65,�<lb />she said. They had circulatory problems,<lb />over 50 percent had diabetes, and a lot<lb />had lung problems.� Because their sur-<lb />geries required them to lie motionless<lb />for long periods, their risks increased.<lb /><lb /><lb /><lb />Dr. Marie Pokorny, center, and nurse Angela Merritt exam-<lb /><lb />¥ 6<lb /><lb />The next step involves testing<lb />whether stringent use of a well-defined<lb />regimen of care will prevent the devel-<lb />opment of ulcers. Nurses in the car-<lb />diac surgery unit perform a detailed<lb />assessment of a new patientTs skin<lb />condition and recheck the skin twice<lb />a day, carefully documenting their find-<lb />ings each time. At any sign of a prob-<lb />lem, they immediately begin outlined<lb /><lb />interventions, ranging from shifting<lb />the patientsT weight to putting them<lb />on specialty beds. Again, the steps are<lb />carefully documented.<lb /><lb />After she has collected data on 100<lb />patients, Pokorny will evaluate the<lb />results. If the procedures appear to<lb />make a difference, she said, she will try<lb />to get them instituted in other high-<lb />risk settings, such as nursing homes.<lb /><lb />Topsoil gone with the wind, rain<lb /><lb />Challenging conventional wisdom, an ECU study has shown that<lb /><lb />significant amounts of topsoil are being eroded every year from the<lb /><lb />flat farm fields of eastern North Carolina.<lb /><lb />Dr. Paul A. Gares, assistant professor of geography, said wind<lb /><lb />alone carries off several tons of soil per acre. Rainfall washes tons<lb /><lb />more into ponds, streams and field margins.<lb /><lb />Erosion generally has not been considered a major threat in the<lb /><lb />coastal plain, in part because of the flat topography. The sandy soil<lb /><lb />also was thought to allow water to pass through the soil layers<lb /><lb />instead of running off. ECU faculty questioned those assumptions in<lb /><lb />the face of shallow, apparently truncated layers of soil and accumu-<lb /><lb />lated sediment in eastern rivers.<lb /><lb />Working with ECU colleagues, Gares obtained a $142,000 grant<lb /><lb />from the U.S. Department of Agriculture to study erosion on coastal<lb /><lb />plain agricultural lands. Gares has continued the project, now in the<lb /><lb />fourth and final year. He presented his initial findings to the 1998<lb /><lb />International Aeolian Conference in England.<lb /><lb />Four tropical storms in the first year of the project left Gares<lb /><lb />ine Donald Wayne Ross for signs of potential skin problems.<lb /><lb />runoff,� he said. Most sediment is carried off then<lb /><lb />awash in data on water erosion. The crucial part is initiation of<lb /><lb />, before the<lb /><lb />ground is saturated.� Most wind erosion occurs in February and<lb />March, generally dry, windy months when fields lie bare.<lb /><lb />Whether it is removed by water or wind, much of the eroded soil<lb />appears to remain on site, but not all. On a windy day coarser sand<lb />particles roll around close to ground and settle nearby, often forming<lb />little sand dunes at the edges of fields,� Gares said. The rest is dust<lb />and flies higher. ThereTs increasing evidence that the distribution of<lb />dust is worldwide.� Dust settling on the East Coast of the United<lb />States has been tracked back to Africa, he said, and North Carolina<lb />top soil may be settling in England.<lb /><lb />edge<lb /><lb />9<lb /><lb />:<lb />|<lb />)<lb />i<lb />|<lb />:<lb /><lb /><lb /></p>
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        <p>10<lb /><lb />ll er nk C<lb /><lb />At the top of their math class<lb /><lb />Three ECU mathematicians are building an international reputation<lb />for work in the highly specialized field of operator algebra. Drs. John<lb />P. Daughtry, Elias G. Katsoulis and Timothy D. Hudson work to dis-<lb />cover results that other mathematicians and quantum physicists may<lb />one day use.<lb /><lb />In their specialty, they are a first-class group,� said David R.<lb />Larson, professor of mathematics at Texas A&amp;M University and associ-<lb />ate editor of the proceedings of the American Mathematical Society.<lb />With three in the same area, itTs one of the strongest groups in this<lb />field in the country.�<lb /><lb />Generally, their work involves determining properties for objects<lb />that defy intuition. More specifically, it means investigating prob-<lb />lems in HilbertTs space theory, which proposes that space has an<lb />infinite number of dimensions. The field is so arcane that it can<lb />be difficult even for other mathematicians to understand. For lay<lb />people, it is harder still. Pressed to simplify, Katsoulis finally says,<lb />ItTs like calculus, only more sophisticated.�<lb /><lb />Because of their stature in the field, mathematicians from other uni-<lb />versities"including Texas A&amp;M, the University of Lancaster in England<lb />and University of Waterloo in Canada"frequently visit the ECU cam-<lb />pus. Every third year, Daughtry, Katsoulis and Hudson host the N.C.<lb />Conference on Operator Theory, which draws researchers from through-<lb />out the southeastern United States. Katsoulis and Hudson also organized<lb />a special session of the 1996 national meeting of the American<lb />Mathematics Society, one of only 12 special sessions held. Furthermore,<lb />Katsoulis was one of a half-dozen plenary speakers at a 1998 interna-<lb />tional conference sponsored by the North Atlantic Treaty Organization.<lb /><lb />Each of the ECU mathematicians tackles a slightly different aspect<lb />of operator theory. For Texas A&amp;M's Larson, those differences consti-<lb />tute part of their strength. This is a creative group that works well<lb />together, as witnessed by their joint papers,� he said. They also have<lb /><lb />the reputation of working well with researchers at other universities.�<lb /><lb />worth $2.78 million.<lb /><lb />edge<lb /><lb />b<lb /><lb />4 eo<lb /><lb />An office for clinical trials<lb />The School of Medicine opened a clinical<lb /><lb />trials office in 1998 to support researchers<lb /><lb />working with pharmaceutical companies, the<lb />federal government and other organizations<lb />to test new drugs.<lb /><lb />We could see we were doing an increasing<lb />number of trials, and it was apparent that clin-<lb />ical trials would be an increasing part of med-<lb />icine,� said Sam N. Pennington, the School of<lb />MedicineTs associate dean for research and<lb />graduate studies. Our vision was to create a<lb />support facility that aids investigators doing<lb />trials or those who want to do trials.�<lb /><lb />In the 1997-98 fiscal year, ECU investigators conducted 33 clinical trials<lb /><lb />Clinical trials are complex, from the initial contract with the trial sponsor<lb />through the process of enrolling patients, administering the drug(s) and track-<lb />ing the resulting data. Usually, a team of three or four people will assist a<lb />physician-investigator on a project. Pennington said the clinical trials office<lb />will enable investigators to get their projects off the ground faster by recruit-<lb />ing and training staff or supplying temporary assistance. During lulls in some<lb />projects, staff can be shifted to work on others, which will help maintain the<lb />integrity of the team. A team is fairly complex,� Pennington said. Once you<lb />have one in place, you donTt want to let go.�<lb /><lb />Dr. W. James Metzger, head of the schoolTs allergy and immunology sec-<lb />tion, is the director of the clinical trials office.<lb /><lb />See ee I iil il ccna ag it<lb /><lb />oe = eae<lb /><lb />You have to keep believing in your own stuff,� Dr.<lb /><lb />Mark Taggart advises students in music composition.<lb /><lb />A parable for the ~90s<lb /><lb />Dr. Mark Taggart, composer and associate professor<lb /><lb />of music, readily acknowledges that his music is not<lb />intended as ear candy.� After all, art claims a high-<lb />er calling than easy listening. Art gives you insight<lb />you wouldnTt get elsewhere,� he said.<lb /><lb />Parable, a 1997 composition, provides a case in<lb />point. The 40-minute opera commemorates a col-<lb />lege classmate who died of AIDS. At the time he<lb />died, the 1994 political campaign was under way<lb />and with it, there was a hate campaign directed at<lb />gays and liberals,� Taggart said. A lot of them were<lb />quoting scripture, to my mind, to suit their own<lb />purposes. It came to me that what they were saying<lb />was almost word for word what JobTs tormentors<lb />said of him.�<lb /><lb />So TaggartTs opera casts Job as a gay man dying of<lb />AIDS and JobTs Old Testament critics as the likes of<lb />Rush Limbaugh and U.S. Sen. Jesse Helms. For the<lb /><lb />loving, encouraging voice of God, he used the poem To One About<lb /><lb />to Die,� which Walt Whitman wrote for a Civil War soldier.<lb /><lb />The piece was premiered with piano accompaniment at ECU in<lb />February 1997. Taggart completed the orchestral score in the fall of<lb />1998 and hopes to find more audiences. This needs to be heard in<lb /><lb />�?<lb /><lb />this region and in this culture,� he said. It lets them know that<lb />words have an effect, and it may not be the effect you wanted.�<lb />TaggartTs work defies neat categories. It includes a setting of the<lb />Shaker hymn The Humble Heart for symphonic band; a tone poem for<lb />band inspired by the legend of John Henry; Circination, for solo organ;<lb />and Lament and Credo, written for a 12-piece saxophone orchestra.<lb />The sax orchestra has proved to be a favorite vehicle for Taggart,<lb />perhaps because he plays the saxophone himself. He has completed five<lb />movements of an eight-movement symphony for sax orchestra called<lb />only rhythm and.... The pieces have premiered individually, and orches-<lb />tras in such places as Appleton, Wis., and Hattiesburg, Miss., have com-<lb />mitted to playing the first four movements as a single work. Taggart also<lb />will fly to Europe in the summer of 1999 to conduct the South German<lb />Saxophone Orchestra in its performance of the four movements.<lb /><lb />Taggart already has had an opportunity to hear the German band<lb /><lb />perform the cycle he named Vigor. They are a very good, very seri-<lb /><lb />ous group,� he said. But this one movement is supposed to be com-<lb />ical. It has allusions to Mickey Mouse and other cartoon characters,<lb />and they were so dedicated to performing the music accurately that<lb />their seriousness added some unintended comedy.�<lb /><lb />Taggart laments the difficulty in finding venues for modern compo-<lb />sition but does not allow it to affect his work. ITve stopped writing for<lb />other people,� he said. I say to students, youTre never going to become<lb /><lb />popular like Madonna. You have to keep believing in your own stuff.�<lb /></p>
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        <p>Bee ne ne ee es<lb />he<lb />a<lb /><lb />ra:<lb />ab<lb /><lb />RANDOLPH CHITWOOD NEVER FORGETS HIS<lb /><lb />ROOTS AS HE BUILDS AN INTERNATIONAL<lb />REPUTATION AS A CARDIOVASCULAR SURGEON<lb /><lb />iad<lb />SMOOTF<lb />OPLRATIOR<lb /><lb /><lb /><lb /><lb /><lb />room.<lb /><lb />and adapts"<lb /><lb />Dr. Randolph Chitwood adopts<lb />new technologies for the operating<lb /><lb />IN HIS YOUTH, RANNY CHITWOOD CAUSED HIS PARENTS FEW HEADACHES, EXCEPT WHEN<lb />IT CAME TO HOMEWORK. HE PREFERRED HOBBIES~-PHOTOGRAPHY AND HAM RADIO-""TO STUDIES.<lb /><lb />DEOPLE PROBABLY DIDNTT THINK |'D AMOUNT TO MUCH,� HE SAYS, FLASHING A QUICK GRIN.<lb /><lb />By most standards, though, Dr. Randolph W. Chitwood Jr. has turned out pretty well. At 53, he chairs<lb />the Department of Surgery of the ECU School of Medicine and Pitt County Memorial Hospital, where he<lb />built the cardiovascular surgery program from scratch. He also is an international pioneer in both mini-<lb /><lb />mally invasive heart surgery and the use of robotics in heart surgery, often flying to Europe or Japan as<lb /><lb />well as around the United States to teach his surgical techniques.<lb /><lb />With so many duties, perhaps it is no wonder that Chitwood fidgets when forced to sit and talk about<lb />himself. He crosses his legs, flips his tie, recrosses the legs, checks his watch, flips the tie again. Later,<lb />ChitwoodTs patients will describe an easygoing charmer who answers questions without the least<lb />sign of hurry. At this moment, however, he is impatient, eager to move on to the patients and papers<lb /><lb />that interest him more than the retelling of his lifeTs story. How long is this going to take?� he asks. <lb /><lb /></p>
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        <p>When my friends meet him, the first thing<lb />they say is, ~HeTs intense.T He may be a<lb />little intimidating when you first meet him.�<lb /><lb />""ANNE CHITWOOD ON HER FATHER<lb /><lb />Intense may be the word most often used<lb />to describe Chitwood. The trait served him well<lb />when, two years out of Hampden-Sydney College,<lb />he decided to follow family tradition and go into<lb />medicine. He quit his job as a DuPont chemist and<lb />spent a year taking additional courses required by<lb />the University of Virginia medical school. He grad-<lb />uated from medical school in three years and<lb />entered DukeTs rigorous 10-year residency pro-<lb />gram for heart surgeons.<lb /><lb />His arrival at Duke, he says, gave him his first<lb />taste of big-time competition. He recalls looking<lb />around in the first meeting of all new residents. I<lb />leaned over to olT Erle Austin, who used to be my<lb />associate here, and | said, ~WhereTd you go to<lb />school?T and he said Dartmouth and Harvard. Next<lb />guy, Berkeley and Harvard. Third guy, Harvard.<lb />The guy behind me said West Virginia. I said,<lb />~We're going to be friends.T�<lb /><lb />He had almost a year to go in his residency<lb />when he came to the attention of Dr. Walter J.<lb />Pories, then-chair of ECUTs surgery department.<lb />Pories was looking for someone to start a heart<lb />surgery program in Greenville. ChitwoodTs mentor<lb />at Duke, Dr. David Sabiston Jr., spoke highly of his<lb />protege, and Pories invited the young doctor for<lb />an interview.<lb /><lb />Chitwood was impressed by the details Pories<lb />had amassed to support plans for a heart program<lb /><lb />eaeanetver<lb /><lb />He will drop everything in a New York minute if his family<lb /><lb />needs him,� Tamara Chitwood says of her husband, Ranny.<lb /><lb />driving an old VW"one car had died,<lb />the other was dying,� he says. So I<lb />called my wife and she said, ~Oh,<lb />thatTs good. You can look at that job.T�<lb /><lb />For the next nine months, Chitwood<lb />worked in Durham weekdays and drove<lb />to Greenville on weekends, hiring<lb />staff, buying equipment and laying the<lb />foundation for a research program. On<lb />July 10, 1984, within a week of arriv-<lb />ing in Greenville full time, Chitwood<lb />performed eastern North CarolinaTs first open-heart<lb />surgery, a coronary bypass operation. He operated<lb />300 more times that first year, spending the night in<lb />the hospital to watch his patient after every opera-<lb />tion. Only then did he begin to hire other surgeons.<lb />The cardiovascular surgery team now performs more<lb />than 1,200 operations annually.<lb /><lb />After five years, a frustrated Chitwood left for<lb />a job in Kentucky. I wanted a heart center here<lb /><lb />�<lb /><lb />and couldnTt get it,� he says. I see now it was<lb />well in advance of the ability of the institution to<lb />respond, but when youTre going at this speed, you<lb /><lb />just expect the next level, and you canTt always<lb /><lb />a<lb /><lb />$$$ $$$ "_"""" a RR ART aT a ae oe a<lb /><lb />convince people.� KentuckyTs bluegrass turned out<lb />to be greener from a distance than close up. Two<lb />years later, Chitwood was back in Greenville,<lb />negotiating for"and getting"a multidisciplinary<lb />heart center that pulls diagnostics, therapeutics,<lb />surgery and rehabilitation under one roof.<lb /><lb />He was a very strong-willed child. HeTs still<lb /><lb />strong-willed. | think he likes to excel and<lb /><lb />wants to be at the top of his field.�<lb />"RUTH ANN CHITWOOD TALKING ABOUT HER SON<lb /><lb />One goal accomplished, Chitwood needed anoth-<lb />er. I had been piddling for a long time with the idea<lb />of how to operate on a totally closed chest,� he says.<lb />Then French surgeon Alain Carpentier announced<lb /><lb />that he had performed the first endoscopic mitral<lb />valve operation. (The mitral valve sits between the<lb /><lb />upper and lower chambers on the left side of the<lb />heart.) Instead of cutting the chest open and spread-<lb />ing the ribs, Carpentier had worked through a rela-<lb />tively small hole in the ribs. A tiny camera inserted<lb /><lb /><lb /><lb />wwe ys te. :<lb />ee<lb /><lb />4 :<lb /><lb />SP Make oor Fels Ju<lb />~Ay<lb /><lb />Gi KA<lb /><lb />~ ay a a \ ANG<lb /><lb />NX<lb /><lb />. a \ ee<lb /><lb />into the incision projected images on a video screen<lb />to guide the surgeonTs hands. For the patient, the<lb />result was less pain and faster recovery. Chitwood<lb />met with Carpentier and set out to develop his own<lb />endoscopic mitral valve operation.<lb /><lb />Step one was to find a way to stop the beating<lb />heart long enough for the surgery but without the<lb />necessity of putting the patient on a heart-lung<lb />machine. A U.S. surgical equipment company was<lb />testing a balloon device that stopped the heart<lb />by shutting off blood flow through the aorta.<lb />Chitwood asked for one of the tools but was<lb />turned down. Only the Stanford University med-<lb />ical center could use the device, the company said.<lb /><lb />So I sat in the cafeteria and sketched out a<lb />design for a clamp that would occlude the aorta<lb />and that would take their $5,000 balloon out of<lb />action,� he says. ChitwoodTs $1,000 clamp, unlike<lb />the balloon, is reusable.<lb /><lb />Chitwood performed the first minimally invasive<lb />mitral valve operation in North America on May 24,<lb />1996. He then designed more instruments, giving<lb />them long handles to make it easier to work through<lb />a small incision. In 1998 he added a new twist. For<lb />his first endoscopic sur-<lb />gery, a human assistant<lb />held the camera, moving it<lb />at ChitwoodTs direction.<lb /><lb />Today, a voice-activated<lb />robot controls the camera.<lb /><lb />The vision is to devel-<lb />op a totally endoscopic<lb />operation so the next gen-<lb />eration of surgeons with<lb />3D cameras and robotic<lb />devices can do this with<lb />facility,� he says.<lb /><lb />HeTs not a workaholic. He just loves what he<lb />does. ItTs hard. ItTs demanding, but itTs not<lb />labor. And heTs great at it. ITve mentioned his<lb />name here, and people recognize who he is.<lb />He has an international reputation.�<lb /><lb />""ROBERT M. JOHNSON, LECTURER IN ENTREPRE-<lb />NEURSHIP AT THE LONDON BUSINESS SCHOOL<lb />AND CHITWOODTS FRIEND SINCE CHILDHOOD<lb /><lb />and even more impressed by what Pories offered" Hard work and medicine were bred into<lb /><lb />Chitwood. His sister is a doctor. So were his father,<lb />grandfather and uncle. His mother and grandmoth-<lb />er were nurses. Saturdays usually took him to the <lb /><lb />a decent salary, a full professorship and chief of<lb /><lb />cardiac surgery, all straight out of training. I was<lb /><lb />: "Chitwood and his staff prepare a patient for surgery one of 1,200<lb />heart operations that will be performed this year at Pitt County<lb />Memorial Hospital. Above right, surgical clamps are sterilized and<lb />ready for use. |<lb /><lb />edge 15<lb /><lb />14 edge<lb /><lb /></p>
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          <lb />with his cardiologist produced a verdict of perfect.�<lb />Even before the check-up, the cardiologist had a<lb />good idea of how his patient was doing. From the<lb />moment I met [Chitwood], he started correspon-<lb />ding with my cardiologist,� Ratchford says. He<lb /><lb />keeps the other guys and girls totally informed.�<lb />Good communication with referring doctors has<lb /><lb /><lb /><lb />Chitwood Clinic in his hometown of Wytheville,<lb />Va., where he folded gauze and blew up gloves to<lb />test for holes. Often, he accompanied his father on<lb />house calls, opening and closing farm gates along<lb /><lb />Chitwood indulges his passion for antique medical instruments and<lb />books and for all things related to fellow Virginian Thomas Jefferson.<lb /><lb />the way.<lb />Chitwood also had watched his father work late<lb /><lb />into the night and on weekends. He knew long<lb />hours came with the territory when he entered<lb />medicine. For eight of the 10 years of his residency, with family. Regrets come with the territory, he<lb />he spent every other night on call at the hospital. says. He wishes that he had called his parents more<lb />At that time, I considered that if you werenTt on often, that he had spent more time with his wife,<lb />call a lot, you were missing stuff,� he says. Tamara, and children, Anne, a University of Virginia<lb /><lb />Harrizene Keyes, his administrative assistant, graduate working in the Washington, D.C., office<lb />suggests that part of the drive comes from the of U.S. Senator Jesse Helms, and Randolph Ill, a<lb />undivided attention he demands for his patients. A | geology major at the University of Montana. The<lb />few years back, the surgeon himself underwent decision that family could not always come first<lb /><lb />The greater cost of his schedule has been time Epen. 8 Sey (0 CORWEORS Senna Seer . One<lb />behind excellence in quality. These guys are going<lb />down to Rotary Club from their office to eat the<lb />chicken and sing the song at lunch and then they<lb />run into Uncle Louie down there and he says,<lb />~HowTs Aunt Sally?T ItTs pretty impressive for him<lb />to say, ~Oh yeah, Dr. Chitwood called me right<lb /><lb />out of the operating room. SheTs in the recovery<lb />room now.T It makes it look like heTs on top of<lb />things. I learned that from my old man.�<lb /><lb />|<lb />|<lb /><lb />|<lb /><lb />|<lb />|<lb /><lb />quadruple coronary bypass surgery. Coming out of | was made when he entered medical school, he says.<lb /><lb />the ICU, he was still worried about the operation<lb />of the office,� Keyes says. When he went home,<lb />he was working there. He even came by the office to<lb />see what needed to be done and check on patients.�<lb /><lb />Chitwood confirms that coronary disease, which<lb />he attributes to genetics, has not slowed him<lb />down. ITm working twice as hard as I was before<lb />surgery,� he says. What gives you coronary dis-<lb />ease, as far as stress is concerned, is not operating<lb />on the human heart. ItTs what most managers deal<lb />with"personnel, deadlines, people calling for<lb />manuscript review, overcommitment, the anger<lb />associated with that, the inability to get things<lb />done. But the stress of operating on a high-risk<lb />patient carries you like the guy coming down the<lb />biggest ski slope. YouTre trained to do it. It carries<lb />you to technical heights. My heart rate in the<lb /><lb />operating room is lower than it is right now.�<lb /><lb />His family is more generous. They say he made<lb /><lb />time for the important events, trick-or-treating on<lb /><lb />Halloween, Honor Society induction, the occa-<lb /><lb />sional college football weekend. He will drop<lb /><lb />everything in a New York minute if his family<lb />needs him,� Tammy Chitwood says. In ~95, | was<lb />diagnosed with HodgkinTs disease. He was right<lb />there with me. When my father became ill, he<lb />dropped everything and was there with him when<lb /><lb />he drew his last breath.�<lb /><lb />When | met him, | wanted him to do it. He<lb />didnTt make us any great promises, but if<lb />somebodyTs going to cut your chest open, itTs<lb />important that you have a good gut feeling<lb />about that person. ItTs not like somebody doing<lb /><lb />your taxes or something that<lb /><lb />can be fixed.�<lb /><lb />"TERRY RATCHFORD, PATIENT<lb /><lb />My heart rate is lower in the operating room than it<lb /><lb />is right now,� Chitwood says in an interview.<lb /><lb />Terry Ratchford, an insurance<lb />agent from Gastonia, got bad news<lb />from his cardiologist in the fall<lb />of 1997. He needed surgery to<lb />correct a defective mitral valve.<lb />After conferring with surgeons in<lb />Charlotte, Ratchford had resigned<lb />himself to open-heart surgery and<lb />valve replacement, but relatives<lb />and friends had heard about a<lb />doctor in Greenville who had<lb />developed a procedure that didnTt<lb />require opening up the chest. At his<lb />motherTs insistence, he drove across<lb />the state to meet Ranny Chitwood.<lb /><lb />Looking back, Ratchford calls his a storybook<lb />case. Chitwood was able to repair, rather than<lb />replace, the defective valve using minimally inva-<lb />sive techniques, and the surgeon made him feel<lb />comfortable throughout.<lb /><lb />He came in that first day and was totally pro-<lb />fessional but very warm,� Ratchford says. He has<lb />tremendous bedside manner. He was charming,<lb />very accommodating and not at all in a hurry. He<lb />makes sure you get all your questions answered.<lb />When he looks you in the eye, you trust him.�<lb /><lb />Ratchford was able to leave the hospital after<lb />only three and a half days. Back home, a check-up<lb /><lb />The old man� crops up frequently in his conver-<lb />sation. A bust of Thomas Jefferson sits in ChitwoodTs<lb />hospital office. In his new home, his wife is hav-<lb />ing the parquet floor of Monticello reproduced in<lb />the suite of rooms that will house ChitwoodTs<lb />study, darkroom, ham radio equipment and a<lb />library for a collection of antique medical books,<lb />instruments and his grandfatherTs medical saddle<lb />bags. It is obvious that Chitwood admires Jefferson<lb />and the many inventors and surgeons he quotes<lb />with ease. He stops short, however, of calling them<lb />heroes. Instead, he recalls his father.<lb /><lb />You have to be careful with heroes,� he says.<lb />You pick out a hero and have to remember<lb />theyTre just people. They have problems, too. But<lb />sure, you have heroes. Your parents are heroes.<lb />Your fatherTs a lot smarter 30 years hence. He's<lb />dead now, and you canTt tell him. Some of those<lb />little things, though"you pick up on the sub-<lb />tleties later on, and you really wish he was around<lb />so you could ask him what he meant.�<lb /><lb />ChitwoodTs voice trails off. Memories of his true<lb />hero, the one he wishes he had called more often,<lb />fill the silence. Miles away, from an office in the<lb />nationTs capital, another Chitwood has found a<lb />hero, too.<lb /><lb />Sometimes | think heTs a little hard on him-<lb />self,� daughter Anne says. ITve met a lot of people.<lb />They say, ~YouTre Ranny ChitwoodTs daughter. He<lb />operated on my fatherT or ~He operated on my<lb />uncle. What would eastern North Carolina<lb />do without him?T I just swell with pride.�<lb /><lb />=<lb /><lb /><lb /><lb />ft<lb /><lb />edge<lb /><lb />17<lb /><lb />NN<lb />ee<lb />a """"<lb /></p>
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          <lb />English professor Ronald Hoag<lb />explores the many v4<lb /><lb />facets of the<lb /><lb />Thoreau legacy<lb /><lb />wre<lb />oe<lb /><lb />TY<lb />ee TA<lb /><lb />s §,<lb />Fs G<lb />he "~<lb /><lb />a a<lb /><lb />Today he is a leading scholar of the works of the pondTs most famous visitor, Henry David Thoreau.<lb />Hoag serves as the treasurer of the Thoreau Society, an organization dedicated to studying Thoreau and<lb />his work, and he edits The Concord Saunterer, the societyTs annual journal. He also is an adviser to the<lb />Walden Woods Project, which seeks to preserve the land most closely associated with Thoreau, and was<lb />a contributor to The Cambridge Companion to Henry David Thoreau. Although Thoreau lived from 1817<lb />to 1861, his work continues to resonate worldwide. In spring 1998, President and Mrs. Clinton joined<lb />the Thoreau Society and Walden Woods Project in dedicating the new Thoreau Institute for research and<lb /><lb />education. Recently, edge talked with Hoag, a professor of English, about ThoreauTs legacy.<lb /><lb />Dr. Ronald Hoag has made Henry David Thoreau<lb />the focus of his career. He studies ThoreauTs<lb /><lb />life and works"and sometimes retraces his steps.<lb /><lb />edge: What accounts for ThoreauTs status as an<lb />American icon?<lb /><lb />Hoa: There are three areas of ThoreauTs life and<lb />work that are particularly important. One is as a<lb />transcendentalist. Another is as a political thinker,<lb />and the third area, which is the subject of most of<lb />the new books and articles today, has to do with<lb />Thoreau as a founder of the science of ecology.<lb /><lb />edge: LetTs explore those one at a time, starting with<lb />transcendentalism. What was ThoreauTs major con-<lb />tribution there?<lb /><lb />Hoac: Ralph Waldo Emerson, his mentor, was the<lb />principal formulator of the theory of transcenden-<lb />talism as it gets translated into American culture<lb />from various other sources. Basically, transcen-<lb />dentalism assumes that there is a relationship<lb />between the physical and the spiritual and that a<lb />person can find spiritual significance by engaging<lb />with physical nature in a conscious, receptive way.<lb />Thoreau was a real pragmatist and put everything<lb />to the test. He read EmersonTs statement of tran-<lb />scendentalism, published in a pamphlet called<lb />Nature, and wanted to see if these ideas would hold<lb />up. ThatTs basically why he went out to Walden<lb />Pond for a couple of years"to see if, away from<lb />the distractions of the community"the transcen-<lb />dental approach will work. ItTs his experiment in<lb />transcendental living, and in the end, he pro-<lb /><lb />nounces it a success. He says, yes, youTre never<lb />going to get to the bottom of the universe, but<lb />you'll get deeper and deeper into the meaning of<lb />it until finally, (the fact) that itTs unfathomable<lb />becomes a good� because it suggests just how<lb />much meaning is there, an infinite amount. It<lb />gives you a reason to get up the next day and go<lb />look for some more. So his contribution is that of<lb />a successful practitioner of transcendentalism.<lb /><lb />edge: Those of us who came of age during the T60s<lb />and T70s think of Thoreau in more political terms.<lb />WhatTs the source of this influence?<lb /><lb />Hoaa: One of his legacies is the rationale for civil<lb />disobedience. He went to jail briefly rather than<lb />pay his poll tax because he saw the poll tax as<lb />supporting slavery. (In the essay On Civil Disobe-<lb />dience�) Thoreau asks why, even in a democracy, <lb /><lb />Walden Pond, where<lb />/alelact-|0mumerlaal-te mumel ty<lb />his experiment in tran<lb />osiare (clad | Mihailo pm ele) 4<lb />today much as it did<lb /><lb />Tam dalce Bcadatma lalallava<lb /><lb /></p>
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          <lb />The Concord Saunterer,<lb /><lb />which<lb /><lb />Hoag edits, carries articles by<lb /><lb />established scholars and _ signifi-<lb /><lb />cant newcomers.<lb /><lb />a simple majority vote should determine what is<lb />right. You could have a majority of people who<lb />happen to be in the wrong. So, he says, con-<lb />science should be the final arbiter when it comes<lb />to making moral decisions, and any man more<lb />right than his neighbors constitutes a majority of<lb />one. And, he says that we should not just wait for<lb />unjust laws to change or obey them while work-<lb />ing to change them, but if they are truly unjust,<lb />then they are immoral and we should go ahead<lb />and break them. That plays out in the 20th centu-<lb />ry in particular with Mohandes Gandhi in India<lb />and also with Martin Luther King Jr. Thoreau is<lb />one of the foundations they both built on, and<lb />his ideas became very popular during the 1960s.<lb /><lb />edge: We know Thoreau went off into the woods to do<lb />his thinking, but youTve suggested that his contribu-<lb />tions to science extend beyond that of nature lover.<lb /><lb />HoaG: ThereTs been a whole spate of new scholar-<lb />ship on this dimension of ThoreauTs work. It<lb />began in 1993 when Bradley Dean, who used to<lb />be a colleague here at ECU, edited and published<lb />Faith in a Seed, a book that presented a previously<lb />unpublished manuscript by Thoreau called The<lb /><lb />Dispersion of Seeds.� This book shows Thoreau<lb />was really ahead of the scientific establishment of<lb />his time. The prevailing assumption of the day was<lb />that some plants just spring up by spontaneous<lb />generation or what was called special creation.�<lb />This was the opinion even of Louis Agassiz of<lb />Harvard, the top American naturalist. Thoreau,<lb />who had been doing lots and lots of field work,<lb />concluded no, it isnTt spontaneous generation.<lb />Instead, you have this whole mechanism in<lb />nature that disperses seed. ItTs done by wind, by<lb />animals. He uses the example of a city person<lb />who goes for an outing in the countryside and<lb />takes a walk and comes back carrying sticky burrs<lb />on his clothes, and those sticky burrs transplant<lb />seeds to wherever that person happens to get off<lb />the train at the end of the day.<lb /><lb />ThoreauTs conclusion was that nature is not a<lb />hodgepodge of isolated phenomena. ItTs a web, and<lb />if you touch the web at one point, youTd better be<lb />careful because itTs going to have an impact some-<lb />where else. That, of,eourse, is the whole notion of<lb />ecology and ecosystems, words that didnTt exist<lb />in his day. Yet you.gan take page after page of his<lb />writing, especially his later writing, and put them<lb />appropriately» into an ecology textbook today.<lb />ThatTs the reason heTs now considered a principal<lb />founder of the science of ecology.<lb /><lb />edge: These three areas of. contribution are very<lb />different from each other. Is there a common denom-<lb />inator to ThoreauTs work?<lb /><lb />Hoaac: In Walden, he says one of the conclusions<lb />he draws from his experience is that the universe<lb />is wider than our views Of it. He tries to get beyond<lb />our narrow views by consciously going beyond<lb />boundaries, in everything. lf you look at the tran-<lb />scendental area, he is going beyond the physical<lb />to see the spiritual. If you look at the political<lb />area, he is going beyond that narrow definition of<lb />right that is inscribed into the laws and insisting<lb />on a wider, more moral definition derived from<lb />conscience and consciousness and God.<lb /><lb />Thoreau was a big advocate of what he called<lb />the wild.� In one of his essays, he states, In wild-<lb />ness is the,preservation of the world,� which the<lb />Sierra Club often quotes. | think for Thoreau, wild-<lb />ness is just another word for that idea of going<lb />beyond bounds. When he made a trip that he dis-<lb />cusses in the first of three essays in The Maine<lb />Woods, he talks about leaving civilization and<lb />climbing a fence and then going into the woods.<lb />When you read it, it sounds like a simple statement<lb />of what he did. But itTs that act of going OVER the<lb />fence, of going BEYOND bounds thatTs in his think-<lb />ing, in his seeing, in his speech, in everything.<lb /><lb />edge: YouTve made a particular study of those essays,<lb />havenTt you?<lb /><lb />Hoac: One of the two best things ITve done as a<lb />scholar is an article I wrote on The Maine Woods<lb />(The Mark on the Wilderness: ThoreauTs Contact<lb />with Ktaadn,� published in Texas Studies in Literature<lb />and Language, spring 1982.) For a lot of people, i<lb />changed the thinking on some key passages. He said<lb />at the beginning of the essay Ktaadn� that here in<lb />the wilderness, one must confront the true source<lb /><lb />_<lb /><lb />THOREAU WAS A _ BIG ADVOCATE<lb /><lb />OF WHAT HE CALLED ~THE WILD.T.<lb />| THINK FOR THOREAU, WILDNESS<lb /><lb />IS JUST ANOTHER WORD FOR THAT<lb /><lb />IDEA OF GOING BEYOND BOUNDS.<lb /><lb />rn<lb /><lb />of evil. At the end of his account, heTs on the top of<lb />this bald mountain, Katahdin (modern spelling).<lb />ItTs windy and off-putting and heTs obviously trem-<lb />bling and feeling overwhelmed. Other commenta-<lb />tors had said well, putting two and two together,<lb />he must now think that nature is evil instead of<lb />being spiritual and something youTd want to tap<lb />into. Someone refers to this key passage as a chink<lb />in his transcendental armor.<lb /><lb />The article I wrote said no, youTve got the lan-<lb />guage right but youTre making the wrong inter-<lb />pretation. What Thoreau was doing here in<lb />Ktaadn� is describing his experience of the sub-<lb />lime. The whole tradition of the sublime in<lb />nature involves things like the Alps or Niagara<lb />Falls or the Grand Canyon or the ocean in a<lb />storm. These are natural phenomena that make<lb />you feel bowled over, but what you're experienc-<lb />ing is the power of nature. Thoreau says that<lb />rather than making fear the controlling principle<lb />of the sublime experience, he sees that principle<lb />as reverence and wonder and awe. This is why<lb />Katahdin becomes his holy mountain and why he<lb />writes about it positively from then on. The evil<lb /><lb />he writes of confronting is actually mankind,<lb />including to some extent Thoreau himself,<lb />because man insists on dominating the wilder-<lb /><lb />ness, confining in one way or another what was<lb />meant to be wild.<lb /><lb />edge: You said this was one of your two most impor-<lb />tant works. WhatTs the other?<lb /><lb />Hoac: The other I did with Brad Dean. It was a book-<lb />length examination of ThoreauTs career as a lectur-<lb />er. Thoreau had an active, long career as a lecturer,<lb />and itTs significant because he would write his<lb />observations in his journal, then take things from<lb />various journal entries and work them into lec-<lb />tures. From the lectures they would become essays,<lb />and then finally some of them would become<lb />books. But no one had fully examined his career<lb /><lb />as a lecturer. We put together the fullest account<lb /><lb />thatTs been published. |<lb />For each lecture, we give a narrative of the<lb /><lb />event, a section that deals with advertisements<lb />and reviews, and a description of the lecture itself.<lb />In some cases, we found accounts in newspapers<lb />where you would swear the newspaper reporter<lb />had a tape recorder because heTs got seemingly<lb />verbatim what the whole lecture would be. You<lb />can take that and put it up against the published<lb />essay Or whatever came as a result, and you can<lb />see ThoreauTs thinking at work as he embellished<lb />some things that got a good response or took out<lb />others that went over like a lead balloon. You can<lb />see him, the writer, at work. Our study was pub-<lb />lished im the Studies in the American Renaissance<lb />series from the University Press of Virginia divid-<lb />ed into lectures before Walden and after Walden.<lb /><lb />edge: The Concord Saunterer, which you edit, goes<lb />to all 1,800 members of the Thoreau Society.and is<lb />also sold to the public. These readers include untver-<lb />sity scholars from many different fields and a major-<lb />ity of members and others who aren't academicians<lb />at all. How do you appeal to such a broad audience?<lb />Hoac: I try to get as many articles of different<lb />kinds in the journal as | can. Thoreau wore many<lb />hats, and Thoreauvians collectively wear many<lb />hats, too. There are lots of different areas of interest<lb />in him. I canTt appeal to them all the time, but I can<lb />be aware that theyTre out there and take advantage<lb />of opportunities to present something that address-<lb />es a constituency that doesnTt often get attention.<lb />ITm also not much into recent trends in critical<lb />theory that require a translator to understand. The<lb />articles we publish are sophisticated"we publish<lb />articles by some of the most established scholars as<lb />well as by significant newcomers"but if a reader<lb />comprehends English and puts in a little time and<lb />thought, thereTs nothing that we publish<lb /><lb />that canTt be understood.<lb /><lb /></p>
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        <p>RESEARCH YIELDS STARTLING CLUES TO THE COMPLEXCONNECTIONS BETWEEN TWO DEMDLY CONDITIONS<lb />\<lb /><lb />besity<lb /><lb /><lb /><lb />Most patients are so surprised that someone will listen<lb /><lb />and agree they have a bad disease,� says Dr. Walter Pories,<lb /><lb />shown here with Glenda Williams.<lb /><lb />A PAMLICO COUNTY WOMAN<lb />sits quietly as she waits to see her<lb />doctor. At age 32, she weighs 419<lb />pounds and suffers from diabetes,<lb />high blood pressure and a host of<lb />other ailments.<lb /><lb />She knows her health risks"<lb />her father weighed 500 pounds<lb />and died from complications of<lb />diabetes"and she has decided to<lb />move beyond the diets and med-<lb />ications that have accomplished<lb />so little: Her hopes now rest<lb />in the staff of the ECU School<lb />of Medicine.<lb /><lb />Her choice is well-founded.<lb />Over the past 15 years, a multidis-<lb />ciplinary research team here has<lb />been redefining medical under-<lb />standing of obesity and diabetes.<lb />[It is led by Dr. Walter Pories,<lb />former chair of the Department<lb />of Surgery, and biochemist Dr.<lb />Lynis Dohm.<lb /><lb />Writing in such prestigious<lb />journals as the Annals of Surgery,<lb />the ECU team has shown that<lb /><lb />Ni: oe: oe ee oe<lb /><lb />when morbidly obese, diabetic<lb />patients undergo a special opera-<lb />tion to bypass much of the stom-<lb />ach, their diabetes lessens, often<lb />disappearing spontaneously. This<lb />finding has led the researchers to<lb />suggest that non-insulin-depend-<lb />ent diabetes stems from hormon-<lb />al signals originating in the lower<lb />stomach or upper small intestine.<lb />They also have shown that as<lb />these surgical patients lose weight<lb />and as control of their diabetes<lb />improves, other measures of oyert-<lb />all health improve disproportion-<lb />ately, and they live longer than<lb />similar patients who do not<lb />undergo surgery.<lb /><lb />More discoveries may be on the<lb />horizon. As the scientists continue<lb />to refine their understanding of<lb />the mechanism of diabetes, they<lb />are opening new explorations into<lb />how the body burns and stores<lb />fat. And, in a new partnership<lb />with the pharmaceutical giant Eli<lb />Lilly, they are seeking out the<lb />genes responsible for both dia-<lb />betes and obesity.<lb /><lb />The team is a rarity in medical<lb />science. WhatTs unique here is<lb />that we have basic scientists and<lb />people who are surgeons working<lb />together,� Dohm said. ItTs not<lb />often you get this kind of collabo-<lb /><lb />\<lb />\<lb />+<lb /><lb />\<lb />\<lb /><lb />ration.� In addition to Pories and<lb />Dohm, the core research group<lb />includes seven lead investigators:<lb />in surgery, Drs. Paul Gunningham<lb />and Kenneth MacDgnald; in the<lb />medical schoolTs basic science<lb />division, Drs. Hisham Barakat and<lb />Madhur Sinha; and in the Human<lb />Performance Laboratory, Drs. Joe<lb />Houmard, Robert Hickner and<lb />Ronald Cortfight. The collabora-<lb />tion has developed out of an equal-<lb />ly unustial set of circumstances.<lb /><lb />4n 1977, when we started (the<lb />fnedical school) here at ECU, we<lb />recognized that obesity was a<lb />major problem in eastern North<lb />Carolina and decided to make it a<lb />focus of our work,� Pories said.<lb />Obesity is closely associated with<lb />numerous health problems, includ-<lb />ing diabetes, heart disease, high<lb />blood pressure, degenerative joint<lb />disease and some cancers.<lb /><lb />Morbid obesity"generally de-<lb />fined as 100 pounds or more over<lb />a personTs ideal weight"carries the<lb />most serious risks, but also has<lb />proved most difficult to treat.<lb />Once the human body has reached<lb />a set point, it vigorously defends<lb />itself against weight reduction.<lb />Cut back on calories, and metabo-<lb />lism slows. Succeed in losing<lb />weight, and the body puts it back<lb />on at the earliest opportunity.<lb />Since exercise revs up the metab-<lb />olism, an average person may<lb /><lb />shed excess pounds through a<lb />combination of diet and exercise.<lb />This approach may be less than<lb />realistic for the morbidly obese,<lb />however. To tell someone whose<lb />weight is 400 pounds to walk four<lb />miles a day is insane,� Pories said.<lb /><lb />He sought another approach"<lb />surgery. By reducing the size of<lb />the stomach, he also would dras-<lb />tically restrict the number of calo-<lb />ries a patient could consume.<lb />Weight loss should follow.<lb /><lb />He tried several operations<lb />described in medical literature.<lb />When none proved optimal, he<lb />began making his own revisions.<lb />After 200 surgeries, he had devel-<lb />oped what has become known<lb />worldwide as the Greenville Gastric<lb />Bypass. This operation divides the<lb />stomach so that food can reach<lb />only a small pouch at the top.<lb />From there, it empties into a<lb />shortened section of intestine.<lb />This both limits the amount of<lb />food someone can eat and speeds<lb />its passage, reducing absorption. <lb /><lb />Dr. Lynis DohmTs work with mice and exercise is<lb /><lb />key to understanding cellular factors in diabetes.<lb /><lb /></p>
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          <lb />From the start, results with the bypass were<lb />remarkable. Most patients lost more than 100<lb />pounds within two years, dropping from an aver-<lb />age of 314 pounds to 206. Equally remarkable,<lb />most of the weight stayed off.<lb /><lb />Pories noticed something else. When he oper-<lb />ated on his first diabetic patient, the diabetes dis-<lb />appeared even before weight loss had occurred.<lb />At first, | thought we hadnTt done a good job of<lb />diagnosing the diabetes,� he said. Then I saw it<lb />happen several more times.�<lb /><lb />The National Institutes of Health estimates that 16 million Americans have dia-<lb /><lb />betes mellitus, a serious disease that may lead to such complications as blind-<lb /><lb />ness, kidney failure, coronary artery disease and nerve damage. It costs the<lb /><lb />United States approximately $100 billion every year, about half of that in direct<lb /><lb />medical expenses.<lb /><lb />Although there are different forms of diabetes, in all cases it affects metabo-<lb /><lb />hina pam dalam elele hae: pel Mmcelualiare mcolerem ial com ivi M Ralcmelele)vmelic-) cmanlesimeleremele\ iia)<lb /><lb />into a simple sugar called glucose, its main source of fuel. To make use of that<lb /><lb />fuel, it also needs insulin, a hormone produced by the pancreas.<lb /><lb />The condition known as insulin-dependent diabetes occurs when the pancreas<lb /><lb />cannot make insulin. As a result, the body is deprived of fuel, and unhealthy<lb /><lb />CZs Kate) Me | Ureenvom olel ie mel em amealcme)(elerem jer r-lasmal Ralhe-(eq@ele(a QM (elm-lelele)l aoe ere cal<lb /><lb />of all diabetes. Most often, insulin-dependent diabetes is diagnosed in children<lb /><lb />role elelare melelelle em lect lepalcial@iiaraiece(onmacelllr-lmial(cedlelar me) Mmiarieliiam-laeme-liiUl maces<lb /><lb />TiFelelelame)mcaicme liam<lb /><lb />Non-insulin-dependent diabetes accounts for 90 to 95 percent of diabetes<lb /><lb />mellitus in the United States. It occurs mostly in adults of middle-age or older<lb /><lb />and in people who are overweight. In this condition, the pancreas produces<lb /><lb />Takieliiapen ele) Gn dalciaclitwr-lecielar-|e)(cm com anl-] comcliici@ Gh Ucmhiome) ml Our ma@elalellelelam dale\i ami:<lb /><lb />insulin resistance. A majority of people who are overweight have some degree of<lb /><lb />insulin resistance, but only a portion develop diabetes. Diabetes is diagnosed<lb /><lb />when blood glucose reaches an unhealthy level. Non-insulin-dependent diabetes<lb /><lb />often may be treated with diet and exercise alone, but oral medication is some-<lb /><lb />times needed.<lb /><lb />Weight and diet affect diabetes in ways that are still being studied. Both body<lb /><lb />fat and fat circulating in the bloodstream appear to interfere with the ability of<lb /><lb />cells to use insulin. The pancreas compensates by producing additional insulin,<lb /><lb />but as people put on more and more weight, the pancreas may be unable to<lb /><lb />keep up with the added demand. Sometimes, the strain may be so great that the<lb /><lb />pancreas wears out, and insulin-dependent diabetes results. A proper diet<lb /><lb />more (U(@ ch Gal omr-lanleleial@elMmiarielipmalce(em em eslialale maalcme[palele lal mre) me lie(@e stom lale mre)<lb /><lb />circulating in the bloodstream. Similarly, weight loss reduces the territory the<lb /><lb />Takieliiamanieniaae) ice<lb /><lb />Exercise has been shown to increase the cellsT ability to use insulin as much<lb /><lb />as twofold. How this occurs is under investigation. Exercise also aids weight<lb /><lb />gore (Ure dela par MiUiadalcim@ elclalcilim@lama@elslace)iiiavemelrleliccme<lb /><lb />edge<lb /><lb />Perplexed, he approached the scientists who<lb />study the chemical and molecular workings of<lb />the body. Together, they began the search for<lb />explanations.<lb /><lb />The gastric bypass patients provided a rare<lb />opportunity. About one-third were diabetic, and<lb />another third had insulin resistance, a precondi-<lb />tion to diabetes. The scientists could study these<lb />patients when they were obese and after they lost<lb />weight and when they exhibited diabetes and<lb />when they did not. They also could compare dia-<lb />betic and non-diabetic patients. A key component<lb />of the research has been-tissue obtained,<lb />with the patientsT permission, at the time<lb />of their bypass surgery. Small sections of<lb />liver, muscle and adipose (fat) tissue go to<lb />the labs where the scientists developed<lb />specialized techniques for preserving and<lb />growing the tissue for experiments.<lb /><lb />These factors together amount to a<lb />tremendous opportunity we have that<lb />almost no one else does,� Dohm said.<lb /><lb />Some of the most stunning results have<lb />come from examining the long-term con-<lb />sequences of surgery. For example:<lb /><lb />¢« Gastric bypass patients and similarly<lb />obese patients who did not undergo<lb />surgery were followed for periods of<lb />six to 10 years. During this time, the<lb />surgery patients had a much lower<lb />chance of dying in any given year.<lb />This was attributed to a decrease in<lb />deaths from cardiovascular disease.<lb /><lb />¢ Among those same surgical and non-<lb />surgical patients, the need for med-<lb />ical treatment for diabetes differed<lb />significantly. The percentage of surgi-<lb />cal patients taking oral medication<lb />for diabetes dropped while the_prfo-<lb />portion of nonsurgical patients on<lb />medication increased.<lb /><lb />e In terms of metabolic fitness, the sur-<lb />gical patients are significantly better<lb />off than their weight predicts. After<lb />surgery, they become more insulin<lb />sensitive, even before they begin to<lb />lose weight. When they are put on an<lb />exercise program, they show greater<lb /><lb />improvements in fitness than do<lb />nonsurgical patients (matched for<lb />such factors as size and sex) on the<lb />same program.<lb /><lb />Ce ee<lb /><lb />_<lb /><lb /><lb /><lb />A nagging question remains"how much the<lb />improvements in the gastric bypass patients<lb />can be attributed to the surgery and how much<lb />to the dietary restrictions it imposes. (After full<lb />recovery, most patients can eat no more than<lb />half a hamburger at one time.) Early on, Pories<lb />ran a study to rule out the effect of diet. To do<lb />this, he compared patients who had gastric bypass<lb />surgery with patients who tried to lose weight<lb />through diet alone. They weighed the same, but<lb />the difference in metabolism was enormous,�<lb />Pories said. When/ diabetic patients diet alone,<lb />insulin resistance lessens, but it doesnTt disappear.�<lb /><lb />A current trial of a different surgical procedure<lb />for morbid obesity may offer further evidence.<lb />Gastric banding cinches the stomach to allow less<lb />food to pass through, but unlike the gastric bypass,<lb />it does not change the basic physiology of the<lb />digestive system. Food continues to pass through the<lb />entire stomach and intestine. As gastric banding<lb />patients return for one-year checkups, their progress<lb />will be compared with that of bypass patients.<lb />If bypass patients\again show superior fitness, it<lb />will give diabetes researchers more reason to focus<lb />tightly on _hormonatsignals originating in the gut.<lb /><lb />Progress also is coming on~the cellular front,<lb />where advances in knowledge are measured in<lb />increments. The researchers, for example, have<lb />narrowed in on at least one factor contributing<lb />to insulin resistance, the overabundance of\an<lb />enzyme that appears to block cells from absorbing<lb />glucose in response to insulin. To prove their the-<lb /><lb />ory, they have developed a mouse in which they<lb />can control the amount of the enzyme being pro-<lb />duced. Next, to prove cause and effect, they will<lb />chart the changes in insulin activity when the<lb />enzyme is activated_at different levels.<lb /><lb />Similarly, they are elose to identifying the<lb />regions on a gene that regulate production of sub-<lb />stances called glucose transporters. We have<lb />found that we can cure diabetes in\mice by over-<lb />expressing glucose transporters,� Dohm said. It<lb />turns out that you can do the same\thing in<lb /><lb />�<lb /><lb />humans by exercising.� In fact, exercise \doubles<lb />the number of glucose transporters in humans.<lb />Production of glucose transporters appears \to be<lb />controlled by several different promoter� regions<lb />on the genes. The scientists have located one<lb />region on the gene that directs the thyroid hor-<lb />mone to produce transporters. Now they are seek-<lb />ing the region that is activated by exercise.<lb /><lb />The basic and applied aspects of this work<lb />dovetail as tightly as the sides of a well-made<lb />drawer. As DohmTs lab splices genes to locate pro-<lb />moter regions, the team in the Human Perform-<lb />ance Lab works with human volunteers to refine<lb />knowledge about the effects of exercise on glucose<lb />transporters. They have shown that the number of<lb />transporters increases substantially with as little as<lb />one week of regular exercise and that the effects<lb />may be maintained when the-frequency of exer-<lb />cise is reduced. The answers to all these questions<lb />about glucose transporters may come together<lb /><lb />one day in-anew treatment for diabetes. <lb /><lb />Pories, shown reviewing x-rays, devel-<lb />oped the Greenville Gastric Bypass to<lb />help obese people lose weight. Above,<lb />a genetically engineered mouse allows<lb />researchers to control production of<lb /><lb />an enzyme that blocks the absorption<lb /><lb />of glucose.<lb /><lb /></p>
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          <lb />The team also is<lb />opening new areas<lb />of exploration. Eli<lb />Lilly has awarded<lb />ECU a five-year, $2.5<lb />million grant for a<lb />cooperative study of<lb />the genetics of obe-<lb />sity and diabetes.<lb />The ECU team _is<lb />providing tilly with<lb />tissue~and blood sam-<lb />ples from, patients<lb />and blood samples<lb />of the patientsT sib-<lb />lings. By comparing<lb />the DNA in these<lb />samples, the Lilly<lb />researchers will try to<lb />| pinpoint key genes.<lb />Once they isolate<lb />Suspect genes, the<lb />ball comes back to the ECU court for experiments<lb /><lb />We think there are<lb /><lb />on the tissue to show how the genes work.<lb /><lb />some changes in lipid<lb /><lb />This isnot something any of us could do<lb /><lb />metabolism that real-<lb /><lb />by ourselves,� Dohm said. They have a large<lb /><lb />ly predispose people<lb />ly predis} ) peopie<lb /><lb />capacity to analyze genes to see which ones<lb /><lb />to become obese,�<lb /><lb />a We xo ie are involved, which is something we couldnTt do.<lb />At the same time, they donTt have the patients,<lb />so itTs only through making this kind of connec-<lb />tion that you could ever do this kind of research.<lb />YouTve got to have\all the components, or it<lb />won't work.�<lb /><lb />The scientists also are opening an inquiry into<lb />the causes of obesity. The National Institutes of<lb />Health, which has funded most of-the research on<lb />diabetes and obesity, is considering~a grant<lb />request for three separate but related studies. In<lb />particular, the team wants to examine the metab-<lb />olism of blood lipids, a family of substances that<lb />include fats, oils and cholesterols. Earlier research<lb />has suggested that people become obese because<lb />their muscles fail to burn fat and instead send it<lb />to the adipose tissue for storage.<lb /><lb />We think there are some changes in lipid<lb />metabolism that really predispose people to<lb />become obese,� Dohm said. They have to take in<lb />more calories than they need, but when they do,<lb />the fat is directly shunted off to the adipose tis-<lb />sue.� The researchers will examine why that hap-<lb />pens"what prevents the muscle from burning<lb />the fat in the first place and why the adipose tis-<lb />sue is so eager to absorb fat.<lb /><lb />26 edge<lb /><lb />One of those three projects, led by Dr. Hisham<lb />Barakat, will study differences in white and<lb />African-American women. African-American women<lb />have been shown to gain more weight, to put on<lb />weight at an earlier age and to have more diffi-<lb />culty\in losing weight. They also deposit fat in<lb />different patterns-than"do_white women. The<lb />issue is made more complex because the pattern<lb />of fat deposits in African-American women should<lb />offer some protection from cardiovascular disease,<lb />and they do indeed have lower cholesterol read-<lb />ings:-Despite the lower cholesterol levels, African-<lb />American womerdie from heart disease in higher<lb />proportions than do white women. These factors<lb />hold true even when economic and cultural fac-<lb />tors are taken out of the equation. Barakat will<lb />try to find out why.<lb /><lb />In the end, there may be implications for<lb /><lb />�?<lb /><lb />different therapies for blacks and whites,� he<lb />said. It may be we need different benchmarks<lb />of health, such as lowering what we consider to<lb />be safe cholesterol levels for blacks.�<lb /><lb />As the research continues, so do the surgeries.<lb /><lb />Since Pories developed the Greenville Gastric<lb /><lb />Elance cole) ol-imar-lemelcelelelal@alhmel-lelics<lb />Wiare(-1mmece)al ace) Mm 7itame-Mmeelanle)iar-lalelamme)|<lb />oral medication and weight loss, but<lb />the pain in his feet refused to go away.<lb />The diabetes had caused nerve dam-<lb />age, called diabetic neuropathy. | had<lb />very little feeling to the touch,� he said.<lb />oa eels] (olamam-\U-ammeihidialeleihiammae) (opm<lb />they hurt like hell. | would walk like |<lb />was 200 years old.�<lb /><lb />Then came what Cooper now con-<lb />siders the best move | ever made.�<lb />Through the Diabetes and Obesity<lb />Center at the ECU School of Medicine,<lb />~atom cole) am ey- 1a Mam Mallialie-|Magt-| mem agl-mce) on<lb />ical drug Clonidine. The trial was<lb />designed to test the effective dose<lb />range and safety for Clonidine cream in<lb />the treatment of diabetic neuropathy.<lb /><lb />For five months, Cooper rubbed the<lb /><lb />Bypass, he and other ECU surgeons have per-<lb />formed the operation more than 850 times.<lb /><lb />In Pories, the patients find hope and com-<lb />passion. Most patients are so surprised that<lb />someone will listen and agree that they have a<lb />bad disease,� Pories said. TheyTre used to being<lb />told they eat too much or they're lazy because<lb /><lb />they donTt exercise.�<lb />Pories, too, sees cause for hope. For the first<lb /><lb />time,� he said, weTre beginning to see hope that<lb /><lb />we will be able to con-<lb /><lb />trol diabetes better ca<lb />than we do today.�<lb /><lb />cream onto his feet three times a day. most up-to-date treatments for teach-<lb /><lb />Gradually, the pain subsided, and nor-<lb /><lb />mal feeling returned. Cooper's recovery<lb /><lb />ing. ThatTs part of what universities are<lb /><lb />supposed to do.�<lb /><lb />was so successful that after his initial In the waning months of 1998, the<lb /><lb />trial, he was allowed to stay on center was participating in nine trials<lb /><lb />and had four more scheduled to start in<lb />early 1999. Some address diabetes itself<lb />while others offer potential help for<lb />complications of the disease. They<lb />included tests of several drugs for treat-<lb /><lb />ment of mild to severe diabetic neuropa-<lb /><lb />Clonidine as part of a compassionate-<lb />use program while the pharmaceutical<lb />company awaits federal approval to<lb />market the drug.<lb /><lb />| even went to a powwow and<lb />danced awhile ago,� said the Native<lb />American from Grimesland. I could tell<lb />it the next day, too, but that had more<lb />to do with age than with my feet.�<lb /><lb />thy, one using commercially grown<lb />human skin to treat foot ulcers, another<lb />testing a drug to inhibit fat Flesvels olacelamce)<lb />help patients lose weight, plus a trial of<lb />an inhaled form of insulin. Next spring,<lb /><lb />the center will participate in a trial of an<lb /><lb />Cooper's story is one example of why<lb />the Diabetes and Obesity Center pursues<lb /><lb />a multi-million-dollar clinical trials pro-<lb />automatic glucose testing device, which<lb /><lb />Pfeifer called the missing link in being<lb /><lb />able to develop an artificial pancreas.<lb />Each trial must be approved by the<lb /><lb />medical schoolTs human subjects review<lb /><lb />gram. In these carefully controlled stud-<lb />ies, the centerTs doctors, staff and patients<lb />work with pharmaceutical companies<lb />and other researchers to test promising<lb />new therapies as part of the Food and<lb />Drug AdministrationTs approval process.<lb /><lb />ItTs important for us to keep at the<lb /><lb />committee. WeTre careful about the<lb />type of trial we do,� Pfeifer said. We're<lb /><lb />not interested in just getting money to<lb /><lb />run a trial. We want to know: Does it<lb />make a difference? Will it change the<lb />way we treat people? lf the answer is<lb />yes, then it helps us bring things quick-<lb />er to eastern North Carolina.�<lb /><lb />Pfeifer came to ECU in 1997 with an<lb />established reputation in clinical trials.<lb /><lb />Doug Allin, clinical research manager<lb /><lb />edge of what's going on,� said Dr.<lb />Witear lo We aiclicmm tale ecalcmmelcracels<lb />and section head of the endocrinology<lb />and metabolism department of the<lb />School of Medicine. We can bring to<lb />our patients the state-of-the-art therapy<lb />right away, often years before itTs gen-<lb />erally available. It also allows us to be at<lb /><lb />the edge and have experience with the<lb />for Curatek Pharmaceuticals in Buffalo<lb /><lb />Grove, Ill., had worked on a project with<lb /><lb />Pfeifer 10 years ago at the University of<lb />Kentucky and followed his work through<lb />the years. When Curatek took on devel-<lb />opment of Clonidine, he sought out<lb />Pfeifer again, this time at ECU.<lb /><lb />He didnTt let me down,� Allin said.<lb />We did a pilot study first. When you<lb />start a study, you figure the patients will<lb />drift in slowly. Within a month, he had<lb />all the patients enrolled. | was amazed<lb />at how fast he got going. And his staff<lb />people are always responsive. Every-<lb />thing is very timely.� Pfeifer was quick<lb />to add more praise for his research<lb />staff"three nurses and two medical<lb />assistants"who, he said, do most of<lb />the work.<lb /><lb />Tale eliecelam com talcm elel(caldt-lmeliarila<lb />for the patients, Pfeifer said new thera-<lb />pies may make significant inroads on<lb />the costs associated with diabetes. Each<lb />year Medicare alone spends $30 billion<lb />to treat diabetes. Two-thirds of the total<lb />goes to treating the complications of<lb />the disease.<lb /><lb />There are studies that show that if<lb />patients followed currently recom-<lb />mended practices, we could decrease<lb />complications by as much as 85 per-<lb />cent in the next five years"without<lb />more research,� he said. The clinical<lb />trials have the potential for helping<lb />reduce complications even further.�<lb /><lb />(For news about Michael PfeiferTs<lb />new book on diabetes complication<lb />and other related publications, see<lb /><lb />page 37.) =<lb /><lb />Dien Vilas wiciicmesse cman ae<lb /><lb />tivity in James CooperTs feet. Cooper<lb /><lb />suffers from diabetic neuropathy.<lb /><lb /></p>
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          <lb />NASATs Marshall Space Flight Center gave Dr.<lb /><lb />Pat Lindsey an opportunity to put virtual reality<lb />to the test.<lb /><lb />proves<lb /><lb />design<lb /><lb />AN ECU PROFESSOR HAS DRAWN ON<lb />NASA technology to answer an impor-<lb />tant question in interior design.<lb /><lb />In interior design, weTre con-<lb />cerned with planning living and work-<lb />ing spaces to fit humans,� said Dr.<lb />Patricia F. Lindsey, assistant professor<lb />in the Department of Apparel, Mer-<lb /><lb />chandising and Interior Design. The anthropomet-<lb /><lb />ric qualities are especially important in medical and<lb /><lb />technology elder care settings, but it really runs throughout<lb /><lb />everything we do.�<lb />The challenge is to be able to preview the archi-<lb />tectural elements of a design in a way that allows<lb /><lb />the designer and client to test the fit. Is the sink<lb /><lb />~e| good placed at a comfortable height for an elderly<lb /><lb />woman bent by osteoporosis? Will people bump<lb /><lb />into cabinets as they turn corners? Computer-ren-<lb /><lb />© . . . .<lb />fit for dered three-dimensional drawings improve on the<lb /><lb />traditional tools"perspective drawings and scale<lb />models"but still fall short of the goal. A NASA fel-<lb /><lb />interior lowship allowed Lindsey to test a newer method.<lb /><lb />Since 1993, Lindsey has spent four summers at<lb />the Marshall Space Flight Center in Huntsville,<lb />Ala., testing the use of virtual reality as a design<lb />tool. Created through sophisticated computer pro-<lb />grams, virtual reality simulates a three-dimensional environment in<lb />what appears to be actual size and gives the user or users the feeling<lb />of being in and moving through the environment. The experience<lb />comes courtesy of NASATs Summer Faculty Fellowship Program, which<lb />brings about SO university faculty members to its Huntsville facility<lb />each year to work alongside its own researchers.<lb /><lb />The first year, NASA had Lindsey create a virtual reality version of<lb />its payload operations control center. She then compared responses<lb />of people using the real and virtual versions of the center. She pub-<lb />lished an article expanding on her findings in the spring 1998 issue<lb />of The Journal of Interior Design. In her later stints in Huntsville,<lb />Lindsey created other virtual environments for NASATs use, including<lb />a redesign of its own virtual reality laboratory.<lb /><lb />The purpose was to see if virtual reality answers the same questions<lb />as a real-size model and whether virtual reality can be used for proto-<lb /><lb />typing interior environments,� she said. And indeed, you see the<lb />same things. But there are several problems that havenTt been<lb />solved. ItTs expensive, especially in time, to make virtual reality<lb />look just like reality. Otherwise, you get a sort of cartoonish<lb />look. We also havenTt found a good way to get tactile feedback,<lb />but it is good for estimating visibility and spatial relationships.�<lb />Lindsey has built on her contacts at NASA to present advanced<lb />interior design students with a real-world problem. The stu-<lb />dents, in a 3-D computer-aided design course, have tried to<lb />solve problems in the design of the living quarters of the interna-<lb />tional space station, such as creating space-efficient work surfaces<lb />and indicating up from down in a micro-gravity environment.<lb />Her next challenge may be the most difficult yet. She wants<lb />ECU to become one of only a handful of universities with its<lb />own Virtual reality equipment. A top-of-the-line setup car-<lb />ries a $1 million price tag.<lb /><lb />AS SURELY AS A NORTEASTER ERODES THE SHORELINE,<lb />rapid development is changing the face of North<lb />CarolinaTs coastal counties. Wealthy retirees<lb />move in, placing new demands on local health<lb />care systems. Sport fishermen compete for a<lb />hiseeledeber-mmelecrbemmer-scelemmsiaemmr.berlUlla mm selemmer- hice<lb />made their living on the water for generations.<lb />Hotels scour the countryside in search of desk<lb />clerks, maids and waiters to serve the bustling<lb /><lb />tourist business.<lb /><lb />In the Institute for Coastal and Marine Resources, two<lb />social scientists noted for their contributions to fisheries<lb />management have turned their minds to the problems<lb />and pressures of coastal development. The coast is a lot<lb /><lb />,<lb /><lb />more complex than just fisheries and fishing,� said Dr.<lb />David C. Griffith.<lb /><lb />Griffith and his long-time collaborator, Dr. Jeffrey C.<lb />Johnson, have begun a research initiative to examine<lb />problems arising from the growth of ports and harbors,<lb />AVOlecl Mm cOlebul yee Pmmcc@elcoleluljeime- baleen ial ielet)meucletucttilashameelie<lb />munities. How, they ask, will these industries compete for<lb />space, labor, resources and political influence? Already in<lb />the Albemarle Sound area, ecotourism has run headlong<lb />into established fishing and hunting clubs opposed to<lb />sharing the waterways. And as hotels on the Outer Banks<lb />bus in low-wage service workers from Elizabeth City,<lb /><lb />Griffith sees problems in the making. <lb />edge<lb /><lb />PHOTO BY DANA EZZELL GAY<lb /><lb />29<lb /><lb /></p>
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          <lb />Look at Florida, where this process is already<lb />advanced,� he said. You end up having ghettos<lb />where people live who service the big luxury<lb />hotels, and theyTre out there only during the day.<lb />ItTs sort of like an apartheid situation. So along<lb />with this coastal development, you have people<lb />being marginalized and ghetto development going<lb />on at the same time. That creates all kinds of prob-<lb />lems for inland counties that are near the coast.�<lb /><lb />Pressure also increases on traditional coastal<lb />industries. Part of the story is whatTs happening to<lb />commercial fishing,� Johnson said. In rural eastern<lb />North Carolina, thatTs traditionally been one of the<lb />primary sources of income for a lot of people. Our<lb />purpose is to identify where there may be problems<lb />and make people aware of where the problems lie.�<lb /><lb />The coastal development project, still in the early<lb />Stages, is the latest in a 15-year history of collab-<lb />oration for Johnson and Griffith. At first they<lb />seem an unlikely duo. Johnson is big, loud and pas-<lb />sionate about numbers. Griffith is soft-spoken and<lb />easygoing, more prone to literary references than<lb />Statistics. Close up, the lines blur. Although he<lb />is based in the sociology department, JohnsonTs<lb />training includes anthropology, and he frequently<lb />publishes articles in anthropology journals. Griffith<lb />holds degrees in anthropology, but his books and<lb />papers are widely read by rural sociologists.<lb /><lb />We're social scientists, and we donTt see bound-<lb />aries,� Johnson said. We see problems, and we<lb />want to study those problems. Often interdiscipli-<lb />nary work is the best way to approach them.�<lb /><lb />Their peers see added strength in the collabora-<lb />tion of two individually strong scientists. Jeff<lb />Johnson is one of the few quantitative anthro-<lb />pologists in the world,� said Dr. B.J. Copeland, a<lb />professor of zoology at North Carolina State<lb />University. But things arenTt always quantitative,<lb />and David keeps you oriented to the social and<lb />cultural aspects. ThatTs where David and Jeff work-<lb />ing together are so important"in the interpre-<lb />tation. Both have contributed considerably to our<lb />understanding of social and economic structure of<lb />coastal communities.�<lb /><lb />Jim Murray, associate director for outreach of<lb />the National Sea Grant Program, first worked with<lb />Johnson and Griffith when he was director of<lb />extension for North Carolina Sea Grant. TheyTve<lb />always been on the cutting edge with regard to<lb />creativity and risk-taking,� Murray said. Jeff was<lb />way out in front with his ability to turn social<lb />science research, specifically marine anthropol-<lb />ogy, from what historically has been qualitative<lb />work into quantitative research. This was 16 years<lb /><lb />ago, at a time very few were doing<lb />it. He set the precedent, and his<lb />name is synonymous nationally<lb />for quantitative techniques.<lb /><lb />One of the things that makes<lb />them such a good team working<lb />together is that their skills are<lb />complementary. Jeff is great at<lb />conceptualizing, at developing the<lb />methodology. DavidTs great at<lb />operationalizing, doing the field<lb />work, collecting the data to make<lb />the methodology work. I truly<lb />believe theyTre leaders in their<lb />field. ECU is recognized as a, or<lb />the, national leader in marine<lb />anthropology, and a large part of<lb />the reason is Jeff and David.�<lb /><lb />The collaborations started in<lb />1983 with a project designed to<lb />interest recreational fishermen in<lb />underutilized fish, such as shark,<lb />amberjack and sheepshead. The<lb />idea was to reduce pressure on the<lb />stock of more popular fish. Drawing<lb />on the precedent of market researchers, Johnson<lb />and Griffith used linguistics and semantics, first, to<lb />understand how people perceived fish and then<lb />to create a more desirable image for underutilized<lb />species. Throughout the project, they worked along-<lb /><lb />YOU WANT TO HELP THE WORLD, BUT YOU ALSO<lb />WANT TO BE ABLE TO PUT FORTH IDEAS,� JOHNSON<lb />SAID. ALMOST EVERY ONE OF OUR PROJECTS HAS<lb />BOTH AN ACADEMIC COMPONENT.AND AN APPLIED,<lb />OR PRACTICAL, COMPONENT. | WOULDN T DO SOME-<lb /><lb />THING THAT DIDNTT HAVE BOTH.�<lb /><lb />side Sea Grant extension specialists, producing<lb />both academic articles and 31 educational prod-<lb />ucts"brochures, posters and cookbooks"targeted<lb />at fishermen.<lb /><lb />They succeeded so well that sharks and amber-<lb />jack have been removed from the underutilized<lb />list, and sharks are actually in danger of being<lb /><lb />Drs. David Griffith, left, and Jeffrey Johnson liken<lb /><lb />their collaborative process to tag-team wrestling.<lb /><lb />overfished. What happened<lb />was, when it went to being<lb />recreational, it also became<lb />commercial,� Johnson said.<lb />Since that first successful<lb /><lb />project, Johnson Apereme@suteenas<lb /><lb />have kept at least one mutu-<lb />Piece) U-loleye-heceyemm-beele)et-mmaete<lb />four or five active projects<lb />each is juggling at any one<lb />time. Also among the lot will<lb />pemere) UCloleye-teleyenmmnsieemeiesca<lb />scientists, including biolo-<lb />gists and economists, and<lb />some solo work. Griffith,<lb />for example, is directing a<lb />mela coyervaiarcehme) mt leemntieca.<lb />related to a special class of<lb />work visas. Johnson has been<lb />running a study of people in<lb />isolation since 1991. His<lb />research subjects"scientists<lb />PYCoavatelcouter-mmtemmatelccvcaelece<lb />On joint projects, they have<lb />tackled such issues as public perceptions of<lb />seafood safety, the effects of fishing policy on fam-<lb />ilies and communities, conflicts among fishermen<lb />and public perceptions of environmental risks.<lb />People are pretty bad about judging risks to the<lb />environment and to themselves from the environ-<lb />ment,� Griffith said. E. coli is a classic example. E.<lb />coli kills just a handful of people every year. Even if<lb />9,000 people die from food-related exposure, thatTs<lb />out of 750 million exposures and it says nothing<lb />about whoTs dying or whether they had pre-existing<lb />conditions or whether they were really riaesoycem-lerenens<lb />food handling. Your risks of dying in a Car accident<lb />are much higher than dying from eating stuff.�<lb />Concern over the toxic dinoflagellate Pfiesteria<lb />piscicida falls into the same category and shows the<lb />harm in public misperception, he said. The prob-<lb />lem is, when people misunderstand or exaggerate<lb />certain environmental risks, they encourage politi-<lb />cians and other people to essentially divert resources<lb />and time to look at these issues when, in fact, we<lb />know there are these real environmental risks, like<lb />lead poisoning, rabies, PCB and problems in the<lb />food supply,� he said. But if all this attention gets<lb />focused away from them and onto some phantom<lb />environmental risk like pfiesteria, well, then thatTs<lb />just a total waste of public funds. In terms of<lb />practical outcomes, thatTs how we would hope to<lb /><lb />influence them.�<lb /><lb />Their research sometimes tries to calm waters so<lb />that opposing groups may eventually reach con-<lb />sensus. Such was the case when they conducted in-<lb />depth interviews about environmental problems<lb />with recreational and commercial fishermen.<lb />While the two sides pointed to different causes<lb />(generally each other) for existing problems, both<lb />held the same ideals. They wanted a clean envi-<lb />ronment and plentiful resources. In the consensus<lb />lies a starting point for public policy discussions.<lb /><lb />Such practical applications can be found in<lb />most projects Griffith and Johnson take on. You<lb />want to help the world, but you also want to be<lb />able to put forth ideas,� Johnson said. Almost<lb />every one of our projects has both an academic com-<lb />ponent and an applied, or practical, component. |<lb />wouldnTt do something that didnTt have both.�<lb /><lb />The two have worked together so long that<lb />they often finish each otherTs sentences, some-<lb />times pausing for the other to add a salient point.<lb />They liken the collaborative process to tag-team<lb />wrestling. One works awhile, then hands off to the<lb />other. Back and forth they go until the project is<lb />finished. Complementary strengths and trust that<lb />each will carry his weight make the collaboration<lb />work. So does mutual admiration.<lb /><lb />JeffTs a lot better at analysis than I am,�<lb />Griffith said.<lb /><lb />DavidTs quite good at conceptualizing some<lb /><lb />ideas, at thinking through how you collect data<lb />PVavemm or bas C@estbubmr- lan eaneber-euam lelebenieyemy-lemmr-lelen bers<lb />with a touch of awe, HeTs not only good at writ-<lb />ing, but he likes to write. My thing is analysis.�<lb /><lb />Even as both bemoaned a backlog of intended<lb />publications, Johnson and Griffith also laid out<lb />plans for a new study. This one, involving biolo-<lb />gists and sea ice experts, will take them to the<lb />Arctic to compare the environmental knowledge<lb />of scientists and Native Alaskan whalers. They<lb />hope to show scientists how to make use of the<lb />accumulated knowledge of the fishermen.<lb /><lb />The whaling captains have some knowledge<lb />about how the ice works and other things, and<lb />maybe their knowledge is useful for scientists so<lb />they can figure out where to put their experimen-<lb />tal stations, how best to use their resources to col-<lb />lect data, things like that,� Johnson said. What<lb />you have to be able to do is show that even though<lb />{the fishermen] are not doing things in a scientif-<lb />ic way, theyTre valid in some of the things theyTve<lb />observed. Once you can model something, once<lb />you can show scientists how people are thinking<lb /><lb />and the logic behind it, it makes it easier to <lb /><lb />be able to compare.� By:<lb /><lb />30 -edge edge 31<lb /><lb />BACKGROUND PHOTO BY DANA EZZELL GAY<lb /><lb />ee ee " """ "" ss "<lb /><lb /></p>
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          <lb />Allen Lawson.<lb /><lb />Dr. Donald Shaw, wearing tie, explores whether telemedicine<lb />can be used to deliver physical therapy. Helping him test an<lb /><lb />electronic goniometer are Ashley Pace, David Gabriel and<lb /><lb />Early studies show telemedicine<lb /><lb />compares well with doctor's visit<lb /><lb />IN SOME OF THE FIRST STUDIES OF THE EFFICACY OF TELEMEDICINE, SCHOOL<lb />of Medicine faculty are asking whether telemedicine consultations give<lb /><lb />patients the same quality of medical care that a visit to the doctorTs office pro-<lb /><lb />vides. The early answer is a qualified yes.<lb /><lb />This is one of the undone pieces of telemedi-<lb />cine,� said dermatology assistant professor Dr.<lb />Charles M. Phillips. ThereTs been a lot of enthu-<lb />siasm for telemedicine, but nobody has any idea<lb />if itTs good in all applications. As a clinician,<lb />thatTs important.�<lb /><lb />Telemedicine uses networks of computers,<lb />video cameras and telephone lines to link patients<lb />with physicians and other medical practitioners.<lb />Electronic stethoscopes and other specialized tools<lb />aid diagnosis. It has been hailed as an especially<lb />promising way to provide cost-effective specialty<lb />care to people living in remote regions. Because<lb />patients and hometown physicians can confer<lb />with distant specialists without leaving their<lb />neighborhood, telemedicine saves time and travel.<lb /><lb />The ECU School of Medicine, which serves 29<lb />predominantly rural counties in eastern North<lb />Carolina, is recognized as an international leader<lb />in telemedicine. It has established a network for<lb />providing clinical and educational programs to<lb />12 remote sites"including six small hospitals,<lb />Central Prison in Raleigh and five clinics. Since<lb />the program was established in 1992, School of<lb />Medicine specialists have provided more than<lb />2,000 telemedicine consultations.<lb /><lb />Everybody would like to have controlled<lb />studies, but theyTre more important in some<lb />applications than in others,� said Dr. Susan<lb />Gustke, medical director of the ECU telemedicine<lb />program. Some applications we know will work<lb />because theyTre similar to others weTre using suc-<lb />cessfully. But even if the specialist is very confi-<lb />dent, controlled studies help us convince the<lb />agencies paying for medical care that this is a valid<lb /><lb />Goniometer Project<lb /><lb />delivery system and should be used. Another pur-<lb />pose of the studies is to make referring doctors feel<lb />comfortable with the results.�<lb /><lb />To test telemedicineTs applications in derma-<lb />tology, where a good view of a suspect lesion<lb />or mole might be critical, Phillips and some<lb />colleagues set up a study in which 60 patients were<lb />seen in person by one dermatologist and over<lb />an interactive video network by another derma-<lb />tologist. The two consultations took place on the<lb />same day but independently of one another<lb />so each physician was unaware of the<lb />otherTs diagnosis. Later compar-<lb /><lb />isons showed they agreed on a 4 |g<lb /><lb />diagnosis 77 percent of the time.<lb /><lb />Some studies since then of<lb />~liveT dermatologist to ~liveT derma-<lb />tologist show 80 to 90 percent<lb />agreement, so weTre in the ball-<lb />park,� Phillips said. The comfort<lb />level (with the technology) gets<lb />down to the individual patient. |<lb />may see a patient and not be sure<lb />whatTs going on. If itTs a telemedi-<lb />cine consultation, thereTs a nag-<lb />ging question: Is it because of the<lb />technology? But in most cases,<lb />when ITve seen that patient live, I<lb />still wasnTt sure.�<lb /><lb />The study was published in the<lb />September 1997 issue of the Journal of the American<lb />Academy of Dermatology. Since then, Phillips said,<lb />better cameras have been installed on the telemed-<lb />icine network. ThatTs one of the problems in this<lb />area,� he said. As soon as you do a study, the tech-<lb />nology advances.�<lb /><lb />Dr. Michael E. McConnell, a pediatric cardiolo-<lb />gist and associate professor, led a study similar to<lb /><lb />PhillipsTs, to compare the results of cardiologistsT<lb />examinations of 21 children sus-<lb /><lb />pected of having heart mur-<lb />murs. We found that telemedi-<lb />cine was reasonably accurate,�<lb />he said. In two cases, though,<lb />the telemedicine consultant<lb /><lb />symptoms within six months.<lb />For the person looking at this,� McConnell<lb /><lb />said, the question is: Is missing two small holes<lb />acceptable?� When he presented his findings at<lb />a meeting of the American College of Cardiology<lb />in April 1998, reaction was generally favorable.<lb />McConnell, however, remains cautious. When I<lb /><lb /><lb /><lb /><lb /><lb />see a patient via telemedicine, I now realize itTs<lb />not a sure thing,� he said. I have a higher index<lb />of suspicion and might do an echocardiogram<lb />when I otherwise wouldnTt, or I might ask them<lb />to drive down to see me.�<lb /><lb />Meanwhile, in fall 1998, physical therapy pro-<lb />fessor Dr. Donald Shaw launched the first phase<lb />of a trial that may lead to a new application for<lb />telemedicine. If folks live in rural settings and<lb />canTt get to a physical therapist, maybe we can<lb />take the physical therapist to them,� he said.<lb /><lb />As a first step, he needed to see whether he<lb />could get accurate readings of joint angles over<lb />the telemedicine network. Joint angles indicate<lb />range of motion, which clues physical therapists<lb />into a patientTs ability to carry out day-to-day tasks.<lb />To do this, he strapped a knee brace equipped with<lb />an electronic goniometer, which measures angles,<lb />onto a leg of healthy student volunteers. Readings<lb />from the goniometer were transmitted over phone<lb />lines to a computer in the physical therapy depart-<lb />ment. At the same time, a physical therapist also<lb />took a direct measurement of the joint angle for<lb />comparison. If the readings on healthy knees prove<lb />accurate, Shaw said his next step will be to test the<lb />electronic goniometer on people with problem joints.<lb /><lb />More and larger studies will help health-care<lb />professionals better assess the merits of telemed-<lb />icine applications, but such research is likely to<lb />be slow in coming. Finding funding is probably<lb />the major limitation to this research,� Gustke<lb />said. Most telemedicine funding has gone to get-<lb />ting the networks up and running. We looked<lb /><lb />long and hard to find the money for these<lb />efficacy studies.� ay<lb /><lb />Alan Branigan of the Center for Health Sciences Commu-<lb /><lb />nication checks goniometer readings from ShawTs experiment.<lb /></p>
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        <p>
          <lb />
          <lb />FOR MARIMBIST MARK FORD,<lb /><lb />MAKING MUSIC<lb /><lb />MEANS HAVING FUN<lb /><lb />MARK FORD, ASSOCIATE PROFESSOR OF MUSIC,<lb />proved to be a musical innovator early on. When<lb />I was 5 or 6 years old, I had long green Tinkertoys,<lb />and ITd take the Tinkertoys out with my brotherTs<lb />Beach Boys album and knock on all the Army hel-<lb />mets,� he says. ITd have a whole string of rhythms<lb />going on there.�<lb /><lb />In succeeding years, Ford has progressed from<lb />playing back-up helmets on Little Deuce Coupe to<lb />solo marimbist, performing his own compositions<lb />in concerts around the country and on his 1996<lb />debut CD Polaris. He also directs the School of<lb />MusicTs touring group, the East Carolina Percussion<lb />Ensemble, which earned one of two performance<lb />spots for student orchestras last fall at the annual<lb />Percussive Arts Society International Conference.<lb />During his off hours, he leads the popular Panama<lb />Steel, a student-based professional steel drum<lb />band he organized 10 years ago. HeTs an entre-<lb />preneur to boot, a founder and vice president<lb />of Innovative Percussion in Nashville, Tenn., one<lb />of the leading companies making mallets for<lb />marimba, vibraphone and xylophone.<lb /><lb />Between his solo and ensemble work, Ford may<lb />be onstage three or four nights a week for long<lb />stretches at a time. He loves every minute. Wow,<lb />they pay me to do this!� he says. Every week is<lb />different. I get to work with wonderful people,<lb />oXoldetebemaetomn ce slole) melaucm-belemeleslour-bushiag-belemrletic<lb />cians around the state. And what I play is a part of<lb />me. I have a love of life, and I want to share that<lb />debueleraemmactomecteny emm<lb /><lb />In a guest artist concert in Chapel Hill, he keeps<lb />his audience entranced with a mixture mellow<lb /><lb />edge<lb /><lb />and mirthful. First comes the<lb /><lb />er Lebehebet:@mmciaslcsuct- Mm etlcl (olehvame) mm gels<lb /><lb />title track from Polaris, his own<lb /><lb />composition. Later, he throws in a<lb /><lb />steel-drum rendition of an Irish jig.<lb /><lb />He concludes by having two stu-<lb /><lb />dents join him on Stubernic, a piece<lb /><lb />he composed for three marimbists<lb /><lb />(o} etme) eCome beh ieuttieloel em Bela amet. bameele<lb /><lb />keys, sides and a little bit of air as<lb /><lb />they rotate around the marimba.<lb /><lb />ItTs a bizarre situation,� he admits. I had<lb /><lb />dreamed of people dancing behind the marimba.�<lb />In its choreography, Stubernic has a touch of<lb /><lb />FordTs first and most famous composition, Head<lb /><lb />Talk, a piece several music publishers didnTt think<lb /><lb />would ever fly. It calls for five drummers to sit on<lb /><lb />the floor playing drum heads (not drums, just the<lb /><lb />heads) and tossing them back and forth. Ford, a<lb /><lb />pack rat, had been inspired by a closet full of used<lb /><lb />heads. Since he wrote it in 1987, Head Talk has<lb /><lb />been performed around the world, including per-<lb /><lb />formances last year in Russia, Taiwan and Brazil.<lb /><lb />In concerts and clinics, ITll hear someone say,<lb /><lb />[loud whisper] ~ThatTs the Head Talk guy.T ItTs only<lb /><lb />a five-minute piece, but itTs a crowd pleaser<lb /><lb />Wow, they pay me to do this,� says<lb />Mark Ford, associate professor of music,<lb />composer and concert marimbist. At<lb />far left, he is pictured with his band,<lb /><lb />Panama Steel.<lb /><lb />because itTs entertaining and very visual. And<lb />drummers love it because they donTt have to cart<lb />anything. They can put their drum heads under<lb />their arms and go.�<lb /><lb />Ford premiered his newest composition, Motion<lb />Beyond, in the fall of 1998 and in spring 1999, will<lb />premiere the Suite for Five-Octave Marimba by<lb />another highly regarded composer, Richard<lb />Maltz. Most of my repertoire lately has been a<lb />good portion of my own composing, which is<lb />good for me because ITm able to get my aeons comenens<lb />to an audience,� he says, but I donTt want to<lb />play just my own music in concerts. I enjoy a<lb />variety of music in a recital.�<lb /><lb />His ensemble work alternates. Panama Steel<lb />will play 50 to 60 concerts between April and<lb />October. The group performs throughout the<lb />Carolinas and Virginia and has made three record-<lb />ings. From October to April, Ford focuses on the<lb />Percussion Ensemble, a laboratory group of<lb />advanced students that is working on its second<lb />CD. The first, with ECU tubist Jeff Jarvis, was<lb />released in January 1999 on the Arizona<lb />University Recordings label. This CD also features<lb /><lb />several duets with Ford and Jarvis.<lb /><lb />Since he founded Panama Steel in 1988, about<lb />40 student musicians have played with the group<lb />at various times. Each year he holds auditions to<lb />replace those who have graduated. I try to<lb />choose individuals who will connect with others<lb />in the group, who have the talent and desire<lb />to take something to a new level,� he says. But<lb />it takes more than desire to keep them going<lb />through rehearsals, performances and all the hours<lb />spent traveling. I aVoyeMaandeteel ar-vehvare) mute wm velticemere<lb />this for money if it werenTt fun,� he says.<lb /><lb />For Ford, itTs all fun"marimba, steel drum,<lb />vibes, performing, composing. If, for some reason,<lb />the school thing went away, ITd still be playing<lb />drums,� he says. I may be on the street play-<lb />ing music with a hat in front of me, but ITd be<lb />doing something in this vein. I don't think ov,<lb /><lb />I could stop.� e<lb /><lb />Mallets vibrate as Ford demonstrates the marimba. At lower right are mal-<lb /><lb />let heads made by the company Ford co-founded, Innovative Percussion.<lb /><lb /></p>
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        <p>ECU IS PLAYING A MAJOR<lb />role in a national movement<lb /><lb />to improve services for chil-<lb />dren with serious emotional<lb />problems and their families.<lb />Seven faculty members, plus<lb />staff and graduate students,<lb />have helped shape a demon-<lb />Stration project that has<lb />won national recognition.<lb />The project, called Pitt<lb />Edgecombe Nash-Public Academic Liaison (PEN-<lb />PAL), originated in 1994 with a four-year, $5 mil-<lb />lion federal grant to the Child and Family Services<lb />Section of the North Carolina Division of Mental<lb />Health. It was one of two dozen grants designated<lb />for demonstration projects that would improve<lb />community-based services for children with serious<lb />emotional problems and reduce the need to place<lb />the children in hospitals or other institutions.<lb />PEN-PAL serves about 400 children who suffer<lb />from such problems as attention deficit disorder,<lb />oppositional and defiant disorder, anxiety and<lb />depression. It works by pulling together multi-agency<lb />teams of service providers, along with parents and<lb />community organizations, to create a seamless sys-<lb />tem of care for affected children. Previously, each<lb />agency involved with the child"social services,<lb />schools, mental health agencies and the juvenile<lb />justice system"worked independently, sometimes<lb />resulting in several intervention plans for a single<lb />child. PEN-PAL also tries to build on the strengths<lb />of the individual children, their families and com-<lb />munities, for example, taking advantage of a childTs<lb />interest in sports or a familyTs involvement in church.<lb />ItTs gone remarkably well, but itTs also been<lb />more of a challenge than any of us imagined,� said<lb />Martha Kaufman, PEN-PAL project manager for<lb />Child and Family Services. In a lot of ways, weTre<lb />trying to change the world.�<lb /><lb />The difficulties have been compounded by<lb />reforms in welfare, education and health care, said<lb />Dr. Susan L. McCammon, ECU associate professor<lb />of psychology. Agencies have so many conflicting<lb />demands that are simultaneous,� she said. In<lb />todayTs climate, people in social services and men-<lb />tal health need to produce and produce quickly.<lb />ThatTs not compatible with restructuring.�<lb /><lb />ECU faculty have provided training, resources<lb />and technical assistance for services providers. The<lb />university also has created an interdisciplinary<lb />course that is based on the system of care concept<lb /><lb />36 edge<lb /><lb />EMOTIONALLY DISTURBED CHILDREN BENEFIT<lb />AS NEW APPROACH TO CARE TAKES HOLD<lb /><lb />and brings parents of emotionally disturbed children<lb />into the classroom as faculty. The ECU team is as<lb />diverse as the children the project serves. McCammon,<lb />from psychology, and Dr. Betty Beacham in educa-<lb />tion have coordinated ECUTs participation in PEN-<lb />PAL. Other faculty involved include Dr. Dorothea S.<lb />Handron in nursing, Dr. David A. Dosser Jr. in mar-<lb />riage and family therapy, Dr. John Y. Powell in<lb />social work, and Dr. John M. Diamond and Dr. Kaye<lb />McGinty of the School of Medicine.<lb /><lb />Stephanie Brown, director of student services for<lb />Nash-Rocky Mount Schools and a member of the<lb />PEN-PAL project management committee, praised<lb />ECUTs contributions. TheyTre on the cutting edge of<lb />where we need to be going,� she said. TheyTve done<lb />a tremendous job of sensing our needs and design-<lb />ing in-service training to suit those needs.�<lb /><lb />Of all the funded projects, only PEN-PAL tied its<lb />program to a university. Kaufman said ECUTs leader-<lb />ship created a framework that allowed the project to<lb />build logically. Otherwise, weTd just learn by doing,�<lb />she said. Also, Dr. Lenore Behar [Child and Family<lb />Services Section chief] felt from the beginning that<lb />it was important to get a university involved so<lb />rather than our spending years and years trying to<lb />retrain professionals, weTre partnering with the uni-<lb />versity to change the way they teach students who<lb />will become professional service providers.�<lb /><lb />Outside evaluators have noted improvements<lb />in children participating in the PEN-PAL program.<lb />In measurements taken six months and one year<lb />after entering the program, the children on average<lb />show higher academic performance and fewer<lb />behavioral problems. Their parents report greater<lb />Satisfaction, too.<lb /><lb />Because of this success, PEN-PAL was selected<lb />for presentation before a congressional panel in<lb />May 1998. PEN-PAL and ECU also have been fea-<lb />tured in four national professional publications.<lb />In addition, McCammon and Powell were invited<lb />to serve on the faculty of a national institute for<lb /><lb />redesigning care programs for emotionally<lb />disturbed children.<lb /><lb />) ,<lb />S Ea  @ ""_1-prine<lb /><lb />Book on Fred ChappellTs poetry nominated for two awards<lb /><lb />elimi een ne Te hae. ee ee ee ee<lb />cian iaae team es ih iat tea ate a ceca ne a eee ee ee ee<lb /><lb />When one poet examines the work of<lb />another, the results can be impressive.<lb />PATRICK A. BIZZARO, poet and associate<lb />professor of English, assembled the first<lb />critical assessment of the poetry of<lb />North CarolinaTs poet laureate in a book<lb />titled DREAM GARDEN: THE POETIC VISION<lb />OF FRED CHAPPELL (LSU Press, 1997). A<lb />collection of essays, the book was<lb />nominated for two awards in 1998"<lb />the James Russell Lowell Award of the<lb />Modern Language Association and the<lb />Hugh Holman Award from the Society<lb />for the Study of Southern Literature.<lb /><lb />Contributors to DREAM GARDEN<lb />included Pulitzer prize-winning poet<lb />Henry Taylor, other internationally<lb />known figures such as Dabney Stuart<lb />and Robert Morgan and ECU faculty<lb />Resa Crane, James Kirkland, Peter<lb />Makuck and Alex Albright.<lb /><lb />Other new books by ECU faculty<lb />range from the erudite to whimsical.<lb />Faculty also serve at the helm of several<lb />respected journals.<lb /><lb />Credit for one of the most complex<lb />and unusual undertakings belongs to<lb />DR. CHARLES FANTAZZI, Whichard pro-<lb />fessor of classics. Fantazzi is deeply<lb />involved in a long-range project by the<lb />University of Toronto Press to publish<lb />an 85-volume English translation of the<lb />COLLECTED WORKS OF ERASMUS. The<lb />16th-century Dutch humanist played<lb />key roles in the development of the<lb />Christian church and in education<lb /><lb />through his writings, translations of<lb />the New Testament and _ influential<lb />friendships. Fantazzi has translated and<lb />annotated five volumes, including the<lb />1998 release of the second volume of<lb />ON THE EDUCATION OF THE CHRISTIAN<lb />WOMAN. He has completed a translation<lb />of volume 13 of the CORRESPONDENCE<lb />OF ERASMUS and begun work on volume<lb />14. Erasmus wrote in Latin, the lan-<lb /><lb />guage of scholars in his day.<lb />On the lighter side, DR. WILLIAM<lb /><lb />HALLBERG, golfing enthusiast and asso-<lb />ciate professor of English, celebrated new<lb />releases in 1998 of three previously<lb />published books. THE SOUL OF GOLF, first<lb />published in 1997 by Fawcett, has been<lb />reissued in paperback by Ballentine. For<lb />this book, Hallberg traveled the country<lb />to try out an assortment of golf courses.<lb />He writes about his travels, his golf game,<lb /><lb />the people he met along the way and<lb />life in general. In addition, Ballentine<lb /><lb />brought out a paperback edition of Hall-<lb />bergTs novel THE RUB OF THE GREEN, and<lb />Simon and Schuster issued a paperback<lb />version of his edited collection PERFECT<lb />LIES: A CENTURY OF GREAT GOLF STORIES.<lb /><lb />The Obesity and Diabetes Center of<lb />the School of Medicine has become<lb />headquarters for several important<lb />publications. DR. MICHAEL A. PFEIFER,<lb />director of the center, edited DEAR<lb />DIABETES ADVISOR and co-edited THE<lb />UNCOMPLICATED GUIDE TO DIABETES<lb />COMPLICATIONS, both of which were<lb /><lb />published by the American Diabetes<lb />Association. DEAR DIABETES ADVISOR,<lb />subtitled PLAIN AND SIMPLE ANSWERS TO<lb />YOUR QUESTIONS ABOUT DIABETES, came<lb />out in 1997. THE UNCOMPLICATED GUIDE<lb />followed a year later. Acknowledging<lb />that people with diabetes are living<lb />longer lives, it gives diabetic people<lb />and their families a thorough under-<lb />standing of many complications that<lb />may ensue and ways to prevent and<lb />treat these complications. Topics range<lb />from disorders of the feet to sexual<lb />health and eye disease.<lb /><lb />Pfeifer and his ECU colleague, DR.<lb />ROBERT TANENBERG, also have taken<lb />over as editors of the American Diabetes<lb />AssociationTs two major lay periodicals.<lb />Tanenberg edits the DIABETES ADVISOR,<lb />a bimonthly newsletter in brief, read-<lb />at-a-glance format. Pfeifer is editor of<lb />DIABETES FORECAST, a monthly newslet-<lb />ter with longer articles. (For articles on<lb />diabetes-related research and clinical<lb />trials, see pages 22-27.)<lb /><lb />On the literary front, assistant pro-<lb />fessor of English DR. MARGARET D. BAUER<lb />assumed editorship of the NORTH CAR-<lb />OLINA LITERARY REVIEW in 1998. She<lb />follows in the steps the journalTs found-<lb />ing editor and another ECU faculty<lb />member, Alex Albright.<lb /><lb />The annual journal is a publication<lb />of the North Carolina Literary and<lb /><lb />Historical Association.<lb /><lb />37<lb /><lb />edge<lb /></p>
        <pb facs="00000419_0021" />
        <p>Among other recent publications<lb /><lb />HARDAWAY REVISITED: EARLY<lb />ARCHAIC SETTLEMENT IN THE<lb />SOUTHEAST (UNIVERSITY OF<lb />ALABAMA PRESS, 1998)<lb /><lb />BY |. RANDOLPH DANIEL JR.<lb /><lb />Daniel, associate professor of anthro-<lb /><lb />pology, revisits one of the most famous<lb /><lb />Early Archaic archaeological sites in<lb />the southeastern United States, North<lb />CarolinaTs own Hardaway site. Located<lb />near Badin in Stanly County, the Hard-<lb />away site provided early hunters and<lb />gatherers with a base camp from which<lb />to exploit the stone outcrops of the<lb />nearby Uwharrie Mountains. Daniel pro-<lb />poses that it was the availability of high-<lb />quality stone that determined the loca-<lb />tion of the settlement. Previously, schol-<lb />ars have asserted that people in the<lb />Early Archaic period (9,000 to 10,500<lb />years ago) concentrated along the major<lb />southeastern river valleys to take advan-<lb />tage of food resources. (See page 8 for<lb /><lb />an article on DanielTs current project.)<lb /><lb />THE NORTH CAROLINA SHORE<lb />AND ITS BARRIER ISLANDS: REST-<lb />LESS RIBBONS OF SAND (DUKE<lb />UNIVERSITY PRESS, 1998) BY<lb />STANLEY R. RIGGS, ORRIN H.<lb />PILKEY, WILLIAM J. NEAL, CRAIG<lb />A. WEBB, DAVID M. BUSH, DEBO-<lb />RAH F. PILKEY, JANE BULLOCK<lb />AND BRIAN A. COWAN.<lb /><lb />This volume follows up on the ground-<lb />breaking 1978 book From Currituck to<lb />Calabash. In the earlier book, Riggs,<lb />ECU geology professor, and Duke<lb />UniversityTs Pilkey outlined the hazards<lb />of building on North Carolina beaches.<lb />The North Carolina Shore provides a<lb />detailed analysis of the two decades<lb /><lb />of change since then, covering all that<lb /><lb />nature and man have wrought, improve-<lb /><lb />ments in mapping techniques and reg-<lb /><lb />ulatory changes.<lb /><lb />LEE MOVES NORTH: ROBERT E. LEE<lb />ON THE OFFENSIVE (JOHN WILEY,<lb />1998) BY MICHAEL A. PALMER.<lb /><lb />This book analyzes Gen. LeeTs three<lb />strategic offensives"the Maryland<lb />campaign of September 1862, the<lb />Gettysburg campaign of June-July 1863<lb />and the Bistoe Station campaign of<lb />October-November 1863. Lee lost all<lb />three offensives, and Palmer, associate<lb />professor of history, highlights the ele-<lb /><lb />ments of LeeTs generalship that con-<lb />tributed to his failure.<lb /><lb />NONLINEAR TIME SERIES ANALYSIS<lb />OF ECONOMIC AND FINANCIAL<lb /><lb />DATA (KLUWER ACADEMIC PUB-<lb /><lb />LISHER, 1998), EDITED BY<lb />PHILIP ROTHMAN.<lb /><lb />Rothman, assistant professor of eco-<lb />nomics, pulled together 16 previously<lb />unpublished papers by economic spe-<lb />cialists in the field of nonlinear time<lb /><lb />series analysis. Rothman is a contributor<lb />as well as editor.<lb /><lb />SERIOUS PLAY: THE CULTURAL<lb />FORM OF THE NINETEENTH-CEN-<lb />TURY REALIST NOVEL (UNIVERSITY<lb />OF PENNSYLVANIA PRESS, 1999)<lb />BY JEFFREY FRANKLIN.<lb /><lb />Franklin, assistant professor of English,<lb />takes a look at gambling, theatricality<lb />and aesthetic theory as they are pre-<lb />sented in Victorian society and novels.<lb />He focuses on novels by Charlotte<lb />Bronte, George Eliot, Charles Kingsley,<lb />William Thackeray and Anthony Trol-<lb /><lb />lope. Along the way, he develops a new<lb /><lb />theory of the novel as a cultural form<lb />and revises the definition of realism.<lb />The book was published as part of the<lb />New Cultural Studies Series.<lb /><lb />STRUCTURALISMTS TRANSFORMA-<lb />TIONS: ORDER AND REVISIONS<lb />IN INDONESIA AND MALAYSIA<lb />(ARIZONA STATE UNIVERSITY<lb />CENTER FOR SOUTHEAST ASIA<lb />STUDIES, 1999), EDITED BY<lb />LORRAINE V. ARAGON AND<lb />SUSAN RUSSELL.<lb /><lb />In the bookTs introduction, Aragon, vis-<lb />iting professor in the ECU anthropology<lb />department, discusses the history of<lb />structural and post-structural theo-<lb />retical analyses of Indonesian and<lb />Malaysian cultures. The volume then<lb />presents 13 new ethnographic contri-<lb />butions concerning Indonesian and<lb />Malaysian cultures by U.S., Canadian,<lb />British, Dutch, Australian, Japanese and<lb />Indonesian authors. AragonTs co-editor,<lb /><lb />Russell, is on the faculty of Northern<lb />Illinois University.<lb /><lb />YOUNG ADULT SCIENCE FICTION<lb />(GREENWOOD PRESS, 1999),<lb />EDITED BY C.W. SULLIVAN III.<lb /><lb />This collection of essays by various<lb />experts examines science fiction written<lb />for the young adult market. It approach-<lb />es the topic with overviews of young<lb />adult science fiction from different<lb />countries and with articles on specific<lb />topics, such as women or war, in these<lb />young adult books. The final section<lb />is a massive annotated research bibli-<lb />ography. Sullivan, professor of English,<lb />also edited GreenwoodTs 1993 volume<lb /><lb />Science Fiction for Young Readers, which<lb /><lb />focuses on specific authors.<lb /><lb />Partnership to investigate<lb />issues in welfare reform<lb /><lb />Responding to the growing complexity<lb />of issues facing social workers, the<lb />School of Social Work and Criminal<lb />Justice Studies and the N.C. Association<lb />of County Directors of Social Services<lb />have established the Partnership for<lb />Human Services. Its purpose is to link<lb />the resources of the university with the<lb />needs of human services agencies in<lb />local communities.<lb /><lb />The partnership officially kicked off<lb />in May 1998 with a $700,000 contract<lb />from the N.C. Division of Social Services<lb />to conduct five research and curriculum<lb />projects. The projects include examina-<lb />tions of Work First welfare reform issues<lb />and methods to reduce the backlog of<lb />cases involving termination of parental<lb />rights. New training programs are being<lb />developed for workers in child protec-<lb />tive services. Most of the projects are<lb />scheduled for completion in 1999.<lb /><lb />Executive director Myra Powell and a<lb />five-person staff run the partnership under<lb />the auspices of the School of Social Work<lb />and Criminal Justice Studies and contract<lb />with school faculty to carry out projects.<lb />Oversight is provided by an executive<lb />committee composed of six social services<lb />directors and three social work faculty<lb />not involved with individual projects. An<lb />advisory board from outside the sponsor-<lb />ing agencies also is being established.<lb /><lb />Faculty leading the first set of proj-<lb />ects are Dr. Reginald O. York, Dr. Vickie<lb />D. Causby, Dr. Lessi L. Bass, Joyce G.<lb />Reed, Dr. Paul E. Knepper and Dr. Mary<lb />S. Jackson. Research assistance is pro-<lb />vided by social work lecturer Shelia G.<lb />Bunch and by Sara Davis and Beverly J.<lb />Brooks of the partnership staff.<lb /><lb />In addition to the state contract, the<lb />partnership has signed four contracts to<lb />provide technical assistance to individ-<lb />ual county social services departments.<lb /><lb />Biomedical physics admits first Ph.D. students<lb /><lb />ECUTs newest doctoral programs are<lb />getting off to a fast start. Biomedical<lb /><lb />physics admitted four students in its<lb />first class for fall 1998, and coastal<lb />resources management is on track to<lb />admit 10 to 12 students in fall 1999.<lb />The UNC Board of Governors approved<lb /><lb />both programs in early 1998.<lb />Meanwhile, ECU awarded 307 grad-<lb /><lb />uate-level degrees, including 17 doc-<lb />torates, in 1998. Approximately 2,900<lb />graduate students and 300 professional-<lb />degree students are enrolled.<lb /><lb />The biomedical physics program<lb />trains scientists in the complex interac-<lb />tions between the physical and biologi-<lb />cal worlds, preparing them to under-<lb />stand and develop advanced medical<lb />technologies. These would include such<lb />devices as laser beams, ultrasound, x-<lb />ray and electromagnetic radiation<lb />equipment. Students will study physics,<lb /><lb />biology, chemistry and medicine.<lb />Dr. Mumtaz Dinno, chair of the<lb /><lb />physics department, directs the pro-<lb />gram. Although based in the physics<lb />department, the program is a collabo-<lb />ration of the College of Arts and<lb />Sciences and the School of Medicine, in<lb />particular, the departments of radiation<lb /><lb />oncology and physiology.<lb /><lb />Dr. Lauriston R. King joined the ECU<lb />faculty in spring 1999 to direct the<lb />coastal resources management pro-<lb />gram. He comes to ECU from the Uni-<lb /><lb />versity of Southern Mississippi, where<lb /><lb />he was director of research and spon-<lb />sored programs. Before that, he had<lb />worked at Texas A&amp;M University as<lb />deputy director of the Office of Univer-<lb />sity Research and deputy director of the<lb />Sea Grant Program and at the National<lb />Science FoundationTs Office for the<lb />International Decade for Ocean Explo-<lb />ration. He is a past president of the<lb />National Coastal Society and has served<lb />on the executive committee of the<lb />Marine Affairs and Policy Association.<lb /><lb />The coastal resources management<lb />program is designed to advance scien-<lb />tific knowledge of the EarthTs oceans<lb />and adjacent coastal environments,<lb />with an emphasis on using scientific<lb />knowledge in the management of<lb />coastal and near-shore marine resources.<lb />It will draw on the expertise of faculty<lb />in seven academic disciplines"anthro-<lb />pology, biology, economics, geogra-<lb />phy, geology, political science and<lb />sociology. It is based in the Institute<lb />for Coastal and Marine Resources.<lb />Within months of its approval, about<lb />50 inquiries had been received from<lb />eight states, Canada and India.<lb /><lb />Another new program, the Ph.D. in<lb />communication sciences and disorders,<lb />will graduate its first student in 1999.<lb />The university also anticipates receiving<lb />approval from the Board of Governors<lb />to admit students to the new doctoral<lb />program in bioenergetics in the fall<lb />of 1999.<lb /><lb />edge<lb /><lb />39<lb /></p>
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          <lb />j<lb />|<lb />|<lb />)<lb />|<lb />}<lb /><lb />Technologies move closer to market<lb /><lb />Medical technologies lead the list of ECU<lb />innovations under review in the Office of<lb />Technology Transfer.<lb /><lb />The office reviews faculty inventions,<lb />files patent applications and helps move<lb />university technology into the market-<lb />place through licensing agreements and<lb />spin-off private enterprises. The office also<lb />encourages multidisciplinary collabora-<lb />tions within the university and collabo-<lb />rations with private companies.<lb /><lb />Innovations under review include:<lb /><lb />« An anti-stuttering device. Three ECU<lb />researchers in the Department of Com-<lb />munication Sciences and Disorders have<lb />identified a process that greatly reduces stut-<lb />tering and frequently eliminates it. When a<lb />stutterer speaks, the cells responsible for<lb />communication receive too many signals<lb />and basically short out, producing the stut-<lb />ter. This new device uses headphones and a<lb />sound board to redirect electric signals in the<lb />brain. ECU researchers involved in the proj-<lb />ect are Drs. Joseph Kalinowski, Michael<lb />Rastatter and Andrew Stuart.<lb /><lb />¢ Pediatric Heart Sounds CD-ROM.<lb />This interactive computer application is<lb />designed to help general medical practi-<lb />tioners and medical students learn to dis-<lb />tinguish between normal and abnormal<lb />heart sounds in children. It allows users to<lb />listen to heart sounds in four areas of the<lb /><lb />chest, closely simulating a physical exam,<lb />and to learn more about congenital heart<lb />problems. Additional interactive text, illus-<lb />trations and a self-test are included. The<lb />program was developed by Dr. Michael<lb />McConnell, a pediatric cardiologist at the<lb />medical school, and Alan Branigan of the<lb />Center for Health Sciences Communication.<lb /><lb />« An alternative to mammography.<lb />Although still in the early stages of devel-<lb />opment, this technology holds the poten-<lb />tial to improve on mammography as a<lb />screening device for breast cancer at lower<lb />cost than current alternatives. The device<lb />uses a continuous-wave laser beam to<lb />create high-resolution images. It is being<lb />developed by Dr. Xin-Hua Hu of the<lb />physics department.<lb /><lb />¢ Telemedicine kiosk. This stand-alone<lb />information booth could put health infor-<lb />mation into shopping centers, hotel lob-<lb />bies and airports. Based on interactive<lb />computer programming, it allows users to<lb />obtain medical information from self-con-<lb />tained software packages or over the<lb />Internet. Diagnostic tools such as blood<lb />pressure cuffs and telecommunication links<lb />can provide live consultations with medical<lb />practitioners. The kiosk has been devel-<lb />oped by the Center for Health Sciences<lb />Communications under the direction of<lb />David C. Balch.<lb /><lb />ECU implements state-of-the-art research administration<lb /><lb />The Office of Sponsored Programs cannot claim to be paperless, but the day may<lb /><lb />come, thanks to a nationwide trend toward electronic research administration, or ERA.<lb /><lb />ERA saves time and money by enabling ECU faculty members to submit grant pro-<lb /><lb />posals to sponsoring agencies electronically, automating necessary accounting and<lb /><lb />reporting functions, and transmitting information to sponsors on-line instead of by<lb /><lb />mail. Traditionally, research management has depended on moving reams of paper.<lb /><lb />As part of this movement, ECU is collaborating with major universities around the<lb /><lb />nation in pilot projects testing electronic administration initiatives by federal agencies,<lb />such as the National Institutes of Health. The Office of Sponsored Programs also has<lb />taken the lead in promoting campuswide electronic sharing of financial information<lb /><lb />and is assisting other UNC campuses in entering the electronic era of grant and con-<lb /><lb />tract management.<lb /><lb />Grant and contract<lb />activity increases<lb /><lb />Total grant and contract activity at ECU<lb />continued its steady climb in 1997-98.<lb />More than 400 faculty participated in<lb />submitting 542 proposals requesting<lb />almost $68 million in external funding.<lb />Faculty received 441 grants and con-<lb />tracts, totaling more than $28 million, a<lb />9 percent increase over 1996-97. The<lb />university was third among the 16-cam-<lb />pus UNC system in external funding.<lb />Just more than half of this funding<lb />(S51 percent) supported projects in public<lb />service, with 37 percent going for<lb />research and 10 percent for instruction<lb />and training. Clinical trials of new treat-<lb />ments for disease maintained a steady<lb />increase, going up by almost 15 percent<lb />over last year. Government (federal, state<lb />and local) accounted for 64 percent of<lb />funding. Business and industry spon-<lb />sored 20 percent, foundations and non-<lb />profit agencies supplied 13 percent, and<lb />other organizations sponsored 3 percent.<lb />Grants and contracts generate<lb />resources, over and above state appro-<lb />priations, for projects that benefit eastern<lb />North Carolina and the state. Some exam-<lb />ples include improving math and science<lb />learning in local schools, training health<lb />practitioners for medically underserved<lb />communities and rural areas, and moni-<lb />toring water quality in the stateTs rivers<lb />and estuaries. Faculty-initiated projects<lb />help small businesses improve their oper-<lb />ations and assist industry in solving funda-<lb />mental manufacturing problems. On a<lb />national and global scale, ECU research<lb />advances the frontiers of basic science in<lb />fields such as biochemistry, geology and<lb /><lb />pure mathematics, and contributes to his-<lb /><lb />torical and cultural scholarship.<lb /><lb />SPILMAN BUILDING<lb /><lb />five-year, $30 million project, was dedicated<lb /><lb />in March as part of Founders Day activities.<lb /><lb /><lb /><lb />Its front porch is a unique sound, water,<lb /><lb />art, music, video and mist environment<lb />,<lb /><lb />created by renowned artist<lb /><lb />Cristopher Janney and dubbed Sonic Plaza.<lb /></p>
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          <lb />~<lb /><lb />Sta i: 2 fet<lb />CAROLINA <lb />UNIVERSITY<lb /><lb />edge<lb />East Carolina University<lb />Greenville, NC 27858-4353<lb /><lb /></p>
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