bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Upper Limb Spasticity after Stroke: One-Year Safety and Efficacy of Botulinum Toxin Type A NT201
Authors: Fiore P. , Santamato A. , Ranieri M. , Bellomo R.G. , Saggini R. , Panza F. , Megna G. , Cristella G. , Megna M.
Published: January 2017

A new preparation of botulinum toxin type A called NT 201, free from complexing proteins, potentially with low antigenicity has been used in the therapy of spasticity in stroke patients. This was an open-label study reported the safety and the efficacy of one-year treatment with NT 201 evaluating the therapeutic effect on functional disability and on quality of life in upper limb spasticity after stroke. Patients received a botulinum toxin therapy in the upper injected intramuscularly. After inoculation, patients were submitted to a motor rehabilitation program for upper limb injected three times/week. Re-treatment was permitted at 12 weeks after the prior treatment. Safety assessment included evaluation of adverse events and efficacy was measured by Modified Ashworth Scale for spasticity (MAS), Spasm Frequency Score (SFS) for the daily spasms, and Disability Assessment Scale (DAS) for disability. Of 35 consecutive patients (13 women and 12 men) screened for study eligibility, 20 (6 women and 14 men) patients (mean age 63,4±7,03) were included in this study and were submitted to NT 201 therapy for one year. At the baseline, botulinum toxin dose in the upper limb ranged from 160 to 450U, whereas total dose in the last treatment administrated was reduced respect the first injections ranging from 120 to 350U. All the enrolled patients completed the year-long study and reported an improvement of clinical picture. MAS, was statistically (p<0,001) reduced in all muscles at T1 (mean score ±SD: 2.65±0.67) and T2 (mean score ±SD: 2.55±0.60) in comparison to the baseline T0 (mean score ±SD: 3.9±0.78). Significant reduction (p<0,001) from baseline T0 (mean score ±SD: 3.25± 0.78) was also noted in SFS at T1 (mean score ±SD: 1.55±0.51) and T2 (mean score ±SD: 1.30±0.47). The DAS score showed a reduction of the T1score (mean score ±SD: 1.70±0.47) and T2 score (mean score ±SD: 1,40±0,50) respect to baseline T0 score (mean score ±SD: 2,65±0,48) statistically significant (p<0,001). No adverse effects were observed in these patients. NT 201 appeared to be an efficacious and well-tolerated long-term treatment option for patients with upper limb spasticity after stroke, obtaining a substantial improvement in functional disability, muscle hypertone, and daily spasms.
A Clinical Study of AlloDerm in Lip Augmentation
Authors: Lang Melanie S. , Waite Peter D. , Holmes Jon D. , Nichols Michael R.
Published: January 2017

Introduction:

Lip augmentation is a frequently requested facial cosmetic procedure. The use of AlloDerm cosmetically has been documented since 1994, with clinical observations of some degree of resorption. The purpose of this prospective study was to objectively and subjectively assess the degree of labial change with AlloDerm implantation and its long-term clinical stability.

Materials and Methods:

Nineteen patients were treated with AlloDerm lip augmentation between January 1999 and October 1999. These patients were then followed up at 3, 6, and 12 months after surgery with a combination of physical evaluation, patient questionnaires, photographs, and lateral cephalometric radiographs. The data obtained were then evaluated objectively and subjectively. Objective analysis included computer analysis of photographs and lateral cephalometric radiographs. Subjective analysis included patient questionnaires and visual photographic assessment by professional independent evaluators.

Results:

Of the 19 patients initially enrolled in the AlloDerm lip study, 74% were seen on 3-month follow-up, 79% on 6-month follow-up, and 58% at 12-month follow-up. At 3 months, the compiled National Institutes of Health computer-analyzed photographic data showed an overall mean increase in the collective vermilion surface area of 16% on frontal and 39% on profile from the preoperative status. By 1 year, the overall mean increase in vermilion surface area was 8% on frontal and 36% on profile. The compiled lateral cephalometric radiographic data showed an overall mean increase in lip projection of 16% in the upper lip and 7% in the lower lip at 3 months. However, by 1 year, the overall mean increase in lip projection from preoperative status had dropped to 6% in the upper lip and 2% in the lower lip. Preoperatively, only 16% of the patients perceived their lips as looking about right or younger; this improved to 91% at 1 year. Independent evaluators viewed 54.5% of the patient's lips as looking about right or younger before surgery, as compared to 82% at 1 year.

Conclusions:

The objective results clearly indicate that there is substantial mean labial volumetric loss from 3 to 6 months after lip augmentation with AlloDerm. From 6 to 12 months, further volumetric loss is less substantial, with more stable clinical results. Despite documented resorption, there is an overall improvement in the subjective perception at all assessed points by both the patients and independent evaluators.
The Ultralift: A Simple, Safe, Effective Facelift Technique
Authors: Stokes Russell B.
Published: January 2017

Background:

Experience with smaller ultrasonic liposuction cannulas for neck and lower facial contouring has led to the incorporation of this technique into face-lifting procedures. Combining ultrasonic liposuction of the neck and a subcutaneous face-lift with the superficial musculoaponeurotic system plication (hereby called the Ultralift) provides a benefit greater than either technique alone.

Objective:

To determine if incorporating ultrasonic liposuction of the submental, jowl, and lateral neck regions is a safe and effective adjunct to a face-lift.

Methods:

The Vaser lipoplasty system was used to emulsify fat in the submental, jowl, and lateral neck regions. The fat was then evacuated with a VentX cannula, and the face-lift was then performed.

Results:

A retrospective chart review was performed on all patients who underwent the Ultralift procedure. This technique has been used on 47 patients. Patient ages ranged from 39 to 78 years, with an average age of 57 years. Follow-up ranged from 4 months to 4 years. There were no hematomas, seromas, skin burns, sloughs, or persistent nerve injuries.

Conclusions:

Ultrasonic liposuction combined with face-lifting is an effective and safe method of facial rejuvenation.
Limited-Incision Brachioplasty with Vaser-Assisted Lipoplasty of the Arm
Authors: Stokes Russell B.
Published: January 2017

Objective:

This study is designed to present a novel, minimally invasive combination of procedures for improving upper arm appearance.

Methods:

Eleven patients underwent Vaser-assisted lipoplasty of the arm and limited-incision brachioplasty between July 2003 and April 2006. Anchoring of the superficial fascial system was used in all patients, and postoperative compression garments were used for 2–3 weeks.

Results:

All patients were satisfied with the improvement they received from this procedure. There were no infections, seromas, or nerve-related complications from this procedure. There were 3 small wound separations among the 22 arms treated with this technique.

Conclusions:

The combination of Vaser-assisted lipoplasty and limited-incision brachioplasty has been a safe, effective treatment for mild or moderate excess skin and fat of the upper arm. Combining these 2 procedures has yielded improved outcomes relative to either alone, and morbidity is comparable to either alone.
Des Logiciels D'Analyse Textuelle Au Service De L'Imagination Sociologique
Authors: Demazière Didier
Published: January 2017

Text-Analysis Programs Serving Sociological Innovation: Beginning with the idea that what text analysis programs do is closely associated with their manner of application to a corpus, the Methods Thematic Network of the French Sociological Association (AFS) organized the analysis of the same corpus by different programs. This comparative perspective allows us to show that these programs are not simple instruments for generating proofs, but, on the contrary, constitute applicable resources – among others – for testing interpretations, for enriching theories, and thus for encouraging sociological innovation.
Cartographie Du Premier Congres De L'Asf Avec La Methode Des Mots Associes
Authors: de Saint Leger Mathilde , van Meter Karl M.
Published: January 2017

Cartography of the First Congress of the AFS Using the Method of Associated Words: The 2004 congress of the French Sociological Association (AFS) included more than 1,000 presentations. Considered as representative of contemporary French sociology, the corpus of abstracts is analyzed with Colliope, a text-analysis computer program based on the associated-words method. A cartography of the entire corpus shows rather varied themes which are interconnected but weakly structured. The role of the term WOMAN as a pole, in the sense that it is the link between many different themes, stands out. Cartographies of sub-sets of abstracts, grouped together by thematic network (RT), reveal more structured results which remain strongly interconnected. It would be interesting to compare these results with those of other text-analysis approaches which should be done soon.
Growing up Masculine: Rethinking the Significance of Adolescence in the Making of Masculinities
Authors: Connell R.W.
Published: January 2017

Adolescence is not a fixed stage in a life-cycle, so much as a terrain of encounters between growing persons and the adult world. International research on youth shows the importance of a relational approach. Masculinities are constructions within a gender order; but gender orders are neither simple nor static. Projects of masculinity formation reflect social diversity and inequality. Developing bodies are re-interpreted and challenged in new practices, institutions such as the high school are encountered and negotiated, the state and the corporate economy are approached. Hegemonic definitions of masculinity exert strong pressure, yet multiple paths through adolescence are found by different groups of youth. The importance of adolescence in the making of masculinities lies both in the ways existing masculinities are appropriated and inhabited, and in the negotiation, and sometimes rejection of old patterns.
Fallen Heroes? All about Men
Authors: Weeks Jeffrey
Published: January 2017

The question of what men are and what they want has become central to public debates and private concerns but we cannot understand what is happening if we see it as a problem for men alone. It needs to be considered as part of a long process in which masculinity and femininity, sexual normality and abnormality, and the nature of intimate life are being profoundly shaken. The emergence of a crisis discourse around masculinity has served to obscure the different conditions under which men live their lives, and to exaggerate in turn the radical dichotomy of men and women. Binary divisions along gender and sexual lines can be seen as an historical fiction which conceals a much more confused mixture of fears, anxieties and desires about what being a man means. The dramatic social and cultural changes that we are now witnessing provide conditions for reinventing the relations of gender and sexuality.
Death Rather Than Disclosure: Struggling to Be a Real Man
Authors: Cleary Anne
Published: January 2017

Non-disclosure of distress emerged as a key issue in examining pathways to suicidal action for a group of men. Disclosure of difficulties was viewed as un-masculine, as implying weakness and this was associated with feminine or homosexual type behaviour. Constant performative work, including hyper-performances, was required to project an image of strength and to conceal growing levels of distress. When extreme, this challenged their sense of a coherent self-identity. Performances were directed at family, friends and work colleagues and this inhibited others from identifying and responding to the distress.
Private Troubles, Public Issues: The Irish Sociological Imagination
Authors: O'Connor Pat
Published: January 2017

In contemporary Irish Society there is considerable uneasiness about both the existence of and threats to the ‘patriarchal dividend’ (O'Connell, 1995a: 82). It is suggested that this wider social and cultural context, characterised by male dominance of key institutions, militates against the identification of gender related private troubles as public issues. Burawoy's (2005) focus on the public aspect of each of the four types of sociology he identifies (viz., policy, critical, public and professional sociology) is used as a framework to explore the recent contribution made by sociologists in Ireland to the identification of gender as such a public issue. The article concludes that, by not explicitly focusing on it their contribution as agenda setters has been more limited than it might otherwise have been.
Transition to Organic Farming in Ireland: How Do Organic Farmers Arrive at the Decision to Adopt and Commit to Organic Farming Methods?
Authors: Devitt Catherine
Published: January 2017

The following paper reviews the research Transition to Organic Farming in Ireland: How do Organic Farmers Arrive at the Decision to Adopt and Commit to Organic Farming Methods? The objective of this research was to examine how individuals arrive at the decision to adopt organic farming methods and commit to this decision on a daily basis through their everyday behaviour. A social movement approach was adopted. This approach considered the impact and appeal of the cosmological, organisational and technological aspects of the organic farming movement and how these aspects combine, in the decision process, to influence the biographies, motivations and behaviour of the organic farmer as well as the extent to which the organic farmer participates in social networks.
Social Policy in a Divided Community: Reflections on the Opsahl Report on the Future of Northern Ireland
Authors: Lister Ruth
Published: January 2017

This paper offers an account of some of the written and oral evidence presented to the Opsahl Commission established to enquire into possible ways forward for Northern Ireland. It examines issues about social policy raised by the contributors to the Commission, in particular in the areas of poverty and exclusion, children and young people, the role of women, community development and the voluntary sector, and the position of minority groups. Lastly, it relates these crucial aspects of social policy to concepts of citizenship in the context of the future for Northern Ireland.
Studies on Microleakage Associated with Visible Light Cured Dental Composites
Authors: Krishnan V. Kalliyana , Bindhu D. B. , Manjusha K.
Published: January 2017

The objective of this investigation was twofold: 1) to determine the extent of microleakage associated with two visible light cured dental composites, one of which is an indigenously developed light cure composite (chitra light cure system) compared with a commercially available control material (Prisma APH light cure system), and 2) to study the effect of using bonding agents upon the above phenomena. The bonding agents used along with the above composites during restoration were chitra bonding agent system containing chitra primer/chitra resin and a control (Probond) which was purchased commercially.

A comparison of microleakage in freshly restored human premolar teeth by silver nitrate staining technique was made during the above study. Cavities were restored with both composites with and without bonding agents, stored in 50% silver nitrate, and sections were cut after developing. The microtomed sections were observed under the optical light microscope and scanning electron microscope. Results indicate that bonding agents are mandatory for effective bonding at the tooth/resin interface and subsequent reduction in marginal leakage. Chitra bonding agent showed excellent adhesive bonding characteristics at the dentine/composite interface with minimal marginal leakage compared to the control bonding system. The chitra light cure composite material also showed lower shrinkage characteristics compared to Prisma APH composite.
Anxiety Sensitivity Mediates Relations Between Attachment and Aggression Differently by Gender
Authors: Watt Margo C. , Gallagher Catherine E. , Couture Marie-Eve , Wells Robyn , MacLean Kim
Published: January 2017

The present study examined relations among attachment, aggression, and anxiety sensitivity (AS) in a sample of male and female undergraduates. Given that some individuals may use aggression to modulate negative emotional states, it was predicted that AS dimensions would mediate relations between attachment anxiety (vs. attachment avoidance) and certain forms of aggression, particularly impulsive aggression. Moreover, it was hypothesized that the relations among attachment, aggression, and AS would be moderated by gender. Participants ( N = 1,042) completed measures of attachment (Experiences in Close Relationships–Revised [ECR-R]), aggression (Aggression Questionnaire [AQ]; Impulsive/Premeditated Aggression Scales [IPAS]), and AS (AS Index–3 [ASI-3]). Results indicated that AS mediated relations between attachment dimensions (both anxiety and avoidance) and most forms of aggression, with each of the AS dimensions playing a unique role differentially by gender. Cognitive concerns emerged as a significant mediator, particularly for men; physical and social concerns played more of a mediating role for women. Interestingly, none of the AS dimensions played a significant mediating role between attachment (either anxiety or avoidance) and physical aggression for men. Results are discussed in terms of their clinical implications and directions for future research.
An Event-Level Investigation of Factors Associated With Young Women’s Experiences of Coerced Consensual Sex
Authors: Stappenbeck Cynthia A. , Norris Jeanette , Wegner Rhiana , Bryan Amanda E. B. , Davis Kelly Cue , Zawacki Tina , Abdallah Devon A. , George William H.
Published: January 2017

Little is known about instances of coerced consensual sex in which women report both that they consented to have sex and that their partner used coercive tactics (e.g., made threats) to get them to have sex when they did not want to. Yet, these experiences are frequently reported by young sexually active women. We examined the relationship between sexual victimization history and the woman’s level of alcohol intoxication in the likelihood of experiencing coerced consensual sex using event-level data collected over a 1-year period from 548 young adult nonproblem drinking women who engaged in sexual activity with men. Twenty percent ( n = 112) reported at least one incident of coerced consensual sex. A generalized estimating equation model revealed main effects of daily estimated blood alcohol content (eBAC) and sexual victimization severity. The more women increased their alcohol consumption above their own average and the more severe their sexual victimization history, the more likely they were to experience coerced consensual sex. Our findings highlight the fact that coercion and consent are not mutually exclusive in some situations and shed light on this important yet understudied coercive sexual experience.
Stressful point-of-care rapid testing for human immunodeficiency virus, hepatitis C virus, and syphilis
Authors: Reynolds Grace L , Fisher Dennis G , Brocato Jo , van Otterloo Lucy , Khahlil Khaloud , Huckabay Loucine
Published: January 2017

Even with technological advances in point-of-care rapid testing for HIV, hepatitis, and syphilis, individuals may still find the experience of submitting to testing, and receiving results, to be stressful. Participants completed the rapid test experience questionnaires to assess stress both prior to and after the specimen collection. Participants completed the risk behavior assessment, the coping strategies indicator, and the Barratt impulsivity scale. Participants chose which rapid tests they wanted using a list administered via computer. Logistic regression analysis was used to model self-reported stress prior to testing and after testing. A total of 1097 individuals completed testing. Individuals who scored high on avoidance reported a stressful experience at pretest (OR = 1.15, CI = 1.04, 1.26) while higher educational attainment was associated with no stress at both time points. Injection drug users, avoidant, and impulsive individuals experience stress either before or after rapid testing. Education appears to be protective against stressful testing.
Genitoanal Papillomavirus Infection: Diagnostic and Therapeutic Objectives in the Light of Current Epidemiological Observations
Authors: von Krogh Geo
Published: January 2017

During the past decade a wide span of heterogeneity has been demonstrated for human papillomaviruses (HPVs), and some basic properties of the HPV genome have been revealed. The use of hybridization assays for HPV DNA detection in infected epithelia, and the recent introduction of synthetic HPV peptides for detection of type-specific circulating antibodies, have resulted in a major rethinking of HPV epidemiology. Recent data indicate that various HPVs may be transmitted perinatally during early infancy and that a long latency with periodic reactivation seems to be quite common. The present review attempts to assess recent epidemiological data with the concept of genitoanal papillomavirus infection (GPVI) as a predominantly sexually transmitted disease. Some diagnostic and therapeutic aspects are outlined with a pragmatic approach to the clinical relevance of GPVI.
Autonomic Dysfunction in Patients with Human Immunodeficiency Virus Infection
Authors: Shahmanesh M , Bradbeer C S , Edwards A , Smith S E
Published: January 2017

Autonomic function tests have been recorded in 40 male homosexual patients with serum antibodies to human immunodeficiency virus (HIV) and 12 male homosexuals without such antibodies. Abnormalities of autonomic function were found in 15 of 31 patients without other recognized reasons for autonomic dysfunction. Four patients had two or more test abnormalities. The profile of these abnormalities was found to be different from that of autonomic neuropathy associated with diabetes and other disorders and was consistent with the presence of sympathetic overactivity.

Abnormalities in autonomic function were particularly associated with clinically identifiable neurological complications of HIV infection.
Cytomegalovirus Retinitis: Diagnosis and Treatment
Authors: Maclean Hunter , Dhillon Baljean
Published: January 2017

Cytomegalovirus (CMV) is a non-pathogenic organism in the immunocompetent, but is a major cause of morbidity and mortality amongst patients with AIDS, and the retina is the commonest site of infection1. If left untreated, patients with CMVR will develop disease in their second eye and ultimately become blind2. However, with correct diagnosis and treatment useful vision can be maintained in the majority of cases. Fifteen to 20% of patients with AIDS will contract cytomegalovirus retinitis (CMVR)3−7 and this may be the AIDS-defining diagnosis though more commonly it occurs months after the diagnosis of AIDS. Given the increasing number of HIV positive patients and their longer survival, it is likely that CMVR will become an increasingly prevalent condition. In these patients loss of sight from CMVR has devastating consequences in terms of loss of independence and quality of life and therefore ophthalmologists and physicians should be aware of the presenting characteristics of CMVR, be familiar with therapy and its complications, and be able to recognize relapsing infection.
Effect of Fuel-Air Mixture Heterogeneity on Vibrations in Continuous Combustion Systems
Authors: Othman M.O. , Abou-Arab T.W. , Najjar Y.S.H.
Published: January 2017

High vibration amplitudes can be a sign of impending failure or deterioration of equipment. In this work, a rarely researched phenomena, namely the effect of fuel heterogeneity in continuous combustion systems on the induced vibration and noise, is studied. The vibration pattern is obtained via a real-time spectrum analyzer. The use of spectrum analyzer with proper filtering made it possible to distinguish between the induced aerodynamic and combustion vibration. This could be done by comparing the vibration characteristic of reacting and nonreacting cases. Noise measurements are also obtained using a sensitive sound level meter. The results show a remarkable effect of the fuel heterogeneity ratio on the vibration and noise pattern. For liquified petroleum gas (LPG) and kerosine the vibration amplitudes at all frequencies were found to decrease with the increase of the air mass flow rate and henceforth increase after they attain certain minimum. The minimum amplitudes were in the range of 80 to 100 kg/h depending on the heterogeneity ratio. For intermediate values of LPG percentage an opposite trend was noticed i.e. the vibration level is first increased as the air mass flow rate increases until it attains a maximum then it decreases with any further increase in the air mass flow rate. Concerning the noise, slight effect of heterogeneity was observed in the high frequency noise pattern, however the low frequency noise (combustion roar) was found to be increasing with the increase of heterogeneity ratio.
The Abatement of Gaseous Emissions by Energy Efficient Lighting
Authors: Eyre N.J.
Published: January 2017

The potential for conserving electricity using energy efficient lighting is investigated for the domestic, service and industrial sectors in the UK. A variety of technologies are considered, of which replacement of incandescent lighting and improved ballasting and control of fluorescent installations are the most important. Lighting currently uses approximately 40 TWh/year (8% of UK electricity). It is found that at least half of this could be conserved using technologies which are already cost effective. A variety of market barriers result in these savings not being achieved. If policy measures were adopted to overcome these barriers, emissions would be reduced by 3.3 MteC/year of carbon dioxide (2% of the UK total) and 100 kteS/year of sulphur dioxide (5% of the UK total).
Institutional Improvement Needs for Effective Energy-Environment Interaction in Asian-Pacific Countries
Authors: Lee Sang-Gon
Published: January 2017

The countries of Asian and the Pacific are diverse but share the common feature of rapid economic growth. Generally energy and environment have not been well coordinated and considerable improvement is needed in institutional arrangements for these sectors. Specific areas of needed improvement are recommended here. Among these are greater weight to environmental management by source, expanding the scope of EIAs, incorporation of environmental management units within energy authorities and a preference for coordination over cooperation.
The Timing of CO2 Emissions Abatement: An Overview of Economic Issues
Authors: Grubb Michael
Published: January 2017

This paper is stimulated by the debate in the US about optimal abatement paths, in particular recent claims that it would be economically preferable to defer such abatement action, in favour of measures that support technology development but do not affect emission trends for many years. This paper categorises the various economic issues involved and concludes that for each economic argument that has been advanced to justify deferring emission constraints, there are countervailing economic arguments that could be used in support of rapid near-term emissions abatement. Rational policy lies between these extremes. A policy of deferring all emissions abatement exposes economic systems and industries, as well as the environment, to significantly greater costs and risks than those arising from a more balanced approach. Furthermore the modelling studies that have been used to justify deferring emissions abatement do so because they embody the economic factors favourable to delay and largely neglect the countervailing issues, to the point where they cannot be considered as relevant to a balanced assessment of the issues relating to economically optimal abatement timing.
The Impact of Energy on the Adoption of Conservation Tillage in the United States
Authors: Uri Noel D.
Published: January 2017

The impact of energy on the adoption of conservation tillage is of special importance in addressing concerns about the effect of agricultural production on the environment in the United States. It is the subject of this paper. After establishing that a relationship exists between the price of energy and the adoption of conservation tillage via cointegration techniques, the relationship is quantified. It is shown that while the real price of crude oil, the proxy used for the price of energy, does not affect the rate of adoption of conservation tillage, it does impact the extent to which it is used. Finally, there is no structural instability in the relationship between the relative use of conservation tillage and the real price of crude oil over the period 1963 to 1997.
Thirty years of cyclophosphamide: assessing the evidence
Authors: Houssiau F
Published: January 2017

The ideal therapy for lupus nephritis should reduce mortality and end-stage renal disease in the long term, induce early response and remission, prevent flares, have minimal side-effects and not compromise fertility. It should also be active in all ethnic groups, widely available and cost effective. Despite 30 years' clinical experience, the ability of cyclophosphamide to meet these needs is not supported by robust evidence.

The first National Institutes for Health (NIH) trial in 1986 led to a shift from oral to intravenous cyclophosphamide. The three NIH trials together then led to the dogma that high-dose intravenous cyclophosphamide is the only cytotoxic agent superior to steroids alone in lupus nephritis and to its general acceptance as the ‘standard of care’. Since then, high-dose intravenous cyclophosphamide has been shown to have no impact on survival, to be less effective in black patients and to have many side-effects, particularly an unacceptable risk of premature menopause.

The Euro-Lupus Nephritis Trial found that low-dose intravenous cyclophosphamide could be used as an alternative to a high-dose regimen and was associated with half as many severe infections. Other advantages include no hospitalisation and virtually no risk of premature gonadal failure. Other studies have looked at regimens in which cyclophosphamide is entirely replaced – for example, with mycophenolate mofetil – and have found fewer side-effects and better induction of remission.

Intravenous cyclophosphamide is the only therapy with long-term data for reduction of end-stage renal disease. As data on other therapies accumulate, however, intravenous cyclophosphamide might no longer be considered the standard treatment for lupus nephritis.
Exploring new territory: considering the future
Authors: Schneider M
Published: January 2017

The European League Against Rheumatism (EULAR)'s guidelines for lupus state that mycophenolate mofetil has at least equivalent efficacy to and less toxicity than cyclophosphamide for the short-and medium-term treatment of lupus nephritis but that long-term data are available only for cyclophosphamide. New therapies are needed to reduce toxicity and the need for steroids and to offer the possibility of cure. Therapies under investigation include other immunosuppressive agents, anticellular therapies, drugs that modify cell-cell interactions, (anti-)cytokine therapy, hormone therapy and lupus-specific immunomodulation.

Rituximab has shown promise in patients refractory to conventional immunosuppression, which suggests that targeting B cells may be successful. Other anti-cell therapies include epratuzumab, belimumab and alemtuzumab. Anti-cytokine approaches include tumour necrosis factor alpha blockade with infliximab, anti-interleukin 6-receptor therapy with tocilizumab and interferon-α blockade. As anti-double-stranded DNA antibodies correlate with flares of lupus nephritis, they may represent another therapeutic target – as do monocyte chemoattractant protein-1 and protein kinase CK2. Therapeutic options to prevent damage in lupus nephritis include non-immunosuppressive treatments aimed at reducing cardiovascular risk (such as statins, angiotensin-converting enzyme inhibitors and aspirin).

As was the case with rheumatoid arthritis, a change in therapeutic aims – from survival through prevention of renal failure to induction of remission – may modify outcomes. EULAR's guidelines state that renal biopsy is the best monitor of clinical outcome in lupus nephritis, as immunological tests have limited predictive value. Measurement of urinary mRNA for cytokine and growth factor genes may provide a more sensitive, non-invasive method of monitoring therapeutic response.
Acute granulomatous lupus pneumonitis: the first case report
Authors: Chaiamnuay S , Heck L W , Bell W C , Bastian H M
Published: January 2017

Acute lupus pneumonitis is a rare form of pulmonary involvement in systemic lupus erythematosus (SLE). We present herein a patient with acute lupus pneumonitis who presented with acute onset of fever, cough, dyspnea and a miliary pattern on chest radiographs and computer tomography. Lung histopathology revealed bronchocentric granulomatosis. To our knowledge, this is the first documented case of granulomas in lung parenchyma believed to be caused by SLE. The differential diagnoses of acute lupus pneumonitis and the pertinent literature are discussed.
The analysis of functional magnetic resonance images
Authors: Rabe-Hesketh S , Bullmore E T , Brammer M J
Published: January 2017

Functional magnetic resonance imaging (fMRI) is a powerful technique for measuring brain activity associated with the performance of different mental tasks. We briefly describe this technique and the images it produces and review methods of analysis that have been applied to fMRI data. Throughout the paper, we illustrate various points on an fMRI dataset.
Enduring biographic heritage – Medical numismatics
Authors: Pearn John
Published: January 2017

The most enduring archive of medical biography is that composed of coins and medals. More than 20,000 commemorative and tribute medals comprise the domain of medical numismatics. Several thousand of these portray individual doctors whose lives and work are thus recorded in gold, silver, bronze and the alloys of medallic art. Such enduring records range from the names and images of the most famous and significant of doctors in international perspective, to those held in local or parochial esteem by their peers. The medical numismatic archive includes medals and coins which portray the gods of medicine; founders of the profession such as Hippocrates and Galen; and those who have been held in local esteem, all such that the record of their service to medicine might not be forgotten.
Invasive Cervical Cancer in Southampton and South West Hampshire: Effect of Introducing a Comprehensive Screening Programme
Authors: Herbert Amanda , Breen Catherine , Bryant TN , Hitchcock A , Macdonald H , Millward—Sadler G H , Smith Jenifer
Published: January 2017

A study of invasive cervical cancer in Southampton and South West Hampshire is reported, covering three consecutive three year periods during which the screening coverage increased from an estimated 60% to a recorded 87% of eligible women aged 20–64. From the first to the third periods of the study in that age group registrations of fully invasive squamous cell carcinoma (stage Ib and above) fell from 64 to 30 (53%), which was largely counteracted by an increase in microinvasive squamous cell carcinoma (linear trend: P<0–0001). In the same age group registrations of adenocarcinoma rose slightly, which resulted from an increase in the number diagnosed at a depth of invasion of less than 3 mm. There were no significant changes in the numbers of stage III and IV cancers or among cancers in women aged 65 and over. A strong inverse association was found between stage of both histological types of cancer and their likelihood of being screen detected rather than symptomatic: 91% of screen detected cancers were diagnosed at stage I compared with 38% of symptomatic cancers.

There was a slight downward trend in the incidence of cancer per 100 000 total female population across the three periods of the study with a significant trend towards low stage disease, which is likely to reduce mortality in years to come. The trend towards screen detected cancers and cancers of less than 3 mm depth of invasion is presented as a positive outcome to be expected in early rounds of increasing the screening coverage.
Uptake of Cervical Screening in General Practice: Effect of Practice Organisation, Structure, and Deprivation
Authors: Ibbotson T , Wyke S , McEwen J , Macintyre S , Kelly M
Published: January 2017

Objectives—

To investigate associations between uptake for cervical screening in general practice and the organisation of screening, features of practice structure, and deprivation.

Setting—

Greater Glasgow Health Board area in the west of Scotland, which covers a socioeconomically varied population.

Methods—

General practice questionnaire survey and interview based study. The main outcome measure was the uptake rate for each participating practice over the five and a half years ending 31 December 1993. This was used to determine whether practices achieved 80% uptake to trigger maximum payment for cervical screening services.

Results—

Forty seven per cent (n = 92) of all practices in the Greater Glasgow Health Board area agreed to take part in the research, with complete data collected for 87 practices. Participation varied according to number of partners in the practice and the average deprivation score of the practice. Uptake rates ranged from 48.2% to 92.9% (median 77.5%, interquartile range 69.8% to 83.4%). Thirty seven practices (43%) achieved the 80% target. None of the recommended features of good organisation of cervical screening showed any statistically significant association with uptake rates. In stepwise multiple regression four variables were shown to have independent associations with uptake. These were the number of partners in the practice, the average deprivation of the practice, the presence of a female general practitioner, and using a practice's own lists for sending out letters of invitation. In stepwise logistic regression just two of these variables contributed to the prediction of achieving 80% uptake – namely, average deprivation and number of partners. There were no significant interactions between deprivation and the organisation of screening in relation to uptake.

Conclusions—

Organising cervical screening in general practice according to accepted standards is less important in predicting uptake than more intractable features of the practice such as the size of the partnership, its average deprivation level, the presence of a female general practitioner, and using their own (presumed more accurate) register of addresses to call women. A flexible incentive scheme may more fairly reward the efforts of those general practitioners who achieve high uptake rates but who do not trigger remuneration at the 80% level.
Can a manager dope? Match analysis in the digital age
Authors: Kioussis George N
Published: January 2017

In his influential book on the evolution of sport, historian Allen Guttmann highlights quantification as a key characteristic of the modern era. Though football has long been believed to be too fluid for statistical analysis, the recent proliferation of performance metrics has challenged traditional ways of understanding the game. This has been spurred in large part by the design of ‘smart’ technologies that offer insights into a side’s positional tendencies or physical capacities. Hence, an endeavour that typically rested on the intellect of a manager has now shifted, in some sense, to the computer. This paper connects match analysis systems to the scholarly discourse on performance enhancement and two prominent issue areas related to doping: the ethos of sport and harm.
Networks, Big Data, and Intermedia Agenda Setting: An Analysis of Traditional, Partisan, and Emerging Online U.S. News
Authors: Vargo Chris J. , Guo Lei
Published: January 2017

This large-scale intermedia agenda–setting analysis examines U.S. online media sources for 2015. The network agenda–setting model showed that media agendas were highly homogeneous and reciprocal. Online partisan media played a leading role in the entire media agenda. Two elite newspapers— The New York Times and The Washington Post—were found to no longer be in control of the news agenda and were more likely to follow online partisan media. This article provides evidence for a nuanced view of the network agenda–setting model; intermedia agenda–setting effects varied by media type, issue type, and time periods.
Reengineering a Home Health Care Agency to Achieve Cost Effectiveness
Authors: Connolly Mary Lou
Published: January 2017

Home health care agencies face a clear challenge in a managed care environment: reduce costs and maintain and improve quality. Organizational efficiencies and customer satisfaction are the outcomes of the reengineered home care organization. The staff of UCSD Home Care recognized that for one agency to survive and thrive, major changes had to occur. The major phases of the staff-driven, staff-led reengineering effort were accomplished within 4 months. The implementation process that affected virtually ALL home care staff continues. One year following the reengineering project's initiation, the agency has achieved a significantly healthy bottom line, customer satisfaction is high, cost per unit of service is significantly reduced, and employee morale is better than ever.
Daily Hassles and Exercise Frequency in Women
Authors: Zaravar Patricia W. , Nies Mary A.
Published: January 2017

Exercise has been associated with a decreased incidence of many chronic diseases that may develop later in life. Today women are working full time, caring for children, husbands, and households. The purpose of this descriptive study was to examine the relationship between daily hassles and exercise frequency of women. The study used a convenience sample of 50 women aged 20 to 46 years. This study found that with increasing hassles related to household activity, family and friends, and personal life, there was a decrease in activity. Home health care nurses and educators can use the findings from this study to influence women to adopt active, healthy lifestyles at home.
To include or not to include? Party representation in electoral institutions and confidence in elections
Authors: Otaola Miguel Lara
Published: January 2017

Existing research does not offer conclusive evidence on which electoral management body (EMB) model is best for having confidence in electoral processes. While some scholars favour partisan autonomy in election administration, others argue for a multiparty-based election management. Others provide mixed evidence. This article focuses on the importance of including political parties in EMBs, measured by a scale with four levels of participation of parties in the appointment of EMB members. Results show that although it may be advantageous to include political parties in the appointment process of the EMB members, not all forms of inclusion yield the same level of benefits in terms of confidence in elections. This is demonstrated through logistic and multilevel regression of results from the Parliamentary Elites of Latin America survey.
Sample Size Calculations for Trials in Health Services Research
Authors: Wood John , Lambert Mark
Published: January 2017

The current orthodox way of estimating sample size for a trial is through a power calculation based on a significance test. It therefore carries the assumption that this test should be the centrepiece of the statistical analysis. However, it is increasingly the case that confidence intervals are preferred to significance tests in summarising the results of trials, particularly in health services research. We believe that the way sample size is estimated should reflect this change and focus on the width of the confidence interval rather than on the outcome of a significance test. Such a method of estimation is described here and shown to have additional advantages of simplicity and transparency, enabling a more informed debate about the proposed size of trials.
End-of-Life decisions: The Policy Issue that Will not Die
Authors: Shortt Samuel , Laver James
Published: January 2017

In most jurisdictions, public policy regarding assisted death has not advanced beyond simple prohibition. However, this issue is increasingly likely to reach the policy agenda. Policy-makers may be tempted to turn for guidance to the three places in the world with developed policy or legislation: the Netherlands; the American state of Oregon; and the Northern Territory in Australia. A review of their legislation and relevant guidelines reveals that they rest on four shared assumptions: the neutral assessor status of physicians; the primacy of pain as a validator of requests for assisted death; the need to exclude depression from influencing the decision-making process; and the exclusion of non-clinical existential factors in granting access to assisted death. Recent research in health services raises questions as to the validity of each of these assumptions. This, in turn, has implications for future public policy on assisted death.
Cannibal Margarine and Reactionary Snapple
Authors: Burke Timothy
Published: January 2017

This article surveys rumors and ‘contemporary legends' concerned with the contamination or adulteration of various commodities. The article compares common Euro-American folktales like the ‘Kentucky Fried Rat’ or stories concerned with the explosive effects of Pop Rocks with southern African rumors about will-sapping sugar and cannibalistic tinned meat. The global prevalence of such rumors suggests that they represent a shared reaction to the advance of modern capitalism, namely, a popular critique of commodity fetishism, of the loss of social knowledge about the production of commodities. However, such a critique is mostly mischievous or at most subversive. The global prevalence of commodity rumors may suggest that capitalism's alienation is evenly balanced by its desirability, even in those societies most marginalized by its global advance