bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of custom cementless stem using finite element analysis and elastic modulus distribution for reducing stress-shielding effect
Authors: Saravana Kumar Gurunathan , George Subin Philip
Published: January 2017

This work proposes a methodology involving stiffness optimization for subject-specific cementless hip implant design based on finite element analysis for reducing stress-shielding effect. To assess the change in the stress–strain state of the femur and the resulting stress-shielding effect due to insertion of the implant, a finite element analysis of the resected femur with implant assembly is carried out for a clinically relevant loading condition. Selecting the von Mises stress as the criterion for discriminating regions for elastic modulus difference, a stiffness minimization method was employed by varying the elastic modulus distribution in custom implant stem. The stiffness minimization problem is formulated as material distribution problem without explicitly penalizing partial volume elements. This formulation enables designs that could be fabricated using additive manufacturing to make porous implant with varying levels of porosity. Stress-shielding effect, measured as difference between the von Mises stress in the intact and implanted femur, decreased as the elastic modulus distribution is optimized.
Evaluation of Possible Effects of Continued Drug Use on HIV Progression among Women
Authors: Rompalo Anne M , Shah Nina , Margolick Joseph B , Farzadegan Homayoon , Arnsten Julia , Schuman Paula , Rich Josiah D , Gardner Lytt I , Smith Dawn K , Vlahov David ,   for the HIV Epidemiology Research Study (HERS) Group
Published: January 2017

Data from a prospective, multi-centred study of HIV infection in women (HIV Epidemiology Research Study [HERS)) was analysed to investigate the effect of continued injection drug use behaviours on progression to AIDS. All women enrolled in the HERS had at enrolment and at six-month intervals, a face-to-face interview which included specific injection drug use, a physical exam, and specimen collection that included T-cell subset analysis and HIV plasma RNA detection. Six hundred and thirty-nine HIV-infected women contributed 3021 person years of observation during 7.25 years of follow-up, and 299 of these women progressed to AIDS (46.8%). In multivariable analysis, there was no significantly increased risk of progression to AIDS for women reporting pre-baseline injection drug use [hazard ratio (HR)=1.07 (0.78, 1.47)] or reported injection drug use during follow-up [HR=0.89 (0.66, 1.21)] compared with never injecting. In a separate multivariable-model, comparing women who reported no injection in past six months to active injection drug users, the frequency of injection during the previous six months measured by daily injection [HR=0.97 (0.61, 1.55)] or less than daily injection [HR=O.84 (0.54, 1.33)] was not associated with progression to AIDS. Being in drug treatment was independently associated with a slower progression to AIDS [HR=0.41 (0.28,0.59)]. Neither injection drug use, nor frequency of injection drug use was associated with progression to AIDS among HIV infected women. Initiation of antiretroviral therapy among drug users should be based on readiness for treatment rather than concern about faster progression.
Perceptions toward HIV, HIV Screening, and the Use of Antiretroviral Medications: A Survey of Maternity-Based Health Care Providers in Zambia
Authors: Chi Benjamin H , Chansa Kayula , Gardner Michael O , Sangi-Haghpeykar Haleh , Goldenberg Robert L , Sinkala Moses , Muchimba Maureen , Stringer Jeffrey S A
Published: January 2017

Mother-to-child transmission of HIV (MTCT) is a major contributor to Zambia's HIV burden, Based on our experience in Zambia, we felt that provider perceptions, knowledge base, and practice patterns toward HIV-positive mothers may pose as significant obstacles to preventing MTCT. Two hundred and twenty-five health care providers throughout Zambia were surveyed in 2002. Providers reported widespread stigma associated with HIV. Physicians (OR= 1.9), providers with research affiliations (OR= 2.3), and those located in Lusaka (OR=9.0) were more likely to offer HIV testing. Only 30% routinely prescribed antiretroviral treatment (ART) to reduce MTCT. Practitioners from district facilities, those from Lusaka, and those employed at research facilities were more likely to prescribe ART routinely (OR=2.8, 10.1 and 3.4 respectively). Among those never prescribing ART, most cited a lack of availability (83%). Our results highlight the need for further provider education, critical appraisal of the current system for HIV testing, and widespread distribution of ART.
Methamphetamine Users in Northern Thailand: Changing Demographics and Risks for HIV and STD among Treatment-Seeking Substance Abusers
Authors: Beyrer C , Razak M H , Jittiwutikarn J , Suriyanon V , Vongchak T , Srirak N , Kawichai S , Tovanabutra S , Rungruengthanakit K , Sawanpanyalert P , Sripaipan T , Celentano D D
Published: January 2017

Our objective was to determine sociodemographic, sexual and drug-use-related risk factors among methamphetamine (MA) users presenting for drug treatment in northern Thailand. Patients admitted for drug detoxification for MA and other drugs were studied cross-sectionally for risk factors associated with substance abuse and blood-borne and sexually transmitted pathogens. In all, 1865 (200 women) patients treated for MA, opiate, and mixed substance abuse between 1 February 1999 and 31 January 2000 completed all study procedures.

Among 1865 participants, 750 (40.2%) were admitted for MA detoxification and 1115 (59.8%) for opiate (heroin, opium, or both). treatment. MA users were significantly younger, better educated, more likely to be Thai than highland ethnic minorities, and had significantly different sexual risks and sexually transmitted disease rates, including lower syphilis seropositivity and higher chlamydial prevalence, than persons admitted for opiate or mixed drug treatment. For those who reported MA use only, use by injection was rare and HIV infections significantly less common than among all other drug users.

Thailand is undergoing an epidemic of MA use. These young users are a strikingly different population from opiate/heroin. users In northern Thailand. MA users had higher rates of chlamydia infection than opiate users, reflecting their young age, and HIV rates in this population were lower than injecting drug users, but still elevated. MA use is a serious public health problem in Thailand and both Improved prevention and treatment methodologies are urgently needed.
Community mapping of sex work criminalization and violence: impacts on HIV treatment interruptions among marginalized women living with HIV in Vancouver, Canada
Authors: Goldenberg Shira M , Deering Kathleen , Amram Ofer , Guillemi Silvia , Nguyen Paul , Montaner Julio , Shannon Kate
Published: January 2017

Despite the high HIV burden faced by sex workers, data on access and retention in antiretroviral therapy (ART) are limited. Using an innovative spatial epidemiological approach, we explored how the social geography of sex work criminalization and violence impacts HIV treatment interruptions among sex workers living with HIV in Vancouver over a 3.5-year period. Drawing upon data from a community-based cohort (AESHA, 2010–2013) and linked external administrative data on ART dispensation, GIS mapping and multivariable logistic regression with generalized estimating equations to prospectively examine the effects of spatial criminalization and violence near women’s places of residence on 2-day ART interruptions. Analyses were restricted to 66 ART-exposed women who contributed 208 observations and 83 ART interruption events. In adjusted multivariable models, heightened density of displacement due to policing independently correlated with HIV treatment interruptions (AOR: 1.02, 95%CI: 1.00–1.04); density of legal restrictions (AOR: 1.30, 95%CI: 0.97–1.76) and a combined measure of criminalization/violence (AOR: 1.00, 95%CI: 1.00–1.01) were marginally correlated. The social geography of sex work criminalization may undermine access to essential medicines, including HIV treatment. Interventions to promote ‘enabling environments’ (e.g. peer-led models, safer living/working spaces) should be explored, alongside policy reforms to ensure uninterrupted treatment access.
Management of Genital Herpes Simplex Infection
Authors: Thin R N
Published: January 2017

Herpes simplex infection of the genitals is a common condition, more often due to herpes simplex virus (HSV) type 2 than to type 1 virus. There is a severe first attack followed by mild recurrences which are more common and more frequent after HSV-2 than after HSV-1 genital infection.

Clinical features with prodrome, vesicles and erosions may be characteristic allowing rapid clinical diagnosis. When possible laboratory confirmation should be attempted. General management includes simple hygiene, avoidance of sexual transmission, use of condoms, and notifying partners. Oral acyclovir (Zovirax, Wellcome) is the drug of choice for initial attacks and should be considered for all women with this diagnosis. Intravenous acyclovir may be used for very severe attacks. Men with initial attacks may be treated with oral acyclovir but mild disease affecting only skin may be treated with 5% acyclovir cream. Recurrences are short so acyclovir has less effect. Frequent recurrences can be troublesome and may be suppressed by continuous oral acyclovir, or individual attacks may be aborted with intermittent therapy. Various systemic complications may occur; an important but rare problem is primary herpes in late pregnancy.

Acyclovir is effective in the treatment of the troublesome herpes simplex disease associated with human immunodeficiency infection.

Acyclovir is one of the more expensive treatments for sexually transmitted diseases. At present in many countries costs are being examined, and application of the principles outlined here should help to minimize cost and maximize care.
Use of the Cytobrush for Concurrent Cytology and Chlamydia Sampling: A Comparison of Immunofluorescence and Culture for Detection of Chlamydia
Authors: Szarewski Anne , Pompey Anna , Cronin Diane , Bertrand John , Bradbeer Caroline , Thin R N
Published: January 2017

Five hundred and thirty-three women attending a genitourinary medicine clinic underwent concurrent cytology and Chlamydia trachomatis screening using a Cytobrush (Medscand AB). In each case, the same Cytobrush was used to give a sample for direct immunofluorescence and culture. 11.1% of samples were positive by immunofluorescence, while 10.6% were positive by culture. This was a close agreement (Kappa=0.875). The ability of the same instrument to be used for both cytology and chlamydial screening, where direct immunofluorescence is used for detection of chlamydiae, may allow more widespread screening for chlamydia to be practical.
Increasing Workload of an HIV/AIDS Counselling Service in a London Teaching Hospital, 1990–91
Authors: Bor Robert , Elford Jonathan , Richey Louise , Murray Derval , Salt Heather , Tilling John , Miller Riva , Johnson Margaret
Published: January 2017

The number of new patients referred to the HIV/AIDS Counselling Unit at the Royal Free Hospital, London, increased from 926 in 1989–90 to 1450 in 1990–91. Follow-up contacts nearly doubled during the same period of time. Growing demand for HIV testing as well as the shift to the treatment of HIV as a chronic condition increased the workload of the HIV/AIDS counsellors.
Birds of a Feather Do Flock Together
Authors: Youyou Wu , Stillwell David , Schwartz H. Andrew , Kosinski Michal
Published: January 2017

Friends and spouses tend to be similar in a broad range of characteristics, such as age, educational level, race, religion, attitudes, and general intelligence. Surprisingly, little evidence has been found for similarity in personality—one of the most fundamental psychological constructs. We argue that the lack of evidence for personality similarity stems from the tendency of individuals to make personality judgments relative to a salient comparison group, rather than in absolute terms (i.e., the reference-group effect), when responding to the self-report and peer-report questionnaires commonly used in personality research. We employed two behavior-based personality measures to circumvent the reference-group effect. The results based on large samples provide evidence for personality similarity between romantic partners ( n = 1,101; rs = .20–.47) and between friends ( n = 46,483; rs = .12–.31). We discuss the practical and methodological implications of the findings.
Theory construction and data analysis
Authors: Tryon Warren W. , Patelis Thanos , Chajewski Michael , Lewis Charles
Published: January 2017

Data analysis should be neutral relative to theory construction in order to be unbiased. Data analysis should not strongly favor one form of theory construction over others. Traditional approaches to theory construction prioritize simplicity of explanation based on parsimony using a few prominent statistically significant variables. Alternative web of causation explanations prioritize comprehensive explanations based on complexity using many small effects. This article presents argument and empirical evidence that contemporary data analytic methods are problematic for all theory construction approaches. They are especially biased against web of causation approaches to theory construction. Mathematical arguments and new empirical evidence that supports web of causation explanations are presented.
Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld’s syndrome) – An update
Authors: Watad A , Quaresma M , Brown S , Cohen Tervaert J W , Rodríguez-Pint I , Cervera R , Perricone C , Shoenfeld Y
Published: January 2017

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been widely described in many studies conducted thus far. The syndrome incorporates five immune-mediated conditions, all associated with previous exposure to various agents such as vaccines, silicone implants and several others. The emergence of ASIA syndrome is associated with individual genetic predisposition, for instance those carrying HLA-DRB1*01 or HLA-DRB4 and results from exposure to external or endogenous factors triggering autoimmunity. Such factors have been demonstrated as able to induce autoimmunity in both animal models and humans via a variety of proposed mechanisms. In recent years, physicians have become more aware of the existence of ASIA syndrome and the relationship between adjuvants exposure and autoimmunity and more cases are being reported. Accordingly, we have created a registry that includes at present more than 300 ASIA syndrome cases that have been reported by different physicians worldwide, describing various autoimmune conditions induced by diverse adjuvants.

In this review, we have summarized the updated literature on ASIA syndrome and the knowledge accumulated since 2013 in order to elucidate the association between the exposure to various adjuvant agents and its possible clinical manifestations. Furthermore, we especially referred to the relationship between ASIA syndrome and systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).
Neurological Aspects of Antiphospholipid Antibody Syndrome
Authors: Levine SR , Brey RL
Published: January 2017

Antiphospholipid antibodies (aPL) have been associated with a variety of neurological disorders, mostly linked to focal neuroparenchymal ischemia or infarction. Cerebral ischemia associated with the antiphospholipid syndrome (APS) occurs at a younger age than typical atherothrombotic cerebrovascular disease, is often recurrent, and high positive GPL values are usually linked to the presence of a lupus anticoagulant. When other features of the syndrome are not present and cerebral ischemia occurs only associated with anticardiolipin immunoreactivity, there appears to be no discerning features of these patients unless GPL > 40 for which recurrent thrombo-occlusive events appear to occur more frequently. Other neurological manifestations associated with aPL include cerebral venous sinus thrombosis, ocular ischemia, dementia, including ischemic encephalopathy, and chorea. The role of aPL in migrainous events is controversial and may not play a role in recent, large case-controlled studies. Most seizures in patients harboring aPL are associated with focal brain infarction.
Clinical Manifestations of the aPL Syndrome
Authors: Levy RA
Published: January 2017

The antiphospholipid syndrome may present itself to virtually all medical specialties. It can be as non-threatening as thrombophlebitis or mild thrombocytopenia or as severe as cerebral arterial infarct or the so called “catastrophic APS”. In order to diagnose it properly, it is important to be aware of its clinical manifestations and laboratory peculiarities. The primary form of APS seems to be more common than the SLE related one. Because any artery or vein may be involved, the spectrum of clinical manifestations of APS is so wide that they include virtually all medical specialties.
Charles Broady Mingaye Syder (1797–1871): Medical Temperance Pioneer
Authors: Due Stephen
Published: January 2017

Mingaye Syder was a general practitioner, a medical teacher, a notable writer and editor of medical textbooks, and an outstanding early advocate of temperance. He started a temperance dispensary, possibly the first of its kind, and was the founder and editor of two medical temperance periodicals. Financial success eluded him, however, and he was twice imprisoned for debt. He later emigrated to Victoria, where he was a country doctor for the last 20 years of his life.
What was the Cause of Franklin Delano Roosevelt's Paralytic Illness?
Authors: Goldman Armond S , Schmalstieg Elisabeth J , Freeman Daniel H , Goldman Daniel A , Schmalstieg Frank C
Published: January 2017

In 1921, when he was 39 years of age, Franklin Delano Roosevelt contracted an illness characterized by: fever; protracted symmetric, ascending paralysis; facial paralysis; bladder and bowel dysfunction; numbness; and dysaesthesia. The symptoms gradually resolved except for paralysis of the lower extremities. The diagnosis at the onset of the illness and thereafter was paralytic poliomyelitis. Yet his age and many features of the illness are more consistent with a diagnosis of Guillain-Barré syndrome, an autoimmune polyneuritis. The likelihoods (posterior probabilities) of poliomyelitis and Guillain-Barré syndrome were investigated by Bayesian analysis. Posterior probabilities were calculated by multiplying the prior probability (disease incidence in Roosevelt's age group) by the symptom probability (likelihood of a symptom occurring in a disease). Six of eight posterior probabilities strongly favoured Guillain-Barré syndrome.
A Doctor on the Front Line: Enrico Pajes (1912–1993)
Authors: Goodstein Judith , Scaramuzzi Carlotta
Published: January 2017

We conducted an interview in the summer and autumn of 1991 with Dr Enrico Chaim Pajes, a Jewish Polish doctor who trained in Italy before World War II. Pajes was arrested when Italy entered the war in 1940. For the next three years he was rotated through various prisons. He witnessed the bombing of Campagna in 1943 and risked his life to treat the wounded. After the war he started a new life as the head of a medical clinic for Jewish displaced persons in Grottaferrata, in the suburbs of Rome. How did a Jew of Polish origin end up practising medicine in Italy for over 40 years? This oral history is the story of Enrico Pajes's life.
More than a Sideshow? An Analysis of GHQ Decision Making during the Planning for the Landings at Suvla Bay, Gallipoli, August 1915
Authors: Cleverly Jeff
Published: January 2017

This paper will examine decision making at GHQ during the planning for the landing of Lieutenant General Sir Frederick Stopford’s IX Corps at Suvla Bay during the MEF’s August offensive. It will show how Hamilton’s expectation that IX Corps would combine closely with ANZAC in a decisive offensive was at odds with the more discreet and limited role for IX Corps expected by his operations staff. This divergence of views at GHQ and Hamilton’s subsequent remoteness from Stopford ensured that it was his staff’s defensive interpretation that was passed on to Stopford and IX Corps.
Military Engineering in Eighteenth-Century Havana and Manila: The Experience of the Seven Years War
Authors: Luengo Pedro
Published: January 2017

The Spanish defeat in the Seven Years War led to a reassessment of the overseas fortification system. This paper analyses the role played by military engineers in the debate over the reconstruction of fortresses in Havana and Manila, and the influence of French discussions on the topic. The results were the product of Franco-Spanish cooperation that improved formal education. The conclusion is that the combined Bourbon response substantially advanced the science of siege craft and significantly improved the status of military engineers in Spain.
Implementation of an Antenatal Serum Screening Programme for Down's Syndrome in Two Districts (Brighton and Eastbourne)
Authors: Piggott M , Wilkinson P , Bennett J ,   For the Brighton Eastbourne Down's Syndrome Screening Group
Published: January 2017

To evaluate the introduction to two health districts of an antenatal serum screening programme for Down's syndrome using the triple test-measurement of a fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin concentrations in second trimester serum samples.

All women delivering at the main maternity units in both districts were eligible for the screening programme. A serum sample was taken between 15 and 22 weeks' gestation, confirmed by ultrasound scan. An estimated risk of 1 in 250 or greater was considered to be a screen positive result and further diagnostic tests were offered. As far as possible the outcome of all screened pregnancies was recorded, and babies with Down's syndrome born to women who declined serum screening were also identified.

6990 singleton pregnancies were screened over a two year period, representing an estimated uptake of 67% (6990/10 443). After a screen positive result 80% of women (168/211; 95% confidence interval 74–2 to 85–1%) opted for amniocentesis. The false positive rate was 2–9% (203/6979; 95% confidence interval 2–5 to 3–3%). The detection rate in the screened population was 73% (8/11). The estimated cost of identifying one Down's syndrome affected pregnancy was about £31 000.

Successful introduction of the triple test to health districts where there is no established serum screening programme for neural tube defects is possible. The programme seems to be acceptable to most of those screened. Uptake of the programme is sufficient to make it more effective than a policy for Down's syndrome screening dependent on age only.
Cascade Testing for the Identification of Carriers of Cystic Fibrosis
Authors: Holloway Susan , Brock David J H
Published: January 2017

It has been suggested that cascade testing, in which relatives of a person affected with cystic fibrosis (CF) are tested for carrier status, is preferable to screening individuals in the general population. This idea was examined by calculating the number of relatives requiring testing, assuming that it is necessary to identify all those of reproductive age no more distantly related to the proband than second cousins. Two hypothetical programmes were used, in each of which only blood relatives of an affected proband were tested and subsequent analysis applied to relatives of those with a positive result.

If started in the grandparental generation, cascade testing of about 28 relatives for each proband would detect 86.4% of carriers in the family. If only carried out for the parental generation and their descendants, testing of about 35 relatives for each proband would detect 92.1% of carriers in the family. If cascade testing were restricted to the second cousin level, however, these programmes would only detect between 8 and 24% of all carrier couples. This contrasts with the 50% detection rate that has already been demonstrated for antenatal CF screening.
Adverse Effects of Screening for Gestational Diabetes: A Prospective Cohort Study in Toronto, Canada
Authors: Kerbel Diane , Glazier Richard , Holzapfel Stephen , Yeung Maria , Lofsky Stanley
Published: January 2017

Objective—

To investigate the adverse effects associated with a false positive SO g glucose challenge test for gestational diabetes mellitus (GDM).

Setting—

Consecutive women attending a prenatal registration clinic at a large community hospital in suburban Toronto, Canada.

Methods—

Prospective cohort study of women between 12 and 24 weeks' gestation with no previous history of diabetes mellitus or GDM. Main outcome measures included anxiety (Spielberger's State-Trait Anxiety Inventory), depression (Centers for Epidemiologic Studies Depression Scale), perceived maternal health, and concern about health of the newborn.

Results—

Among 2564 eligible subjects, there were 897 subjects with complete data at enrolment and at 32 weeks' gestation, including 88 who had false positive glucose challenge test results. At 32 weeks, only 20% (95% confidence limits 11%, 28%) of women with false positive glucose challenge test results rated their health as excellent, compared with 38% (35%, 42%) of those having negative results and those not tested (P = 0.001). These results were sustained at 36 weeks. There was no association between glucose challenge test result and the change in anxiety (P = 0.57), depression (P = 0.09) or concern about health of the newborn (P = 0.91) between baseline and 32 weeks' gestation, nor were these associations found at 36 weeks.

Conclusions—

False positive glucose challenge test results are about six times more likely than true positive results in the general population. Pregnant women with false positive GDM screening results experience a significant decline in their perception of their own health. These adverse effects should be taken into account when deciding about a policy of screening all pregnant women for gestational diabetes.
Evaluation of Surveillance Programmes for Colorectal Cancer in Ulcerative Colitis Patients by Case-Control Studies: Methodological Considerations
Authors: Zack M M , Ekbom A , Adami H O , Persson P G
Published: January 2017

Objectives—

The evaluation of the efficacy of colonoscopy screening in patients with ulcerative colitis for colorectal cancer is associated with methodological difficulties. Case-control studies can, however, be used to determine the efficacy of such a programme and the outline of the methodology in such a programme is presented.

Methods—

The randomised controlled trial provides perspective for case-control studies of screening efficacy. Cases are selected from persons who have ulcerative colitis with manifestations of colorectal cancer: for example, those who have died of colorectal cancer or have symptomatic metastases. Controls are selected from persons who have ulcerative colitis, who had been alive when the case died of colorectal cancer, and who had been subject to the risk of dying from, but had not had, colorectal cancer diagnosed when the case was diagnosed with colorectal cancer. The relevant screening history for cases begins with the case's diagnosis of ulcerative colitis and ends with the case's diagnosis of colorectal cancer; that for controls should be comparable to that for cases to avoid bias. Cases and controls are compared with respect to their “exposure” to colonoscopy during their screening histories: the occurrence of any screening, which took place during the period of time that an occult tumour (or an identifiable lesion) may plausibly have been present.

Conclusion—

The proposed methodology can evaluate the efficacy of a screening programme rapidly, practically, and ethically.
Impact of Workplace Spirituality on Knowledge Sharing Intention: A Conceptual Framework
Authors: Khari Chitra , Sinha Shuchi
Published: January 2017

Knowledge forms a crucial source for gaining competitive advantage and its sharing a dominant challenge facing several organizations. In this paper we propose a positive role of workplace spirituality (WPS) (at individual and collective levels) on knowledge sharing intention (KSI) by employing the theory of decomposed planned behaviour. We argue that WPS with its focus on inner spirit, meaningful work, sense of interconnectedness and alignment with organizational values and mission positively strengthens an individual’s knowledge sharing attitude, subjective norms and perceived behavioural controls (thereby, strengthening their KSI) by affecting the underlying behavioural, normative and control beliefs. We also take into account the role of transformational leadership (TL) in creating a pro-social working environment, which facilitates knowledge sharing. In proposing a holistic and multi-level framework linking WPS (at individual and collective levels) and TL with KSI, this paper contributes to both, knowledge sharing and WPS literatures.
Gender Disparities in Health Outcomes of Elderly Persons in India
Authors: Borooah Vani Kant
Published: January 2017

This article uses data from India’s National Sample Survey (NSS), relating to respondents’ health outcomes between January and June 2014, to quantify a particular form of gender inequality: inequality in self-rated health (SRH) outcomes between men and women aged 60 years and above. In so doing, it makes five contributions to the existing literature. The first is in terms of analytical technique; this study contains a more detailed and nuanced exposition of the regression results than in previous studies. Second, it controls for environmental factors—like poor drainage, lack of toilets or ventilation in the kitchen—which might have adverse impact on health and, in particular, affect the health of women more than that of men. Third, it takes an account of interaction effects by which the effect of a variable on an elderly person’s SRH differed according to whether the person was male or female. Lastly, it examines whether SRH is correlated with objective health outcomes. In particular, this study answers two central questions: Did men and women, considered collectively, have significantly different likelihoods of ‘poor’ SRH between the different regions/income classes/social groups/education levels? Did men and women, considered separately, have significantly different likelihoods of a ‘poor’ SRH within a region/income class/social group/education level?
The Impact of Food Price Crises on the Demand for Nutrients in Pakistan
Authors: Shabnam Nadia , Santeramo Fabio Gaetano , Asghar Zahid , Seccia Antonio
Published: January 2017

The global economic crisis in 2007–2008 resulted in a tremendous food price increase that is likely to have adversely affected the food security and nutritional status in many developing countries. Understanding how nutritional intakes may have changed as a result of the food price crisis is important, especially for Pakistan, the country under scrutiny which, despite of being a large producer of staple food, suffers from severe problems of undernourishment. We used two survey rounds, 2005–2006 and 2010–2011, to investigate how calorie and macronutrient intakes have evolved. The analysis was carried out with the use of a time varying model and is enriched by an in-depth investigation for different quantiles. The results show that food security deteriorated because of the food price crisis. In the light of this outcome, policy implications are discussed.
Globalization, Growth and Employment in India
Authors: Ghose Ajit K.
Published: January 2017

The opening-up of India’s economy to trade and capital flows in the early 1990s did lead to growth acceleration. But it also led to developments that had not been anticipated. Far from promoting specialisation in unskilled-labour-intensive products, openness to trade increased the capital-and-skill-intensity of exports. Inflow of foreign finance stimulated growth not by boosting investment but by boosting consumption. Not surprisingly, the growth stimulus generated by increased openness was short-lived. The stimulating effect of trade disappeared after 2004. And the stimulating effect of capital inflow was visible only during 2004–08.

Employment conditions showed substantial improvement only after 2000. During 2000–10, growth of the organised sector was both rapid and employment-intensive. So the sector was pulling labour out of the unorganised sector. The consequent deceleration in labour force growth combined with accelerated output growth to produce rapid improvement in employment conditions in the unorganised sector. The increased employment intensity of growth in the organised sector is explained by (a) the rapid growth of construction and services, and (b) the declining unit cost of labour that resulted from the rapid expansion of informal employment of relatively low-skilled labour.
Assembler-Supplier Relations in the Auto Industry: Globalisation and National Development
Authors: Humphrey John
Published: January 2017

Governments in developing countries continue actively to promote the auto industry. However, the benefits derived from this industry are changing as a result of global restructuring. The key relationships in the auto industry are between the major assemblers and a small number of first-tier suppliers with global reach. The latter are increasingly responsible for designing and delivering component systems and sub-assemblies at multiple locations around the world. This restructuring has direct consequences for auto component manufacturers in developing countries. This paper examines the extent to which the practices of standardisation of vehicle designs across countries and the use of the same supplier across many markets are being applied in these countries. It examines the consequences of this change for the auto components industries of Brazil and India.
Integrating International Student Mobility in Work-Based Higher Education
Authors: Graf Lukas , Powell Justin J. W. , Fortwengel Johann , Bernhard Nadine
Published: January 2017

Dual study programs are hybrid forms of work-based higher education that have expanded very rapidly in Germany—a country traditionally considered a key model in both higher education (HE) and vocational education and training (VET). The continued expansion of these hybrid programs increasingly raises questions if, how, and why they may be internationalized. Although comparative research suggests that this could be challenging due to the uniqueness of the German education and training system, strong forces support internationalization. This study examines the current state and the future prospects of internationalization of such innovative dual study programs by focusing on student mobility, a key dimension of internationalization. We find growing interest in but still relatively little mobility related to dual study programs, whether among German (outgoing) or international (incoming) students. Based on expert interviews and document analysis, we extend existing typologies of student mobility regarding specific features of work-based HE programs. Furthermore, we discuss opportunities—at home and abroad—for increasing student mobility in this rapidly expanding sector.
Mechanisms of bone response to injury
Authors: Dittmer Keren E. , Firth Elwyn C.
Published: January 2017

Bone, despite its relatively inert appearance, is a tissue that is capable of adapting to its environment. Wolff’s law, first described in the 19th century, describes the ability of bone to change structure depending on the mechanical forces applied to it. The mechanostat model extended this principle and suggested that the amount of strain a bone detects depends on bone strength and the amount of muscle force applied to the bone. Experimental studies have found that low-magnitude, high-frequency mechanical loading is considered to be the most effective at increasing bone formation. The osteocyte is considered to be the master regulator of the bone response to mechanical loading. Deformation of bone matrix by mechanical loading is thought to result in interstitial fluid flow within the lacunar–canalicular system, which may activate osteocyte mechanosensors, leading to changes in osteocyte gene expression and ultimately increased bone formation and decreased bone resorption. However, repetitive strain applied to bone can result in microcracks, which may propagate and coalesce, and if not repaired predispose to catastrophic fracture. Osteocytes are a key component in this process, whereby apoptotic osteocytes in an area of microdamage promote targeted remodeling of the damaged bone. If fractures do occur, fracture repair can be divided into 2 types: primary and secondary healing. Secondary fracture repair is the most common and is a multistage process consisting of hematoma formation and acute inflammation, callus formation, and finally remodeling, whereby bone may return to its original form.
Embryotoxic effects of Poincianella (Caesalpinia) pyramidalis leaves on pregnant rats
Authors: Câmara Antônio Carlos L. , Gadelha Ivana Cristina N. , Castro Márcio B. , Medeiros Rosane Maria T. , Riet-Correa Franklin , Soto-Blanco Benito
Published: January 2017

We investigated the embryotoxic and fetotoxic effects of Poincianella pyramidalis (Tul.) L.P. Queiroz (syn. Caesalpinia pyramidalis Tul.) leaves on pregnant rats ( Rattus norvegicus). Pregnant rats were divided into 4 groups: G1—fed a ration containing 5% P. pyramidalis leaves beginning on day 1 of pregnancy; G2—fed a ration containing 5% P. pyramidalis leaves commencing on day 6 of pregnancy; G3—fed a ration containing 10% P. pyramidalis leaves starting on day 6 of pregnancy; G4—control group. On day 21 of pregnancy, parameters of reproductive performance were recorded. Fetal growth was measured, and fetuses were subjected to external examination and identification of skeletal anomalies. Rations containing P. pyramidalis resulted in dead or undeveloped fetuses and reduced the number, length, and weight of the fetuses. Rations also increased postimplantation losses and the frequency of skeletal anomalies. Furthermore, P. pyramidalis was also responsible for dose-dependent lesions in the placentas. In conclusion, the ingestion of P. pyramidalis promotes fetal and placental damage.
Extreme punishments characterize weak Pareto optimality
Authors: Leoni Patrick L.
Published: January 2017

In normal form games, we model the largely observed psychological phenomenon of systematic and extreme punishment after a deviation, regardless of the cost. After establishing basic properties, we show that this notion characterizes a weak form of Pareto optimality. Every Pareto optimal outcome can also be sustained by the threat of extreme punishment, which cannot be achieved in general through Nash equilibria strategies, nor with tit-for-tat strategies.
Impact of Pharmacist Intervention to Increase Compliance With Guideline-Directed Statin Therapy During an Acute Coronary Syndrome Hospitalization
Authors: Tunney Robert K. , Johnson Daniel C. , Wang Li , Cox Zachary L.
Published: January 2017

Background: Despite evidence on poor adherence to guideline-directed statin therapy (GDST) following an acute coronary syndrome (ACS), little information has been published on pharmacist-led statin pilot programs for secondary prevention. Objective: We sought to evaluate the impact of a pharmacist intervention (PI) on GDST during an ACS hospitalization. Methods: A historical control (HC) group consisting of 125 ACS hospitalizations was retrospectively identified, with prospective data of 113 patients captured over 6 months in the PI group. The primary outcome of GDST was defined according to 2013 clinical guidelines and evaluated in all 238 qualifying patients. Secondary outcomes included number of interventions and use of logistic regression to investigate the relationship of ACS subtype with statin dose. Results: On admission, GDST was ordered in 62.5% of the HC and 75.9% of the PI group. At discharge, the PI group had a higher rate of GDST relative to HC among all patients (86.7 % vs 77.4%, P = 0.06), and after exclusion of contraindications (84.8% vs 74.5%; P = 0.1), 10 patients required PI, accounting for an increase in GDST of 5.3%. Statin dose selection did not differ by ACS subtype (odds ratio = 0.79; 95% CI = 0.0.29-2.17; P = 0.18). Conclusion: PI did not significantly increase GDST. Increased compliance rates measured were primarily driven by higher baseline adherence and guideline incorporation over time.
Topical Treatment with Minoxidil 2% and Smoking Intolerance
Authors: Trattner Akiva , Ingber Aryeh
Published: January 2017

OBJECTIVE:

To report smoking intolerance that occurred in two patients while they were treated with minoxidil.

DATA SYNTHESIS:

Minoxidil is a potent vasodilator useful in treating severe hypertension. Topical minoxidil was approved as a treatment for androgenital alopecia. Only few side effects have been reported during treatment with topical minoxidil, most of them localized skin reactions. Two of our patients developed smoking intolerance during treatment with topical minoxidil for androgenital alopecia. The relation between treatment with minoxidil and smoking intolerance was emphasized by stopping treatment and the disappearance of the smoking intolerance, and then by rechallenge in both patients.

CONCLUSIONS:

Topical minoxidil may cause smoking intolerance; further studies are needed to evaluation this side effect.
Controversies over the Use of Magnesium Sulfate in Delirium Tremens
Authors: Jermain Donna M. , Crismon M. Lynn , Nisbet Robert B.
Published: January 2017

OBJECTIVE:

To critically address the controversy of using parenteral magnesium sulfate in delirium tremens (DT).

DATA SOURCES:

English-language journal articles published between 1954 and 1987.

STUDY SELECTION:

All literature available, mostly case reports, that either support or discourage magnesium sulfate administration to patients with DT.

DATA EXTRACTION:

Pertinent information (as judged by the authors) was summarized and interpreted.

DATA SYNTHESIS:

DT has long been associated with magnesium deficiency because many alcoholic patients with DT have low serum magnesium concentrations. Recent literature, however, suggests that hypomagnesemia is not noted universally in this patient population and that patients' serum magnesium concentrations may return to normal without exogenous magnesium administration. Thus, there is most likely not a specific causal relationship of hypomagnesemia in DT.

CONCLUSIONS:

Routine administration of parenteral magnesium sulfate in patients with DT is not recommended.
Drug-Use Patterns among Black and Nonblack Community-Dwelling Elderly
Authors: Hanlon Joseph T. , Fillenbaum Gerda G. , Burchett Bruce , Wall William E. , Service Connie , Blazer Dan G. , George Linda K.
Published: January 2017

OBJECTIVE:

To describe and compare drug-use patterns among black and nonblack community-dwelling elderly.

DESIGN:

Survey.

SETTING:

Five-county urban and rural region in Piedmont, NC.

PARTICIPANTS:

Stratified probability household sample of 4164 community residents aged 65 or older from the Piedmont Health Survey of the Elderly (65 percent women, 54 percent black, mean age 73.56 ± 6.74 y).

MAIN OUTCOME MEASURES:

Prevalence of medication use and mean drug use; therapeutic medication category use.

RESULTS:

Data were weighted to represent the population in this geographic area. Fewer blacks reported the use of over-the-counter (OTC) medications and total medications than did nonblacks (66 vs. 76 percent and 88 vs. 92 percent, respectively; p<0.001). Compared with nonblacks, blacks reported using a lower mean number of prescription (2.02 vs. 2.35; p<0.001), OTC (1.12 vs. 1.42; p<0.001), and total (3.14 vs. 3.77; p<0.001) drugs. The therapeutic medication categories varied by race for prescription cardiovascular, analgesic, and central nervous system (CNS) drugs and OTC nutritional supplements. More nonblacks than blacks reported the use of analgesics (62.5 vs. 55.6 percent, respectively; p<0.001), CNS drugs (26.1 vs. 14.2 percent, respectively; p<0.001), nutritional supplements (27.5 vs. 16.9 percent, respectively; p<0.001), and gastrointestinal agents (29.0 vs. 23.5 percent, respectively; p<0.001). Blacks were more likely to report problems in managing their medications than were nonblacks (9.0 vs. 6.1 percent, respectively; p=0.001).

CONCLUSIONS:

Our data suggest that there are distinct racial differences in medication-use patterns among the elderly.
Suspected Cross-Reactivity of Enalapril- and Captopril-Induced Hepatotoxicity
Authors: Hagley Michael T. , Benak Robert L. , Hulisz Darrell T.
Published: January 2017

OBJECTIVE:

To present evidence that enalapril and captopril may produce hepatotoxicity by a common mechanism.

DATA SOURCES:

A case report and review of pertinent literature.

DATA SYNTHESIS:

A patient developed hepatotoxicity once while taking enalapril and again while taking captopril. Hepatotoxicity resolved with cessation of therapy. Hepatotoxicity has been reported with use of captopril, enalapril, and lisinopril. Apparent cross-reactivity has been reported on just one other occasion.

CONCLUSIONS:

Because hepatotoxicity is uncommon with angiotensin-converting enzyme (ACE) inhibitors, our observations suggest the possibility that these agents produce hepatotoxicity by a common mechanism. In patients who develop hepatotoxicity while taking one ACE inhibitor, other agents in this class probably should be avoided.
Variability in Plasma Lipoprotein Profiles When Comparing Diltiazem and Propranolol
Authors: Labreche Dustan G. , Kondos George T. , Bartels David W. , Bauman Jerry L.
Published: January 2017

OBJECTIVE:

To examine the effects of diltiazem and propranolol on plasma lipoproteins in a double-blind, comparative trial.

PATIENTS:

Twenty-one mild-to-moderate hypertensive patients.

METHODS:

Following discontinuation of previous antihypertensive treatments, and a 4-week, single-blind, placebo run-in, subjects were randomized to receive sustained-release diltiazem or propranolol. Total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very-low-density lipoproteins (VLDL) were measured during placebo administration and after 12–16 weeks of treatment.

RESULTS:

No significant changes in plasma lipoprotein concentrations were noted in either the diltiazem or propranolol group compared with baseline values or each other. Marked variation in HDL, LDL, and VLDL were noted following drug treatment and in eight subjects whose lipoprotein concentrations were remeasured prior to drug treatment during the placebo period. The alterations were bidirectional, and similar in magnitude to those found following drug treatment.

CONCLUSIONS:

In many cases, changes in plasma lipoproteins reported to be a consequence of antihypertensive treatment may merely reflect normal intrapatient variability.
Granulocyte-Colony Stimulating Factor for Sulfasalazine-Induced Agranulocytosis
Authors: Gales Barry J. , Gales Mark A.
Published: January 2017

OBJECTIVE:

To report a case of sulfasalazine-induced agranulocytosis that was successfully treated with granulocyte-colony stimulating factor (G-CSF).

CASE SUMMARY:

An 82-year-old woman developed agranulocytosis within two months of initiating sulfasalazine therapy. She was hospitalized, empiric antibiotics and antifungal agents were prescribed, and sulfasalazine therapy was stopped. The patient received G-CSF 600 μg/d subcutaneously for six consecutive days, starting on hospital day 5. Agranulocytosis resolved on day 5 and leukopenia on day 6 of G-CSF therapy. No adverse reactions were attributed to administration of this agent and the patient was discharged on hospital day 13.

DISCUSSION:

Numerous agents, including sulfasalazine, have been associated with agranulocytosis. Agranulocytic patients frequently experience life-threatening bacterial and fungal infections. Administration of colony stimulating factors may reduce the duration of agranulocytosis and incidence of life-threatening infections.

CONCLUSIONS:

G-CSF administration appears to have decreased the duration of this elderly patient's agranulocytosis and hospitalization.