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Spatial income disparities have increased in the US since 1980, a pattern linked to major social, economic, and political challenges. Yet, today's spatial inequality, and how it relates to the past, remains insufficiently well understood. The primary contribution of this article is to demonstrate a deep polarization in the American spatial system—yet one whose character differs from that commonly reported on in the literature. The increase in spatial inequality since 1980 is almost entirely driven by a small number of populous, economically important, and resiliently high-income superstar city-regions. But we also show that the rest of the system exhibits a long-run pattern of income convergence over the study period. A secondary contribution is historical: today's superstars have sat durably atop the urban hierarchy since at least 1940. Third, we describe six distinctive pathways of development that regions follow between 1940 and 2019, with certain locations catching up, falling behind, and surging ahead. We explore the role played by initial endowments in driving locations down these pathways, finding population, education, industrial structure, and immigrant attraction to be key distinguishing features. These insights are enabled by a fourth contribution: methodologically, we use group-based trajectory modeling—an approach new to the field that integrates top-down and bottom-up views of the evolving national spatial system. We conclude by exploring implications for the mid-twenty-first century. [ABSTRACT FROM AUTHOR]

We report a case of a needlefish jaws retained near the C5–C6 joint that was associated with chronic pain and inflammation and seen confirmed by FDG-PET scan. Two unsuccessful surgeries using an anterior approach were complicated by vascular and nerve injuries. We used image-guided surgery with a posterior approach. [ABSTRACT FROM AUTHOR]

A growing literature has shown that greater diversity among immigrants offers material benefits in terms of higher wages and productivity. One limitation of existing work is that it has considered immigrants from a given country to be homogenous. However, immigrants differ in various ways, not least in their level of assimilation. This article considers how assimilation might shape diversity's economic effects. Intuition suggests two conflicting dynamics. Assimilation could lower barriers immigrants and natives face in interacting with one another, and thus enhance benefits. Equally, however, assimilation could reduce heuristic differences between immigrants and native-born workers, dampening spillovers from diversity. We use linked employer–employee data from Norway to test these ideas. We construct diversity indices at the regional and workplace scale to capture different aspects of assimilation, and observe how these are related to worker productivity, proxied using wages. We find that assimilation dampens externalities from immigrant diversity. Diversity among second-generation or childhood migrants offers smaller benefits than diversity in teenage or adult arrivals. Immigrants' cultural proximity to Norway, and their experience of tertiary education in Norway, each also reduce the social return to diversity. While assimilation processes may benefit society in various ways, these findings are consistent with the idea that, by diminishing the heuristic gaps between migrants and native-born workers, integration reduces the productivity externalities derived from immigrant diversity. [ABSTRACT FROM AUTHOR]

Objectives: Systemic sclerosis (SSc) is a rare, chronic connective tissue disease involving multiple organ systems, including the eye. We evaluated the detailed clinical ocular manifestations of outpatients with SSc.Methods: Demographics, disease duration and subtype, nailfold capillaroscopy (NFC) patterns and laboratory parameters encompassing the autoantibody profile of 51 SSc patients were evaluated, and a general ocular examination was performed for each participant.Results: Twenty-nine patients (56.86%) had eyelid skin alterations, 26 (50.98%) had retinal abnormalities, 26 (50.98%) had cataracts, 8 (15.69%) had conjunctival changes, 7 (13.73%) had iris abnormalities, 33 (64.71%) suffered from dry eye disease (DED), and 11 (21.57%) suffered from glaucoma. Significant positive correlations were found between NFC data and both tear breakup time and Ocular Surface Disease Index test values.Conclusions: Eyelid skin abnormalities, DED and retinal abnormalities are among the most common SSc-related ocular involvements. Diverse ophthalmic findings are attributed to the heterogeneity of SSc. [ABSTRACT FROM AUTHOR]

Despite maximal surgical resection and chemoradiation, glioblastoma (GBM) continues to be associated with significant morbidity and mortality. Novel therapeutic strategies are urgently needed. Given success in treating multiple other forms of cancer, checkpoint inhibitor immunotherapy remains foremost amongst novel therapeutic strategies that are currently under investigation. Through a systematic review of both published literature and the latest preliminary data available from ongoing clinical studies, we provide an up-to-date discussion on the immune system in the CNS, a detailed mechanistic evaluation of checkpoint biology in the CNS along with evidence for disruption of these pathways in GBM, and a summary of available preclinical and clinical data for checkpoint blockade in GBM. We also include a discussion of novel, emerging targets for checkpoint blockade which may play an important role in GBM immunotherapy. Evidence indicates that while clinical success of checkpoint blockade for the treatment of GBM has been limited to date, through improved preclinical models, optimization in the context of standard of care therapies, assay standardization and harmonization, and combinatorial approaches which may include novel targets for checkpoint blockade, checkpoint inhibitor immunotherapy may yield a safe and effective therapeutic option for the treatment of GBM. [ABSTRACT FROM AUTHOR]

The article offers insights into regional academic research to help address the global impact of COVID-19 pandemic. Topics mentioned include the impact of the delay in providing government subsidies and policies on businesses, the analysis of the influence of pandemic on the spatial-industrial value chains, and the role of knowledge production and innovation in the performance of regional economy.

This paper compares the creative economies of the US and the UK regions and nations using high-quality administrative microdata spanning the period 2011–13. The creative industries are highly urbanized in both countries. However, important differences are found in the size, density and diversity of creative activity between the two countries, which reflect differences in both urban systems and industrial organization. By testing the 'Creative Trident' approach in a comparative international context, the analysis adds to the literature on definition and classification of creative economies, as well as to discussions of regional economic development through the creative economy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate corneal parameters in patients with polymyositis (PM) and dermatomyositis (DM) and compare them with those of healthy controls.Methods: A total of 43 PM and 32 DM patients and 93 controls were enrolled in this cross-sectional, observational, case-control study. Corneal parameters were evaluated by Pentacam. Objective clinical tests of dry eye disease (DED) were also performed.Results: All pachymetric measurements and corneal volumes (CVs) proved to be significantly lower both in PM and DM patients. The values of DM patients were closer to control values than those of the PM patients. For tear break-up time and Schirmer-I test values significant differences were observed between patients and controls, with values decreased both in PM and DM patients.Conclusions: PM patients rather than DM patients tend to develop thinner and low-volume corneas as compared to controls. Additionally, a high prevalence of DED among both PM and DM patients was also detected. [ABSTRACT FROM AUTHOR]

The article calls for the submission of papers in the field of regional studies, spanning social, political and environmental dimensions of urban and regional change.

Purpose: To evaluate detailed corneal parameters of inflammatory bowel disease (IBD) patients, including Crohn's disease (CD) and ulcerative colitis (UC) patients, and to assess associations between anterior segment values and other clinical variables.Methods: This prospective cross-sectional case-control study at a tertiary referral center included 30 CD patients, 36 UC patients and 80 age- and gender-matched controls with no ocular symptoms or ocular surface disorders. All study participants underwent a comprehensive ophthalmological evaluation with special interest in dry eye disease (DED). Corneal parameters were evaluated by Pentacam.Results: The mean age of CD patients, UC patients, and controls was 45.80 ± 11.55 years, 52.00 ± 16.05, and 50.68 ± 14.62, respectively. The average disease duration was 12.72 ± 5.83 years for CD patients and 15.94 ± 10.09 years for UC patients. All pachymetric (center, apex and thinnest) and corneal volume (CV) measurements were significantly decreased, while anterior chamber angle width (ACA) values were significantly increased on both sides in all IBD patients compared to those in controls (p < .05). In addition, several anterior segment parameters were altered unilaterally in CD or UC patients. Negative correlations were found between corneal parameters and Schirmer I test values.Conclusions: Our investigations suggest that IBD patients have thinner corneas compared to that of controls. The coexistence of reduced tear quantity seems to have an additional impact on the thinning of the cornea in IBD patients. Early recognition of corneal impairments, a possible extraintestinal manifestation of IBD, should be included in the disease checkup to reduce vision-threatening developments. [ABSTRACT FROM AUTHOR]

Purpose: Corneal involvement in systemic sclerosis (SSc) is rare, but due to rich collagen composition cornea is especially vulnerable to connective tissue diseases. Therefore, our aim was to evaluate corneal parameters of SSc patients. Methods: The study included 32 SSc patients and 39 control subjects with no ocular symptoms or ocular surface disorders. All study participants underwent Pentacam evaluation and objective signs of dry eye disease (DED), and clinical parameters were evaluated. Results: All pachymetric values, most of the corneal front surface, corneal volume, as well as anterior chamber depth measurements were significantly lower in the SSc group than in the control group (p < 0.05). Significant negative correlation was found between corneal parameters and age on the one hand, and disease duration on the other. Conclusions: Early recognition of corneal impairment, a possible extraintestinal manifestation of SSc, should be included in the check-up of the disease in order to reduce sight-threatening complications. [ABSTRACT FROM AUTHOR]

Individuals' social experiences are associated with their mental health, physical health, and even mortality. Over the last 30 years, researchers have examined the ways in which these social experiences might be associated with chronic inflammation - a component underlying many of the chronic diseases of aging. Little research, however, has examined the role of adults' attachment style as a specific social component that might be associated with inflammation. In the present study, we utilized data from a sample of 59 African-American adults from the Maryland Adolescent Development in Context Study (MADICS) to examine the links between attachment avoidance and attachment anxiety and C-reactive protein (CRP) and interleukin (IL)-6. After controlling for demographic characteristics, body mass index, and depressive symptoms, attachment avoidance and anxiety were associated with IL-6 but not CRP. This study adds to the growing body of research identifying the wide range of social experiences associated with inflammation and further suggests that attachment relationship experiences may have implications for biological processes relevant to many chronic diseases of aging. [ABSTRACT FROM AUTHOR]

Purpose: Although phacoemulsification is routinely performed with the patient in a supine position, certain locomotor deformities and other severe ailments can lead to the inability of the patient to recline flat.Methods: The present article surveys publications and summarizes our own experience regarding positioning techniques during cataract surgery on patients unable to adopt a supine position.Results: The successful and effective performance of cataract surgery by phacoemulsification depend on the comfortable positioning of both the patient and the surgeon. In order to achieve the highest possible success rate in phacoemulsification surgery, optimal positioning of the patient and the operating microscope are essential. There are other features of pivotal importance, including the construction of the operating table, the anesthesia technique, and the surgical approach.Conclusions: Surgeons often have to rely on their own imagination and experience in finding optimal positioning in order to perform effective and successful phacoemulsification surgery. [ABSTRACT FROM AUTHOR]

Background:Data are limited on the effectiveness of anti-TNF and other biologics on psoriatric arthritis (PsA) in Central and Eastern Europe (CEE). The objective of this analysis was to evaluate the efficacy of etanercept (ETN) in PsA patients from CEE. Methods:In PRESTA, patients were randomized to receive ETN 50 mg BIW or 50 mg QW for 12 weeks (double-blind phase) and ETN 50 mg QW for 12 additional weeks (open label). In this analysis, only patients from Czech Republic, Hungary, Poland and Serbia were included. The primary efficacy variable was the proportion of subjects achieving a physician global assessment (PGA) of psoriasis status: “clear” or “almost clear” at week 12. Results:In the 307 patients, 54% BIW/QW compared with 40% (QW/QW) (p = .02), achieved “clear”/”almost clear” for PGA of psoriasis at week 12 increasing, to 68% and 60%, respectively (p = .134) by week 24. Mean improvement from baseline in PASI were 59% versus 49% (p = .005) at week 6 and 87% versus 81% (p < .05) at week 24, for the BIW/QW and QW/QW groups, respectively. ETN was well tolerated in both groups over 24 weeks. Conclusions:Both dose regimens of ETN provided significant improvements in efficacy in PsA treatment and were well tolerated. [ABSTRACT FROM PUBLISHER]

Evangelical colleges and universities situated in rural communities are uniquely positioned to bridge the ever-widening cultural, economic, and political divide that threatens American democracy. However, success in this endeavor will require an appreciation for what it means to be a neighbor in this particular context. Thus, this article begins with a brief overview of how the common good has been conceptualized and pursued throughout the history of American higher education, followed by a description of features common to rural contexts. Next, a group of 31 member institutions of the Council for Christian Colleges and Universities is identified as rurally located, and their group characteristics are contrasted with their urban counterparts. Attention then turns to the contours of community engagement in the rural context, and the potential for rural evangelical colleges and universities to fulfill the place-based roles of stewarding and anchoring is explored. The article concludes by casting a vision for the common good in which Christian institutions of higher education partner with their surrounding communities to co-create a shared perspective, shared knowledge, and shared places. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal cancer is a significant global health issue with over 1 million cases diagnosed annually throughout the world. 15% of patients diagnosed with colorectal cancer will have liver metastases and 60% will develop liver metastases if they have metastatic disease. Oligometastatic colorectal cancer confined to the liver represents an intermediate state in the evolution of metastatic capacity that opens the opportunity for local interventions. Areas covered: The literature supports long-term survival if patients undergo liver resection of colorectal metastases. This article reviews the liver-directed therapeutic strategies available for the management of metastatic liver disease including hepatic arterial infusion therapy, radiofrequency ablation, radiation therapy and transarterial chemoembolization. Expert commentary: Great advances have been made with the use of liver directed therapies. In the USA using hepatic arterial infusions with FUDR and Decadron along with systemic therapy, 5 year survivals after liver resection have improved. In Europe with the use of HAI of Oxaliplatin, more patients have been able to get to resection and have obtained higher survival rates, even in second line therapy. New advances in ablative therapy have improved results to get all disease treated at resection for the treatment of reccurrence. [ABSTRACT FROM AUTHOR]

Well-intentioned policy governing the training of direct care workers (DCWs) who serve older persons, in practice, may become merely a compliance issue for organizations rather than a meaningful way to improve quality of care. This study investigates the relationships between best practices in DCW training and the structure and culture of long term support service (LTSS) organizations. Using a mixed-methods approach to analyzing data from 328 licensed LTSS organizations in Pennsylvania, the findings suggest that public policy should address methods of training, not just content, and consider organizational variations in size, training evaluation practices, DCW integration, and DCW input into care planning. Effective training also incorporates support for organizations and supervisors as key aspects of DCWs' learning and working environment. [ABSTRACT FROM AUTHOR]

In 1668–1669 William Neile and John Wallis engaged in a protracted correspondence regarding the nature of motion. Neile was unhappy with the laws of motion that had been established by the Royal Society in three papers published in 1668, deeming them not explanations of motion at all, but mere descriptions. Neile insisted that science could not be informative without a discussion of causes, meaning that Wallis's purely kinematic account of collision could not be complete. Wallis, however, did not consider Neile’s objections to his work to be serious. Rather than engage in a discussion of the proper place of natural philosophy in science, Wallis decided to show how Neile's preferred treatment of motion lead to absurd conclusions. This dispute is offered as a case study of dispute resolution within the early Royal Society. [ABSTRACT FROM AUTHOR]

Recent studies identify a robust positive correlation between the productivity of urban workers and the presence of a diverse range of immigrants in their midst. Seeking to better understand this relationship, this article tests the hypothesis that the rewards from immigrant diversity will be higher in metropolitan areas that feature more inclusive social and economic institutions. Institutions ought to matter because they regulate transaction costs, which, in principle, determine whether or not diversity offers advantages or disadvantages. We exploit longitudinal linked employer–employee data for the United States to test this idea, and we triangulate across two measures that differently capture the inclusiveness of urban institutions. Findings offer support for the hypothesis. In cities with low levels of inclusive institutions, the benefits of diversity are modest and in some cases nonexistent; in cities with high levels of inclusive institutions, the benefits of immigrant diversity are positive, significant, and substantial. We also find that weakly inclusive institutions hurt natives considerably more than foreign-born workers. These results confirm the economic significance of immigrant diversity, while suggesting the importance of local social and economic institutions. [ABSTRACT FROM AUTHOR]

The article offers information on anniversary issue of the periodical that completes 50 years in publication. Topics include observation of changes in global context related to regional studies management; impact of the 2008 financial crisis over enhancement of growth in several regions that leads to reduction in hyper-globalization; inhibition of foreign direct investment that provokes resurgence of industries; and concerns related to regional development along with infrastructure upgradation.

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In this article, we examine intuitive dimensions of personal cancer risk likelihood, which theory and empirical evidence indicate may be important elements in the risk perception process. We draw on data from a study of risk perceptions in three social groups: university students, men living in the community, and primary care patients living in an urban area. The study took place from 2007 to 2011, in Garden City and New York City, NY and Boston, MA. This study used items developed from categories identified in prior qualitative research specifying emotions and attitudes activated in cancer risk determination to examine perception of cancer risks. Across three samples – university students (N= 568); community men (N= 182); and diverse, urban primary care patients (N= 127) – we conducted exploratory factor and construct analyses. We found that the most reliable two factors within the five-factor solution were cognitive causation, tapping beliefs that risk thoughts may encourage cancer development, and negative affect in risk, assessing negative feelings generated during the risk perception process. For these factors, there were high levels of item endorsement, especially in minority groups, and only modest associations with established cancer risk perception and worry assessments, indicating novel content. These items may prove useful in measuring and comparing intuitive cancer risk perceptions across diverse population subgroups. [ABSTRACT FROM AUTHOR]

In this article, we examine intuitive dimensions of personal cancer risk likelihood, which theory and empirical evidence indicate may be important elements in the risk perception process. We draw on data from a study of risk perceptions in three social groups: university students, men living in the community, and primary care patients living in an urban area. The study took place from 2007 to 2011, in Garden City and New York City, NY and Boston, MA. This study used items developed from categories identified in prior qualitative research specifying emotions and attitudes activated in cancer risk determination to examine perception of cancer risks. Across three samples – university students (N= 568); community men (N= 182); and diverse, urban primary care patients (N= 127) – we conducted exploratory factor and construct analyses. We found that the most reliable two factors within the five-factor solution were cognitive causation, tapping beliefs that risk thoughts may encourage cancer development, and negative affect in risk, assessing negative feelings generated during the risk perception process. For these factors, there were high levels of item endorsement, especially in minority groups, and only modest associations with established cancer risk perception and worry assessments, indicating novel content. These items may prove useful in measuring and comparing intuitive cancer risk perceptions across diverse population subgroups. [ABSTRACT FROM AUTHOR]

Temozolomide (TMZ) has been proposed as a therapeutic option in aggressive pituitary tumors. Among the published cases, GH expressing tumors were rare. We describe a patient with initially benign silent GH adenoma that transformed into an aggressive GH secreting tumor resistant to usual therapy. MGMT expression was high and the MGMT promoter was unmethylated. Before this aggressive course, patient received three cycles of TMZ; no response was observed. Four cases of GH aggressive tumor treated by TMZ have been reported. Response to TMZ was observed in one of these four patients. Predictive factors of failure of TMZ remain unclear. [ABSTRACT FROM AUTHOR]

Objectives. Pineal tumours continue to present considerable clinical dilemmas and challenges. We were, therefore, interested to review our cumulative experience with a view to formulating a potential treatment strategy. Methods. A retrospective analysis of all patients treated with Stereotactic radiosurgery (SRS) for pineal tumours in one centre between 1987 and 2009. Forty-four patients (66% male) were treated radiosurgically with a mean age(± 1sd) of 33.6 (16.4) years. Eleven had biopsy-proven pineal parenchymal tumours (PPT), six astrocytomas, three ependymomas, two papillary epithelial tumours and two germ cell tumours. Twenty (45%) patients had no definitive histology despite attempted surgical biopsy in 11. Prior to radiosurgery, 17 had undergone craniotomy, 10 radiotherapy and four chemotherapy. Nine patients were referred for primary SRS. Results. Fifty Gamma knife treatments were performed on 44 patients prescribing 18.1 (4.2) Gy with a treatment volume of 3.8 (3.8) cm3. Routine clinical and MRI assessments were reviewed to calculate control rates. Mean follow up was 62.5 (52.9) months. Five patients (two ependymomas and three PPT) died at 36.2 (36.7) months after initial radiosurgical treatment. Overall progression-free survival (PFS) results were 93% at 1 year, 77% at 5 years, 67% at 10 and 20 years. Log-rank analysis revealed that higher initial tumour grade ( P = 0.04), previous radiotherapy ( P = 0.002) and radiological evidence of necrosis (P = 0.03) were associated with worse outcomes. The 5-year PFS for patients who possessed these 'aggressive' features was 47.1% compared with 91% for those patients who did not have these features. No persistent complications were attributed to SRS. Conclusions. These results further demonstrate the increasingly significant role played by STRS in the treatment of pineal tumours. Based on our findings, we believe a re-examination of the role of more established therapies for this patient group may be warranted. [ABSTRACT FROM AUTHOR]

An essay is presented on health care in Helmand, Afghanistan. It states that ongoing war in the country has affected medical care, particularly in southern provinces like Helmand. It mentions that lack of central government and public service health services have led to dependency on non-governmental organizations (NGOs) for health care services. It highlights that finances ultimately dictate what care is available to people.

Stereotactic radiosurgery is one of a number of recognised treatments for the management of trigeminal neuralgia refractory to drug therapy. The reported success of stereotactic radiosurgery in managing patients with trigeminal neuralgia varies in different units from 22 to 75%. This paper reports the outcomes of patients with trigeminal neuralgia who were treated at the National Centre for Stereotactic Radiosurgery in Sheffield, UK. The study reports the outcome of 72 patients treated consecutively between October 2004 and May 2008. Data were collected prospectively by a postal questionnaire sent to patients at 6, 12 and 24 months after treatment. The median age was 65.6 years (39 males: 33 females). Fourteen patients had secondary trigeminal neuralgia (eight multiple sclerosis). Fifteen of the patients included in the study were receiving a second treatment (an initial treatment having improved their pain significantly for at least 6 months). All radiosurgical procedures were performed using a single 4 mm collimator isocenter covering the region of the dorsal root entry zone with a maximal radiation dose of 80 Gy. The percentage of patients defined as having an excellent outcome (pain free without medication) was 39% after 6 months, 36% after 12 months and 64% after 24 months. The percentage of patients who reported being very satisfied with treatment was 71% after 6 months, 57% after 12 months and 53% after 24 months. Half the patients with secondary trigeminal neuralgia were pain free without medication after treatment, and 60% of patients who underwent a second treatment were pain free. A new trigeminal sensory deficit was reported by 31% of patients after radiosurgical treatment. [ABSTRACT FROM AUTHOR]

Objectives: Relationship between hyperglycemia and stroke outcome is unclear, partly due to the small sample size in most studies, and partly due to lack of consensus concerning the cutoff level for hyperglycemia. Methods: In a cohort study, we investigated whether on-admission hyperglycemia is an independent predictor for 30-day case fatality by analyzing data of 2496 consecutive computed tomography (CT) verified acute ischemic stroke patients (2077 non-diabetic and 419 diabetic) included in the prospective, hospital-based Debrecen Stroke Database. Instead of using an arbitrary cutoff level for hyperglycemia, quartiles of on-admission glucose level were used for Kaplan-Meier survival curves and Cox proportional hazard modeling. Results: The four quartiles of serum glucose level were in the range as follows: <5·2 mmol/l, 5·201-6·1 mmol/l, 6·101-7·5 mmol/l, and >7·501 mmol/l (n = 664, 618, 597, and 617, respectively). Among all 2496 participants, the adjusted hazard ratios for death increased with each quartile of admission glucose 1·96 [95% confidence interval (CI): 1·07-3·60; P = 0·03], 1·56 (95% CI: 0·83-2·94; P = 0·17), and 3·04 (95% CI: 1·70-5·44; P<0·0001) for the second, third, and fourth quartiles, respectively). Upon stratification with respect to diabetes, we found similarly high risk for poor outcome among non-diabetic patients, while the risk was considerably lower among diabetic patients. Discussion: These data suggest that even mild elevation of on-admission glucose levels is an independent predictor of 30-day case fatality. So, we propose that the ideal target blood glucose level is lower for non-diabetic than diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Clinical trials to test investigational drugs for the treatment of chronic plaque psoriasis currently lack standards for comparison of efficacy and safety data.The majority of studies do not address the important need for long-term treatment. Methods: The International Psoriasis Council (IPC) conducted two surveys of its members to assess the need for gold standards, active comparators, and long-term therapy in clinical trials. In Survey 1, 30 participants delivered viewpoints on active comparators for topical therapy (six questions), systemic therapy (nine questions), and continuous versus intermittent therapy (six questions). In Survey 2, 31 participants provided input on gold standards for treatment (five questions), appropriate comparators (four questions), and continuous versus intermittent therapy (six questions). The IPC leadership interpreted the results after each survey. Results: The majority of participants (77% in Survey 1 and 89% in Survey 2) agreed that studies of investigative treatments should include an active comparator. Participants described the most important feature of a gold standard as a treatment that: is widely used and generally accepted (45%); has the best efficacy (42%); and is well tolerated (13%). The majority agreed that gold standards should be dependent on: patient subgroup; location/extent of psoriasis; and psoriasis subtype/morphology. It was also agreed that continuous therapy for more than 3 years is needed for patients with moderate-to-severe plaque psoriasis. We have provided an expert opinion regarding the definition of a gold standard in psoriasis and have also established that no single treatment can be the gold standard across all subgroups and types of the disease. Conclusions: A single gold standard for the treatment of psoriasis does not exist. The complexity and heterogeneity of psoriasis requires different gold standards for the various manifestations of psoriasis and for subgroups of patients reconciling comorbidities. Of note, 17 experts out of 30 selected methotrexate as the most nominated gold standard amongst systemic agents. The experts support the election of an active comparator as one that is most efficacious over just the best in a particular class. In concordance, 87% of respondents agreed that good tolerability is therefore not the lead criterion for selection of an active comparator in favor of effectiveness and broad use. Patients with moderate-to-severe plaque psoriasis require continuous therapy; this statement was supported by 93% of the experts. Reasons for considering long-term therapy included appearance of comorbidities, impairment of quality of life, possibility of relapse, and subjective complaints such as itch, pain, and joint disease. [ABSTRACT FROM AUTHOR]

The aim of this study was to pilot test in a minority cancer patient population a communication workshop to improve doctor-patient communication skills. Thirty-two patients participated. Eighteen evaluated a face-to-face workshop, while 14 completed surveys only. Participants in the workshop group completed the Patient Report of Communication Behavior (PRCB) before and after the workshop and a course evaluation. Participants did not differ on baseline PRCB scores. Posttest scores were significantly higher than pretest scores (p < 0.01). All participants agreed or strongly agreed that they would use the communication skills; 93% agreed or strongly agreed that the skills would improve their health care. [ABSTRACT FROM AUTHOR]

The I Can Do It, You Can Do It Program (ICDI) national model, sponsored by the Division of Nutrition Research Coordination (DNRC), of the National Institutes of Health, implements a health promotion mentoring model for individuals with disabilities by leveraging the structural and human resources of community partners. The evidence-based model incorporates: (1) accessibility; (2) individual choice; (3) affordability; (4) public and nonprofit collaboration; (5) mentor support; and (6) evaluation. The university evaluated a pilot with 163 mentor-mentee pairs, to measure physical activity and healthy eating outcomes. In addition to reporting satisfaction, mentees increased physical activity levels, and decreased BMI. Mentees also increased fruit and salad intake. Mentors knowledge improved, but they also gained better communication, strategies for self-efficacy, and more comfort with supporting individuals with a disability. Through an expansion of ICDI in nine sites throughout the United States, larger-scale evaluation of the model continues. [ABSTRACT FROM AUTHOR]

An essay is presented regarding the response to the review of geographer Ron Martin on the article which focuses on divergence, specialization and evolution. Topics discussed include the regional development research that should be anchored on theory and data, the role of specialization in regional income and economic development, and the evolutionary economic geography.

A growing body of research suggests that threats to the social self, or threats to one's social esteem, acceptance, or status, can elicit a coordinated response, including increases in self-conscious emotion, cortisol, and proinflammatory cytokine activity. These psychobiological changes may have important benefits under certain acute contexts, including providing a signaling function for detecting social threat, initiating biological processes to adequately respond to the threat, and supporting behavioral patterns of submission or disengagement, which may be adaptive in this context. However, prolonged or chronic experiences of social self threat could have damaging mental and physical health consequences; situational and individual characteristics may render some more vulnerable to these negative effects. [ABSTRACT FROM AUTHOR]

Objective. Recombinant human (rHu) interleukin (IL)-12 has been shown to reduce levels of blood and sputum eosinophils in patients with mild allergic asthma in a randomized controlled study. The aim of the study was to investigate whether four escalating weekly subcutaneous injections of rHuIL-12 in allergic asthmatic patients could induce changes in the intracellular cytokine profile of the circulating blood CD4+ and CD8+ T cells. Material and methods. Purified CD4+ and CD8+ T cells from peripheral blood mononuclear cells of 11 patients (six received rHuIL-12 and five received placebo) were collected before and after 4 weeks of treatment, and cultured in the presence of phorbol myristate acetate for 4 days, with or without the addition of IL-12 in vitro. Expression of various intracellular cytokines was determined using flow cytometry following treatment with brefeldin-A and saponin. Results. Compared to placebo, the proportions of peripheral blood interferon-γ-, IL-4-, IL-2- or IL-10-producing CD4+ or CD8+ T cells were not significantly changed following rHuIL-12 treatment. Conclusion. Four weekly treatments with rHuIL-12 do not produce peripheral blood T-cell changes detectable with our experimental setting and methodology. [ABSTRACT FROM AUTHOR]

When driving in curves, how do drivers use the force appearing on the steering wheel? As it carries information related to lateral acceleration, this force could be necessary for drivers to tune their internal model of vehicle dynamics; alternatively, being opposed to the drivers' efforts, it could just help them stabilize the steering wheel position. To assess these two hypotheses, we designed an experiment on a motion-based driving simulator. The steering characteristics of the vehicle were modified in the course of driving, unknown to drivers. Results obtained with standard drivers showed a surprisingly wide range of adaptation, except for exaggerated modifications of the steering force feedback. A two-level driver model, combining a preview of vehicle dynamics and a neuromuscular steering control, reproduces these experimental results qualitatively and indicates that adaptation occurs at the haptic level rather than in the internal model of vehicle dynamics. This effect is related to other theories on the manual control of dynamics systems, wherein force feedback characteristics are abstracted at the position control level. This research also illustrates the use of driving simulation for the study of driver behavior and future intelligent steering assistance systems. [ABSTRACT FROM AUTHOR]

According to Torgersen (1978), education, health care, social security and housing are the four pillars of the welfare state. However, he describes housing as the “wobbly pillar under the welfare state” because to a far greater degree than education, health care and social security, housing is a market product. When examining welfare, the equivocal position of housing between state and market leads welfare researchers to focus on one or more of the other pillars (Torgersen, 1987, p 117; Wilensky, 1975, pp. 7–9). Because housing straddles both state and market, it is probable that vested market interests are more prominent in housing than in other welfare sectors. For this reason the housing market is likely to reflect the power balance between different interest groups particularly clearly, especially in comparison with other important welfare sectors where the market still plays a much more limited role. The market dependency of housing therefore makes it especially interesting for the study of power in welfare research. In this article I discuss the place of housing in the welfare system, emphasizing the dimension of power. I begin with a survey of the difference between integrated rental markets and dualist rental systems. This is followed by an examination of Esping-Andersen's thesis presented in Three Worlds of Welfare Capitalism (1990), focusing on his concept of regime and his application of corporatist theory to his welfare regime typology. My examination points to a clear connection between countries with an integrated rental housing market and countries viewed by leading corporatist theorists as classic examples of society with a corporatist power structure. [ABSTRACT FROM AUTHOR]

The distinction between dual rental systems and unitary rental markets is refined and developed. In particular, unitary rental markets are defined as markets in which barriers to non-profit providers competing on the rental market are removed, reserving the term ‘integrated rental markets’ for markets in which non-profit providers are sufficiently developed to be able to compete without the need for invasive regulation. The study also develops the distinction made in previous work between markets in which non-profit providers influence, lead and dominate the market. Case studies are then presented: Switzerland, where non-profit renting is weakly influencing, Sweden where it is leading, and the Netherlands where it is dominating. It is concluded that while in both the Netherlands and Sweden there is evidence of continual deregulation consistent with a tendency from unitary to integrated markets, there is no evidence of consistent change in that direction and even signs of some retrograde changes. [ABSTRACT FROM AUTHOR]

25 years ago, on the basis of very general statistics I argued that countries with high rates of home ownership tended to be countries with poorly-developed welfare states. Nearly 20 years later, in 1998 this thesis was tested by Frank Castles who, using more sophisticated statistical techniques and a larger number of countries, found the thesis to have some validity. He dubbed the phenomenon “The really big trade-off” between home ownership and public welfare. Both the original thesis and Castles' analysis are reviewed, and a way of testing the thesis a quarter of a century after its formulation is proposed. It is argued that if those countries that still today enjoy a functioning integrated rental market and have low rates of home ownership begin to experience major declines in welfare – especially among the elderly – we can expect them to begin to transform into monotenural home owning societies. Sweden is taken as an illustrative example of a country with potential for such a transformation. Housing researchers will hopefully monitor such changes in all countries with integrated rental markets to see if declines in welfare can explain increases in home ownership as a means of coping with poverty and ill health in old age. But more important, housing research needs to broaden its focus from housing studies to relating housing to broader issues of welfare and society. [ABSTRACT FROM AUTHOR]

Responds to comments made on the author's writings and discussions of issues related to housing. Author's discussion of the condition of the Dutch integrated rental markets; Basis for the argument that reduced pensions combined with both qualitative and quantitative reductions in the general range of public elderly care will increase the sense of insecurity created by the decline in general welfare provision such that more people will choose to buy rather than rent housing as just one of a number of hedges against old-age penury; Author's claim that the purpose of dualist rental systems is to channel household choice into home ownership.

This is a systematic review of a consecutive series of 309 meningiomas treated with gamma knife stereotactic radiosurgery between 1994 and 2000. There was an extreme selection bias towards lesions unfavourable for surgery, determined by the patients referred for treatment: 70% of tumours involved the skull base, 47% specifically the cavernous sinus: 15% of patients had multiple meningiomatosis or type 2 neurofibromatosis. Tumour histology was the main determinant of growth control ( p <0.001), the 5-year actuarial control rates being 87% for typical meningiomas, 49% for atypical tumours and 0% for malignant lesions. Complications from radiosurgery were rare, occurring in 3% of tumours, and were most frequently trigeminal and eye movement disturbances treating cavernous sinus meningiomas. Given the problems inherent in managing these tumours, radiosurgery is a valuable strategy and adjuvant treatment for these meningiomas. [ABSTRACT FROM AUTHOR]

Haemangioblastomas secondary to von Hippel - Lindau (VHL) disease can be difficult to manage surgically, which has lead to an interest in the use of stereotactic radiosurgery. Retrospectively reviewed here are 30 tumours treated in 14 patients with a mean ± SD follow-up of 34 ± 24 months. During this time, three of the 14 patients (21%) died, two of generalized progressive disease. Before radiosurgery, the median time between interventions for cranial haemangioblastomas was 3 years (mean 3.9 ± 5.0 years). After radiosurgery, the tendency for cranial disease progression was similar, 50% of patients developing further disease by 5 years. Local tumour control was achieved in the majority of cases and estimates of this are included. Radiosurgery is a useful palliative measure controlling the majority of haemangioblastomas, although its efficacy in these patients is limited by the tendency of further disease to develop or progress intracranially. [ABSTRACT FROM AUTHOR]

This prospective study examined the unique predictors of grief and depressed mood in a sample of gay men (34 HIV positive, 69 HIV negative) who lost a close friend to AIDS. Individuals low in self-esteem reported greater depressed mood but no differences in grief following the death. Individuals with personality factors that predispose toward negative affect (e.g., negative affectivity, sensitizer style) were more likely to experience depressed mood but not grief. Other factors also differentially predicted grief and depressed mood. Results suggest that there are distinctive antecedents to grief and depressed mood. Theoretical distinctions between depressed mood and grief are discussed. [ABSTRACT FROM AUTHOR]

Focuses on shame as the emotional response to threat to the social self. Relevance of shame to survival goals; Basic emotion in shame.

A constructionist approach to the study of social problems and housing policy provides a theoretically informed means of analysing the ways in which housing policy is formulated and implemented. Yet despite a strong commitment by housing researchers to policy relevance, constructionist studies of how specific social problems are generated and deployed have so far made only a limited impact on housing research. The paper addresses this lacuna by first discussing important literature and the key conceptual issues in this field of study. This is followed by a discussion of two examples from recent UK housing policy (the shift in the 1980s from defining lone mothers as the victims of housing shortages to a morally questionable group subverting needs-based allocation policies and the re-emergence of anti-social behaviour as a problem on housing estates). The paper's conclusion is that the 'construction of problems' provides a rich source of new material as well as offering significant opportunities to develop a more critically informed housing research agenda. [ABSTRACT FROM AUTHOR]

Recognizing a change in our workload and variabilities in referral patterns, we reviewed our previous activity from 1994 to 2000 retrospectively and examined prospectively formal referrals to the Unit in 2001. Arteriovenous malformations still constitute 30% of referrals and treatments, although as a proportion of our workload, this has declined. Radiosurgery is increasingly being chosen as a first line treatment for small and moderate-sized acoustic neuromas, although referral rates vary widely, some neuroscience units referring all and others none of their acoustic neuromas at least for a radiosurgical opinion. About 100 meningiomas, mainly skull-base and/or recurrent tumours after previous surgery, are now treated per year. Compared with other units world-wide, very few pituitary adenomas and cerebral metastases are treated. The implications of this are discussed. [ABSTRACT FROM AUTHOR]

Following Margaret Somers, the paper explores the implicit metanarrative that underlies and informs basic concepts in the social sciences - and hence also basic concepts in housing research - of "society/market" and "state". Somers shows how the Hobbesian thesis that society is impossible without the state was countered by the Lockeian project of making a conceptual distinction between them that redefined society/market as "natural" and as existing prior to the creation of the artificial state as a means of controlling and distorting society. She then shows how and why this abstract model became historicised into a storyline ("once upon a time"...) involving a struggle between good (society) and evil (the state). Somers argues that modern anglo-american social science is predicated on this confrontational conceptual distinction and its accompanying narrative of good versus evil, natural versus artifical, voluntarism versus coercion, spontaneity versus regulation and other "great dichotomies". The paper illustrates how this conceptual distinction has been adopted by housing researchers from Donnison through Castells, Harloe and Saunders, but that the narrative that is recounted varies from one housing researcher to another. The paper concludes by arguing for an abandonment of the simplistic Lockeian thesis of "society/market versus the state" and for developing a conceptual framework that does not polarise them. [ABSTRACT FROM AUTHOR]

Malignant change in schwannoma is rare. Malignant change in a vestibular schwannoma (acoustic neuroma) is even more rare. This paper presents a case of rapidly growing vestibular schwannoma first treated by radiosurgery whose histopathology after surgical excision 42 months later showed malignant changes. Up to now, eight cases of malignancy in eighth nerve tumours have been reported, four of which, including the present case, had previously been treated with radiosurgery and four cases that had not received radiation. Thus, it would seem, the overall incidence is extremely low. Nevertheless, extreme vigilance and careful reporting continues to be necessary. [ABSTRACT FROM AUTHOR]

Motion cueing in a driving simulator is necessary for advanced studies requiring drivers to accurately perceive and control the motion of their vehicle. The Renault Dynamic Simulator uses a 6-axes electro-mechanical mobile platform with an adequate motion control software. The physical and perceptual validity of the motion cueing is analyzed with respect to actual vehicle acceleration data and human self-motion per-ception criteria. Within the actuator displacement limits, it is capable of directly rendering transient vehicle accelerations whereas sustained linear acceleration cues are simulated by a coordinated platform tilt. Accel-eration transients are extracted by high-pass filtering, but a classical implementation based on linear filters may produce artifacts in some key driving situations. A non-linear motion cueing algorithm was developed to anticipate and reduce these false motion cues. [ABSTRACT FROM AUTHOR]