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    The role of nutrition and physical exercise in promoting musculoskeletal health in individuals with rheumatic diseases undergoing glucocorticoid therapy

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    Glicocorticoides (GC) são medicamentos empregados no tratamento de doenças reumáticas pelo seu potencial anti-inflamatório e imunossupressor, mas que acarretam em importantes efeitos adversos, como a perda de massa muscular e óssea. Intervenções do estilo de vida representam potenciais terapias coadjuvantes capazes de reduzir o impacto desses efeitos adversos. A presente tese é composta por três estudos, com o objetivo principal de investigar o papel de intervenções nutricionais e de exercício físico na saúde musculoesquelética de indivíduos com doenças reumáticas utilizando GCs. O Estudo I é uma revisão narrativa que buscou resumir o atual nível de evidência de intervenções nutricionais para combater os efeitos adversos dos GCs. O Estudo II é uma análise exploratória da base de dados do National Health and Nutrition Examination Survey (NHANES), com o objetivo compreender a potencial associação entre consumo de proteína, massa magra e massa óssea em indivíduos com doenças reumáticas. O Estudo III é um ensaio clínico randomizado, controlado com grupos paralelos, com o objetivo de investigar o efeito de um programa de treinamento físico home-based de 6 meses na saúde e metabolismo ósseo de indivíduos com Lúpus Eritematoso Sistêmico (LES) submetidas a pulsoterapia com GCs. O Estudo I identificou que a adequação do consumo de cálcio, vitamina D, e proteínas parecem ser recomendações importantes na preservação da massa óssea e muscular, e destaca o potencial papel de uma dieta baseada em alimentos in natura e minimamente processados para a saúde metabólica dessa população. Entretanto, mostrou também que intervenções nutricionais são pouco investigadas, sugerindo estudos futuros que possam solucionar essas lacunas da literatura. O Estudo II encontrou associações não-lineares significativas e positivas entre o consumo de proteína e massa óssea de colo femoral e massa magra, mesmo quando o modelo foi ajustado para variáveis de confusão. O Estudo III mostrou efeitos significativos da intervenção em determinados parâmetros de microarquitetura óssea em comparação ao grupo controle, entretanto, este desfecho teve tamanho amostral reduzido, o que reduz a certeza nesse achado. Não foram vistos efeitos significativos da intervenção na densidade mineral óssea e nos biomarcadores do metabolismo ósseo. Em resumo, os estudos dessa tese reforçam que as intervenções nutricionais baseadas no fornecimento adequado de cálcio, vitamina D e proteína podem ter efeitos relevantes na preservação da massa óssea e muscular de indivíduos com doenças reumáticas em terapia com GCs. Em relação ao exercício, resultados sugerem um potencial efeito benéfico em parâmetros de microarquitetura, mas este achado precisa ser confirmado por estudos futuros. Coletivamente, esta tese destaca o papel promissor dieta e do treinamento físico na massa muscular e saúde óssea dessa população, mas também reforça a importância de mais estudos para compreender seus efeitos de maneira abrangente.Glucocorticoids (GCs) are medications used in the treatment of rheumatic diseases due to their anti-inflammatory and immunosuppressive potential; however, they can lead to adverse effects, such as bone and muscle loss. Lifestyle interventions represent potential adjunct therapies capable of mitigating these adverse effects. This thesis comprises three studies, the primary objective of which is to investigate the role of nutritional and physical exercise interventions in promoting musculoskeletal health of individuals with rheumatic diseases using GCs. Study I is a narrative review summarizing the current level of evidence regarding nutritional interventions to counteract the adverse effects of GCs. Study II is an exploratory analysis of the National Health and Nutrition Examination Survey (NHANES) database, designed to assess potential associations between protein intake, lean mass, and bone mass in individuals with rheumatic diseases. Study III is a randomized parallel-group controlled trial, evaluating the effect of a six-month home-based training program on the bone health and metabolism of participants with Systemic Lupus Erythematosus (SLE) undergoing pulse therapy with GCs. Study I identified that adequate calcium, vitamin D and protein intake appears to be important recommendations for bone mass and muscle mass preservation, and the potential role of a diet based on minimally processed foods for aiding metabolic health in this population. However, it also noted that nutritional interventions are under-investigated, highlighting the need for future studies to address these gaps in the literature. Study II found significant non-linear positive associations between protein intake and femoral neck bone mass as well as lean mass, even after adjusting the models for confounding variables. Study III showed significant effects of the intervention on certain bone microarchitecture parameters in comparison to the control group. However, this outcome had a reduced sample size which reduces certainty in the finding. No significant effects of the intervention were observed on bone mineral density or bone metabolism biomarkers. In summary, the studies in this thesis reinforce that nutritional interventions based on adequate calcium, vitamin D, and protein intake may have relevant effects on preserving bone and muscle mass in individuals with rheumatic diseases undergoing GC therapy. Regarding exercise, results suggest a potential beneficial effect on microarchitecture parameters, but this finding needs to be confirmed by future studies. Collectively, this thesis highlights the promising role of diet and physical training in muscle mass and bone health in this population while also emphasizing the need for further studies to comprehensively understand their effects

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods

    Author Index

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    koamabayili/VECTRON-author-checklist: VECTRON author checklist

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    We have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used

    Author Under Sail The Imagination of Jack London, 1893-1902

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    In Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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