bluuebunny/crossref_metadata_2025 huggingface dataset:
Is lithium monitoring NICE? Lithium monitoring in a UK secondary care setting
Authors: Nikolova Viktoriya L , Pattanaseri Keerati , Hidalgo-Mazzei Diego , Taylor David , Young Allan H
Published: March 2018

Background:

Lithium is widely used for the treatment of bipolar disorder. Owing to its narrow therapeutic index and side-effect profile, regular monitoring of serum levels, renal and thyroid function has been recommended by all major guidelines on lithium use.

Objectives:

We investigated whether lithium monitoring during maintenance phase treatment in clinical practice meets the latest recommendation by the National Institute for Health and Clinical excellence (i.e. lithium levels between 0.6 and 1.0 mmol/L and lithium level, thyroid and renal function tests every 6 months) in one of the largest mental health organizations in Europe, the South London and Maudsley (SLaM) NHS Foundation Trust.

Methods:

Retrospective data were extracted from SLaM’s Clinical Record Interactive Search (CRIS) system. Adult patients with a psychiatric disorder who were on lithium at any point during the period January 2012–January 2016 and had at least one lithium level test result in the system were included in the analyses.

Results:

A total of 2639 lithium level tests results were retrieved for 412 patients. Overall, the serum level was within the recommended range in 50.7% of all tests, below the range in 42.4% and above in 6.9%. Lithium level, renal and thyroid function tests were performed at the recommended frequency of 6 months (or less) in 76.2%, 72.7% and 60.2% of patients, respectively.

Conclusion:

These data demonstrate that there is a gap between the NICE 2014 recommendation and lithium monitoring practice in secondary care, with a high number of lithium level results below the therapeutic minimum. Reminder strategies for secondary care practitioners, shared care agreements or a central registry for lithium users could improve monitoring performance.
The University of Wisconsin Breast Cancer Epidemiology Simulation Model: An Update
Authors: Alagoz Oguzhan , Ergun Mehmet Ali , Cevik Mucahit , Sprague Brian L. , Fryback Dennis G. , Gangnon Ronald E. , Hampton John M. , Stout Natasha K. , Trentham-Dietz Amy
Published: March 2018

The University of Wisconsin Breast Cancer Epidemiology Simulation Model (UWBCS), also referred to as Model W, is a discrete-event microsimulation model that uses a systems engineering approach to replicate breast cancer epidemiology in the US over time. This population-based model simulates the lifetimes of individual women through 4 main model components: breast cancer natural history, detection, treatment, and mortality. A key feature of the UWBCS is that, in addition to specifying a population distribution in tumor growth rates, the model allows for heterogeneity in tumor behavior, with some tumors having limited malignant potential (i.e., would never become fatal in a woman’s lifetime if left untreated) and some tumors being very aggressive based on metastatic spread early in their onset. The model is calibrated to Surveillance, Epidemiology, and End Results (SEER) breast cancer incidence and mortality data from 1975 to 2010, and cross-validated against data from the Wisconsin cancer reporting system. The UWBCS model generates detailed outputs including underlying disease states and observed clinical outcomes by age and calendar year, as well as costs, resource usage, and quality of life associated with screening and treatment. The UWBCS has been recently updated to account for differences in breast cancer detection, treatment, and survival by molecular subtypes (defined by ER/HER2 status), to reflect the recent advances in screening and treatment, and to consider a range of breast cancer risk factors, including breast density, race, body-mass-index, and the use of postmenopausal hormone therapy. Therefore, the model can evaluate novel screening strategies, such as risk-based screening, and can assess breast cancer outcomes by breast cancer molecular subtype. In this article, we describe the most up-to-date version of the UWBCS.
Comparing CISNET Breast Cancer Models Using the Maximum Clinical Incidence Reduction Methodology
Authors: van den Broek Jeroen J. , van Ravesteyn Nicolien T. , Mandelblatt Jeanne S. , Cevik Mucahit , Schechter Clyde B. , Lee Sandra J. , Huang Hui , Li Yisheng , Munoz Diego F. , Plevritis Sylvia K. , de Koning Harry J. , Stout Natasha K. , van Ballegooijen Marjolein
Published: March 2018

Background. Collaborative modeling has been used to estimate the impact of potential cancer screening strategies worldwide. A necessary step in the interpretation of collaborative cancer screening model results is to understand how model structure and model assumptions influence cancer incidence and mortality predictions. In this study, we examined the relative contributions of the pre-clinical duration of breast cancer, the sensitivity of screening, and the improvement in prognosis associated with treatment of screen-detected cases to the breast cancer incidence and mortality predictions of 5 Cancer Intervention and Surveillance Modeling Network (CISNET) models. Methods. To tease out the impact of model structure and assumptions on model predictions, the Maximum Clinical Incidence Reduction (MCLIR) method compares changes in the number of breast cancers diagnosed due to clinical symptoms and cancer mortality between 4 simplified scenarios: 1) no-screening; 2) one-time perfect screening exam, which detects all existing cancers and perfect treatment (i.e., cure) of all screen-detected cancers; 3) one-time digital mammogram and perfect treatment of all screen-detected cancers; and 4) one-time digital mammogram and current guideline-concordant treatment of all screen-detected cancers. Results. The 5 models predicted a large range in maximum clinical incidence (19% to 71%) and in breast cancer mortality reduction (33% to 67%) from a one-time perfect screening test and perfect treatment. In this perfect scenario, the models with assumptions of tumor inception before it is first detectable by mammography predicted substantially higher incidence and mortality reductions than models with assumptions of tumor onset at the start of a cancer’s screen-detectable phase. The range across models in breast cancer clinical incidence (11% to 24%) and mortality reduction (8% to 18%) from a one-time digital mammogram at age 62 y with observed sensitivity and current guideline-concordant treatment was considerably smaller than achievable under perfect conditions. Conclusions. The timing of tumor inception and its effect on the length of the pre-clinical phase of breast cancer had a substantial impact on the grouping of models based on their predictions for clinical incidence and breast cancer mortality reduction. This key finding about the timing of tumor inception will be included in future CISNET breast analyses to enhance model transparency. The MCLIR approach should aid in the interpretation of variations in model results and could be adopted in other disease screening settings to enhance model transparency.
Analysis of haemostasis biomarkers in patients with advanced stage lung cancer during hypofractionated radiotherapy treatment
Authors: Wolny-Rokicka Edyta , Brzeźniakiewicz-Janus Katarzyna , Wydmański Jerzy , Tukiendorf Andrzej , Zembroń-Łacny Agnieszka
Published: March 2018

Objective

To investigate the relationship between changes in inflammatory and coagulatory biomarkers before and after short palliative radiotherapy in patients with advanced stage lung cancer.

Methods

This prospective observational single-centre study enrolled patients with histologically- or cytologically-confirmed lung cancer who were eligible for palliative radiotherapy. Inflammatory and coagulatory biomarkers including complete blood count, D-dimer and fibrinogen levels were evaluated before and after short hypofractionated radiotherapy.

Results

Seventy-two patients with advanced stage lung carcinoma were enrolled in this study. Metastases were associated with an increase in white blood cells, neutrophils and mean platelet volume. Increased volume of the primary tumour had a borderline level of correlation with white blood cell and neutrophil counts. After radiotherapy, white blood cells, neutrophils, haemoglobin and lymphocyte counts were decreased. After radiotherapy, the change in fibrinogen and mean platelet volume were borderline significant.

Conclusion

The levels of inflammatory and coagulatory biomarkers can be used to monitor treatment.
Optimal platelet function test for in-stent tissue protrusion following carotid artery stenting
Authors: Tsujimoto Masanori , Enomoto Yukiko , Miyai Masafumi , Egashira Yusuke , Iwama Toru
Published: March 2018

Purpose

To determine the best platelet function test for in-stent tissue protrusion following carotid artery stenting (CAS).

Methods

Patients who underwent CAS were recruited prospectively in this observational study. Combination of aspirin 100 mg/day and clopidogrel 75 mg/day was administered for a minimum of 7 days prior to procedure. Platelet aggregation was measured by light transmittance aggregometry (LTA) following stimulation by adenosine diphosphate (ADP), collagen, and thrombin receptor activating peptide (TRAP) and by the point of care assay, VerifyNow which measures aspirin and thienopyridine reaction units.

Results

In-stent tissue protrusion with maximum projection area of ≥1 mm2 was detected by optical coherence tomography (OCT) in 10/28 (36%) patients. Baseline characteristics were not significantly different between the two in-stent size groups (i.e., ≥1 mm2 vs. <1 mm2) but after stimulation by collagen at 10 and 20 μg/ml, platelet reactivity as measured by LTA was significantly higher in the ≥1 mm2 group compared with the <1 mm2 group. No other differences in platelet function were detected.

Conclusions

Collagen-induced platelet reactivity was related to in-stent tissue protrusion size following CAS.
India’s Northeast and the Enigma of the Nation-state
Authors: Sarmah Bhupen
Published: March 2018

One of the major challenges before the “mainstream Indian nationalists” at the dawn of India’s independence was the political integration of the “Northeast” with India envisaged as a nation-state. Some parts of the colonial frontier, such as the Naga Hills, had already witnessed a parallel nationalist discourse with the imagination of sovereignty before India’s independence. With independence, the Indian nation-state project was made difficult by the geopolitical significance of the region, shaped by the experience of the partition, which separated India and Pakistan (East and West), creating a milieu of not-so-favorable international politics. The postcolonial history of the troubled periphery has been marked by an imposed notion of homogeneity and a binary of the nation-state (or the Indian mainstream) and the Northeast. Political theorists have long refuted the notion of national homogeneity. Nevertheless, the dichotomy between the plains and the valley constructed by the colonial logic was and is reinforced by the nation-state ideology, turning the periphery into a cauldron of conflict. This article engages critically with the history of conflict witnessed in the region since independence, against the backdrop of colonial interventions and the integrationist logic of the nation-state. This article argues that the political and developmental strategies, adopted by the Indian state to integrate the region, have led to the perpetuation of conflict in different forms.
Influence of Professors on Student Satisfaction With e-Portfolio Use
Authors: Gámiz-Sánchez V. , Gutiérrez-Santiuste E. , Hinojosa-Pareja E.
Published: March 2018

This study analyzes the use of e-portfolios in Higher Education, specifically, participants' opinion concerning various aspects of the experience and the teaching methods used. Its main purpose is to determine the influence of professors in student satisfaction in this virtual environment, through a descriptive study performed using a mixed focus that combines quantitative and qualitative data analysis. The data collection instruments were a questionnaire for recording the students' opinions and a structured interview of three professors. The study's sample of 251 was drawn from students who were enrolled in different subjects. According to the results obtained, the professor is a decisive variable in student satisfaction when analyzing pedagogical issues concerning the e-portfolio, students' opinions about the professor's teaching actions, and usability of the platform. The students' opinions differ most on issues of time management and collaborative learning, but also on issues such as participation, motivation, and reflection on learning.
Postconcussive Symptoms After Single and Repeated Concussions in 10- to 20-Year-Olds: A Cross-Sectional Study
Authors: Oyegbile Temitayo Oyefunmike , Delasobera Bronson Elizabeth , Zecavati Nassim
Published: March 2018

The objective was to characterize cognitive deficits and postconcussive symptoms in a pediatric population with no concussion, a single concussion, and ≥2 concussions, using a cross-sectional design. Cognitive function and postconcussive symptoms were assessed in participants (age 10-20) with no concussion (n = 1118), single concussion (n = 368), and repeated (≥2) concussions (n = 252). Analyses were adjusted for age and gender. Individuals with ≥2 concussions exhibited more total postconcussive symptoms; more loss of consciousness, amnesia and confusion; more headaches; and poorer cognitive function compared to no concussion and single concussion. Postconcussive symptoms may play a modulatory role in cognitive dysfunction after repeated concussions as those with loss of consciousness, amnesia, confusion, or headaches exhibited worse verbal memory, visual memory, visual-motor processing, and poorer impulse control compared to those without these symptoms. This analysis demonstrates that repeated concussions is associated with poorer cognitive function and postconcussive symptoms compared to a single concussion.
Global Longitudinal Strain Using Speckle-Tracking Echocardiography as a Mortality Predictor in Sepsis: A Systematic Review
Authors: Vallabhajosyula Saraschandra , Rayes Hamza A. , Sakhuja Ankit , Murad Mohammad Hassan , Geske Jeffrey B. , Jentzer Jacob C.
Published: March 2018

The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate. A total of 120 studies were identified, with 5 studies (561 patients) included in the final analysis. All studies were prospective observational studies using the 2001 criteria for defining sepsis. Three studies demonstrated worse systolic GLS to be associated with higher mortality, whereas 2 did not show a statistically significant association. Various cutoffs between −10% and −17% were used to define abnormal GLS across studies. This systematic review revealed that STE may predict mortality in patients with sepsis; however, the strength of evidence is low due to heterogeneity in study populations, GLS technologies, cutoffs, and timing of STE. Further dedicated studies are needed to understand the optimal application of STE in patients with sepsis.
Red Blood Cell Product Transfusion Thresholds and Clinical Outcomes
Authors: Lilly Craig M. , Badawi Omar , Liu Xinggang , Gill Christine S. , Harris Ilene
Published: March 2018

Objective:

To determine whether patients transfused red blood cell (RBC) products according to guideline-specified pretransfusion hemoglobin (Hb) concentrations or for other reasons were more likely to survive their intensive care unit (ICU) stay.

Design:

An observational study of 375 478 episodes of ICU care, over 5 years, was performed with ICU survival as the primary outcome. Outcomes were analyzed as a function of pretransfusion Hb concentration for groups with distinct transfusion indications while adjusting for potential confounders.

Setting and Patients:

This study included all adult patients discharged from 1 of 203 adult ICUs from 32 US health-care systems. The patients were from community hospitals, tertiary, and academic medical centers.

Intervention:

Transfusion of allogenic packed RBCs or whole blood was prescribed at the discretion of the treating clinicians.

Measurements and Main Results:

We found that 15% of adult ICU patients are transfused RBC products, and most transfusions for hemodynamically stable patients are administered above the guideline-specified pretransfusion Hb threshold of 7 g/dL. Hemodynamically stable patients transfused below this threshold were significantly more likely to survive their ICU stay than those not transfused (odds ratio [OR] 0.59, 95% confidence interval [CI], 0.43-0.81; P = .001), and patients transfused at thresholds above 9 g/dL were less likely to survive their ICU stay than those not transfused. Patients of the acute blood loss group who were transfused appeared to benefit or were not harmed by transfusion.

Conclusion:

Conservative RBC product transfusion practices for groups that are targeted by guidelines are justified by outcomes observed in clinical practice. This study provides evidence for the liberal administration of RBC products to critically ill adults with acute blood loss based on association with lower risk of mortality.
Speaking of Contradiction
Authors: Harvey Geraint , Turnbull Peter , Wintersberger Daniel
Published: March 2018

Whereas McGovern calls for a moratorium on the ever increasing (ab)use of the word ‘contradiction’, principally because scholars of work and employment fail to connect different levels of analysis and/or demonstrate how and why contradiction(s) lead to widespread instability and upheaval, it can be demonstrated how both can be achieved through the ‘system, society, dominance’ framework. In what follows, the empirical focus is on the safety-critical work of airport ground service providers (GSPs), where key elements of the employment relationship embody contradictions that can be traced to the (sub-)system (mode of production) of a Single European Aviation Market (SEAM) that is now dominated by low fares airlines (LFAs). Instead of a moratorium, scholars of work and employment need to reconnect with society and theoretically ground their analysis in a (capitalist) system beset with contradictions between the forces and relations of production.
Multiple Dimensions of Work Intensity: Ambulance Work as Edgework
Authors: Granter Edward , Wankhade Paresh , McCann Leo , Hassard John , Hyde Paula
Published: March 2018

Working life in public sector professions is undergoing significant change and becoming increasingly demanding. This article explores work intensity in NHS ambulance services in England, describing four distinct but interrelated dimensions of intensity: temporal; physical; emotional; and organizational. We use the concept of edgework to explore the complexities involved in how emergency workers attempt to negotiate the rewards and risks associated with multidimensional work intensity. Although certain parts of ambulance work may be intrinsically intense and can provide an important source of validation, organizational elements have the potential to push work intensity to unnecessary extremes. Ambulance services are ‘professionalizing’, but as work in ambulance trusts continues to intensify, issues over dignity, staff retention and the meaning of work are becoming ever more challenging, just as they are in other public service professions.
Bayesian semiparametric modeling for HIV longitudinal data with censoring and skewness
Authors: Castro Luis M , Wang Wan-Lun , Lachos Victor H , Inácio de Carvalho Vanda , Bayes Cristian L
Published: March 2018

In biomedical studies, the analysis of longitudinal data based on Gaussian assumptions is common practice. Nevertheless, more often than not, the observed responses are naturally skewed, rendering the use of symmetric mixed effects models inadequate. In addition, it is also common in clinical assays that the patient’s responses are subject to some upper and/or lower quantification limit, depending on the diagnostic assays used for their detection. Furthermore, responses may also often present a nonlinear relation with some covariates, such as time. To address the aforementioned three issues, we consider a Bayesian semiparametric longitudinal censored model based on a combination of splines, wavelets, and the skew-normal distribution. Specifically, we focus on the use of splines to approximate the general mean, wavelets for modeling the individual subject trajectories, and on the skew-normal distribution for modeling the random effects. The newly developed method is illustrated through simulated data and real data concerning AIDS/HIV viral loads.
25 years of ESCOM: Achievements and challenges
Authors: Sloboda John A. , Ginsborg Jane
Published: March 2018

This reflection on the first 25 years of ESCOM’s activities is in two parts. In the first part we analyse the country and discipline spread of contributors to its journal Musicae Scientiae and its formal membership. In the second we address the choice of “cognitive sciences of music” as the initial focus of both Society and journal by comparing the topics of early meetings and publications with those that are current now. Journal contributors and members are both concentrated in a small number of countries. When corrected for population size, the countries with the highest levels of activity are, in order: Finland, Estonia, UK, Sweden, Germany, Belgium, Switzerland, and Austria. This has not changed substantially over the duration of ESCOM’s existence. In contrast, there have been significant changes in the disciplinary spread of contributions, psychology becoming increasingly popular in recent years to the near exclusion of some other disciplinary approaches including ethnomusicology, computational modelling and theoretical musicology. Current topics include performance and composition, emotion, musical development, perception, music therapy and well-being, music learning, preferences, cognition, and neuropsychological approaches. An early aspiration of the Society was that the wide range of disciplines represented by the cognitive sciences of music might eventually converge, but this has proved difficult to achieve. An increasing convergence on the use of English as its normative language, however, has provided ESCOM with both new challenges and some opportunities.
Neoliberal reformers: Economics as class warfare
Authors: Dabscheck Braham
Published: March 2018

This review article discusses MacLean’s study of the ideas of a group of economists and their embracing by an oligarchy of business groups to implement a Neoliberal agenda and its implications for American democracy. It mainly focuses on the Nobel Prize winning economist James McGill Buchanan and the industrialist Charles Koch. Business groups provided funds to Buchanan and others to train right-minded people in the precepts of Neoliberalism, established think tanks and institutes to disseminate their views, and ‘directed’ and/or provided advice and draft legislation for Republican politicians at both the state and federal level. Inspiration for how to achieve this Neoliberal ‘revolution’ can be found in Lenin’s 1902 What is to be Done?. The Neoliberal attack on government and statism is consistent with Orwell’s notion of doublethink. It constitutes a weakening of those parts of the state which are inimical to the interests of a wealthy oligarchy, the federal government and agencies/government departments who are viewed as imposing costs (taxes) on and interfering with (regulating) the actions of the oligarchy, and strengthening other parts such as state governments, the judiciary, at both the state (especially) and federal level and police forces to protect and advance their interests.
Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate
Authors: Ungkanont Kitirat , Boonyabut Panrasee , Komoltri Chulaluk , Tanphaichitr Archwin , Vathanophas Vannipa
Published: March 2018

Objective:

To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate.

Design:

Retrospective cohort study in the tertiary care center.

Patients:

Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies.

Main outcome measures:

Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes.

Results:

Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%).

Conclusion:

Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.
Treatment of Stress Velopharyngeal Incompetence With Injection of Hyaluronic Acid
Authors: Koprowski Steven , VanLue Michael J. , McCormick Michael E.
Published: March 2018

Stress velopharyngeal incompetence (VPI) is a challenging clinical entity that can be managed by a variety of surgical and nonsurgical approaches. We describe the case of a clarinetist who presented with nasal air escape while playing. She had successful improvement in her symptoms after targeted injection of a hyaluronic acid compound to her posterior pharyngeal wall. Our objective is to describe the safety and efficacy of this technique, to emphasize the multidisciplinary management of patients with stress VPI, and to review the importance of both nasopharyngoscopy and videofluoroscopy in their evaluation.
Improvement of Aesthetic and Nasal Airway in Patients With Cleft Lip Nasal Deformities
Authors: Zhang Lei , Bai Xiaofeng , Li Zengjian , Liu Qiang , Yang Mingliang , Wang Xukai , Lu Li
Published: March 2018

Objective:

To assess the improvement of nasal morphologies and ventilation after septal cartilage graft and septoplasty of patients with unilateral cleft lip and palate (UCLP).

Design:

Retrospective case-control study.

Setting:

Tertiary stomatology hospital.

Patients:

In total, 118 patients with UCLP who had been diagnosed with a secondary nasal deformity and had reconstructive rhinoplasty and/or septoplasty between 2010 and 2015.

Main Outcome Measures:

Nasal Obstruction Symptoms Evaluation (NOSE) questionnaire, septum deviated angle, rhinoplasty satisfaction questionnaire, and 3-dimensional photographs.

Results:

Average follow-up period was approximately 12 months for both groups. NOSE and 3-dimensional computed tomography (3DCT) analysis demonstrated postoperative improvement in nasal airway function of those patients who underwent rhinoplasty and septoplasty simultaneously ( P < .05). Subjective assessment by patients’ visual analog scale (VAS) and objective assessment by 3-dimensional stereophotography demonstrated postoperative improvement in nasal morphologies, particularly the columella deviation angle and nasal depth (representing nasal tip height), which are crucial parameters of nasal aesthetics ( P < .05).

Conclusions:

In patients who underwent simultaneous rhinoplasty and septoplasty, nasal symmetry and ventilation function were significantly improved compared to the control group. Septum grafts could provide nasal tip support for patients with cleft lip. Three-dimensional stereophotogrammetry helped us to better visualize the surgical results. Although the septal cartilage of Asian patients is sometimes insufficient for simultaneous use for multiple grafts, septum grafts in rhinoplasty of patients with cleft lip nasal deformities could give support for nasal tips.
The Efficacy and Safety of Intermittent Low-Dose Urokinase Thrombolysis for the Treatment of Senile Acute Intermediate-High-Risk Pulmonary Embolism: A Pilot Trial
Authors: Zhao Tianming , Ni Jixiang , Hu Xuehua , Wang Yingnan , Du Xinge
Published: March 2018

Thrombolysis and anticoagulation were the main treatment methods for acute pulmonary embolism. However, the use of thrombolysis drugs may lead to bleeding complications. We compared intermittent low-dose urokinase (UK) and alteplase (recombinant tissue plasminogen activator [rt-PA]) in normotensive patients with intermediate-high-risk pulmonary embolism. The UK group was treated with intravenous UK 10 000 U/kg once a day for 7 days. The rt-PA group was given alteplase 50 mg by intravenous injection within 2 hours of admission. After thrombolytic therapy, 48 patients were included in this trial. Compared with before treatment, right and left ventricular diastolic diameter ratio, systolic pulmonary artery pressure, and cardiac troponin I of the 2 groups all significantly decreased 8 and 14 days after treatment, which indicated that right heart function improved. Total efficacy rates for the UK group 8 and 14 days after treatment (79.2%, 87.5%) and the rt-PA group (75.0%, 91.67%) were not significantly different. Adverse bleeding reactions were higher in the rt-PA group (20.8%) than in the UK group (8.3%). This pilot study indicates that intermittent low-dose UK thrombolysis is equally effective as rt-PA. However, future large-scale studies must also determine whether small doses of UK thrombolysis reduce the risk of bleeding.
Examining the Relevance of Online Customer Textual Reviews on Hotels’ Product and Service Attributes
Authors: Xu Xun
Published: March 2018

Online reviews left by guests have business value in terms of understanding customers’ perceptions of hotels’ product and service attributes. By focusing on customers’ textual reviews through a text-mining approach (specifically, latent semantic analysis) and statistical tests, this study examined and compared the relevance of core attributes with customer satisfaction and dissatisfaction for both chain and independent hotels of various star levels. We found that the attributes of products and services—including staff, physical setting, value, and location—have different effects on customer satisfaction or dissatisfaction for chain and independent hotels, and for hotels with different star levels. Based on these findings, we concluded that a given hotel’s status as either an independent or a chain establishment and its star-level play a role in influencing the importance of product and service attributes for customers. Our study helped hotels in different market segments understand customers’ different needs as they relate to each attribute of the hotel’s products and services. Hoteliers can use this information to set priority rules for improving the corresponding attributes and use the generated electronic word-of-mouth effect from online customer reviews to enhance their performance.
The Effects of Experienced Customer Incivility on Employees’ Behavior Toward Customers and Coworkers
Authors: Kim Haemi , Qu Hailin
Published: March 2018

This study investigates how customer incivility is related to employee incivility toward both customers and coworkers by assessing the effects of emotional job demands and burnout. The target population of this research is frontline employees working in the full-service restaurant segment in the United States. Convenience sampling was used to select participants for an online survey. The results show that employees’ experienced customer incivility is positively associated with both emotional job demands and burnout. In addition, emotional job demands mediate the association between experienced customer incivility and burnout. Moreover, it presents the positive relationships not only between burnout and employee incivility toward customers but also between burnout and employee incivility toward coworkers. This study provides theoretical and practical implications by investigating the detrimental influence of customer incivility as a stressor to trigger emotional job demands and burnout, which can lead to deviant behaviors toward both customers and coworkers.
Prospective study comparing Xalatan® eye drops and two similar generics as to the efficacy and safety profile
Authors: Diagourtas Andreas , Kagelaris Kostantinos , Oikonomakis Kostantinos , Droulias Andreas , Kokolakis Nikolaos , Papaconstantinou Dimitrios
Published: March 2018

Purpose:

To evaluate the efficacy and safety between two generic prostaglandins Lataz–Xalaprost (Greece) and the corresponding original drops (Xalatan®).

Material and methods:

In this prospective randomized study, 60 patients diagnosed with open-angle glaucoma or ocular hypertension were enrolled, who had never received antiglaucoma treatment. Subjects were divided randomly into three groups (Xalatan, Lataz, and Xalaprost groups) and they were studied over 16 weeks. At each visit, the mean applanation tonometry values and tear break-up time were measured. The Ocular Surface Disease Index questionnaire was used to evaluate patient’s symptoms.

Results:

There was a statistically significant difference (p < 0.001) in the mean values of the intraocular pressure between the baseline and the last visit (Xalatan group: from 23.11 ± 1.61 mmHg to 15.81 ± 1.22 mmHg, Lataz group: from 23.26 ± 1.33 mmHg to 15.80 ± 1.47 mmHg, and Xalaprost group: from 23.08 ± 1.45 mmHg to 16.08 ± 1.38 mmHg). Both generic eye drops showed mean percentage intraocular pressure reduction comparable to the standards of prostaglandin analogues (Xalatan: 31.57%, Lataz: 32.06%, and Xalaprost: 30.34%). Xalatan reduced the tear break-up time less, followed by Lataz and then by Xalaprost (Xalatan: from 8.5 to 8 s, Lataz: from 8.2 to 7.4 s, and Xalaprost: from 8.7 to 7.7 s). Xalatan presented the best safety profile, followed by Lataz and least was Xalaprost, according to Ocular Surface Disease Index questionnaire’s results.

Conclusion:

No significant difference was recorded in the effectiveness of each generic prostaglandin compared to the original. Furthermore, no patient had to change medication. The differences that arose in the safety profile of the three eye drops suggest a prompt closer initial monitoring of patients who are administered generic eye drops.
Cardiac implantable electronic device and vascular access: Strategies to overcome problems
Authors: Kusztal Mariusz , Nowak Krzysztof
Published: March 2018

For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter. Fortunately, cardiac electrotherapy is moving toward miniaturization and less transvenous wires. Whenever feasible, one should avoid transvenous leads and choose alternative options such as subcutaneous implantable cardioverter defibrillator, epicardial leads, and leadless pacemaker. Based on recent reports on the leadless pacemaker/implantable cardioverter defibrillator effectiveness, in patients with rapid progression of chronic kidney disease (high risk of renal failure) or glomerular filtration rate <20 mL/min/1.73 m2, this option should be considered by the implanting cardiologist for future access protection.
Thigh arteriovenous grafts. Quantitative comparison with alternative options: A meta-analysis
Authors: Lazarides Miltos K , Argyriou Christos , Koutsoumpelis Andreas , Georgakarakos Efstratios I , Georgiadis George S
Published: March 2018

Thigh arteriovenous grafts are required in a number of patients with exhausted upper extremity veins and comprise 1%–5% of the total access procedures performed. Alternative autogenous lower extremity options are the rarely used sapheno-tibial arteriovenous fistulae, the saphenous vein transpositions, and the femoral vein transpositions. The latter have proven to be the most durable lower limb access procedures, with low infection rates and their primary patency rates ranged from 74% up to 87% at 2 years. Synthetic thigh grafts are suitable for patients who are not good candidates for any upper limb or any autogenous lower limb access and their secondary patency rates ranged from 54% up to 83% at 2 years. Thigh grafts often get infected and their average weighed infection rate in 920 such grafts included in eight large series was 22.9%. A literature search was performed to evaluate thigh grafts compared with alternative options using meta-analysis. Lower limb accesses were found superior compared to HeRO® device regarding 1-year primary failure rate (odds ratio = 0.28, confidence interval = 0.09–0.88, p = 0.03) and additionally autogenous lower limb accesses were found superior compared to thigh grafts regarding the 1-year primary failure rate (odds ratio = 6.54, confidence interval = 2.29–18.72, p = 0.0005).
Thyroid Nodule Management: Thyroid-Stimulating Hormone, Ultrasound, and Cytological Classification System for Predicting Malignancy
Authors: Al Dawish Mohamed Abdulaziz , Alwin Robert Asirvatham , Thabet Mohammed A , Braham Rim
Published: March 2018

Background/objectives:

Thyroid nodule (TN) is a common thyroid disorder globally, and the incidence has been increasing in recent decades. The objective of this study was to determine the contribution of thyroid-stimulating hormone (TSH), ultrasound (US), and cytological classification system for predicting malignancy among the surgically excised nodules.

Design and methods:

A retrospective analysis was performed between January 2012 and December 2014, using data drawn from 1188 patients (15-90 years), who had 1433 TN and fine-needle aspiration in Prince Sultan Military Medical City, Saudi Arabia. After reviewing all the thyroid cytopathological slides and US reports, classification was done based on the Bethesda System for Reporting Thyroid Cytology and the Thyroid Imaging Reporting and Data System (TI-RADS).

Results:

A total of 1188 patients’ medical records were reviewed for this study, among them 311 patients had undergone surgical intervention (253 patients had single nodule and 58 had 2 nodules), with a total of 369 nodules. However, as 54 nodules on the US were either unavailable or unclear, the 315 remaining nodules were analyzed, revealing 30.2% (n = 95) malignancy overall. Patients with TSH values of >4.5 mIU/L (38.2%), TN <1 cm (48.8%), TI-RADS category 5 (75.6%), and Bethesda category VI (88.9%) revealed a higher percentage of malignancy. From the univariate analysis using the χ2 test, significant relationship between the TSH, nodule size, TI-RADS, and the Bethesda category between the malignant and benign nodules emerged. The regression analysis showed that patients with a TSH value of 0.5 to 4.5 mIU/L (odds ratio [OR]: 2.96), TSH >4.5 mIU/L (OR: 6.54) had higher risk for malignancy than those with a TSH value of ≤0.4 mIU/L. Thyroid nodules with sizes of 1 to 1.9 cm (OR: 1.12), 2 to 2.9 cm (OR: 0.74), 3-3.9 cm (OR: 1.21), and ≥4 cm (OR: 0.52) were found to have no association with the risk of malignancy. Compared with TI-RADS 2 patients, those with categories 4B (OR: 1.35) and 5 (OR: 2.3) were found to be at higher risk of malignancy. Similarly, Bethesda IV (OR: 2.72), V (OR: 8.47), and VI (OR: 20; P < .02) category patients had a higher risk for malignancy than those in Bethesda class I. Among the study population, the papillary thyroid carcinoma was the most common type of thyroid cancer (86, 90.5%) followed by 7.4% (n = 7) of follicular thyroid carcinoma, 1.05% (n = 1) of anaplastic carcinoma, and 1.05% (n = 1) of medullary thyroid carcinoma.

Conclusions:

A predictive model for risk of malignancy using a combining characteristic of the TSH, US, and cytological classification systems could assist the clinicians in minimizing exposing the patients with TNs to nonessential invasive procedures.
Researching precarious migrations: Qualitative strategies towards a positive transformation of the politics of migration
Authors: Squire Vicki
Published: March 2018

How can research contribute to a positive transformation of the politics of migration? This article addresses the question with reference to a recent research project, Crossing the Mediterranean Sea by Boat, which maps and documents the journeys and experiences of people on the move across the Mediterranean. It explores how qualitative research engaging research participants as people with the authority to speak can affect change by exposing claims and demands that compel ‘receiving communities’ to bear witness to the contemporary violence of policies and practices. Exploring the dissemination strategy of sharing stories through interactive maps and research–art collaboration, the article emphasises the importance of strategies that foster constructive connections between diverse constituencies. This development, the article argues, involves a process of translation that goes beyond a form of passive empathy and that works towards positive transformation of a slower duration, albeit in terms that remain discomforting.
Workshop salutogenesis and the future of health promotion and public health
Authors: Lindström Bengt
Published: March 2018

This presentation is a synthesis of a workshop on Salutogenesis and the Future of Health Promotion and Public Health at the Nordic Health Promotion Research Conference in June 2016. A brief historical review of Public Health and Health Promotion development in a Nordic perspective is included. However, the main thrust of the article is to present how the salutogenic theory and approach could strengthen society’s organised efforts to prevent disease, promote health and prolong life. A critical view based on existing evidence is maintained through the presentation that arrives at the conclusion it would be worthwhile to invest in effective theory driven approaches to the development of Public Health and Health Promotion in the future.
Concerns and future challenges of health literacy in the Nordic countries – From the point of view of health promotion practitioners and researchers
Authors: Ringsberg K.C. , Olander E. , Tillgren P. , Thualagant N. , Trollvik A.
Published: March 2018

Background: Health literacy is an essential social determinant for promoting and maintaining the health of a population. Aim: From a health promotion perspective, explore health literacy issues, concerns and future challenges among Nordic practitioners and researchers. Methods: Data were collected in a workshop at the 8th Nordic Health Promotion Conference, and in a literature review, with articles from five databases. The search included title and abstract with the search terms health literacy* and health literacy as a MeSH term and all the Nordic countries. Qualitative and quantitative analysis were used. Results: Twenty-five persons participated in the workshop. The discussions were summarized in six themes: concept of health literacy in national language; risk of victim blaming; measuring health literacy; content in school curricula on health literacy; new technologies for information and communication; communication and collaboration between different actors in support of health. Forty-three articles on health literacy were identified, mainly conducted within three fields: development, test and adaptation of instruments for measuring health literacy; measurement of health literacy among patients, or other defined target groups and on populations; and developing and evaluating methods/tools for the training of personnel groups or different target groups. Conclusions: There is a need for further studies providing a more in-depth understanding of the health literacy concept, knowledge on how to measure health literacy, ethical aspects, application in intersectoral collaboration as well as the adaptation to new technologies for information and communication in education supporting health literacy. As health literacy is an essential social health determinant, a concern and a future challenge must be, to make the health literacy concept familiar and visible in health promotion policies, research and practice such as health education.
Implementation of a web-based national child health-care programme in a local context: A complex facilitator role
Authors: Tell Johanna , Olander Ewy , Anderberg Peter , Berglund Johan Sanmartin
Published: March 2018

Aim: The aim of this study was to investigate child health-care coordinators’ experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. Methods: The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. Results: The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives. There were eight subcategories. In the latent analysis, the theme ‘Being a facilitator: a complex role’ was formed to express the child health-care coordinators’ experiences. Conclusions: Facilitating a national guideline or decision support in a local context is a complex task that requires an advocating and mediating role. For successful implementation, guidelines and decision support, such as a web-based guide and the new child health-care programme, must match professional consensus and needs and be seen as relevant by all. Participation in the development and a strong bottom-up approach was important, making the web-based guide and the programme relevant to whom it is intended to serve, and for successful implementation. The study contributes valuable knowledge when planning to implement a national web-based decision support and policy programme in a local health-care context.
An investigative journalist and a stand-up comic walk into a bar: The role of comedy in public engagement with environmental journalism
Authors: Chattoo Caty Borum , Green-Barber Lindsay
Published: March 2018

Public engagement with investigative journalism content is a challenging pursuit in the competitive digital era. As investigative journalism organizations innovate to engage the public, leveraging comedy may be worth considering, given comedy’s ability to attract attention and encourage public sharing. To explore this proposition, an investigative reporting collaborative project about toxic environmental contamination in New Jersey, Dirty Little Secrets, worked with stand-up comics to translate investigative news material into stand-up comedy routines performed in front of two live audiences. Through post-viewing surveys, this study found that the stand-up comedy show audiences learned factual information and perceived comedians as credible sources of environmental contamination information. In-depth interviews with one participating journalist and four participating stand-up comics reveal a positive collaborative experience.