bluuebunny/crossref_metadata_2025 huggingface dataset:
Abnormalities in gray and white matter volumes associated with explicit memory dysfunction in patients with generalized anxiety disorder
Authors: Moon Chung-Man , Jeong Gwang-Woo
Published: June 2016

Background

The neuroanatomical abnormalities associated with behavioral dysfunction on explicit memory in patients generalized anxiety disorder (GAD) have not yet been clearly identified.

Purpose

To investigate the regional gray matter (GM) and white matter (WM) volume alterations over the whole brain in patients with GAD, as well as the correlation between the brain structural abnormality and explicit memory dysfunction.

Material and Methods

Twenty patients with GAD and 20 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted magnetic resonance imaging (MRI). The participants performed the explicit memory tasks with the neutral and anxiety-inducing words.

Results

Patients with GAD showed significantly reduced GM volumes in the midbrain (MB), thalamus, hippocampus (Hip), insula, and superior temporal gyrus (STG); and reduced WM volumes in the MB, anterior limb of the internal capsule (ALIC), dorsolateral prefrontal cortex (DLPFC), and precentral gyrus (PrG). It is important to note that the GM volume of the Hip and the WM volume of the DLPFC were positively correlated with the recognition accuracy (%) in the explicit memory tasks with neutral and anxiety-inducing words, respectively. On the other hand, the WM volume of the PrG was negatively correlated with the reaction time in the same memory tasks.

Conclusion

This study demonstrated the regional volume changes on whole-brain GM and WM and the correlation between the brain structural alteration and explicit memory dysfunction in GAD patients. These findings would be helpful to understand the association between the brain structure abnormality and the functional deficit in the explicit memory in GAD.
Long-term Trends in the Development of the Family Structure in Christian Russia from the Sixteenth to the Twentieth Centuries
Authors: Mironov Boris N.
Published: June 2016

Various forms of family organization among Russian peasants and urban dwellers coexisted from the sixteenth to the beginning of the twentieth centuries. The correlation of family types changed and was a function of circumstances and economic conditions. The available data indicate that from the middle of the sixteenth century to the middle of the nineteenth century, extended and multiple families predominated among peasants, though the relationship between single-family and multifamily households changed. In the second half of the nineteenth century, a steady process of nuclearization of family structure began, as a result of which the simple family gradually replaced multiple families at first in the cities later in the villages.
Neuroprotective effect of grape seed extract against cadmium toxicity in male albino rats
Authors: El-Tarras Adel El-Sayed , Attia Hossam Fouad , Soliman Mohammed Mohamed , El Awady Mohammed Abdelhamid , Amin Adnan Abelghani
Published: June 2016

Cadmium toxicity can disturb brain chemistry leading to depression, anxiety, and weakened immunity. Cadmium disturbs the neurotransmitter dopamine, resulting in low energy, lack of motivation, and depression, which are predisposing factors for violence. The purpose of this study was to evaluate the ameliorative effect of grape seed extract (GSE) on the brain of 40 male albino rats after exposure to cadmium chloride (Cd) toxicity. The rats were separated into either the control group, the Cd group, the GSE group, or the GSE and Cd mixture (treated) group. The cerebrum showed evidence of degeneration of some nerve fibers and cells. Fibrosis, vacuolations, and congestion in the blood vessels were demonstrated. Satelletosis was located in the capsular cells. Immunohistochemical expression of Bax was strongly positive in the Cd group and decreased in the treated group. These histopathological changes were decreased in the brain tissue of the treated group, but a few blood vessels still had evidence of congestion. Cadmium administration increased the level of MDA and decreased MAO-A, acetylcholinesterase, and glutathione reductase (GR), while the treatment with GSE affected the alterations in these parameters. In addition, cadmium downregulated the mRNA expression levels of GST and GPx, while GSE treatment normalized the transcript levels. The expression of both dopamine and 5-hydroxytryptamine transporter was downregulated in the rats administered cadmium and the addition of GSE normalized the expression of these aggression associated genes.
Cytokine and Chemokine Expression in CSF May Differentiate Viral and Autoimmune NMDAR Encephalitis in Children
Authors: Ygberg Sofia , Fowler Åsa , Wickström Ronny
Published: June 2016

Childhood encephalitis is a potentially devastating condition with significant morbidity and mortality. Researchers currently lack biomarkers for differentiating infectious encephalitis from those with autoimmune causes which may delay adequate treatment. The authors studied the possibility of using cerebrospinal fluid cytokine and chemokine levels for this purpose. Children admitted to hospital care fulfilling criteria for encephalitis were prospectively included. Children who underwent lumbar puncture but were not classified as central nervous system infections served as controls. Cytokine and chemokine levels in the cerebrospinal fluid obtained upon initial presentation were analyzed using Luminex technology. In children with infectious encephalitis (n = 13), the cerebrospinal fluid displayed markedly elevated mean levels of IL6, IL7, and IL13 as compared to N-methyl-D-aspartate receptor (NMDAR) encephalitis (n = 4) and controls (n = 13). The expression of IL6 appeared to precede that of IL13. Analysis of selected cerebrospinal fluid cytokines may thus allow differential diagnosis of infectious and NMDAR encephalitis already at the initial lumbar puncture and enable immediate therapy.
Informal Human Milk Sharing
Authors: O’Sullivan Elizabeth J. , Geraghty Sheela R. , Rasmussen Kathleen M.
Published: June 2016

Background:

Little is known about women’s participation or likely participation in informal human milk (HM) sharing. The US Food and Drug Administration recommends against feeding infants shared HM acquired directly from individuals or through the Internet.

Objective:

This study explored the experiences of and attitudes toward HM sharing among mothers with experience of HM feeding and breast pump use, regardless of whether or not they had participated in HM sharing.

Methods:

We conducted qualitative, semistructured, in-depth interviews with 41 mothers from 4 counties in upstate New York, asking about their attitudes toward HM sharing. Interviews were transcribed and analyzed inductively.

Results:

Most women were aware of informal HM sharing and some had personal experience with sharing. Many mothers reported a willingness to provide their own HM if they had extra and their own child had enough. Mothers were less trusting about receiving HM, voicing concerns about the dietary intake or disease status of potential providers. Mothers felt that whether or not they participated in HM sharing would depend on the situation; they were most amenable to sharing with a family member or close friend. A novel finding was the involvement of lactation consultants and midwives, who coordinated HM exchanges for mothers in this sample.

Conclusion:

Awareness of HM sharing was high in this sample. Depending on the situation, mothers may consider participating in informal HM sharing and they may be facilitated by health professionals. Future research is required to establish the benefits and risks associated with informal HM sharing.
Healing and Transcendence
Authors: DeSanto-Madeya Susan , Fawcett Jacqueline
Published: June 2016

Healing and transcendence are concepts of considerable interest to nurses who engage in holistic nursing practice. The two concepts are often used within the context of adaptation to describe the processes experienced by individuals who experience suffering and distress from various life events. Despite their intuitive significance to the human experience, the similarities and differences between the two concepts remains unclear. The purpose of this paper is to present the results of a Roy adaptation model-guided comparison of the two concepts that addresses their shared and distinct characteristics.
Riptide
Authors: Bunkers Sandra Schmidt
Published: June 2016

In this article the author describes her experience of being diagnosed with breast cancer as a riptide experience. The ocean and many of its characteristics, such as the riptide, are used to describe the powering necessary to prevail during a cancer diagnosis and treatment. Five themes or currents within this riptide experience are identified: a shattered sense of well-being; feelings of anxiety, fear and uncertainty; learning to live one day at a time; the loving attention of family and friends; and,swimming with the turbulent sea. Concepts of powering uncovered in nursing research studies along with other theoretical concepts are presented to develop further these currents.
Light in the Darkness
Authors: Baumann Steven L.
Published: June 2016

The story of an El Salvadorian women made pregnant by a rape while immigrating to the United States is discussed from a humanbecoming paradigm perspective. Nursing practice from such a paradigm is seen as the opposite of such a violent crime and injustice, because it seeks to tenderly respect and provide for the dignity and freedom of all people.
Structural and torsional vibration and noise analysis of a dry screw compressor
Authors: Willie James , Sachs Ronald
Published: June 2016

This paper investigates torsional vibration and pulsating noise in a dry screw compressor. The compressor is designed at Gardner Denver (GD) and is oil-free and use for mounting on highway trucks in the dry bulk industry. They are driven using a power take-off (PTO) transmission and gear box on a truck. Torque peak fluctuations and noise measurements are made and their sources are investigated and reported in this work. To accurately predict the torsional response (frequency and relative angular deflection and torque amplitude), the Holzer method is used. It is shown that the first torsional frequency is manifested as sidebands in the gear train meshing frequencies and this can lead to noise. Using measurement data and curve fitting it is deduced that the pulsating noise is a result of amplitude modulation and not frequency modulation. Sensitivity analysis of the drive train identifies the weakest link in the drive train that limits the first torsional frequency to a low value. Tuning options like increasing the stiffness or inertia of the weakest element and shifting the input speed to the right are presented and discussed. Finally, the effect of higher-order torsional modes on inter-lobe clearance distribution of the rotors is investigated.
Numerical assessment of an L-shaped Gurney flap for load control
Authors: Motta Valentina , Zanotti Alex , Gibertini Giuseppe , Quaranta Giuseppe
Published: June 2016

The aerodynamic performance of a novel trailing edge L-shaped flap design is characterized numerically by means of computational fluid dynamics. The device is primarily thought for aerodynamic load adaptation to flight conditions. The device could be applied on a broad range of flying vehicles, like rotorcraft, for which it has been primarily designed, and also fixed wing aircraft and wind turbines. The operation of this movable surface is twofold. On one side, when the device is deployed downward, it acts as a Gurney flap, allowing the increase of the aerodynamic lift, without severe drawbacks in terms of drag rise. On the other side, when it is deflected upward, it is found capable to significantly alleviate the negative effects of stall. Simulations are carried out on a NACA 0012 airfoil equipped with the present L-shaped device at several angles of attack, both in linear and stall regimes. The reliability of numerical computations is supported by comparisons with pressure measurements and PIV surveys. Moreover, for small angles of attack, a Mach sensitivity analysis is performed, to assess the effects of compressibility on the L-shaped flap. Additionally, this work highlights how such device, when designed appropriately, can even delay the static stall onset.
Novel acquisition of global positioning system signals based on parameter prediction and the chirp z-transform
Authors: Xu Bing , Dou Lei
Published: June 2016

The acquisition stage in global positioning system receivers provides a coarse estimation of the Doppler shift and the code phase of the incoming signals. The accuracy of the estimation, especially the Doppler shift, greatly influences the subsequent tracking loops. Based on the parameter prediction and the chirp z-transform algorithm, a novel acquisition approach to acquire the Doppler shift accurately is proposed. The code phase and the Doppler shift are predicted first according to the desired trajectory of the vehicle and satellite ephemeris. Then, frequency refinement of the code-stripped signal is conducted within a small interval around the predicted Doppler shift by using the chirp z-transform algorithm. To reduce the computational load, the data sequence is down-sampled with an integrate and dump accumulator without degrading the performance of the proposed algorithm. Results indicate that, with only 1 ms sampled data, the proposed algorithm can achieve a high-frequency accuracy. Besides, the proposed algorithm can acquire signals with the carrier-to-noise ratio down to 31 dB-Hz.
Fanon, Foucault, feminisms: Psychoeducation, theoretical psychology, and political change
Authors: Burman Erica
Published: June 2016

In this article I juxtapose three critical resources for theoretical psychology: Fanon, Foucault, and feminisms. While the primary focus is on Fanon, some shared methodological assumptions—arising from the influence of Marxism and psychoanalysis on all three—are noted, albeit giving rise to mutual tensions. I then apply this critical frame to a close reading of a clinical case discussed by Fanon in The Wretched of the Earth. As a psychiatrist, but also political revolutionary and psychoeducator, Fanon’s account is read here as indicative of his pedagogical address in motivating for sociopolitical as well as personal change and his therapeutic approach, albeit in need of a feminist re-reading of the gendering of violence, including sexual violence. The paper concludes by suggesting that Fanon’s psychoaffective analysis, first, indicates how resistance and transformation are simultaneously intrapersonal, interpersonal, and sociopolitical, but also that, second, attending to their shifting unstable and relational features works not only to renew and reinvigorate theoretical psychology but also the interventions and perspectives informing psychological and pedagogical activisms.
High spatial resolution of late-Holocene human activities in the moist forests of central Africa using soil charcoal and charred botanical remains
Authors: Morin-Rivat Julie , Biwolé Achille , Gorel Anaïs-Pasiphaé , Vleminckx Jason , Gillet Jean-François , Bourland Nils , Hardy Olivier J , Smith Alexandre Livingstone , Daïnou Kasso , Dedry Laurent , Beeckman Hans , Doucet Jean-Louis
Published: June 2016

Palaeoecological and archaeological studies have demonstrated that human populations have long inhabited the moist forests of central Africa. However, spatial and temporal patterns of human activities have hardly been investigated with satisfactory accuracy. In this study, we propose to characterize past human activities at local scale by using a systematic quantitative and qualitative methodology based on soil charcoal and charred botanical remains. A total of 88 equidistant test-pits were excavated along six transects in two contrasting forest types in southern Cameroon. Charred botanical remains were collected by water-sieving and sorted by type (wood charcoals, oil palm endocarps and unidentified seeds). A total of 50 Accelerator Mass Spectrometry 14C dates were also obtained. Results showed that charred macroremains were found at multiple places in the forest, suggesting scattered human activities, which were distributed into two main periods (Phase A: 2300–1300 BP; Phase B: 580 BP to the present). Charred botanical remains indicated two types of land-use: (1) domestic, with oil palm endocarps most often associated with potsherds (villages) and (2) agricultural, with charcoal as probable remnant of slash-and-burn cultivation (fields). Oil palm endocarp abundance decreased with distance from the identified human settlements. Our methodology allowed documenting, at high resolution, the spatial and temporal patterns of human activities in central African moist forests and could be applied to other tropical contexts.
Book Review: Christine Gledhill and Julia Knight (Eds), Doing Women’s Film History: Reframing Cinemas, Past and Future
Authors: Menon Bindu
Published: June 2016

Christine Gledhill and Julia Knight (Eds), Doing Women’s Film History: Reframing Cinemas, Past and Future. Urbana-Champagne: University of Illinois Press, 2015, 275 pp, US$ 28, ISBN978-0-252-08118
Pharmacist-Provided Medication Management in Interdisciplinary Transitions in a Community Hospital (PMIT)
Authors: Rafferty Aubrie , Denslow Sheri , Michalets Elizabeth Landrum
Published: June 2016

Background: Medication management during transitions of care (TOC) impacts clinical outcomes. Published literature on TOC implementation is increasing, but data remains limited regarding the optimal role for the inpatient pharmacist, particularly in the community health setting. Objective: To evaluate the impact of a dedicated inpatient TOC pharmacist on re-presentations following discharge. Methods: This is a prospective study with historical control. All adult patients discharging home from study units were eligible. The TOC pharmacist (1) reviewed medication history and admission reconciliation, (2) met the patient/caregiver to assess barriers, (3) reviewed discharge reconciliation, (4) performed discharge education, and (5) communicated with next level of care. The primary outcome was 30 day re-presentation rate. Secondary outcomes included 60, 90, and 365 day re-presentation rates. IRB approval was obtained. Results: Three hundred and eighty four patients met inclusion criteria. When compared to 1,221 control patients, the intervention had an 11% absolute and 50.2% relative reduction in 30 day re-presentation rate (OR 0.43, 95% CI 0.30-0.61, NNT 9). Reductions in re-presentations at 60, 90 and 365 days remained statistically significant. Utilization avoidance was $786,347. For every $1 invested in pharmacist time, $12 was saved. The TOC pharmacist made a total of 904 interventions (mean 2.4 per patient). Conclusion: This study provides new information from previous studies and represents the largest study with significant and sustained reductions in re-presentations. Integrating a pharmacist into an interdisciplinary team for medication management during TOC in a community health system is beneficial for patients and financially favorable for the institution.
An Algorithmic Approach to Management of Venous Thromboembolism
Authors: Dhakal Prajwal , Gundabolu Krishna , Bhatt Vijaya R.
Published: June 2016

Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Factors such as the presence of transient risk factors for VTE, risk of bleeding, and location of deep vein thrombosis (DVT) determine the duration of anticoagulation. Extended anticoagulation is offered to patients with unprovoked pulmonary embolism (PE) or proximal DVT and a low risk of bleeding. Anticoagulation for 3 months is advised in patients with provoked DVT or PE, high risk of bleeding, and isolated distal or upper extremity DVT. In patients with unprovoked PE or proximal DVT and a low risk of bleeding, who want to stop anticoagulation after 3 months, further risk stratification is necessary. Clinical scoring system, and thrombophilia testing otherwise not routinely performed, may be considered to measure risk of annual recurrence in such cases. Short-term anticoagulation may be considered in subsegmental PE and superficial vein thrombosis, particularly if patients are at low risk of bleeding and have persistent risk factors for recurrent VTE. In cases of catheter-associated thrombosis, the catheter need not be removed routinely, and the patient may be anticoagulated for 3 months or longer if the catheter is maintained in patients with cancer. Extensive screening for occult cancer in cases of unprovoked VTE is not beneficial. New oral anticoagulants such as apixaban, rivaroxaban, or dabigatran may be preferred to vitamin K antagonists in patients without cancer or renal failure, more so after the development of reversal agents such as idarucizumab and andexanet alfa.
When the Perpetrator Is a Partner
Authors: O’Neal Eryn Nicole , Spohn Cassia
Published: June 2016

Law enforcement officials and prosecutors have been called “gatekeepers” of the criminal justice system, as their discretionary decisions determine case outcomes. Using the focal concerns perspective as our theoretical foundation, we explore the factors that influence arrest and charging decisions in intimate partner sexual assaults (IPSA) reported to Los Angeles law enforcement in 2008. Quantitative findings are supplemented with qualitative examples from Los Angeles Police Department (LAPD) detectives interviewed in 2010 and charge evaluation sheets from complaints referred to Los Angeles prosecution in 2008. Attempting to expand its theoretical relevance, we develop an alternative conceptualization and operationalization of the focal concerns perspective that is more appropriate to IPSA cases. Findings suggest that arrest decisions are motivated by suspect blameworthiness, community protection, and practical constraints and organizational consequences. In addition, charging decisions are influenced by community protection and practical constraints. Extralegal factors did not influence decision making. Directions for future research are discussed.
Functioning of Young Adults With ADHD in the Military
Authors: Fruchter Eyal , Marom-Harel Hadar , Fenchel Daphna , Kapra Ori , Ginat Keren , Portuguese Shirley , Weiser Mark
Published: June 2016

Objective: To assess the functioning of young adults with ADHD in a military setting. Method: In all, 14,655 young adults with ADHD (mean age at first examination 17.8 ± 0.7) attending mandatory service in the Israeli military were compared with matched controls on several functioning domains. Results: Young adults with ADHD had more sessions with mental health care professionals, physician appointments, sick days, and disqualifications of professions than controls ( p < .001). Young adults with ADHD were also less medically fit for combat service (odds ratio [OR] = 0.75, 95% confidence interval [CI] = [0.72, 0.79]), more medically unfit for military service in general (OR = 1.26, 95% CI = [1.13, 1.40]), and had higher rates of overweight and obesity ( p < .001). In addition, they were more likely to be diagnosed with a personality disorder (OR = 1.29, 95% CI = [1.07, 1.53]) or with minor affective and anxiety disorders (OR = 1.33, 95% CI = [1.06, 1.67]) than matched controls. Conclusion: These results support a negative effect of ADHD on the functioning of young adults in a military setting.
Rates of Intimate Partner Violence Perpetration and Victimization Among Adults With ADHD
Authors: Wymbs Brian T. , Dawson Anne E. , Egan Theresa E. , Sacchetti Gina M.
Published: June 2016

Objective: Research has demonstrated an association between ADHD and intimate partner violence (IPV). However, it is unclear whether adults with ADHD persisting from childhood are especially at risk, and whether ADHD is a unique risk factor beyond well-established predictors of IPV. Method: Adults with ( n = 95) and without childhood histories of ADHD ( n = 121) who were recruited from Amazon’s Mechanical Turk reported their levels of IPV perpetration and victimization, and provided data on additional risk factors of IPV (e.g., childhood maltreatment, alcohol abuse). Results: While controlling for additional risk factors, adults diagnosed with ADHD as children, particularly those with elevated current ADHD symptoms (ADHD-Persist), reported higher rates of IPV perpetration and victimization than adults with ADHD histories but low current symptoms (ADHD-Desist) and adults who were never diagnosed with ADHD (control). Conclusion: Adults with ADHD histories and elevated current symptoms are most likely to report IPV perpetration and victimization.
What Does It Mean for Something to Be “Scientific”? Community Understandings of Science, Educational Attainment, and Community Representation Among a Sample of 25 CBPR Projects
Authors: Spears Johnson Chaya R. , Kraemer Diaz Anne E. , Arcury Thomas A.
Published: June 2016

Community-based participatory research (CBPR) seeks to conduct relevant, sustainable research that is tailored to the needs of the communities with which it is engaged through equitable collaboration between community representatives and professional researchers. Like other participatory approaches to research and planning, CBPR has been criticized for the potential to engage a biased sample of community representatives and, thereby, undermine the fundamental purpose of the approach. Moreover, the varying educational levels and areas of expertise, especially regarding science literacy, among those participating in CBPR has raised concern about the ability for true collaboration to exist within CBPR projects. This article presents findings from a qualitative study of 25 CBPR research projects and explores matters of science literacy, community representation, and the nature of CBPR. Ultimately, it is suggested that those who engage in CBPR should carefully consider the potential for biased community representation and seek to purposely and mindfully avoid any partiality.
Masculinity and Sexual Abuse
Authors: Cossins Annie , Plummer Malory
Published: June 2016

Psychological theories attempt to prove the abnormality of child sex offenders’ behavior through a deterministic analysis, whereby particular psychological characteristics are considered to predict child sex offending. Such a focus ignores the structures of power that influence men’s lives, a man’s active engagement with that social context, and how we might understand child sexual abuse as part of that engagement. By considering the meanings that sexual behavior with children has for offenders’ lives as men, this article discusses how an offender’s body and the body of a child are related to the concepts of sexuality and potency, how those bodies are ascribed meanings by the individual offender and other men, as well as the analytic utility of social learning theory and the power/powerlessness theory for understanding why sexually abused boys rather than sexually abused girls are more likely to become sex offenders with reference to two case studies.
Young People’s Strategies for Handling Economic Adversity
Authors: Bolin Anette
Published: June 2016

As an extension of the research into strategies for handling economic adversity of young people in poor families, this study examines strategy use in the context of middle-income families affected by unemployment. Interviews with 39 young people in previously comfortably-off families where one or both of the parents had become unemployed were conducted. The purpose was to explore how, in a Swedish context, young people think about and respond to situations following a drastic reduction in family income. Results indicate that while the strategies used by these young people are generally similar to those in poor families, no use of avoidance-oriented strategies was found. This, it is argued, is because parental unemployment and financial adversity are not perceived as stigmatizing.
Wendy, Peter and the Lost Boys—The Gendered Discourses of Welfare Service Practitioners and Their Young Clients
Authors: Berg Päivi , Aaltonen Sanna
Published: June 2016

The article examines the discourses related to gender in interviews with welfare service practitioners and their young, 18- to 29-year-old clients using ‘boy discourse’ as an analytical framework and J. M. Barrie’s story of Peter Pan as a metaphorical framework. Those beyond the reach of the welfare services are referred to by the practitioners as ‘lost young people’. Some practitioners see young men in particular as poor creatures, unable to achieve anything without a girlfriend, whose task is to get these Peter Pans ‘on the right track’ as Wendy does. The ‘Lost Girls’ are in a similar position to the ‘Lost Boys’ but the practitioners are more concerned about the boys. Their assumption is that girls can cope but boys need Wendys in order to succeed in life. As a result, the combined efforts of the female staff and nurturing girlfriends are seen as instrumental in steering ‘failing boys’ towards adulthood.
Using propinquital loops to blend social media and offline spaces: a case study of the ALS Ice-Bucket Challenge
Authors: Sutherland Karen E
Published: June 2016

The social media phenomenon of the amyotrophic lateral sclerosis (ALS) Ice-Bucket Challenge attracted more than 3 million donors to upload 1.2 million Facebook videos and give more than US$115 million. In fundraising terms, it was a social media anomaly. This article applies Kent and Taylor’s dialogic theoretical component of propinquity (immediacy of presence, temporal flow and engagement) to explore how the ALS Ice-Bucket Challenge leveraged a propinquital loop (and subsequent chain), to enable participants to move between social media and offline spaces, while creating relational elasticity between participant and cause. Propinquity and its function within a social media context is an area of research that has not yet been greatly considered in the literature, yet may have the potential of informing public relations professionals from the non-profit sector and more widely about social media practice.
Carotid Artery Stenting With Proximal Embolic Protection via a Transradial or Transbrachial Approach
Authors: Montorsi Piero , Galli Stefano , Ravagnani Paolo M. , Tresoldi Simone , Teruzzi Giovanni , Caputi Luigi , Trabattoni Daniela , Fabbiocchi Franco , Calligaris Giuseppe , Grancini Luca , Lualdi Alessandro , de Martini Stefano , Bartorelli Antonio L.
Published: June 2016

Purpose: To compare the feasibility and safety of proximal cerebral protection to a distal filter during carotid artery stenting (CAS) via a transbrachial (TB) or transradial (TR) approach. Methods: Among 856 patients who underwent CAS between January 2007 and July 2015, 214 (25%) patients (mean age 72±8 years; 154 men) had the procedure via a TR (n=154) or TB (n=60) approach with either Mo.MA proximal protection (n=61) or distal filter protection (n=153). The Mo.MA group (mean age 73±7 years; 54 men) had significantly more men and more severe stenosis than the filter group (mean age 71±8 years; 100 men). Stent type and CAS technique were left to operator discretion. Heparin and a dedicated closure device or bivalirudin and manual compression were used in TR and TB accesses, respectively. Technical and procedure success, crossover to femoral artery, 30-day major adverse cardiovascular/cerebrovascular events (MACCE; death, all strokes, and myocardial infarction), vascular complications, and radiation exposure were compared between groups. Results: Crossover to a femoral approach was required in 1/61 (1.6%) Mo.MA patient vs 11/153 (7.1%) filter patients mainly due to technical difficulty in engaging the target vessel. Five Mo.MA patients developed acute intolerance to proximal occlusion; 4 were successfully shifted to filter protection. A TR patient was shifted to filter because the Mo.MA system was too short. CAS was technically successful in the remaining 55 (90%) Mo.MA patients and 142 (93%) filter patients. The MACCE rate was 0% in the Mo.MA patients and 2.8% in the filter group (p=0.18). Radiation exposure was similar between groups. Major vascular complications occurred in 1/61 (1.6%) and in 3/153 (1.96%) patients in the Mo.MA and filter groups (p=0.18), respectively, and were confined to the TB approach in the early part of the learning curve. Chronic radial artery occlusion was detected by Doppler ultrasound in 2/30 (6.6%) Mo.MA patients and in 4/124 (3.2%) filter patients by clinical assessment (p=0.25) at 8.1±7.5-month follow-up. Conclusion: CAS with proximal protection via a TR or TB approach is a feasible, safe, and effective technique with a low rate of vascular complications.
Multisystemic Sarcoidosis Presenting as Pretibial Leg Ulcers
Authors: Wollina Uwe , Baunacke Anja , Hansel Gesina
Published: June 2016

Sarcoidosis is a multisystemic disease of unknown etiology. Up to 30% of patients develop cutaneous manifestations, either specific or nonspecific. Ulcerating sarcoidosis leading to leg ulcers is a rare observation that may lead to confusions with other, more common types of chronic leg ulcers. We report the case of a 45-year-old female patient with chronic multisystemic sarcoidosis presenting with pretibial leg ulcers. Other etiology could be excluded. Histology revealed nonspecific findings. Therefore, the diagnosis of nonspecific leg ulcers in sarcoidosis was confirmed. Treatment consisted of oral prednisolone and good ulcer care. Complete healing was achieved within 6 months. Sarcoidosis is a rare cause of leg ulcers and usually sarcoid granulomas can be found. Our patient illustrates that even in the absence of sarcoid granulomas, leg ulcers can be due to sarcoidosis.
An Integrative Theoretical Framework for HPV Vaccine Promotion Among Male Sexual Minorities
Authors: Wheldon Christopher W. , Daley Ellen M. , Walsh-Buhi Eric R. , Baldwin Julie A. , Nyitray Alan G. , Giuliano Anna R.
Published: June 2016

The objective of the current study was to quantify the behavioral intentions of young adult male sexual minorities (MSM) to initiate human papillomavirus (HPV) vaccination and test an integrative model of HPV vaccine decision making. Participants were 575 MSM who were residing in the United States and were between ages 18 and 26 years. Standard direct and indirect measures of attitudes, perceived norms, and perceived behavioral control were employed to explain variation in behavioral intention. Additional background factors—such as concealment of one’s sexual identity, suspicion of health care provider competence in LGBT health issues, perceived threat, and information orientation—were also included in the model. The final model fit the data well and identified a set of salient attitudinal and control beliefs as the strongest determinants of intention ( R2 = .38). Perceived threat and information orientation were positively correlated with HPV-related beliefs. Perceived threat was higher among men infected with HIV and lower among men in monogamous relationships. Self-efficacy, as an indirect measure of perceived behavioral control, was inversely related to the general tendency to conceal aspects of one’s sexual orientation and a suspicion of health care providers. Bisexual identified men were more likely to conceal their sexual orientation and be more suspicious of health care providers. In this study, a number of modifiable determinants of HPV vaccine intentions—both psychosocial and environmental—were identified and have implications for targeted and tailored behavioral interventions to promote HPV vaccination among MSM.
A scoping review of weight bias by community pharmacists towards people with obesity and mental illness
Authors: Murphy Andrea L. , Gardner David M.
Published: June 2016

Background:

Community pharmacists are accessible health care professionals who are increasingly offering weight management programs. People living with serious mental illness have markedly higher rates of obesity and associated illness outcomes than the general population, providing pharmacists who are interested in offering weight management services with an identifiable patient subgroup with increased health needs. Issues with stigma within obesity and mental illness care are prevalent and can lead to inequities and reduced quality of care.

Methods:

We conducted a scoping review to map and characterize the available information from published and grey literature sources regarding community pharmacists and weight bias towards obese people with lived experience of mental illness. A staged approach to the scoping review was used.

Results:

Six articles and 6 websites were abstracted after we removed duplicates and applied our inclusion and exclusion criteria. The published studies that we found indicated that pharmacists and pharmacy students do demonstrate implicit and explicit weight bias.

Conclusions:

Very limited research is available regarding weight bias in pharmacists and stigma towards people with obesity, and we found no information on these phenomena relating to people with lived experience of mental illness. Investigations are needed to characterize the extent and nature of anti-fat bias and attitudes by pharmacists and the consequences of these attitudes for patient care.
Overview of a Novel Sensor for Continuous Glucose Monitoring
Authors: Schmelzeisen-Redeker Günther , Staib Arnulf , Strasser Monika , Müller Ulrich , Schoemaker Michael
Published: June 2016

The core element of a continuous glucose monitoring (CGM) system is the glucose sensor, which should enable reliable CGM readings in the interstitial fluid in subcutaneous tissue for a period of several days. The aim of this article is to describe the layout and constituents of a novel glucose sensor and the rationale behind the measures that were used to optimize its performance. In order to achieve a stable glucose sensor signal, special attention was paid to the sensor materials and architecture, i.e., biocompatible coating of the sensor, limitation of glucose flux into the working electrode, low oxidation potential by use of manganese dioxide, and a tissue-averaging sensor design. A series of in vitro and in vivo evaluations showed that the sensor enables stable and accurate glucose sensing in the subcutaneous tissue for up to 7 days. Parallel measurements with four sensors in a single patient showed a close agreement between these sensors. In summary, this high-performance needle-type glucose sensor is well suited for CGM in patients with diabetes.
Prevalence of Bacterial Contamination of Glucose Test Strips in Individual Single-Use Packets versus Multi-Use Vials
Authors: Pérez-Ayala Millán , Oliver Paloma , Cantalejo Fernando Rodríguez
Published: June 2016

Background:

Glucose measurement is the cornerstone of diabetes control. In the hospital setting, the same device and package of test strips (50 or 100 strips) can be used to monitor glucose in several patients, which can increase cross contamination. The objective of our study is to measure bacterial contamination in glucose test strips, comparing results in individual single-use packets (one hospital) versus multi-use vials (two hospitals) in Spain.

Methods:

Test strips were collected from five different wards. Each hospital also collected two unopened vials from a single ward as controls. They were sent to a reference laboratory for microbiologic study. A number equal or higher than two colony forming units per strip was considered as a positive result.

Results:

Out of 423 glucose test strips collected and cultured, 146 were contaminated (34%); only 7% of individually packed strips were contaminated versus 45% of strips packed in multi-use vials, with a high statistical significance (p < .001).

Conclusions:

In the strips from multi-use vials, a high contamination rate was found and highly pathogenic organisms were identified, such as methicillin-resistant Staphylococcus epidermidis or Staphylococcus hemolyticus. In contrast, in strips packed individually, there was a much lower contamination rate and no such pathogen organisms were found. Therefore, in the hospital setting, the use of blood glucose test strips in individual packages would be more advantageous (mainly from a clinical point of view, but also from a financial one) than those packed in multi-use vials.
A Consensus Perceived Glycemic Variability Metric
Authors: Marling Cynthia R. , Struble Nigel W. , Bunescu Razvan C. , Shubrook Jay H. , Schwartz Frank L.
Published: June 2016

Objective:

Glycemic variability (GV) is an important component of overall glycemic control for patients with diabetes mellitus. Physicians are able to recognize excessive GV from continuous glucose monitoring (CGM) plots; however, there is currently no universally agreed upon GV metric. The objective of this study was to develop a consensus perceived glycemic variability (CPGV) metric that could be routinely applied to CGM data to assess diabetes mellitus control.

Methods:

Twelve physicians actively managing patients with type 1 diabetes mellitus rated a total of 250 24 h CGM plots as exhibiting low, borderline, high, or extremely high GV. Ratings were averaged to obtain a consensus and then input into two machine learning algorithms: Multilayer perceptrons (MPs) and support vector machines for regression (SVR). In silica experiments were run using each algorithm with different combinations of 12 descriptive input features. Ten-fold cross validation was used to evaluate the performance of each model.

Results:

The SVR models approximated the physician consensus ratings of unseen CGM plots better than the MP models. When judged by the root mean square error, the best SVR model performed comparably to individual physicians at matching consensus ratings. When applied to 262 different CGM plots as a screen for excessive GV, this model had accuracy, sensitivity, and specificity of 90.1%, 97.0%, and 74.1%, respectively. It significantly outperformed mean amplitude of glycemic excursion, standard deviation, distance traveled, and excursion frequency.

Conclusions:

This new CPGV metric could be used as a routine measure of overall glucose control to supplement glycosylated hemoglobin in clinical practice.
Perioperative Management of Patients with Diabetes Undergoing Ambulatory Elective Surgery
Authors: Coan Kathryn E. , Schlinkert Andrew B. , Beck Brandon R. , Haakinson Danielle J. , Castro Janna C. , Schlinkert Richard T. , Cook Curtiss B.
Published: June 2016

Objective:

The objective was to assess processes of care for patients with diabetes undergoing elective surgery.

Methods:

A retrospective review of medical records was conducted to determine frequency of perioperative glucose monitoring, changes in glucose control, and treatment of intraoperative hyperglycemia.

Results:

A total of 268 patients underwent 287 elective procedures. Mean age was 67 years, 63% were men, 97% had type 2 diabetes, and most (57%) were treated with oral hypoglycemic agents. Average perioperative time was approximately 8 h. Mean preoperative hemoglobin A1c was 7.0%; however, this value was checked in only 52% of cases. A glucose measurement was obtained in 89% of cases in the preoperative area and in 87% in the postanesthesia care unit, but in only 33% of cases did a value get checked intraoperatively. Average glucose was 139 mg/dl preoperatively, increasing to 166 mg/dl postoperatively ( p <.001). Glucose levels increased regardless of type of outpatient medical therapy used to treat hyperglycemia, except for those on combination oral agents plus insulin ( p =.06).

Conclusions:

These data indicate suboptimal documentation of outpatient hemoglobin A1c. Intraoperative glucose monitoring seldom occurred, despite prolonged periods under anesthesia and perioperative deterioration of glycemic control. Standards need to be developed and interventions are needed to enhance management of diabetes patients undergoing elective procedures.
Noninvasive Skin Fluorescence Spectroscopy is Comparable to Hemoglobin A1c and Fasting Plasma Glucose for Detection of Abnormal Glucose Tolerance
Authors: Olson Byron P. , Matter Nathaniel I. , Ediger Marwood N. , Hull Edward L. , Maynard John D.
Published: June 2016

Aim:

We compare performance of noninvasive skin fluorescence spectroscopy (SFS), fasting plasma glucose (FPG), and hemoglobin A1c (A1C) for detection of abnormal glucose tolerance (AGT).

Methods:

The NSEEDS trial evaluated SFS, FPG, and A1C in an at-risk population of 479 previously undiagnosed subjects from nine US centers, each of whom received a 75 g, 2 h oral glucose tolerance test (OGTT). Skin fluorescence spectra were collected and analyzed with SCOUT DS® devices. Disease truth was AGT, defined as OGTT ≥140 mg/dl. Abnormal glucose tolerance sensitivity, false positive rate (FPR), and receiver operating characteristic (ROC) curves were computed for each measurement technique. Skin fluorescence spectroscopy reproducibility was also assessed.

Results:

The AGT sensitivity of SFS was 68.2%, higher than that of FPG (thresholds of 100 and 110 mg/dl) and A1C (thresholds of 5.7% and 6.0%). The FPR of SFS was 37.7%, comparable to A1C at the 5.7% threshold (30.7%). Partial ROC areas of SFS, FPG, and A1C were similar for FPRs of 20–50% (average sensitivities of 64.0%, 59.0%, and 68.6%, respectively). The interday coefficient of variation for SFS was 7.6%.

Conclusions:

Skin fluorescence spectroscopy has similar screening performance to FPG and A1C and is a viable approach for detection of AGT.
Common Causes of Glucose Oxidase Instability in In Vivo Biosensing: A Brief Review
Authors: Harris James M. , Reyes Catherine , Lopez Gabriel P.
Published: June 2016

Clinical management of diabetes must overcome the challenge of in vivo glucose sensors exhibiting lifetimes of only a few days. Limited sensor life originates from compromised enzyme stability of the sensing enzyme. Sensing enzymes degrade in the presence of low molecular weight materials (LMWM) and hydrogen peroxide in vivo. Sensing enzymes could be made to withstand these degradative effects by (1) stabilizing the microenvironment surrounding the sensing enzyme or (2) improving the structural stability of the sensing enzyme genetically. We review the degradative effect of LMWM and hydrogen peroxide on the sensing enzyme glucose oxidase (GOx). In addition, we examine advances in stabilizing GOx against degradation using hybrid silica gels and genetic engineering of GOx. We conclude molecularly engineered GOx combined with silica-based encapsulation provides an avenue for designing long-term in vivo sensor systems.
Using Avatars to Model Weight Loss Behaviors: Participant Attitudes and Technology Development
Authors: Napolitano Melissa A. , Hayes Sharon , Russo Giuseppe , Muresu Debora , Giordano Antonio , Foster Gary D.
Published: June 2016

Background:

Virtual reality and other avatar-based technologies are potential methods for demonstrating and modeling weight loss behaviors. This study examined avatar-based technology as a tool for modeling weight loss behaviors.

Methods:

This study consisted of two phases: (1) an online survey to obtain feedback about using avatars for modeling weight loss behaviors and (2) technology development and usability testing to create an avatar-based technology program for modeling weight loss behaviors.

Results:

Results of phase 1 ( n = 128) revealed that interest was high, with 88.3% stating that they would participate in a program that used an avatar to help practice weight loss skills in a virtual environment. In phase 2, avatars and modules to model weight loss skills were developed. Eight women were recruited to participate in a 4-week usability test, with 100% reporting they would recommend the program and that it influenced their diet/exercise behavior. Most women (87.5%) indicated that the virtual models were helpful. After 4 weeks, average weight loss was 1.6 kg (standard deviation = 1.7).

Conclusions:

This investigation revealed a high level of interest in an avatar-based program, with formative work indicating promise. Given the high costs associated with in vivo exposure and practice, this study demonstrates the potential use of avatar-based technology as a tool for modeling weight loss behaviors.