bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Validation: Black Women’s Retention at Predominantly White Institutions
Authors: Kelly Bridget Turner , Raines Alyscia , Brown Rachel , French Andrew , Stone Joakina
Published: April 2019

Retention of Black students at predominantly White institutions (PWIs) is often studied. However, very few researchers examine what helped retain Black women undergraduate students from PWIs with multiple intersecting identities. Through a qualitative research design that honors the stories of 16 Black women who graduated from PWIs, we explore what helped to retain them at the PWI. Using Rendón’s validation theory as a framework, we sought to understand how validating agents assisted in the retention of Black women undergraduate students. We provide implications for practice and practical suggestions on how PWIs can be more thoughtful about retention of this population.
Adjournment in Community HIV Prevention: Exploring Transitions in Community–Academic Partnerships
Authors: Dill LeConté J. , Gousse Yolene , Huggins Kimberly , Fraser Marilyn A. , Browne Ruth C. , Stewart Mark , Salifu Moro , Joseph Michael A. , Wilson Tracey E.
Published: April 2019

Barbershop-based interventions have been increasingly implemented as a means to support culturally relevant and community-accessible health promotion and disease prevention efforts. Specifically, in neighborhoods of Brooklyn, New York, with high HIV seroprevalence rates, barbers have volunteered to support an initiative to help reduce sexual risk behavior. After implementing the Barbershop Talk With Brothers program for 5 years, we explored how program participation has affected barbers’ HIV prevention and counseling skills to promote their clients’ health, and assessed their views of next stages of the community–academic partnership, once the specific project ended. Through employing rigorous qualitative research methods with personnel at participating barbershops, key results include that although barbers self-identify as community leaders and even as health educators, they want ongoing support in educating customers about other topics like nutrition and physical activity, including upstream social determinants of health, such as housing and employment. They are also concerned regarding how best to support continuity of efforts and maintenance of partnerships between projects. These findings provide insight toward adjourning community-based participatory research projects, which can inform other academic researchers, organizations, and businesses that partner with community members.
Capacity Building for Public Health: Participant-Guided Training
Authors: Hawley Suzanne R. , Crimmings Karen P. , Rivera-Newberry Ivonne , Orr Shirley A. , Walkner Laurie M.
Published: April 2019

Growth in the demand for public health services, along with limited funding, makes workforce collaboration and capacity building imperative. The faculty and staff of the Midwestern Public Health Training Center, with two Robert Wood Johnson Public Health Nurse Leaders, postulated that training could be more effective, and public health workers more effective in the field, if workers contributed to training format and content. The learning paradigm was tested on diabetes prevention and self-management programs. Public health professionals were surveyed on infrastructure, practices, roles, and gaps in diabetes-related services. Responses influenced the format and content of a one-day diabetes summit training program. Participants submitted evaluations immediately afterward. Eight months postsummit, participants were surveyed to self-assess behavioral changes attributed to the training. Using the Kirkpatrick model for evaluation, participants (n = 112) stated that the training met their expectations and that knowledge gained was consistent with stated training objectives. Qualitative postsummit survey results indicated that improvements in participants’ delivery of diabetes prevention services to the public could be attributed to the training they received at the summit. Results suggest that training about specific programs and practices, as well as facilitated sessions of collaboration, can yield individual and organizational change.
Potential Crisis in Nurse Practitioner Preparation in the United States
Authors: Mundinger Mary O'Neil , Carter Michael A.
Published: April 2019

The Doctor of Nursing Practice (DNP) degree was established to expand nurse practitioner education by adding new competencies. In 2004, the American Association of Colleges of Nursing released a position statement that redefined practice from only clinical care of patients to include nonclinical care. This policy position likely contributed to the rapid growth of DNP programs. Historical background on the development of the DNP is provided. An analysis was conducted of the programs reported in the American Association of Colleges of Nursing list of accredited DNP programs between 2005 and 2018 to compare whether the programs prepared graduates for advanced clinical practice or administrative or leadership. During this time, 553 DNP programs were established, 15% ( n = 83) are clinical, and 85% ( n = 470) are nonclinical. The adequate production of nurse practitioners in the future may be in jeopardy with this imbalance in educational resources, especially with the nation's growing need for primary care clinicians.
Exploring the Boundaries of Diversity and Inclusion in Human Resource Development
Authors: Sparkman Torrence E.
Published: April 2019

This article reviews literature focused on diversity and inclusion in human resource development (HRD) journals. A focused analysis of articles published from 2010 to the present reveals shifting conceptualizations of diversity inside and outside the Academy of Human Resource Development. This integrative review summarizes the types of diversity articles presented and captures the frameworks, approaches, and foci of current diversity and inclusion research. The influence of social cognitive psychology becomes apparent, as the awareness of multiple identities and experiences becomes central to teaching and learning how to value diversity. The findings also suggest that research and practice in the context of marginalized communities, and non-Western countries, is crucial to broadening the scope of diversity and inclusion in both dominant and nondominant cultures. After categorizing the articles, a discussion of recent theories, pedagogy, and utility follows. The review concludes with a discussion of practice and research implications.
Assessing the Efficacy of a Training Intervention to Reduce Acceptance of Questionable Research Practices in Psychology Graduate Students
Authors: Sacco Donald F. , Brown Mitch
Published: April 2019

We designed and tested the efficacy of a 1-hr training session to mitigate endorsement of questionable research practices (QRPs), research practices that raise ethical concerns and are detrimental to reproducible science, in psychology graduate students. We assessed attitudes toward QRPs 1 week prior to the training, 1 week following the training, and at 2-month follow-up. Participants reported QRPs as less ethically defensible 1 week following the intervention compared with 1 week prior, with attitudes at 2-month follow-up falling in between these time points. Results were maintained even when controlling for socially desirable responding. Participants who rated the training more favorably demonstrated greater attitude change toward detrimental research practices. These results provide evidence that an intervention to educate graduate students about QRPs and their negative impact on science can mitigate consideration of such practices as ethically defensible, although such benefits may not hold over time without additional training sessions.
Design and Implementation of a Lifestyle Medicine Curriculum in Undergraduate Medical Education
Authors: Trilk Jennifer L. , Elkhider Ihsan A. , Asif Irfan , Buchanan April , Emerson John , Kennedy Ann Blair , Masocol Robert , Motley Elizabeth , Tucker Matthew
Published: April 2019

While scientific evidence demonstrates conclusive associations between unhealthy lifestyle behaviors and increased morbidity and mortality related to noncommunicable chronic diseases (NCDs), most physicians are not formally taught the root causes of NCDs nor how to counsel patients regarding their lifestyle behaviors for disease prevention and treatment. Since its inception in 2012, the University of South Carolina School of Medicine Greenville has designed, developed, and implemented an innovative, formalized lifestyle medicine curriculum to provide required undergraduate medical student training with a graduating program-level goal to “Deliver total health care using lifestyle medicine to prevent and treat morbidity and mortality related to chronic diseases.” The process was guided by the Association of American Medical Colleges’ Core Entrustable Professional Activities (required for graduates entering residency) and aimed to satisfy the Quadruple Aim components of better outcomes, lower cost, improved patient experience, and improved physician experience. Four essential instructional design phases, Analysis, Design, Development, and Evaluation, were used as systematic steps to create and deploy the curriculum. This article describes the evidence-based approach used and offers guidance to other undergraduate medical schools that may wish to implement lifestyle medicine training to improve physicians’ medical knowledge and clinical skills for optimum health care.
A randomized 500-subject open-label phase 3 clinical trial of minimally invasive surgery plus alteplase in intracerebral hemorrhage evacuation (MISTIE III)
Authors: Ziai Wendy C , McBee Nichol , Lane Karen , Lees Kennedy R , Dawson Jesse , Vespa Paul , Thompson Richard E , Mendelow A David , Kase Carlos S , Carhuapoma J Ricardo , Thompson Carol B , Mayo Steven W , Reilly Pat , Janis Scott , Anderson Craig S , Harrigan Mark R , Camarata Paul J , Caron Jean-Louis , Zuccarello Mario , Awad Issam A , Hanley Daniel F ,   On Behalf of the MISTIE III Investigators
Published: April 2019

Rationale and hypothesis

Surgical removal of spontaneous intracerebral hemorrhage may reduce secondary destruction of brain tissue. However, large surgical trials of craniotomy have not demonstrated definitive improvement in clinical outcomes. Minimally invasive surgery may limit surgical tissue injury, and recent evidence supports testing these approaches in large clinical trials.

Methods and design

MISTIE III is an investigator-initiated multicenter, randomized, open-label phase 3 study investigating whether minimally invasive clot evacuation with thrombolysis improves functional outcomes at 365 days compared to conservative management. Patients with supratentorial intracerebral hemorrhage clot volume ≥ 30 mL, confirmed by imaging within 24 h ofknown symptom onset,and intact brainstem reflexes were screened with a stability computed tomography scan at least 6 h after diagnostic scan. Patients who met clinical and imaging criteria (no ongoing coagulopathy; no suspicion of aneurysm, arteriovenous malformation, or any other vascular anomaly; and stable hematoma size on consecutive scans) were randomized to either minimally invasive surgery plus thrombolysis or medical therapy. The sample size of 500 was based on findings of a phase 2 study.

Study outcomes

The primary outcome measure is dichotomized modified Rankin Scale 0–3 vs. 4–6 at 365 days adjusting for severity variables. Clinical secondary outcomes include dichotomized extended Glasgow Outcome Scale and all-cause mortality at 365 days; rate and extent of parenchymal blood clot removal; patient disposition at 365 days; efficacy at 180 days; type and intensity of ICU management; and quality of life measures. Safety was assessed at 30 days and throughout the study.
Ana as god: Religion, interdiscursivity and identity on pro-ana websites
Authors: Stapleton Karyn , Evans Sarah L , Rhys Catrin S
Published: April 2019

Pro-anorexia (pro-ana) is an Internet-based movement that provides advice and support for the development/maintenance of an eating disorder (ED). The movement is sometimes framed as a religion, with rituals, psalms, creeds and the invocation of a deity (Ana) who personifies the ED. The latter aspect is likely to influence identities and behaviours as well as providing emotional support and motivation for community members. However, there is little sustained empirical analysis of how members themselves orient to and self-position within the religious discourse. Here, we apply the concept of interdiscursivity to examine the construction of Ana as god(dess). Drawing on a body of online interactions from one pro-ana website over a 47-day period, we discursively analyse members’ constructions of Ana and their relationship with her. With reference to biblical texts, we consider how these constructions directly reference concepts of Christian religion and faith. Implications for understanding pro-ana and interdiscursivity are discussed.
Effect of miR-301a/PTEN pathway on the proliferation and apoptosis of cervical cancer
Authors: Peng Li-na , Shi Wen-tian , Feng Huan-rong , Wei Chuan-yu , Yin Qi-nan
Published: April 2019

The aim of this study was to evaluate the effect of the miR-301a/PTEN pathway in cervical cancer. miR-301a and PTEN expression were measured by quantitative real-time PCR (qRT-PCR) in tissues samples and HeLa cells. PTEN protein level was determined by Western blotting. Dual reporter luciferase assay was performed to validate PTEN as a direct target of miR-301a. The gain- and loss-of function assay was performed by miR-301a overexpression and silencing. Cell proliferation was monitored by cell counting Kit-8 (CCK-8). Cell apoptosis was quantitated by flow cytometry. SPSS was used to analyze the significant difference in the treatments. miR-301a demonstrated a significantly higher expression in cervical carcinoma tissues compared with the paired non-carcinoma tissues ( n = 12), while PTEN expression was found to be significantly lower in cervical carcinoma tissues than their paired non-carcinoma tissues ( n = 12). In addition, PTEN was identified as the direct target of miR-301a. Moreover, overexpression of miR-301a significantly promoted HeLa cells proliferation and anti-apoptosis which had a reverse pattern after PTEN overexpression. Our results confirm PTEN as a direct target of miR-301a in HeLa cells and suggest that miR-301a/PTEN pathway contributes to the development and progression of cervical cancer.
Clinical outcomes of chemical pleurodesis using a minocycline
Authors: Hsu Li-Han , Feng An-Chen , Soong Thomas C. , Ko Jen-Sheng , Chu Nei-Min , Lin Yung-Feng , Kao Shu-Huei
Published: April 2019

Background:

Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. We tried to evaluate their impact on patient survival.

Methods:

There were 314 consecutive patients with symptomatic MPE that underwent minocycline pleurodesis with ( n = 109) and without ( n = 205) the antecedent IPUK therapy between September 2005 and August 2015, who were recruited for the pleurodesis outcome and survival analysis.

Results:

The rate of successful pleurodesis was similar between the simple pleurodesis group and the IPUK therapy group followed by the pleurodesis group (69.0% versus 70.5%; p = 0.804). The patients who succeeded pleurodesis had a longer survival rate than those who failed in either the simple pleurodesis group (median, 414 versus 100 days; p < 0.001) or the IPUK therapy followed by pleurodesis group (259 versus 102 days; p < 0.001). The survival differences remained when the lung and breast cancer patients were studied separately.

Conclusion:

Successful pleurodesis translated into a better survival rate that promotes performing pleurodesis on lung re-expansion. The apparent shorter survival of the patients with loculated MPE or trapped lung, and those that did not respond to the IPUK therapy, lowered the probability of the survival benefit through the simple physical barrier by the fibrin formation to prevent the tumor spreading. The successfully induced inflammatory response by minocycline is supposed to prohibit the tumor invasion and metastasis. Further studies are warranted to clarify the mechanism and provide opportunities to develop novel therapeutic strategies.
Clinical commissioning groups
Authors: Moran Laura , Mills Jonathan , Hindocha Sunil
Published: April 2019

When the Health and Social Care Act (2012) was passed, it was one of one of the most extensive NHS reforms ever seen in England. It gave rise to Clinical Commissioning Groups, which replaced Primary Care Trusts and larger strategic health authorities in April 2013. Commissioners identify the needs of the local population, set clinical priorities and purchase services on behalf of their community from a provider. Hospital trusts, community health groups, general practices, charities and private healthcare providers can ‘sell' services to the ‘buying' commissioner. This article will outline how services are commissioned in England, and explains how services are decommissioned when no longer required.
An efficient parameter update method of 360-degree VR image model
Authors: Lee Hyunchul , Choi Okkyung
Published: April 2019

Recently, with the rapid growth of manufacture and ease of user convenience, technologies utilizing virtual reality images have been increasing. It is very important to estimate the projected direction and position of the image to show the image quality similar to the real world, and the estimation of the direction and the position is solved using the relation that transforms the spheres into the expanded equirectangular. The transformation relationship can be divided into a camera intrinsic parameter and a camera extrinsic parameter, and all the images have respective camera parameters. Also, if several images use the same camera, the camera intrinsic parameters of the images will have the same values. However, it is not the best way to set the camera intrinsic parameter to the same value for all images when matching images. To solve these problems and show images that does not have a sense of heterogeneity, it is needed to create the cost function by modeling the conversion relation and calculate the camera parameter that the residual value becomes the minimum. In this article, we compare and analyze efficient camera parameter update methods. For comparative analysis, we use Levenberg–Marquardt, a parameter optimization algorithm using corresponding points, and propose an efficient camera parameter update method based on the analysis results.
Accuracy of a Point-of-Care Hemoglobin A1c Assay
Authors: Nathan David M. , Griffin Amanda , Perez Francesca M. , Basque Erica , Do Lily , Steiner Barbara
Published: April 2019

Point-of-care test (POCT) HbA1c assays provide rapidly available results for clinical decision-making. Accuracy and precision must be established. Venous blood samples from 300 patients were assayed for HbA1c by a laboratory technician (“laboratory assessment”) with the POCT Alere Afinion™ assay and a laboratory (Premier AffinityTM) assay. POCT results from 402 patients’ fingerstick samples assayed by nine nontechnician staff (“clinical assessment”) were compared with the laboratory assay. The laboratory assessment showed tight correlation ( r2 = .977, P < .001) between the assays. Mean absolute and relative differences were 0.01 percentage points and 2.1%, respectively. CVs for the POCT and laboratory assays were <2% and <1%, respectively. The clinical assessment also showed a tight correlation between the assays ( r2 = .978, P < .001), with mean absolute and relative differences of 0.2 percentage points and 3.41%, respectively. CV for the POCT assay was <2%. The POCT performed acceptably compared to the laboratory assay under realistic clinical conditions.
Real-World Evidence Should Be Used in Regulatory Decisions About New Pharmaceutical and Medical Device Products for Diabetes
Authors: Klonoff David C. , Gutierrez Alberto , Fleming Alexander , Kerr David
Published: April 2019

Randomized clinical trials (RCTs) are no longer the sole source of data to inform guidelines, regulatory, and policy decisions. Real-world data (RWD), collected from registries, electronic health records, insurance claims, pharmacy records, social media, and sensor outputs from devices form real-world evidence (RWE), which can supplement evidence from RCTs. Benefits of using RWE include less time and cost to produce meaningful data; the ability to capture additional information, including social determinants of health that can impact health outcomes; detection of uncommon adverse events; and the potential to apply machine learning and artificial intelligence to the delivery of health care. Overall, combining data from RCTs and RWE would allow regulators to make ongoing and more evidence-based decisions in approving and monitoring products for diabetes.
Real-World Hypoglycemia Avoidance With a Predictive Low Glucose Alert Does Not Depend on Frequent Screen Views
Authors: Puhr Sarah , Derdzinski Mark , Parker Andrew Scott , Welsh John B. , Price David A.
Published: April 2019

Background:

Frequent real-time continuous glucose monitoring (rtCGM) data viewing has been associated with reduced mean glucose and frequent scanning of an intermittently scanned continuous glucose monitoring (isCGM) system has been associated with reduced hypoglycemia for patients with diabetes. However, requiring patients to frequently interact with their glucose monitoring devices to detect actual or impending hypoglycemia is burdensome. We hypothesized that a predictive low glucose alert, which forecasts glucose ≤55 mg/dL within 20 minutes and is included in a new rtCGM system, could mitigate hypoglycemia without requiring frequent device interaction.

Methods:

We analyzed estimated glucose values (EGVs) from an anonymized convenience sample of 15,000 patients who used Dexcom G6 (Dexcom, Inc, San Diego, CA, USA) and its mobile app for at least 30 days with or without the “Urgent Low Soon” alert (ULS) enabled. Screen view frequency was determined as the frequency with which the trend screen was accessed on the app. Multiple screen views within any 5-minute interval were counted as one. Hypoglycemia exposure for patients in the top and bottom quartiles of screen view frequency (>8.25 and <3.30 per day, respectively) was calculated as the percentage of EGVs below various thresholds.

Results:

Over 93% of users enabled the ULS alert; its use was associated with significantly reduced hypoglycemia <55 and <70 mg/dL, independent of screen view frequency.

Conclusion:

Use of the G6 ULS alert may disencumber rtCGM users by promoting significant reductions in hypoglycemia without requiring frequent device interactions.
A Comparative Study of Different Energy Efficiency of OECD and Non-OECD Countries
Authors: Li Ying , Chiu Yung-Ho , Wang Lihua , Liu Yi-Chu , Chiu Ching-Ren
Published: April 2019

Greater and greater attention is being paid to air pollution problems, because of their negative impact on the environment and human health. This article measures energy efficiency, carbon dioxide emissions efficiency, and particulate matter (PM2.5) concentration efficiency to compare the energy efficiency differences between Organisation for Economic Co-operation and Development (OECD) member countries and non-OECD member countries from 2010 to 2014 using a metafrontier dynamic Data Envelopment Analysis model. We calculate technology gap ratio and input and output efficiency values to measure the energy efficiencies of each economy, finding that (a) OECD countries have a technology gap ratio of 1 or very close to 1; and except for the United Arab Emirates and Singapore, both of which exhibit annual improvements, the non-OECD countries have a significant need for efficiency improvements; (b) the average technology gap ratio of OECD is higher than that of non-OECD countries; that is, while OECD countries’ technology gap ratio (TGR) changes are relatively stable, non-OECD countries’ TGRs are gradually increasing; (c) non-OECD countries have large PM2.5 concentration efficiency gaps, with the annual efficiencies in China, India, and Nepal being less than 0.2; (d) Switzerland, Denmark, France, the United Kingdom, Iceland, Luxembourg, Norway, the United States, and the United Arab Emirates all have new and traditional energy efficiency values of 1; and (e) Botswana, Algeria, and Cambodia have poor traditional energy efficiencies, but better new energy efficiencies, whereas Hungary, South Korea, Slovakia, and Slovenia have poor new energy efficiencies and better traditional energy efficiencies.
Arthroscopic Treatment of Patellar and Trochlear Cartilage Lesions with Matrix Encapsulated Chondrocyte Implantation versus Microfracture: Quantitative Assessment with MRI T2-Mapping and MOCART at 4-Year Follow-up
Authors: Olivos Meza Anell , Cortés González Socorro , Ferniza Garza Jairo José , Pérez Jiménez Francisco Javier , Enrique Villalobos Córdova , Ibarra Clemente
Published: April 2019

Methods

Seventeen patients aged 18 to 55 years with symptomatic full-thickness cartilage lesions on either patella or trochlea were treated with matrix autologous chondrocyte implantation (MACI) or microfracture (MF). Both procedures combined with unloading/realigning techniques. Clinical assessment and T2-mapping were evaluated at 48-months.

Results

Clinically results from pre-op to 48-months improved significantly in MACI and MF for Lysholm ( p = 0.001, p = 0.001), IKDC-S ( p = 0.001, p = 0.002), KOOS-P ( p = 0.000, p = 0.002), KOOS-DLA ( p = 0.002, p = 0.003), KOOS-Sports/Rec ( p = 0.000, p = 0.004), KOOS-QoL ( p = 0.000, p = 0.003), KOOS-symptoms ( p = 0.001, p = 0.020), and Kujala ( p = 0.000, p = 0.01), respectively. Tegner was significant between baseline and 48 months only for MACI ( p < 0.008) compared with MF ( p = 0.25). No significant difference was observed between groups for any score at 3, 12, 24, and 48-months ( p > 0.05). T2-mapping values improved significantly over time in MACI compared with MF at 24 months (39.35 vs. 50.44, p = 0.007) and 48 months (36.54 vs. 48.37, p = 0.005). When comparing control values to MACI at 12-m ( p = 0.714), 24-m ( p = 0.175), and 48-m ( p = 0.097), no significant difference was found. MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score comparison gave no statistical difference between groups.

Conclusions

Clinically both techniques improved significantly over time. However, quantitative assessment showed that only newly formed tissue with MACI technique improves significantly since 12-months and maintains stable values compared with native cartilage until 48-month follow-up. MF results were never comparable to those native values. Level of evidence II.
Contact Capacity and Its Effect on Intergroup Relations
Authors: Pfister Miriam , Wölfer Ralf , Hewstone Miles
Published: April 2019

Although intergroup contact is an effective means to improve intergroup attitudes, it does not always have a positive impact on them. This study introduces contact capacity as a factor that may impede intergroup contact. Longitudinal social network data ( N = 6,600; M age = 14.87 years) was collected in Germany, the Netherlands, and Sweden and used to accurately calculate participants’ out-group, in-group, and total contact. Multilevel models (L1: students, L2: school classes) showed that the total amount of contact at Wave 1 negatively predicts individuals’ out-group friends at Wave 2 while controlling for out-group attitudes, existing out-group friendships and sociodemographic variables. An additional robustness check showed that this effect holds true for future in-group friendships. The study highlights the importance of contact capacity for whether people engage in intergroup contact and the contribution of social network analysis to contact research.
Lithium treatment, nephrogenic diabetes insipidus and the risk of hypernatraemia: a retrospective cohort study
Authors: Ott Michael , Forssén Björn , Werneke Ursula
Published: April 2019

Background:

Hypernatraemia is a serious condition that can potentially become life threatening. It is known that lithium is associated with polyuria and nephrogenic diabetes insipidus, risk factors for hypernatraemia. In this study, we tested the hypothesis that lithium treatment was a risk factor for hypernatraemia.

Methods:

We performed a retrospective cohort study in the Swedish region of Norrbotten into the effects and potential adverse effects of lithium treatment and other mood stabilizers (LiSIE). For this particular study, we included all patients who had experienced at least one episode with a sodium concentration ⩾150 mmol/L between 1997 and 2013. Medical records were reviewed regarding past or current lithium exposure, diabetes insipidus and other potential risk factors for hypernatraemia.

Results:

Of 2463 patients included, 185 (7.5%) had experienced 204 episodes of hypernatraemia within the 17-year review period. In patients 65 years or older, infections dominated as the cause with 51%. In patients younger than 65 years, intoxications, particularly with alcohol, dominated as the cause with 35%. In the whole sample, dehydration accounted for 12% of episodes, 25% of which in the context of suspected or confirmed nephrogenic diabetes insipidus. Of all episodes, 25% resulted in death, with infection being the most common cause of death in 62% of cases.

Conclusions:

In our sample, infections and harmful use of substances including alcohol were the most common causes of hypernatraemia. Both current and past use of lithium also led to episodes of hypernatraemia, when associated with nephrogenic diabetes insipidus. Clinicians should remain vigilant, have a low threshold for checking sodium concentrations and consider even risk factors for hypernatraemia beyond lithium.
Optimal treatment of HIV-associated neurocognitive disorders: myths and reality. A critical review
Authors: Bougea Anastasia , Spantideas Nikolaos , Galanis Petros , Gkekas George , Thomaides Thomas
Published: April 2019

Background:

The aim of this study was to review the clinical data on the effectiveness of the pharmacotherapy of HIV-associated neurocognitive disorders (HANDs).

Methods:

A literature search of PubMed was performed (from January 1996 to October 2018) using the terms: ‘HIV-associated neurocognitive disorders’, ‘HIV-associated dementia’, ‘mild neurocognitive disorder (MND)’, ‘asymptomatic neurocognitive impairment (ANI)’, ‘adjuvant therapies’, ‘antiretroviral treatment (cART)’, ‘neurotoxicity’, ‘cART intensification’, ‘fluid markers’, ‘cerebrospinal fluid’, ‘protease inhibitors’, ‘nonnucleoside reverse transcriptase inhibitor’, ‘nucleoside reverse transcriptase inhibitors’, and ‘integrase strand transfer inhibitors’. Additional references were identified from a review of literature citations. All English language clinical studies of adjunctive therapies and neuronal markers were selected in order to evaluate a closer relationship between the early involvement and the onset of cognitive decline. We identified 407 relevant studies, of which 248 were excluded based on abstract analysis. Finally, we analyzed 35 articles, organizing the results by cART, adjuvant and neuronal markers (total of 7716 participants).

Results:

It is important to inform clinicians about the importance of accurate phenotyping of HIV patients, incorporating an array of markers relevant to HAND pathophysiology, in order to assess the individual’s risk and potential response to future personalized antiretroviral treatment

Conclusion:

So far, no clinical trials of HAND therapies are effective beyond optimal suppression of HIV replication in the central nervous system. Combination of validated neuronal markers should be used to distinguish between milder HAND subtypes and improve efficiency of clinical trials, after strict control of confounders.
Healthcare professionals’ perceptions on the use of opioid analgesics for the treatment of cancer-related pain in Cyprus: A mixed-method study
Authors: Charalambous Andreas , Zorpas Marios , Cloconi Constantina , Kading Yolanda
Published: April 2019

Objectives:

Pain is considered the most common and debilitating symptom reported by patients affected by cancer, and opioids are at the front line for its effective management. However, the appropriate use of opioids can be limited by healthcare professionals’ perceptions on opioids. Therefore, the aim of this study was to explore their perceptions on the use of opioids medication.

Methods:

This was a study of sequential mixed-method design conducted in Cyprus. As part of the quantitative phase of the study, the Barriers to Opioid Analgesic Availability Test questionnaire was completed by 73 physicians randomly selected. In the qualitative phase, 28 healthcare professionals working in primary and secondary healthcare centers participated in two focus groups. They were asked to express their perceptions on the use of opioid analgesics for the treatment of cancer-related pain. Data were analyzed according to Colaizzis’ seven-stage phenomenological analysis.

Results:

The quantitative analysis showed that 69.85% of physicians acknowledge opiophobia as a main barrier to appropriate pain relief but also explicitly for cancer pain which is not adequately managed (45.19%). In terms of opioids availability, physicians stated that moderate to severe problems in opioids availability were mainly caused by their reluctance to prescribe opioids (49.3%) followed by the laws/regulations in place (41.08%). The qualitative analysis yielded the following six main themes: inadequate training of healthcare professionals in the use of opioid analgesics, inadequate patient/caregivers’ awareness of opioid analgesics, opiophobia in healthcare professionals, opiophobia of patients/caregivers, poor management of opioid analgesics by healthcare professionals and patients/caregivers, and ineffective pain relief with opioids.

Conclusions:

The lack of appropriate education is a significant barrier to opioids use in Cyprus. This is compounded by the attitudes and phobias of both healthcare professionals and the general public. In addition, there are barriers to opioid availability and unsatisfactory cancer pain relief.
Necrotizing fasciitis and the midterm outcomes after survival
Authors: Kruppa Christiane , Hutter Danial J , Königshausen Matthias , Gessmann Jan , Schildhauer Thomas A , Coulibaly Marlon O
Published: April 2019

Background and Aims:

Radical surgical intervention is necessary to save patients’ lives in cases of necrotizing fasciitis. This leads to persistent disabilities and most likely to a deteriorated quality of life. The purpose of this study was to evaluate the midterm outcomes after survival of necrotizing fasciitis.

Materials and Methods:

A retrospective analysis of 69 patients, treated for necrotizing fasciitis between 2003 and 2012. The patients were identified using the International Classification of Diseases (10th Revision) code M 72.6. Of the 50 survivors, 22 patients completed the Short Form 36 and Short Musculoskeletal Function Assessment questionnaires as a postal survey. The follow-up averaged 59 months (range: 6–128 months).

Results:

The average age at the time of necrotizing fasciitis was 60.0 years. The body mass index average was 29.7. The patients had a significantly decreased physical component summary score of 33.3 compared to a normative group (p < 0.001) (Short Form 36). They further showed a significantly decreased dysfunction and bother indices (Short Musculoskeletal Function Assessment) (p < 0.001). An increased age (⩾70 years) was associated with an inferior role emotional (p = 0.048) and physical functioning (p = 0.011) as well as social functioning (p = 0.038) (Short Form 36). The majority of patients (16, 72.7%) complained of pain at the final follow-up and 50% of patients required an assistive device on a regular basis.

Conclusion:

Patients who survived necrotizing fasciitis suffer from functional impairment and changed body appearance. Assistive devices or pain medication are often required, and the patients present with significantly decreased physical, social, and emotional functioning at the midterm follow-up. The patient’s age is a critical factor regarding functional or mental outcome parameters. Further research on the post-hospital course and long-term multidisciplinary care is required to improve the outcomes of these patients.
A 64-year-old man suffering from ST-elevation myocardial infarction and severe thrombocytopenia: Procedures in the case of a patient not fitting the guidelines
Authors: Ilnicki Dawid , Wyderka Rafał , Nowicki Przemysław , Sołtowska Alicja , Adamowicz Jakub , Ciapka Adam , Jaroch Joanna
Published: April 2019

The objective of this case report is to present how the chronic condition significantly complicates life-saving procedures and influences further treatment decisions. A 64-year-old man suffering from arterial hypertension and immune thrombocytopenic purpura presented to the Emergency Department with anterior ST-elevation myocardial infarction. An immediate coronary angiography was performed where critical stenosis of the proximal left anterior descending was found. It was followed by primary percutaneous intervention with bare metal stent. In first laboratory results, extremely low platelet count was found (13 × 109/L). Consulting haematologist advised the use of single antiplatelet therapy and from the second day of hospitalisation only clopidogrel was prescribed. On the sixth day of hospital stay, patient presented acute chest pain with ST elevation in anterior leads. Emergency coronary angiography confirmed acute stent thrombosis and aspiration thrombectomy was performed. It was therefore agreed to continue dual antiplatelet therapy for 4 weeks. As there are no clinical trials where patients with low platelet count are included, all therapeutic decisions must be made based on clinician’s experience and experts’ consensus. Both the risk of haemorrhagic complications and increased risk of thrombosis must be taken into consideration when deciding on patient’s treatment.
Vancomycin-induced DRESS syndrome treated with systemic steroids in a 16-year-old male
Authors: Maldonado Dylan , Lakhani Jay
Published: April 2019

This is a case report of a 16-year-old patient with DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) associated with vancomycin who improved with systemic steroid treatment. DRESS syndrome is a life-threatening disease process typically secondary to medications, such as anticonvulsants, sulfonamides, and allopurinol. Vancomycin has also been associated with this condition. Apart from discontinuation of the offending agent, there are no clear treatment guidelines, but reports of improvement with systemic corticosteroids are described. We present a case of a 16-year-old male who had been on vancomycin for greater than 4 weeks before developing symptoms consistent with the diagnosis of DRESS syndrome. Our patient demonstrated marked improvement with systemic corticosteroids.
Presumed immune-mediated haemolytic anaemia associated with pregnancy in a cat
Authors: Kopke Matthew A , Pemberton Sarah , Ruaux Craig G
Published: April 2019

Case summary

A 7-year-old female entire Birman presented with acute-onset haemorrhagic vulvar discharge. Moderate, normocytic, normochromic, non-/pre-regenerative anaemia, along with a moderate mature neutrophilia, were seen on haematology. Saline test for agglutination was positive. No haemotropic mycoplasmas were identified. Serum biochemistry revealed severe hyperbilirubinaemia. Retroviral testing was negative. Serology for toxoplasmosis revealed a titre of 1:512. Abdominal ultrasound identified a large uterus, containing at least three advanced-stage fetuses, two of which failed to exhibit independent motion or cardiac activity. Ovariohysterectomy was performed. Histology demonstrated mild, multifocal suppurative placentitis, with Gram staining revealing no evidence of bacteria. Complete resolution of the anaemia was seen within 1.5 months of ovariohysterectomy.

Relevance and novel information

Immune-mediated haemolytic anaemia (IMHA) in association with pregnancy has not been previously reported in cats. This case represents a potential novel cause for IMHA in cats, which resolved following ovariohysterectomy.
Selfies, Policies, or Votes? Political Party Use of Instagram in the 2015 and 2016 Spanish General Elections
Authors: Turnbull-Dugarte Stuart J.
Published: April 2019

Do parties in Spain use Instagram and for what purpose? What characterizes posts that are effective at engaging the electorate? This article examines the use of Instagram during the Spanish general elections of 2015 and 2016. Content analysis of party publications on Instagram was carried out to test whether parties use the application to broadcast their policy positions, mobilize voters, or to promote their main party candidate. Regression estimation models are then used to explain the varying levels of user engagement with party posts. The findings illustrate that the new challenger parties, Podemos and Ciudadanos, use the social media app in a systematic way that is distinct from the traditional mainstream parties in Spain. Moreover, party newness, attempts at mobilization, and the promotion of the main party candidate are found to be important explanations for party success on Instagram.
The Civic Labor of Volunteer Moderators Online
Authors: Matias J. Nathan
Published: April 2019

Volunteer moderators create, support, and control public discourse for millions of people online, even as moderators’ uncompensated labor upholds platform funding models. What is the meaning of this work and who is it for? In this article, I examine the meanings of volunteer moderation on the social news platform reddit. Scholarship on volunteer moderation has viewed this work separately as digital labor for platforms, civic participation in communities, or oligarchy among other moderators. In mixed-methods research sampled from over 52,000 subreddit communities and in over a dozen interviews, I show how moderators adopt all of these frames as they develop and re-develop everyday meanings of moderation—facing the platform, their communities, and other moderators alike. I also show how this civic notion of digital labor brings clarity to a strike by moderators in July 2015. Volunteer governance remains a common approach to managing social relations, conflict, and civil liberties online. Our ability to see how communities negotiate the meaning of moderation will shape our capacity to address digital governance as a society.
Insta-Politicos: Motivations for Following Political Leaders on Instagram
Authors: Parmelee John H. , Roman Nataliya
Published: April 2019

This study expands uses and gratifications research into the area of political Instagram use. A survey shows the motives for following political leaders on the social media platform and how followers’ motives are associated with their demographics and political attitudes. Findings indicate that information/guidance motives are the most important for following political leaders on Instagram, with social utility being the next highest motive. Also, males use Instagram more for social utility purposes than females, and having an entertainment motive is related to being young. The results also provide insight into how the politically active can be more influential on Instagram.
Mundane Content on Social Media: Creation, Circulation, and the Copyright Problem
Authors: Meese James , Hagedorn Jennifer
Published: April 2019

This article examines the practices of social media users and explores how people value, protect, and circulate content on social media platforms. Legal scholarship shows us that much of the mundane online distribution and consumption of media infringes copyright law and as a result raises complex questions around the distribution and circulation of content. Through exploring this misalignment between copyright law and everyday social media practices, this article identifies existing norms on social media platforms and asks whether they could provide guidance for a future copyright reform agenda. Drawing on a series of group interviews with people who identified as regular users of social media, we explored emergent norms of attribution and circulation. Applying a grounded theory approach, an emergent thematic analysis of the data uncovered a range of responses coalescing around the themes of attribution, platform norms, and commercialization. The data show that people make complex and nuanced decisions around when they should attribute content, seek permission to use content, or allow others to use their content. We suggest that these decisions are informed by the vernaculars of each platform and a critical assessment of the broader commercial logics of social media, which results in many people placing a greater importance around attribution. The authors conclude by proposing that rather than stretching the logic of a legal framework that is increasingly not fit for purpose for everyday social media content distribution, policymakers should take into account these emergent practices on social media platforms when considering reform opportunities.
The transition to adulthood in China, Germany and the US: Prevalence and timing in private and professional life
Authors: Fulda Barbara E. , Nauck Bernhard , Ren Qiang
Published: April 2019

We explore cross-country differences in the transition to adulthood between China, Germany, and the USA. Using large-scale panel studies, we examine the timing of leaving the parental home, first marriage and first parenthood. For those born between 1933 and 1988, we observe a delay in the timing of first marriage in all three societies. But the delay is steeper in the USA than in Germany and China. The age at first childbirth is increasing in all three countries. By age 30, most individuals in China have married their first partner and become parents, whereas in the USA and Germany less than half of the population have experienced one of these events. There are large differences in educational and employment trajectories between the urban and rural populations in China, less so in the USA, whereas almost no differences are observed in Germany. The three countries are alike in the proportion of individuals who have left the parental home by age 30. In all three countries, individuals without tertiary qualifications are more likely to have experienced all three events by age 30. But with regard to first marriage, a larger share of higher-educated individuals get married by the age of 30 in the USA, whereas in China it is the less educated who are more likely to get married.
“Go See Somebody”: How Spouses Promote Mental Health Care
Authors: Reczek Corinne , Thomeer Mieke Beth , Gebhardt-Kram Lauren , Umberson Debra
Published: April 2019

This study considers when, whether, and how spouses encourage professional mental health care by analyzing qualitative data from 90 in-depth interviews with gay, lesbian, and heterosexual spouses. Findings show that a majority of spouses are engaged in promoting each other’s mental health care but that the strategies used to promote care vary by gender and the gender composition of the couple. The majority of gay men and lesbian women promote care by framing mental health problems as largely biochemical, fixable only with professional care or medicine, and work to destigmatize this care. Lesbian women uniquely emphasize the influence of a spouse’s symptoms on marital quality as a reason to pursue care. Some heterosexual women and men also report seeing their spouse’s mental health care as something for them to deal with on their own and thus do not encourage care. This study has important implications for researchers looking to understand why some individuals seek mental health care and others do not and provides policymakers insight into mental health interventions via spouses.