bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiential Marketing and Internet: Assessing the Role of Gender
Authors: Sana  , Azam Mohd. Khalid
Published: March 2018

Gender has always been a favourite topic of researchers to dig down. Considerable research works have focused the role of gender in the domain of consumer behaviour, but there is much more to explore in the area of experiential marketing as it is relatively a new concept in this field. The article discusses an examination of the differences in the ways men and women perceive sense, feel, think, act and relate experiences while using social networking sites (SNS), such as Facebook, Twitter and Instagram. Purpose of the study is to examine the gender differences within the context of five experiences of experiential marketing. Through convenience sampling, 250 set of questionnaires were distributed to the university students, out of which 226 were found usable. T-test was applied for the analysis of data using SPSS software version 21. Shopping habits of women are considered to be highly influenced by social media. But results of the study indicate that men relate the experience provided by the sites with them more than the women do. Marketers can use the findings in tailoring their sites to enhance the customer experience.
Resetting journalism in the aftermath of Brexit and Trump
Authors: Zelizer Barbie
Published: March 2018

This article considers the lifeline of the Anglo-American imaginary in news. It tracks its evolution, consolidation during the Cold War era and centrality in the UK/US coverage of Brexit and Trump in 2016-2017. It argues that not only has the imaginary prevailed but it continues to shape contemporary coverage to the detriment of public understanding of current events.
Testimonial rallies and the construction of memetic authenticity
Authors: Shifman Limor
Published: March 2018

This article traces the role of ‘testimonial rallies’ – Internet memes in which participants post personal photos and/or written accounts as part of a coordinated political protest – in the formulation of truth-related values. Rather than endorsing the value of truth per se, rallies such as ‘We are the 99 percent’ or ‘I never ask for it’ valorize what I term ‘memetic authenticity’. This construction of the authentic incorporates four basic components: evidence, self-orientation, affective judgement, and mimesis. By combining ‘external authenticity’ that relates to the aggregation of factual proofs with forms of ‘internal authenticity’ that focus on emotive individual experiences, testimonial rallies serve as a grassroots weapon of the weak against those in power. While ‘external’ and ‘internal’ forms of authenticity are happily married in this genre, I conclude with a reflection on our grim future in the case of divorce.
Polysaccharide from Angelica sinensis protects H9c2 cells against oxidative injury and endoplasmic reticulum stress by activating the ATF6 pathway
Authors: Niu Xiaowei , Zhang Jingjing , Ling Chun , Bai Ming , Peng Yu , Sun Shaobo , Li Yingdong , Zhang Zheng
Published: March 2018

Objectives

Angelica sinensis exerts various pharmacological effects, such as antioxidant and anti-apoptotic activity. This study aimed to investigate the active ingredients in A. sinensis with antioxidant properties and whether A. sinensis polysaccharide (ASP) protects H9c2 cells against oxidative and endoplasmic reticulum (ER) stress.

Methods

The ingredients of A. sinensis and their targets and related pathways were determined using web-based databases. Markers of oxidative stress, cell viability, apoptosis, and ER stress-related signalling pathways were measured in H9c2 cells treated with hydrogen peroxide (H2O2) and ASP.

Results

The ingredient–pathway–disease network showed that A. sinensis exerted protective effects against oxidative injury through its various active ingredients on regulation of multiple pathways. Subsequent experiments showed that ASP pretreatment significantly decreased H2O2-induced cytotoxicity and apoptosis in H9c2 cells. ASP pretreatment inhibited H2O2-induced reactive oxygen species generation, lactic dehydrogenase release, and malondialdehyde production. ASP exerted beneficial effects by inducing activating transcription factor 6 (ATF6) and increasing ATF6 target protein levels, which in turn attenuated ER stress and increased antioxidant activity.

Conclusions

Our findings indicate that ASP, a major water-soluble component of A. sinensis, exerts protective effects against H2O2-induced injury in H9c2 cells by activating the ATF6 pathway, thus ameliorating ER and oxidative stress.
Anatomic Predictors of Sagittal Hip and Pelvic Motions in Patients With a Cam Deformity
Authors: Ng K.C. Geoffrey , Lamontagne Mario , Jeffers Jonathan R.T. , Grammatopoulos George , Beaulé Paul E.
Published: March 2018

Background:

As there is a high prevalence of patients with cam deformities and no ongoing hip dysfunction, understanding the biomechanical factors predicting the onset of symptoms and degenerative changes is critical. One such variable is how the spinopelvic parameters may influence hip and pelvic sagittal mobility.

Hypothesis/Purpose:

Pelvic incidence may predict sagittal hip and pelvic motions during walking and squatting. The purpose was to determine which anatomic characteristics were associated with symptoms and how they influenced functional hip and pelvic ranges of motion (ROMs) during walking and squatting.

Study Design:

Controlled laboratory study.

Methods:

Fifty-seven participants underwent computed tomography and were designated either symptomatic (n = 19, cam deformity with pain), asymptomatic (n = 19, cam deformity with no pain), or control (n = 19, no cam deformity or pain). Multiple femoral (cam deformity, neck angle, torsion), acetabular (version, coverage), and spinopelvic (pelvic tilt, sacral slope, pelvic incidence) parameters were measured from each participant’s imaging data, and sagittal hip and pelvic ROMs during walking and squatting were recorded using a motion capture system.

Results:

Symptomatic participants had large cam deformities, smaller femoral neck-shaft angles, and larger pelvic incidence angles compared with the asymptomatic and control participants. Discriminant function analyses confirmed that radial 1:30 alpha angle (λ1 = 0.386), femoral neck-shaft angle (λ2 = 0.262), and pelvic incidence (λ3 = 0.213) ( P < .001) were the best anatomic parameters to classify participants with their groups. Entering these 3 parameters into a hierarchical linear regression, significant regressions were achieved for hip ROM only when pelvic incidence was included for walking ( R2 = 0.20, P = .01) and squatting ( R2 = 0.14, P = .04). A higher pelvic incidence decreased walking hip ROM ( r = −0.402, P = .004). Although symptomatic participants indicated a trend of reduced squatting hip and pelvic ROMs, there were no significant regressions with the anatomic parameters.

Conclusion:

A cam deformity alone may not indicate early clinical signs or decreased ROM. Not only was pelvic incidence a significant parameter to classify the participants, but it was also an important parameter to predict functional ROM. Symptomatic patients with a higher pelvic incidence may experience limited sagittal hip mobility.

Clinical Relevance:

Patients with symptomatic femoroacetabular impingement showed a higher pelvic incidence and, combined with a cam deformity and varus neck, can perhaps alter the musculature of their iliopsoas, contributing to a reduced sagittal ROM. With an early and accurate clinical diagnosis, athletes could benefit from a muscle training strategy to protect their hips.
Embedded in the Crowd: Creative Freelancers, Crowdsourced Work, and Occupational Community
Authors: Schwartz David
Published: March 2018

Although scholars are beginning to examine the experience of crowdsourced work, the extant literature and popular accounts paint an undersocialized picture of the labor process. This study explores how crowdsourced work remains socially embedded in the structure of an occupational community that exists exclusively online and in relation to a focal firm. The findings draw on interviews and observation of creative freelancers who designed, developed, and distributed digital goods in a crowdsourced work arrangement with an entertainment publisher. The online meeting places of an occupational community supported workers in their responses to three challenges of contingency: limited communication with the firm, sporadic and unpredictable compensation for their work, and unclear career trajectory. Within the community, freelancers found direction and meaning for their work, built collective strategies to smooth compensation, and illuminated a pathway from amateur to expert. As an occupational institution, the community also structured collaborations that transferred knowledge of industry standard practice and coordinated work in the absence of bureaucratic organization.
Development of a Transgender and Gender Nonconforming Language Self-Efficacy Scale for Social Service Providers Working With Older Adults
Authors: Warren Allison R. , Steffen Ann M.
Published: March 2018

There is consensus that providers who work with transgender and gender nonconforming (TGNC) older adults should use the language preferred by the older adult; however, assessment tools to document professional training efforts are lacking. This study presents data on a new TGNC Language Self-Efficacy Scale, using responses collected from employees and volunteers of area agencies on aging (AAA) across the United States ( N = 155). Exploratory factor analysis supports a two-factor model: Interactions and Information subscales significantly correlated with knowledge of TGNC terminology, genderism and transphobia, gender role beliefs, beliefs about gender and gender identity, and attitudes toward lesbians and gay men. Future directions include additional measurement development work and replication of these findings outside of AAAs.
High Degree of Satisfaction With the Support Given by Multidisciplinary Palliative Home Care Teams in the County of Stockholm
Authors: Nordström Marie , Strang Peter
Published: March 2018

Objective:

At the initiative of Stockholm County Council, a survey was performed by an independent investigator to evaluate satisfaction among patients and their families with the advanced palliative home care teams in the county of Stockholm. The survey was performed in 2010 and compiled in 2011. The aim was to evaluate the impressions of patients and their families of the support given by the palliative home care teams in the Stockholm area and to evaluate the management of symptom control, availability, continuity, confidence, and quality of communication.

Methods:

A questionnaire was sent to 1424 patients and 329 family members to evaluate the views of the users of the home care service.

Results:

The response rate was 78% among both patients and their families or other caregivers. The proportion of positive and very positive responses among those who needed the specific help of the team was as follows: information about the service 86%, availability around the clock 96%, influence and feeling of shared responsibility 88%, and possibility of family members to have supportive discussions 95%. Eighty-three percent of patients experienced total pain relief and 99% total or partial relief. The corresponding figures for anxiety were 77% and 97% and for other symptom reliefs 79% and 98%, respectively. These figures were comparable to a smaller survey in 2014 and were high compared to the results from other medical services using similar questionnaires.

Significance of the Results:

A high quality of care is possible to achieve within palliative home care services.
Significant reinforcement of polypropylene/wood flour composites by high extent of interfacial interaction
Authors: Jiang Xianyou , Wang Jikui , Wu Genhua , Peng Xing , Ma Xiangyan
Published: March 2018

Polypropylene (PP)/wood flour/fiber (WF) composites with strong interfacial compatibility were prepared, and properties of the composites were studied. First, the wood fiber was surface modified by alkali treatment—this process is also termed as fibrillation that creates rough surface, cavities, and much interspace between smaller fibrils. Then multi-monomer grafted copolymers of PP (MPP-St) and PP wax (MPPW-St) were synthesized. The so synthesized MPP-St/MPPW-St well compatibilized the interfaces of the PP/alkali-treated WF (TWF) composites. Mechanical property and water resistance results demonstrated that synergistically compatibilized PP/TWF composites had a better performance than composites compatibilized by MPE-St or MPPW-St separately, uncompatibilized composites, and PP/untreated wood flour (UWF) composites. The interfacial structures of all these composites were characterized by scanning electron microscopy. A three-dimensional mold was constructed to reveal that MPP-St affords a strong interfacial interaction between PP and rough surface of treated fiber, while MPPW-St supplements the interfacial interaction by permeating into the interspace between smaller fibrils of alkali-treated fiber. The mold fitted the results very well.
A Field Too Crowded? How Measures of Market Structure Shape Nonprofit Fiscal Health
Authors: Paarlberg Laurie E. , An Seung-Ho , Nesbit Rebecca , Christensen Robert K. , Bullock Justin
Published: March 2018

This article explores how various dimensions of market structure, often used to measure organizational crowding, affect the fiscal health of nonprofit organizations. Using 2011 National Center for Charitable Statistics (NCCS) nonprofit sector data, our findings generally support population ecology’s model of a curvilinear relationship between density and days of spending. However, we also find that single dimensions of market structure do not fully capture the effects of market competition. Increasing density has a negative effect on the fiscal health of organizations in markets in which resources are more evenly distributed among actors, whereas increasing density of organizations has a positive effect on organizational fiscal health in markets in which resources are less evenly distributed among actors. These results are sensitive to different specifications of fiscal health and field of nonprofit activity.
Freedom and its limitations: The contemporary mainland Chinese debate over liberalism
Authors: Hua Lu , Galway Matthew
Published: March 2018

The emergence of Chinese liberalism carries with it a specific China-centric character that reflects both a Chinese and a foreign focus on the nation’s complicated domestic situation. As part of the research dialogue on the intellectual public sphere in China, this article provides a historical perspective of the development of contemporary Chinese liberalism and explores the complexities of those Chinese liberals’ engagement with a number of key issues in political thought, both among themselves and with their principal opponents, the New Left. We review four themes in these ongoing debates: the relationship between freedom and equality; the liberals’ demands for a more open civil society; their call for balanced social structures, including a mechanism for expressing interest; and their search for a new synthesis of Chinese tradition with a strong nation state. Contemporary Chinese liberals propose their visions for a China that operates within and against a Euro-American-dominated system. Thus, their interpretation of classical liberal texts is characterized by one of creative adaptation, and informed by both local and foreign intellectual resources. The article’s ultimate goal is to provide a deeper understanding of the internal debates among Chinese liberals, which may give a sense of the multifarious predicaments and opportunities that China’s intellectuals face as China attempts to pursue wealth, power, and a revitalized role in a new world order.
Land-based financing in sub-Saharan African cities
Authors: Berrisford Stephen , Cirolia Liza Rose , Palmer Ian
Published: March 2018

Decentralization reforms and rapid urbanization place increasing pressure on African urban authorities. In response, land-based finance has been gaining popularity within development discourses as a method of increasing local autonomy and financing local government infrastructure provision. This paper discusses the conceptual basis for land-based finance, the instruments that form part of this approach, and the actual application in several African cities. Drawing on three case studies (Addis Ababa, Harare and Nairobi) and a high-level scan of 29 developments in various African cities, we show how land-based finance is being implemented in practice and discuss the potential for wider uptake. We conclude that African city governments are using land-based financing, albeit in inconsistent ways. We argue that urban authorities should consider the more extensive and progressive use of land-based financing instruments, despite the constraints imposed by both technical and political conditions. A progressive agenda for local government finance in African cities should take land-based finance seriously, as well as the local practices and institutional arrangements through which it operates.
Talk to me: Exploring user interactions with the Amazon Alexa
Authors: Lopatovska Irene , Rink Katrina , Knight Ian , Raines Kieran , Cosenza Kevin , Williams Harriet , Sorsche Perachya , Hirsch David , Li Qi , Martinez Adrianna
Published: March 2018

Amazon Alexa is a voice-controlled application that is rapidly gaining popularity. We examined user interactions with this technology, and focused on the types of tasks requested of Alexa, the variables that affect user behaviors with Alexa, and Alexa’s alternatives. The data about Alexa usage were collected from 19 participants via the online questionnaire and diary methods over the course of several days. The results indicate that across all age groups, Alexa was primarily used for checking weather forecasts, playing music, and controlling other devices. Several participants reported using Apple Siri and Google Now applications in addition to Alexa for similar purposes except for controlling other devices. Alexa uses over the weekends were more frequent than on weekdays, but its overall usage tended to decrease over time. The users reported being satisfied with Alexa even when it did not produce sought information, suggesting that the interaction experience is more important to the users than the interaction output. More work is required to understand whether users treat Alexa and similar voice-controlled applications as primarily a traditional information retrieval system, a casual leisure system, a control interface for smart home devices, or, simply, a new toy.
The Psychology of Offering an Apology: Understanding the Barriers to Apologizing and How to Overcome Them
Authors: Schumann Karina
Published: March 2018

After committing an offense, a transgressor faces an important decision regarding whether and how to apologize to the person who was harmed. The actions he or she chooses to take after committing an offense can have dramatic implications for the victim, the transgressor, and their relationship. Although high-quality apologies are extremely effective at promoting reconciliation, transgressors often choose to offer a perfunctory apology, withhold an apology, or respond defensively to the victim. Why might this be? In this article, I propose three major barriers to offering high-quality apologies: (a) low concern for the victim or relationship, (b) perceived threat to the transgressor’s self-image, and (c) perceived apology ineffectiveness. I review recent research examining how these barriers affect transgressors’ apology behavior and describe insights this emerging work provides for developing methods to move transgressors toward more reparative behavior. Finally, I discuss important directions for future research.
The Use of Quantitative Methods in Labour Law Research
Authors: Deakin Simon
Published: March 2018

This article considers the potential and limits of quantitative approaches to labour law research. It explores the methods used to construct and validate indicators of labour regulation (‘leximetrics’) and those used in the econometric analysis of the effects of labour law rules on employment, productivity and inequality. It is argued that while there is a risk of the misuse and misappropriation of legal indicators, they can provide new evidence on the nature and effects of labour law rules, and thereby contribute to labour law theory as well as to the resolution of some practical issues of regulatory policy.
Prediction of saponin content in soapnut (Sapindus mukorossi Gaertn.) fruits by near infrared spectroscopy
Authors: Li Yanjie , Shao Wenhao , Dong Ruxiang , Jiang Jingmin , Diao Songfeng
Published: March 2018

In this study, near infrared spectroscopy has been demonstrated to quickly determine the saponin content in soapnut fruits. Partial least squares analysis combined with pre-processing methods and significance multivariate correlation variable selection was introduced to develop a statistical model calibrated for saponin content in soapnut fruits. The results showed that the first derivative yielded the best partial least squares calibration models with spectra of both the surface of dried fruits and the powder of dry seeded fruits with root mean square error of calibration values of 0.85% and 0.59%, respectively. The surface model presented less accuracy than the powder model. However, when the significance multivariate correlation variable selection method was applied to select the best variables from the spectra, the partial least squares models using spectra of surface and powder samples became similar, with higher R2 values (0.84 and 0.90), lower root mean square error of calibration values of 0.23% and 0.39%. It was suggested that near infrared spectroscopy could be a promising and rapid method for predicting the saponin content in the soapnut fruits without grinding them into powder.
A Strategic Initiative for Successful Reverse Logistics Management in Retail Industry
Authors: Panigrahi Shrikant Krupasindhu , Kar Foo Weng , Fen Tan Ai , Hoe Lam Kah , Wong Melvin
Published: March 2018

This study aims to identify critical factors for developing a successful reverse logistics strategic framework that could guide the managers for improving customer satisfaction and managing retail returns. Qualitative interviews were performed with logistics manager in retail industry to develop successful reverse logistics strategic framework with critical factors. A problem-driven content analysis methodology was also conducted reviewing previous studies published from 2008 through 2015 to determine the key factors that affect reverse logistics decisions of managers towards successful reverse logistics management. This study provided new insight on reverse logistics as an important strategic initiative for the retailers to gain customer satisfaction, competitive advantage and cost effectiveness. A reverse logistics framework that is developed in this article will be able to add value to supply chain and logistics studies. Reverse flow driven by motivation is an important implication for managers to manage logistics activities. Managers must emphasize on potential corporate benefits to reduce costs and add customer value.
Palliative Care Patients’ Quality of Dying and Circumstances of Death—Comparison of Informal Caregivers’ and Health-Care Professionals’ Estimates
Authors: Stiel Stephanie , Heckel Maria , Wendt Kim Nikola , Weber Martin , Ostgathe Christoph
Published: March 2018

Background:

Patient-reported outcomes are usually considered to be the gold standard assessment. However, for the assessment of quality of dying and death, ratings of informal caregivers (ICGs) or health-care professionals (HCPs) must be considered for ethical and methodological reasons. This article aims to present results of ICGs’ and HCPs’ estimates of the questionnaire, quality of dying and death (QoDD) on patients who died in PCUs and to compare the level of agreement of both ratings/raters.

Methods:

The parent validation study to this analysis assessed the ICG and HCP versions of the QoDD. Descriptive statistics are presented for each item in both versions. T tests for the estimation of differences between ICG and HCP were performed. Case-related absolute differences between estimates were analyzed regarding the extent of agreement and deviation.

Results:

Two hundred fifteen matched ICG and HCP ratings were analyzed. The ratings in all 6 QoDD dimensions were high; single items scored low. Mean absolute difference between both ratings was 0.33 (standard deviation [SD]: 3.08; median 0.05) on a 0 to 10 numerical rating scale and ranges between −8.24 (higher rating of ICGs compared to HCPs) and 9.33 (higher rating of HCPs compared to ICGs).

Conclusions:

The findings appear to show a high satisfaction with quality of dying and death as rated by ICGs and HCPs, but we suspect this might be indicative of a methodological challenge, that is, a ceiling effect in both assessments. Single low scoring items may provide important clues for improvement in end-of-life care. Although descriptive data show comparable mean values and standard deviations, the actual congruence of ratings is low. In summary, replacing one rating by another cannot be recommended.
Please Ask Gently: Using Culturally Targeted Communication Strategies to Initiate End-of-Life Care Discussions With Older Chinese Americans
Authors: Chi Han-Lin , Cataldo Janine , Ho Evelyn Y. , Rehm Roberta S.
Published: March 2018

Background:

Health-care providers (HCPs) find facilitating end-of-life (EOL) care discussions challenging, especially with patients whose ethnicities differ from their own. Currently, there is little guidance on how to initiate and facilitate such discussions with older Chinese Americans (≥55 years) and their families.

Objective:

To explore communication strategies for HCPs to initiate EOL care discussions with older Chinese Americans in the San Francisco Bay Area.

Design:

This qualitative (focused) ethnographic study included field observations and individual semistructured interviews with 14 community-dwelling older Chinese Americans who lived independently at home, 9 adult children, and 7 HCPs. Responses were analyzed using open coding, memos, and comparison across participants.

Results:

The study participants emphasized the importance of assessing readiness for early EOL care discussions. All recommended using indirect communication approaches to determine older Chinese Americans’ readiness. Indirect communication can be culturally targeted and applied at both system-wide (ie, health-care system) and individual (ie, HCP) levels. To institutionalize the practice, health-care facilities should implement EOL care discussion inquiries as part of routine during check-in or intake questionnaires. In individual practice, using depersonalized communication strategies to initiate the discussion was recommended to determine older Chinese Americans’ readiness.

Conclusion:

Assessing readiness should be an essential and necessary action for early EOL care discussions. Culturally targeted assessment of older Chinese Americans includes using indirect communication approaches to initiate an EOL care discussion to determine their readiness. In addition to health-care system integration, providers should implement and evaluate proposed EOL discussion initiation prompts with their older Chinese American patients.
The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review
Authors: Smith Madison B. , Macieira Tamara G. R. , Bumbach Michael D. , Garbutt Susan J. , Citty Sandra W. , Stephen Anita , Ansell Margaret , Glover Toni L. , Keenan Gail
Published: March 2018

Objectives:

To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families.

Background:

Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills.

Methods:

Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role.

Results:

Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices.

Conclusion:

While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.
Palliative Care Matters: Lessons From the Loss of a Facility Dog
Authors: Holman Elizabeth , Levy Cari , Kennedy Brenda
Published: March 2018

Animal-assisted intervention is gaining attention as a stress reduction modality. Quantitative data demonstrate its effectiveness, as a recent study published in AJHPM supported that a Veterans Affairs (VA) hospital facility dog paired with a palliative care psychologist had a measurable impact on salivary cortisol levels and heart rate in hospitalized veterans. There remains an important role for qualitative insights. The Denver VA palliative care team learned a range of lessons from the sudden loss of their facility dog, many of which relate directly to palliative care. The importance of communication, adjusting to changing teams, and the need for consultation and support based in shared goals and values all became evident in the course of the facility dog’s illness. After her death, lessons shifted to grief and loss and how providers, patients, and a community care for each other. People’s connection to the facility dog ultimately proved to be a critical factor in helping them connect with one another.
Optimal Antithrombin Activity Threshold for Initiating Antithrombin Supplementation in Patients With Sepsis-Induced Disseminated Intravascular Coagulation: A Multicenter Retrospective Observational Study
Authors: Hayakawa Mineji , Yamakawa Kazuma , Kudo Daisuke , Ono Kota
Published: March 2018

Low-dose antithrombin supplementation therapy (1500 IU/d for 3 days) improves outcomes in patients with sepsis-induced disseminated intravascular coagulation (DIC). This retrospective study evaluated the optimal antithrombin activity threshold to initiate supplementation, and the effects of supplementation therapy in 1033 patients with sepsis-induced DIC whose antithrombin activity levels were measured upon admission to 42 intensive care units across Japan. Of the 509 patients who had received antithrombin supplementation therapy, in-hospital mortality was significantly reduced only in patients with very low antithrombin activity (≤43%; bottom quartile; adjusted hazard ratio: 0.603; 95% confidence interval: 0.368-0.988; P = .045). Similar associations were not observed in patients with low, moderate, or normal antithrombin activity levels. Supplementation therapy did not correlate with the incidence of bleeding requiring transfusion. The adjusted hazard ratios for in-hospital mortality increased gradually with antithrombin activity only when initial activity levels were very low to normal but plateaued thereafter. We conclude that antithrombin supplementation therapy in patients with sepsis-induced DIC and very low antithrombin activity may improve survival without increasing the risk of bleeding.
Postthrombotic Syndrome in Patients Treated With Rivaroxaban or Warfarin for Venous Thromboembolism
Authors: Coleman Craig I. , Beyer-Westendorf Jan , Bunz Thomas J. , Mahan Charles E. , Spyropoulos Alex C.
Published: March 2018

Postthrombotic syndrome (PTS) is a frequent complication of venous thromboembolism (VTE). Using MarketScan claims data from January 2012 to June 2015, we identified adults with a primary diagnosis code for VTE during a hospitalization/emergency department visit, ≥6 months of insurance coverage prior to the index event and newly started on rivaroxaban or warfarin within 30 days of the index VTE. Patients with <4-month follow-up postindex event or a claim for any anticoagulant during 6-month baseline period were excluded. Differences in baseline characteristics between rivaroxaban and warfarin users were adjusted for using inverse probability of treatment weights based on propensity scores. Patients were followed for the development of PTS starting 3 months after the index VTE. Cox regression was performed and reported as hazard ratios with 95% confidence intervals (CIs). In total, 10 463 rivaroxaban and 26 494 warfarin users were followed for a mean of 16 ± 9 (range, 4-39) months. Duration of anticoagulation was similar between cohorts (median = 6 months). Rivaroxaban was associated with a 23% (95% CI: 16-30) reduced hazard of PTS versus warfarin. Rivaroxaban was associated with a significant risk reduction in symptoms of PTS compared to warfarin in patients with VTE treated in routine practice.
Hepatic Adenoma Arising in a Patient With Alagille Syndrome: A Case Report
Authors: Pacheco M Cristina , Monroe Eric J , Horslen Simon P
Published: March 2018

Alagille syndrome is associated with decreased bile ducts, cardiac abnormalities, vertebral body fusion defects, and a typical facies. While regenerative nodules and hepatocellular carcinoma have been described in these patients, hepatic adenoma has not. Herein, we present a patient with Alagille syndrome caused by a mutation in NOTCH2 with a hepatic adenoma. The clinical, imaging, and histologic features are discussed.
Altered DNA Methylation Patterns Associated With Clinically Relevant Increases in PTSD Symptoms and PTSD Symptom Profiles in Military Personnel
Authors: Martin Christiana , Cho Young-Eun , Kim Hyungsuk , Yun Sijung , Kanefsky Rebekah , Lee Hyunhwa , Mysliwiec Vincent , Cashion Ann , Gill Jessica
Published: March 2018

Military personnel experience posttraumatic stress disorder (PTSD), which is associated with differential DNA methylation across the whole genome. However, the relationship between these DNA methylation patterns and clinically relevant increases in PTSD severity is not yet clearly understood. The purpose of this study was to identify differences in DNA methylation associated with PTSD symptoms and investigate DNA methylation changes related to increases in the severity of PTSD in military personnel. In this pilot study, a cross-sectional comparison was made between military personnel with PTSD (n = 8) and combat-matched controls without PTSD (n = 6). Symptom measures were obtained, and genome-wide DNA methylation was measured using methylated DNA immunoprecipitation (MeDIP-seq) from whole blood samples at baseline and 3 months later. A longitudinal comparison measured DNA methylation changes in military personnel with clinically relevant increases in PTSD symptoms between time points (PTSD onset) and compared methylation patterns to controls with no clinical changes in PTSD. In military personnel with elevated PTSD symptoms 3 months following baseline, 119 genes exhibited reduced methylation and 8 genes exhibited increased methylation. Genes with reduced methylation in the PTSD-onset group relate to the canonical pathways of netrin signaling, Wnt/Ca+ pathway, and axonal guidance signaling. These gene pathways relate to neurological disorders, and the current findings suggest that these epigenetic changes potentially relate to PTSD symptomology. This study provides some novel insights into the role of epigenetic changes in PTSD symptoms and the progression of PTSD symptoms in military personnel.
Primer in Genetics and Genomics, Article 7—Multifactorial Concepts: Gene–Gene Interactions
Authors: Stanfill Ansley Grimes , Starlard-Davenport Athena
Published: March 2018

Most common disorders affecting human health are not attributable to simple Mendelian (single-gene) inheritance patterns. Rather, the risk of developing a complex disease is often the result of interactions across genes, whereby one gene modifies the phenotype of another gene. These types of interactions can occur between two or more genes and are referred to as epistasis. There are five major types of epistatic interactions, but in human genetics, additive epistasis is most often discussed and includes both positive and negative subtypes. Detecting epistatic interactions can be quite difficult because seemingly unrelated genes can interact with and influence each other. As a result of this complexity, statistical geneticists are constantly developing new methods to enhance detection, but there are disadvantages to each proposed method. In this article, we explore the concept of epistasis, discuss different types of epistatic interactions, and provide a brief introduction to statistical methods researchers use to uncover sets of epistatic interactions. Then, we consider Alzheimer’s disease as an exemplar for a disease with epistatic effects. Finally, we provide helpful resources, where nurses can learn more about epistasis in order to incorporate these methods into their own program of research.
Single-Cell Transcriptomics Reveals Regulators of Neuronal Migration and Maturation During Brain Development
Authors: Pensold Daniel , Zimmer Geraldine
Published: March 2018

The correct establishment of inhibitory circuits is crucial for cortical functionality and defects during the development of γ-aminobutyric acid–expressing cortical interneurons contribute to the pathophysiology of psychiatric disorders. A critical developmental step is the migration of cortical interneurons from their site of origin within the subpallium to the cerebral cortex, orchestrated by intrinsic and extrinsic signals. In addition to genetic networks, epigenetic mechanisms such as DNA methylation by DNA methyltransferases (DNMTs) are suggested to drive stage-specific gene expression underlying developmental processes. The mosaic structure of the interneuron generating domains producing a variety of interneurons for diverse destinations complicates research on regulatory instances of cortical interneuron migration. To this end, we performed single-cell transcriptome analysis revealing Dnmt1 expression in subsets of migrating interneurons. We found that DNMT1 preserves the migratory morphology in part through transcriptional control over Pak6 that promotes neurite complexity in postmigratory cells. In addition, we identified Ccdc184, a gene of unknown function, to be highly expressed in postmitotic interneurons. Single-cell mRNA sequencing revealed a positive correlation of Ccdc184 with cell adhesion–associated genes pointing to potential implications of CCDC184 in processes relying on cell-cell adhesion–like migration or morphological differentiation of interneurons that deserves further investigations.
Real Entertainment: New Factual Hybrid Television
Authors: Roscoe Jane
Published: March 2018

Popular factual entertainment has changed the face of broadcasting in Australia. Where once dramas, long-running serials and current affairs programs filled prime-time scehdules, we now have docu-soaps such as Popstars, and reality gameshows like Big Brother. While some have expressed concern about this shift to light entertainment in factual programming, it can be argued that such programs have brought a new audience to non-fiction and revitalised debates concerning the real. This paper examines some of the current trends in popular factual entertainment programming, considers their innovations and explores why they are so compelling.
Effects of classroom acoustics on speech intelligibility and response time: A comparison between native and non-native listeners
Authors: Lam Alice , Hodgson Murray , Prodi Nicola , Visentin Chiara
Published: March 2018

This study evaluates the speech reception performance of native (L1) and non-native (L2) normal-hearing young adults in acoustical conditions containing varying amounts of reverberation and background noise. Two metrics were used and compared: the intelligibility score and the response time, taken as a behavioral measure of listening effort. Listening tests were conducted in auralized acoustical environments with L1 and L2 English-speaking university students. It was found that even though the two groups achieved the same, close to the maximum accuracy, L2 participants manifested longer response times in every acoustical condition, suggesting an increased involvement of cognitive resources in the speech reception process.
Supply chain finance risk management
Authors: Chen Yenming J , Tsai Henry , Liu Yi-Fen
Published: March 2018

Based on mechanism design theory on asymmetric information, this study devises a selectable menu of contracts with price discounts and trade credit rates and proposes strategies for mitigating the risk of payment default when a tourism service provider trades with unfamiliar tour operators. Tourism service providers are suggested to remain conservative under a positive economic condition and progressive under a moderate economic condition when engaging in a new business opportunity. However, a fringe level of progressivism may be maintained under a moderate economy and a low-risk environment. The net benefit of tourism service providers increases when the bank rate is high, and the profit of the entire tourism channel increases when the percentage or ability to pay reliable agents is high.
Managing professional knowledge boundaries during ECHO telementoring consultations in two Veterans Affairs specialty care liver clinics: A theme-oriented discourse analysis
Authors: Koenig Christopher J , Wenger Matthew , Graham Glenn D , Asch Steven , Rongey Catherine
Published: March 2018

Introduction

Consultations are the traditional method of communication between generalist and specialist providers managing patients with specialty care needs. Traditional written consultations have limitations, including inadequate clinical information and inappropriate, or unclear consultation questions. Teleconsultations minimize these limitations through real-time communication between generalist and specialist providers to actively manage professional knowledge boundaries about specialty care problems.

Methods

We video-recorded 37 teleconsultation sessions, resulting in 115 consultations between generalist and specialty care providers participating in Veterans Affairs (VA) Extension for Community Healthcare Outcomes (ECHO) liver clinics. Data were collected at two US sites across nine months to observe consultation communication among 33 primary care generalists and three liver specialists. Video recordings were transcribed verbatim and analysed using theme-oriented discourse analysis to characterize consultation question content and format.

Results

Generalists' consultation question content addressed a range of topics, including treatment, diagnosis, interpreting results, patient communication, screening and surveillance, and care coordination. Some generalists relied on descriptive narratives rather than a specific question to convey complex patient cases. Consultation question format showed nearly even division between targeting general medical knowledge and specialty care knowledge domains, including specialty care, medical, organizational, and experiential knowledge.

Discussion

Timely access to specialists through teleconsultation has the potential to transform specialty care delivery. This article examines provider-to-provider interactions to understand how the communication process contributes to knowledge management during teleconsultations. Video studies of health information technology use provide a rich opportunity for analysing real-time communication that may help improve cross-specialty collaboration and the coordinated management of patients with specialty care needs.
Can a phone call make a difference? Breastfeeding self-efficacy and nurse responses to mother’s calls for help
Authors: Gallegos Danielle , Cromack Ceridwen , Thorpe Karen J
Published: March 2018

Telephone support is a format that presents an opportunity to sustain breastfeeding at a time when mothers identify themselves as at risk of cessation. The interactive mechanisms by which support is provided have not, however, been well investigated. We aimed to identify characteristics of calls that support breastfeeding self-efficacy. Thematic analysis of 149 calls from mothers seeking help for breastfeeding made to a 24-hour parenting helpline over a four week period, in Brisbane, Australia. Call-takers were 12 qualified and experienced maternal and child health nurses. Calls classified according to changes in breastfeeding self-efficacy across the call were thematically analysed to identify distinguishing interactional characteristics. Key interactional characteristics that served to build self-efficacy were privileging the mother, teamwork and credible affirmation while those that failed to build self-efficacy were laissez-faire affirmation and pragmatic problem-solving responses. Nurse responses that undermined caller self-efficacy conceptualized breastfeeding as a problem. Telephone helplines have potential to enhance mothers’ confidence and sustain breastfeeding when there is a call for help, this study highlights that the style of interaction is critical. The findings identify the need for specific training to increase awareness of interactional styles and delivery of advice through telehealth formats.
The moderating effect of income on the relationship between body mass index and health-related quality of life in Northern Sweden
Authors: Ramadani Royasia Viki , Mosquera Paola A. , Sebastián Miguel San , Gustafsson Per E.
Published: March 2018

Objectives: This study aimed to investigate the relationship between body mass index (BMI) and health-related quality of life (HRQoL) and whether this relationship is influenced by the level of income in Northern Sweden. Overweight and obesity are rising major public health problems which also affect HRQoL. While socioeconomic inequalities in health are persisting or increasing in many countries, including Sweden, little attention has been paid to the more complex roles of income in relation to health. Methods: Data were drawn from a 2014 cross-sectional survey from Northern Sweden (Health on Equal Terms), comprising individuals aged 20–84 years ( N = 20,082 individuals included for analysis). BMI and HRQoL were self-reported and individual disposable income in 2012 was retrieved from population registers. Multiple linear regressions were performed with HRQoL scores regressed on BMI and income, their interaction and additional covariates. Results: The underweight, overweight and obesity groups reported significantly lower HRQoL compared to the normal weight group. Moreover, the relationship between BMI and HRQoL varied significantly by level of income, with a stronger association among those with the lowest level of income. Conclusions: Income has a role as an effect modifier in the relationship between BMI and HRQoL that can be construed as an indirect income inequality. Efforts to promote HRQoL in populations should consider the different impact of being overweight and obese in different socioeconomic groups.