bluuebunny/crossref_metadata_2025 huggingface dataset:
Meta-analysis of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement
Authors: Liu Guang , Hou Wenbo , Zhou Chao , Yin Yuxia , Lu Shoutao , Duan Cuihai , Li Maoquan , Toft Egon Steen , Zhang Haijun
Published: March 2019

Background:

Recently, intracavitary electrocardiogram technology has been applied to peripherally inserted central catheter placement and demonstrates many potential advantages. However, the tip positioning accuracy of intracavitary electrocardiogram technology compared to conventional X-ray method is unknown.

Objective:

We did a meta-analysis to compare the tip positioning accuracy between intracavitary electrocardiogram technology and conventional X-ray method.

Data sources:

We searched several databases, including Cochrane Library, PubMed, Web of science, and Embase. Additional studies were identified through hand searches of bibliographies and Internet searches. All human studies published in full text, abstract, or poster form were eligible for inclusion. Search terms included peripherally inserted central catheter, PICC, intracavitary electrocardiogram, IC-ECG, EKG, ECG, and catheter tip location.

Study eligibility criteria:

Only randomized controlled trials of using intracavitary electrocardiogram technology versus X-ray method for peripherally inserted central catheter placement were included. All studies included adult patients aged at least 18 years.

Study appraisal and synthesis methods:

Independent extraction of articles by two authors using predefined data fields, including study quality indicators. Of the 178 citations identified, 5 studies that included 1672 patients met the eligibility criteria. It was found that statistical heterogeneity existed among the various studies (I2 = 16%, p < 0.00001); therefore, the fixed effect model was used in the meta-analysis (p < 0.05). The meta-analysis compared the tip positioning accuracy between intracavitary electrocardiogram technology and X-ray method and showed that intracavitary electrocardiogram technology had a better positioning accuracy (odds ratio: 2.88, 95% confidence interval: 2.15–3.87, p < 0.0001).

Limitations:

Only five randomized trial met inclusion criteria, and the lack of an incomplete search led to the publication bias seen in these results.

Conclusion:

The intracavitary electrocardiogram method had a more favorable positioning accuracy versus traditional X-ray method for peripherally inserted central catheter placement in adult patients. The intracavitary electrocardiogram can be a promising technique to guide tip positioning of peripherally inserted central catheter.
Ambiguous intimacy as queer potential: touch, desire and adolescence in She Monkeys
Authors: Bradbury-Rance Clara
Published: March 2019

This article analyses the ambiguous intimacies generated by the competition that permeates desire in Lisa Aschan’s She Monkeys (2011). The article argues that in a new corpus of films about adolescence, the queerness of lesbian desire is evoked as a series of affects outside of figurative norms. Desire meets and is confused with other affects such as envy and disgust, all of which attach, sometimes simultaneously, to objects that do not always seem to recognise or permit them. Slow and languid scenes reveal desire’s potential but rarely its achievement. The article explores the erotic potential of those intimacies that reside in the spaces between bodies, asking what happens to that potential when it is generated but immediately contained by the negotiations of control. In dialogue with psychoanalytic work on the ambivalent relations between desire, envy, attachment and idealisation, the article advances a reading of an affective mode of filmmaking that is saturated with desire but not defined by desire’s labelling.
Not scraping the bottom of the barrel: Disadvantage, diversity and deficit as rich points
Authors: Hale Adrian
Published: March 2019

First-year students’ literacy deficits are not the problem. They are emblematic of an overall skill set which can be scaffolded from the first year of university study. If we treat literacy deficits as contingent upon other items of motivation, and as an element of Academic Motivational Literacy, we can usually also see these deficits as ‘rich points’ ( Agar (2000) Border lessons: linguistic “rich points” and evaluative understanding. New Directions for Evaluation 2000: 93–109.). That is, in many cases, students have a desire to succeed, and we can typically build from one or more literacies to greater motivation and success in other areas. Or, to put it another way, a deficit might be a problem, but it is also an opportunity. This concept, of targeting weaknesses to build overall confidence, underpins the approach taken in a first-year subject for a cohort of students who are particularly disadvantaged, diverse and underconfident. This paper will present examples of programs undertaken in this course over the space of six years which addressed each need as an opportunity, and it will provide evidence to show that success, in student retention, in overall grade distributions, and in student satisfaction, was the result.
Populist Peril to Democracy: The Sacralization and Singularization of Competitive Elections
Authors: Sozen Yunus
Published: March 2019

In this article, I critically engage with the populism literature, and predicated on a conceptualization of modern democracy as a mixed regime (combining oligarchy and democracy), I provide a mechanism to connect populism-in-power to authoritarianism. As such, I elucidate a particular populist path to authoritarianism in a competitive setting by exploring two questions. First, what is the impact of populism-in-power on the modern democratic mixed regime? Second, what is the locus of populism in a modern democratic institutional framework? Utilizing the Turkish and Argentinean cases as illustrative examples of populism-in-power, I conclude that, first, unless a populist vision is accompanied by democratic institutions outside of the spectrum that modern democracy offers, when that vision which sacralizes and singularizes competitive elections becomes preponderant, it will lead to the opposite of its claim of making the people sovereign, and instead will make the rulers sovereign. Second, I argue that although there is no internal contradiction between modern democracy’s liberal or constitutional and democratic elements, there is still a paradox surrounding modern democracy. This paradox is found between the sources of its imaginative appeal and its practice as a mixed regime, and this is where we should place the perennial potential of populism.
Adjuvant Hyperbaric Oxygen Therapy Enhances Healing of Nonischemic Diabetic Foot Ulcers Compared With Standard Wound Care Alone
Authors: Salama Shimaa Elhossieny , Eldeeb Ali Eid , Elbarbary Ahmed Husseiny , Abdelghany Salwa Elmorsy
Published: March 2019

Recent systematic reviews and meta-analyses have produced conflicting results about the efficacy of hyperbaric oxygen therapy (HBOT) in improving the healing rate for chronic diabetic foot wounds. This study aimed to assess the efficacy of systemic HBOT in healing of chronic nonischemic diabetic foot ulcer. Thirty adult patients having Wagner’s grade 2 or 3 chronic diabetic foot ulcers, in whom the response to 30 days of standard wound care was not favorable, were prospectively randomized to have either HBOT (20-40 sessions) plus conventional treatment (n = 15) or conventional treatment alone (n = 15). Ischemic wounds and patients with contraindications to systemic HBOT were excluded. The primary end point was complete healing of the target ulcer. Secondary endpoints included the following: rate of ulcer healing at the end of treatment period and at 4 and 8 weeks thereafter as well as rate of amputation. A significantly greater percentage of HBOT-treated wounds (33.3%, 5/15) achieved complete closure than conventional therapy–treated wounds (0%, 0/15; P = .014) at the end of treatment. This significant difference was maintained throughout the 8 weeks of follow-up. Complications frequency was nonsignificantly different between both groups. Our study showed that HBOT plus conventional therapy appears as safe as and probably more effective than conventional therapy alone for the healing of chronic nonischemic diabetic foot wounds. Larger studies are required to confirm its specific indications.
Microbiome Imbalances: An Overlooked Potential Mechanism in Chronic Nonhealing Wounds
Authors: Pang Mengru , Zhu Meishu , Lei Xiaoxuan , Xu Pengcheng , Cheng Biao
Published: March 2019

Chronic nonhealing wounds are a severe burden to health care systems worldwide, causing millions of patients to have lengthy hospital stays, high health care costs, periods of unemployment, and reduced quality of life. Moreover, treating chronic nonhealing wounds effectively and reasonably in countries with limited medical resources can be extremely challenging. With many outstanding questions surrounding chronic nonhealing wounds, in this review, we offer changes to the microbiome as a potentially ignored mechanism important in the formation and treatment of chronic wounds. Our analysis helps bring a whole new understanding to wound formation and healing and provides a potential breakthrough in the treatment of chronic nonhealing wounds in the future.
Predicting the costs of war
Authors: Henrickson Phil
Published: March 2019

The expected cost of war is a foundational concept in the study of international conflict. However, the field currently lacks a measure of the expected costs of war, and thereby any measure of the bargaining range. In this paper, I develop a proxy for the expected costs of war by focusing on one aspect of war costs – battle deaths. I train a variety of machine learning algorithms on battle deaths for all countries participating in fatal military disputes and interstate wars between 1816 and 2007 in order to maximize out-of-sample predictive performance. The best performing model (random forest) improves performance over that of a null model by 25% and a linear model with all predictors by 9%. I apply the random forest to all interstate dyads in the Correlates of War dataverse from 1816 to 2007 in order to produce an estimate of the expected costs of war for all existing country pairs in the international system. The resulting measure, which I refer to as Dispute Casualty Expectations, can be used to fully explore the implications of the bargaining model of war, as well as allow applied researchers to develop and test new theories in the study of international relations.
Are Men Making Informed Decisions According to the Prostate-Specific Antigen Test Guidelines? Analysis of the 2015 Behavioral Risk Factor Surveillance System
Authors: Cooper Dexter L. , Rollins Latrice , Slocumb Tanesha , Rivers Brian M.
Published: March 2019

The prostate-specific antigen (PSA) screening recommendation endorses the opportunity for men to make an informed decision about whether or not to screen. This entails speaking with a provider to discuss the potential advantages, disadvantages, and uncertainties about the PSA screening test. The purpose of this study was to examine (a) the reported level of being informed about the PSA test by race and (b) the association between the receipt of the PSA test and participants reporting that they were informed about the test. U.S. adult males (ages 40–74 years) were identified from the 2015 Behavioral Risk Factors Surveillance System (BRFSS; n = 3,877). Chi-square analysis assessed bivariate differences among men who received different levels of PSA screening information. Binomial logistic regression models assessed the relationship of race/ethnicity and the receipt of the PSA test on being informed about the PSA test. Over half (54.3%) of the sample had a PSA test and most (72.0%) reported that they did not receive information about both the advantages and disadvantages (being informed) of the PSA test. Black men (40.3%) were significantly most likely to report being informed ( p < .001), and 61.3% reported receipt of a recommendation from their provider ( p < .001). White men (63.1%) were significantly more likely to report receiving the PSA test. Findings indicate that more men reported receiving the PSA test than men who reported being informed about it. Future research and interventions should strive for men of all racial and ethnic backgrounds to be informed about the PSA test before making a decision.
Prospective Study on Sexual Dysfunction in Male Chinese Liver Transplant Recipients
Authors: Chan Miu Yee , Chok Kenneth Siu Ho , Fung James Yan Yue , Ng Sau Loi , Yiu Ming Kwong , Lo Chung Mau
Published: March 2019

In patients with end-stage liver disease, hypogonadism and erectile dysfunction are often seen. This study was to determine the incidence of erectile dysfunction before and after liver transplantation (LT) with correlation to change in sex hormone levels from a Chinese cohort. This prospective longitudinal study was registered with The University of Hong Kong Clinical Trials Centre (HKUCTR-1563). The Institutional Review Board approval number is UW-12-273. The study period was from January 2012 to December 2016. Adult male patients with end-stage liver disease enlisted for LT were recruited on informed written consent. All recruited patients were to complete a cross-sectional cohort questionnaire—International Index of Erectile Function, version 5 (IIEF5)—and to receive serum sex hormone checks before and after LT. Twenty-eight patients who underwent LT were included in the analysis. The included patients had significantly reduced prolactin ( p < .001) and 17-beta-estradiol ( p = .024) after LT. There was also a significant drop of IIEF5 score at 1 month after LT, but the score returned to pre-LT level at 6 months. This study demonstrated that there was improvement in sex hormone levels after LT, namely, normalization of estradiol level and lowering of prolactin and progesterone levels. However, improvement in sex hormone levels did not translate into improvement of erectile dysfunction.
Downregulation of glucose-6-phosphate dehydrogenase contributes to diabetic neuropathic pain through upregulation of toll-like receptor 4 in rats
Authors: Sun Qian , Zhang Bing-Yu , Zhang Ping-An , Hu Ji , Zhang Hong-Hong , Xu Guang-Yin
Published: March 2019

Background and aim

Diabetic neuropathic pain is a refractory and disabling complication of diabetes mellitus. The pathogenesis of the diabetic neuropathic pain is still unclear, and treatment is insufficient. The aim of this study is to investigate the roles of glucose-6-phosphate dehydrogenase (G6PD) and toll-like receptor 4 (TLR4) in neuropathic pain in rats with diabetes.

Methods

Type 1 diabetes model was induced by intraperitoneal injection of streptozotocin (STZ, 75 mg/kg) in adult female Sprague-Dawley rats. Paw withdrawal threshold and paw withdrawal latency of rats were measured by von Frey filaments and thermal radiation, respectively. The expressions of G6PD and TLR4 in L4-L6 dorsal root ganglions (DRGs) were measured by western blotting and quantitative real-time polymerase chain reaction analysis. Fluorescent immunohistochemistry was employed to detect expressions of G6PD and TLR4 and co-location of G6PD with TLR4.

Results

The mRNA and protein expression levels of G6PD in DRGs were significantly decreased in diabetic rats when compared with age-matched control rats. Upregulation of G6PD by intrathecal injection of G6PD overexpression adenovirus markedly attenuated hindpaw pain hypersensitivity of diabetic rats. The mRNA and protein expression levels of TLR4 in DRGs of diabetic rats were significantly increased when compared with control rats. Intrathecal injection of TLR4-selective inhibitor CLI-095 attenuated diabetic pain in dose- and time-dependent manners. Furthermore, G6PD and TLR4 were co-localized in DRG neurons. Intrathecal injection of G6PD overexpression adenovirus greatly reduced TLR4 expression, while intrathecal injection of CLI-095 had no significant effect on G6PD expression in diabetic rats.

Conclusions

Our results suggest that decrease in G6PD expression was involved in diabetic peripheral neuropathic pain, which was most likely through upregulation of TLR4 expression in the DRGs of rats.
Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making
Authors: Anderson Natalie Elizabeth , Slark Julia , Gott Merryn
Published: March 2019

Background

Clinical decision making is a complex, but important, research area. Decision-making theories have evolved to recognise that, although heuristics and biases can lead to error, expert clinician decision makers can also use intuition to good effect. More research is needed to understand how nurses and other clinicians make sense of complexity and uncertainty.

Aim

This paper discusses the utility of interpretative phenomenological analysis to elucidate clinical decision making, expertise and intuition.

Methods

A narrative review of published interpretative phenomenological analysis studies exploring clinical decision-making, and discussion of an exemplar study.

Results

A limited number of interpretative phenomenological analysis studies have been published in this area. By seeking out descriptions of real-world decision making, interpretative phenomenological analysis research provides ecologically valid insights into what it is like to make time-critical, high-stakes decisions with limited information.

Conclusion

Contributing to the study of complex clinical decision making in combination with other research approaches, interpretative phenomenological analysis research has significant unrealised potential to inform education, assessment and support interventions and the development of clinical guidelines. Future applications could enhance understanding of multi-disciplinary decision-making and the development of expertise and intuition, over time.
Sexuality as taboo: using interpretative phenomenological analysis and a Foucauldian lens to explore fathers’ practices in talking to their children about puberty, relationships and reproduction
Authors: Bennett Clare , Harden Jane
Published: March 2019

Background

Fathers can play an important role in their children’s learning about relationships and sexuality but we know very little about the father’s lived experience in this regard.

Aim

To explore eight fathers’ perceptions and experiences of discussing puberty, relationships and reproduction with their 10-year-old children.

Methods

The paper commences with a genealogical analysis of the history of sex education in England from the Public Health Act of 1848 to the present day. Interpretative phenomenological analysis (IPA) was used as both a methodology and a method. Face-to-face interviews were conducted with each father and results were analysed ideographically, followed by analysis across the group. Interpretations were developed using a Foucauldian lens of governmentality and biopower.

Findings

The paper explores how synthesis of IPA with a Foucauldian lens revealed significant tensions between the fathers’ cognitions, accounts and behaviours, which were underpinned by an enduring perception of sexuality as taboo.

Conclusion

By providing a contextualised understanding of the fathers’ practices, this study demonstrates that a more informed approach to health promotion strategy can be achieved and the implications for nursing are explored.
An interpretative phenomenological analysis of young men’s experiences of addressing their sexual health and the importance of researcher reflexivity
Authors: Sydor Anna
Published: March 2019

Background

Incidence of sexually transmitted infections has increased in both young men and young women. Young men do not access sexual health services in the same numbers as young women, this study sought to discover young men’s experiences.

Aims

This paper reports one overarching theme from an interpretative phenomenological study that sought to discover the experiences of young males (aged 20–24) addressing or failing to address their sexual health. Owing to the sensitive subject under investigation, these participants were hard to reach for research purposes.

Methods

This study used interpretative phenomenological analysis and the researcher was a young female (aged 20–30), in contrast with participants. This affected data collection and analysis so the importance of reflexivity in interpretative phenomenological analysis is discussed here.

Results

Six superordinate themes were identified: sexual health knowledge and attitudes; feelings about masculinities; communication; feelings about healthcare; feelings about working; and keeping fit. From these, three overarching themes were developed, these reflect the depth of data analysis undertaken. One of these themes, the ‘hidden moral code’, and the importance of researcher reflexivity in its identification are discussed here.

Conclusions

It is suggested that interpretative phenomenological analysis is a particularly suitable method for nursing research, which allows and embraces the influence and attributes of the researcher. This paper considers one superordinate theme in depth, chosen because the researcher’s attributes are a significant factor in its recognition.
False Equivalence: Are Liberals and Conservatives in the United States Equally Biased?
Authors: Baron Jonathan , Jost John T.
Published: March 2019

On the basis of a meta-analysis of 51 studies, Ditto et al. (this issue, p. 273) conclude that ideological bias is equivalent on the left and right of U.S. politics. In this commentary, we contend that this conclusion does not follow from the review and that Ditto and his colleagues are too quick to embrace a false equivalence between the liberal left and the conservative right. For one thing, the issues, procedures, and materials used in the studies reviewed by Ditto and his colleagues were selected for purposes other than the inspection of ideological asymmetries. Consequently, methodological choices made by researchers were systematically biased to avoid producing differences between liberals and conservatives. We also consider the broader implications of a normative analysis of judgment and decision making and demonstrate that the bias examined by Ditto and his colleagues is not, in fact, an irrational bias, and that it is incoherent to discuss bias in the absence of standards for assessing accuracy and consistency. Other conclusions about domain-general asymmetries in motivated social cognition have suggested that epistemic virtues are more prevalent among liberals than conservatives, and these conclusions are closer to the truth of the matter when it comes to current American politics. Finally, we question the notion that the research literature in psychology is necessarily characterized by liberal bias, as several authors have claimed.
Partisan Bias and Its Discontents
Authors: Ditto Peter H. , Clark Cory J. , Liu Brittany S. , Wojcik Sean P. , Chen Eric E. , Grady Rebecca H. , Celniker Jared B. , Zinger Joanne F.
Published: March 2019

Baron and Jost (this issue, p. 292) present three critiques of our meta-analysis demonstrating similar levels of partisan bias in liberals and conservatives: (a) that the studies we examined were biased toward finding symmetrical bias among liberals and conservatives, (b) that the studies we examined do not measure partisan bias but rather rational Bayesian updating, and (c) that social psychology is not biased in favor of liberals but rather toward creating false equivalencies. We respond in turn that (a) the included studies covered a wide variety of issues at the core of contemporary political conflict and fairly compared bias by establishing conditions under which both liberals and conservatives would have similar motivations and opportunities to demonstrate bias; (b) we carefully selected studies that were least vulnerable to Bayesian counterexplanation, and most scientists and laypeople consider these studies demonstrations of bias; and (c) there is reason to be vigilant about liberal bias in social psychology, but this does not preclude concerns about other possible biases, all of which threaten good science. We close with recommendations for future research and urge researchers to move beyond broad generalizations of political differences that are insensitive to time and context.
Spatial–musical association of response codes without sound
Authors: Ariga Atsunori , Saito Shiori
Published: March 2019

Humans tasked with pressing a key on a computer keyboard in response to a pitch can respond more quickly to a high-pitched sound by pressing a key higher on the keyboard and to a low-pitched sound by pressing a lower key, compared with the opposite configuration. This so-called spatial–musical association of response codes (SMARC) has been considered to reflect the spatial coding of sound pitch rather than to be an artefact of the verbal labels denoting spatial positions for localising sounds. In this study, we completely excluded the latter possibility, that is, the directional effects of automatic sound localisation on the SMARC effect. We did this by examining whether the SMARC effect occurs without sound; that is, we investigated whether the effect would be elicited by written pitch names alone. We found that when musically trained participants judged pitch height labelled by visually presented word stimuli, the SMARC effect still occurred. This also happened among musically naïve participants when the height of the pitch was explicitly comparable with that of a referential pitch. We also found that musically trained participants exhibited the SMARC effect in response to pitch names even when the indicated pitch height was irrelevant to the task they were asked to perform. These results suggest that the SMARC effect can occur at the semantic level in the absence of sound, clearly excluding the directional effects of automatic sound localisation.
Consistency influences altered auditory feedback processing
Authors: Franken Matthias K , Acheson Daniel J , McQueen James M , Hagoort Peter , Eisner Frank
Published: March 2019

Previous research on the effect of perturbed auditory feedback in speech production has focused on two types of responses. In the short term, speakers generate compensatory motor commands in response to unexpected perturbations. In the longer term, speakers adapt feedforward motor programmes in response to feedback perturbations, to avoid future errors. The current study investigated the relation between these two types of responses to altered auditory feedback. Specifically, it was hypothesised that consistency in previous feedback perturbations would influence whether speakers adapt their feedforward motor programmes. In an altered auditory feedback paradigm, formant perturbations were applied either across all trials (the consistent condition) or only to some trials, whereas the others remained unperturbed (the inconsistent condition). The results showed that speakers’ responses were affected by feedback consistency, with stronger speech changes in the consistent condition compared with the inconsistent condition. Current models of speech-motor control can explain this consistency effect. However, the data also suggest that compensation and adaptation are distinct processes, which are not in line with all current models.
Response-irrelevant number, duration, and extent information triggers the SQARC effect: Evidence from an implicit paradigm
Authors: Simmons Fiona , Gallagher-Mitchell Thomas , Ogden Ruth S
Published: March 2019

Spatial–Numerical Association of Response Codes (SNARC) and Spatial–Quantity Association of Response Codes (SQARC) effects are evident when people produce faster left-sided responses to smaller numbers, sizes, and durations and faster right-sided responses to larger numbers, sizes, and durations. SQARC effects have typically been demonstrated in paradigms where the explicit processing of quantity information is required for successful task completion. The current study tested whether the implicit presentation of task-irrelevant magnitude information could trigger a SQARC effect as has been demonstrated previously when task-irrelevant information triggers a SNARC effect. In Experiment 1, participants ( n = 20) made orientation judgements for triangles varying in numerosity and physical extent. In Experiment 2, participants ( n = 20) made orientation judgements for triangles varying in numerosity and for a triangle preceded by a delay of varying duration. SNARC effects were observed for the numerosity conditions of Experiments 1 and 2 replicating Mitchell et al. SQARC effects were also demonstrated for physical extent and for duration. These findings demonstrate that SQARC effects can be implicitly triggered by the presentation of the task-irrelevant magnitude.
Sex differences in stroke metrics among Southeast Asian countries: Results from the Global Burden of Disease Study 2015
Authors: Hwong Wen Yea , Bots Michiel L , Selvarajah Sharmini , Sivasampu Sheamini , Reidpath Daniel D , Law Wan Chung , Musa Kamarul Imran , Vaartjes Ilonca
Published: March 2019

Background

Sex differences in cardiovascular diseases generally disadvantage women, particularly within developing regions.

Aims

This study aims to examine sex-related differences in stroke metrics across Southeast Asia in 2015. Furthermore, relative changes between sexes are compared from 1990 to 2015.

Methods

Data were sourced from the Global Burden of Disease Study. Incidence and mortality from ischemic and hemorrhagic strokes were explored with the following statistics derived: (1) women-to-men incidence/mortality ratio and (2) relative percentage change in rate.

Results

Women had lower incidence and mortality from stroke compared to men. Notable findings include higher ischemic stroke incidence for women at 30–34 years in high-income countries (women-to-men ratio: 1.3, 95% CI: 0.1, 16.2 in Brunei and 1.3, 95% CI: 0.5, 3.2 in Singapore) and the largest difference between sexes for ischemic stroke mortality in Vietnam and Myanmar across most ages. Within the last 25 years, greater reductions for ischemic stroke metrics were observed among women compared to men. Nevertheless, women below 40 years in some countries showed an increase in ischemic stroke incidence between 0.5% and 11.4%, whereas in men, a decline from −4.2% to −44.2%. Indonesia reported the largest difference between sexes for ischemic stroke mortality; a reduction for women whereas an increase in men. For hemorrhagic stroke, findings were similar: higher incidence among young women in high-income countries and greater reductions for stroke metrics in women than men over the last 25 years.

Conclusions

Distinct sex-specific differences observed across Southeast Asia should be accounted in future stroke preventive guidelines.
The Theatrical Life and Death of Wych Street
Authors: Emeljanow Victor
Published: March 2019

In London’s Lost Theatres of the Nineteenth Century (1925), Errol Sherson describes Wych Street, located on the eastern periphery of the West End and within 200 metres of Drury Lane Theatre, as ‘one of the narrowest, dingiest and most disreputable thoroughfares the West End has ever known.’ By this time Wych Street had long disappeared, although its memory lingered. In a short story entitled ‘Where was Wych Street’ ( Strand Magazine, 1921), Stacy Aumonier attempted to recall the street’s existence and its significance. In the course of the story the street is identified in relation to two theatres – the Gaiety and the Globe – only the latter of which was connected to the street. Surprisingly, no reference is made to the Olympic Theatre with which Wych Street had been identified since the early nineteenth century or to the Opera Comique immediately adjacent to the Globe, highlighting the problematic role of memory in mapping historical space. This article examines the historical, theatrical and geographical mapping of Wych Street, bringing out contrasts, contradictions and paradoxes, and considering its role as part of the theatrical and extra-theatrical milieu of London.
Chemical disinfectants: Controversies regarding their use in low risk healthcare environments (part 1)
Authors: Curran Evonne T , Wilkinson Martyn , Bradley Tina
Published: March 2019

In recent years, the number of disinfectants designed to decontaminate healthcare environments and reusable, non-invasive care equipment (NICE) has increased markedly, making the selection of the most appropriate disinfectant a somewhat daunting prospect. In addition to the microbial challenge, there are numerous factors to consider including: efficacy; range and speed of activity; stability of the ingredients; compatibility of the disinfectant with surfaces; inactivation of the disinfectant by organic matter; method of application; convenience; health and safety concerns; and cost. While the microbial challenge continues to evolve, and novel disinfectants continue to emerge, guidance updates have been notably absent. Most healthcare surfaces belong to a UK-defined category of ‘low risk’ for which guidance dictates ‘cleaning and drying is usually sufficient’. This paper assesses the evidence and arguments regarding the use of disinfectants for low-risk healthcare surfaces. A novel subcategorisation of ‘low risk’ is presented to provide a more specific up-to-date disinfectant needs assessment.
Progressive left lower extremity weakness in a patient with multiple myeloma: A diagnostic dilemma
Authors: Sardar Muhammad , Shaikh Nasreen , Malik Saad Ullah , Faridi Warda , Balshan Eli , Maniar Mihir
Published: March 2019

Extramedullary plasmacytoma is a type of plasma cell dyscrasia that can present as solitary tumor or secondary to multiple myeloma. We experienced a case of intramuscular plasmacytoma in the left thigh muscles of a patient secondary to multiple myeloma. A 73-year-old male with relapsed multiple myeloma and bilateral hip arthroplasty complained of lxeft lower limb weakness and hip pain 3 months after relapse. He underwent contrast-enhanced magnetic resonance imaging of lumbar spine and hip which was inconclusive. Subsequently, patient had multiple admissions for progressive lower limb weakness. His clinical course was complicated by a biopsy-proven plasmacytoma of the neck. He received localized radiation therapy to the neck in addition to a change in multiple myeloma chemotherapy regimen, resulting in resolution of the neck mass but his left lower extremity weakness continued to worsen. Repeat magnetic resonance imaging of hip and spine revealed an intramuscular mass in left thigh which was consistent with the diagnosis of extramedullary plasmacytoma on biopsy. Localized radiation to the thigh accompanied with a change in chemotherapy improved his symptoms and a significant reduction in size of plasmacytoma was observed. When an unexplained lower limb weakness is encountered with a history of multiple myeloma, secondary intramuscular plasmacytoma should be considered.
Iatrogenic lumbar artery pseudoaneurysm after lumbar transpedicular fixation: Case report
Authors: Latka Kajetan , Zurawel Robert , Maj Boguslaw , Olbrycht Tomasz , Chowaniec Jacek , Latka Dariusz
Published: March 2019

Only a few cases of iatrogenic lumbar injury have been reported in the literature. A 58-year-old male with severe back pain was admitted to our department. The patient was qualified for the transpedicular stabilization with interbody fixation at L4/L5 and L5/S1 levels. On the first day after surgery, the patient was mobile and reported significant pain relief. He was discharged the same day. After 2 weeks, the patient returned with severe right lower abdominal pain and radicular pain in his right leg. He was administered to the Neurology Department where the presence of a lumbar muscle hematoma and lumbar artery pseudoaneurysm were discovered. He was transferred to the Vascular Surgery Department where aortography was performed and the pseudoaneurysm was embolized. After few days, the patient’s overall condition improved significantly. Eight weeks after surgery, he was pain-free. Our case shows how initially innocuous symptoms may be the result of serious complications.
Mitochondrial Respiratory Capacity is Restored in Hibernating Cardiomyocytes Following Co-Culture with Mesenchymal Stem Cells
Authors: Stone Laura L. Hocum , Chappuis Erin , Marquez Maribel , McFalls Edward O , Kelly Rosemary F. , Butterick Tammy
Published: March 2019

Hibernating myocardium is a subset of ischemic cardiac disease characterized by viable but dysfunctional tissue. Standard treatment for hibernating myocardium is coronary artery bypass graft, which reduces arrhythmias and improves survival but does not fully restore function, presenting a gap in currently available treatments. Large animal studies of hibernating myocardium have identified impaired mitochondrial dynamics as a root cause of persistent cardiac dysfunction despite surgical revascularization. This study presents a novel in vitro model of hibernating myocardium cardiomyocytes to study active mitochondrial respiration in hibernating myocardium cells, and to test the paracrine effect of mesenchymal stem cells on impaired mitochondrial function. Exposure of cardiomyocytes to hypoxic conditions of 1% oxygen for 24 hours resulted in a phenotype consistent with hibernating myocardium cardiac tissue, including decreased respiratory capacity under high work states, decreased expression of mitochondrial proteins, and preserved cellular viability. Co-culture of hibernating myocardium cardiomyocytes with mesenchymal stem cells restored mitochondrial respiratory function, potentially via an increase in proliferator-activated receptor gamma coactivator 1-alpha-driven mitochondrial biogenesis. Co-culture treatment of hibernating myocardium cardiomyocytes with mesenchymal stem cells shows improvement in both mitochondrial function and ATP production, both of which are critical for effectively functioning cardiac tissue. These results suggest that mesenchymal stem cell therapy as an adjunct treatment to revascularization may address the current gap in treatment for hibernating myocardium patients.
Work-Related Perceptions, Injuries, and Musculoskeletal Symptoms: Comparison Between U.S.-Educated and Foreign-Educated Nurses
Authors: Kim Kyung Mi , Lee Soo-Jeong
Published: March 2019

Immigrants account for a significant proportion of the nursing workforce in the United States (U.S.). Although different cultural backgrounds may affect immigrant nurses’ perceptions of work and occupational health risks, little research has been conducted. Defining immigrant nurses as those who received initial nursing education in foreign countries, this study examined the differences in work-related perceptions and experiences of musculoskeletal (MS) symptoms and injuries between U.S.-educated and foreign-educated nurses. We analyzed data from a cross-sectional study using a statewide random sample of 419 California registered nurses. Foreign-educated nurses reported a more positive safety climate ( p = .017) and perceived their jobs as less demanding ( p = .008) than did U.S.-educated nurses. The prevalence of work-related MS symptoms was significantly lower in foreign-educated nurses than in U.S.-educated nurses ( p = .044), but the difference was not significant in the multivariable analyses. Positive safety climate was significantly associated with a decreased risk of work-related MS symptoms and injuries, and this relationship was greater among U.S.-educated nurses than among foreign-educated nurses. Our findings suggest that immigrant nurses may have different perceptions about safety climate and job demand, which may modify their occupational health risks.
Reducing Radiation and Lowering Costs With a Standardized Care Pathway for Nonoperative Thoracolumbar Fractures
Authors: Hanson Gregory , Lyons Keith W. , Fournier Debra A. , Lollis S. Scott , Martin Eric D. , Rhynhart Kurt K. , Handel Wanda J. , McGuire Kevin J. , Abdu William A. , Pearson Adam M.
Published: March 2019

Study Design:

Retrospective observational study.

Objective:

There is marked variation in the management of nonoperative thoracolumbar (TL) compression and burst fractures. This was a quality improvement study designed to establish a standardized care pathway for TL fractures treated with bracing, and to then evaluate differences in radiographs, length of stay (LOS), and cost before and after the pathway.

Methods:

A standardized pathway was established for management of nonoperative TL burst and compression fractures (AOSpine classification type A1-A4 fractures). Bracing, radiographs, costs, complications, and LOS before and after pathway adoption were analyzed. Differences between the neurosurgery and orthopedic spine services were compared.

Results:

Between 2012 and 2015, 406 nonoperative burst and compression TL fractures were identified. A total of 183 (45.1%) were braced, 60.6% with a custom-made thoracolumbosacral orthosis (TLSO) and 39.4% with an off-the-shelf TLSO. The number of radiographs significantly reduced after initiation of the pathway (3.23 vs 2.63, P = .010). A total of 98.6% of braces were custom-made before the pathway; 69.6% were off-the-shelf after the pathway. The total cost for braced patients after pathway adoption decreased from $10 462.36 to $8928.58 ( P = .078). Brace-associated costs were significantly less for off-the-shelf TSLO versus custom TLSO ($1352.41 vs $3719.53, respectively, P < .001). The mean LOS and complication rate did not change significantly following pathway adoption. The orthopedic spine service braced less frequently than the neurosurgery service (40.7% vs 52.2%, P = .023).

Conclusions:

Standardized care pathways can reduce cost and radiation exposure without increasing complication rates in nonoperative management of thoracolumbar compression and burst fractures.
Geographical and temporal patterns of interstate security competition: Global and regional evidence
Authors: Jakobsen Jo , Halvorsen Thomas
Published: March 2019

This article tests what seems to be a reasonably widespread perception, namely, that the last few years have witnessed intensified interstate security competition in several of the world’s regions. Specifically, we investigate whether or not states’ military budgets tend to change as a function of changes to the armaments levels of neighbouring states, as the security dilemma model would suggest. We perform two empirical analyses. First, we specify a least square dummy variables model, whose results we map using standard geographic information system software. Our ‘hot spot’ analysis for the period 2008/2009–2014 suggests that action–reaction dynamics are present in the Middle East, Central and Southern Africa, and the South Caucasus. Neither South nor East or South East Asia is ridden by severe security competition. Europe generally forms a ‘cold spot’ region, indicating a lower-than-expected level of changes in arms spending. Second, our spatial lag model suggests the presence of action–reaction globally for the whole post-Cold War era, although results are still substantially driven by the last few years. Interstate security competition is now, apparently, an important element of international politics – albeit only in some regions. Our findings also reveal the potential for disarmament spirals.
Fueling rebellion: Maritime piracy and the duration of civil war
Authors: Prins Brandon , Phayal Anup , Daxecker Ursula E
Published: March 2019

Extant research shows that the presence of natural resources can prolong civil wars. But research also indicates that as rebel groups become stronger, conflicts tend to shorten. These studies suggest an unclear association among the three variables—resources, rebel strength, and conflict duration. If resources increase the fighting ability of rebels, then why do they not shorten conflicts? To understand this relationship, we examine incidents of maritime piracy, which unlike other resources are more clearly exploited by rebel groups rather than states and offer new insight on how this might affect the persistence of civil war. The findings suggest that the use of piracy by weaker rebel groups shortens conflict but prolongs it when exploited by stronger rebel groups. We think our conditional analyses allow us to discern insurgencies driven at least in part by greedy rebels and therefore better illuminate the causal process by which resource wealth prolongs civil war.
Sex Differences in Statin Prescribing in Diabetic and Heart Disease Patients in FQHCs: A Comparison of the ATPIII and 2013 ACC/AHA Cholesterol Guidelines
Authors: Khan Nazia Naz S. , Kelly-Blake Karen , Luo Zhehui , Olomu Adesuwa
Published: March 2019

Purpose:

The purpose of this study was to determine the difference in the rate of statin prescribing based on the Adult Treatment Panel (ATP) III and 2013 American College of Cardiology (ACC)/American Heart Association cholesterol guidelines across sex in Federally Qualified Health Centers (FQHCs), and to determine the proportion of patients on recommended statin dosage based on the 2013 cholesterol guideline.

Methods:

The Office Guidelines Applied to Practice (Office-GAP) study is a quasi-experimental, 2 FQHCs center study that enrolled patients with coronary heart disease and diabetes mellitus (DM). We computed 10-year atherosclerotic cardiovascular disease (ASCVD) risks scores based on ACC guidelines and determined the rate of statin prescribing across sex in FQHCs using both guidelines. Main outcomes measures were (1) rate of statin prescribing based on ATPIII and 2013 cholesterol guidelines across sex and (2) proportion of patients on recommended statin dosage based on the 2013 cholesterol guideline.

Results:

The 2013 cholesterol guideline did not increase the rate of eligibility of statin for men and women compared to ATPIII guideline. No significant difference between men and women in statin prescribing under ATPIII (67% vs 57%, P = .13) and 2013 cholesterol guidelines (66% vs 63%, P = .69) and in the recommended dosage of statin per the 2013 cholesterol guidelines between men and women in FQHCs (12% vs 22%, P = .22).

Conclusions:

We found statin underprescribing for both men and women with ASCVD and DM in FQHCs. Utilizing both the ATPIII and the 2013 cholesterol guidelines, men with ASCVD and DM were prescribed statin more than women. However, fewer men were found to be on the recommended dosage of statin based on the 2013 cholesterol guideline. Our findings suggest that Office-GAP may have improved the prescription/use of statin in both men and women.
High-flux hemodialysis versus glucarpidase for methotrexate-associated acute kidney injury: What’s best?
Authors: Kitchlu Abhijat , Shirali Anushree C
Published: March 2019

Kidney-related adverse drug effects from chemotherapeutic agents can cause acute kidney injury that may influence cancer treatment and patient outcomes. Many current chemotherapy drugs are associated with acute kidney injury, including methotrexate which causes dose-dependent tubular injury. In this review, we will focus on the manifestations of kidney disease secondary to methotrexate and discuss management strategies. In particular, we will review the use of high-flux hemodialysis versus glucarpidase for reducing toxic serum levels of methotrexate.
The Potential for Using Sonography to Measure Abdominal Adiposity in Children
Authors: Stigall A. Nicole , Evans Kevin D. , Hunter Randee L. , Spees Colleen K.
Published: March 2019

The accumulation of abdominal adiposity has been associated with many risk factors in adults and children. Currently, body mass index (BMI) percentiles, computed tomography (CT), and dual X-ray absorptiometry (DXA) are widely used to evaluate body fat but are not widely acceptable for measuring visceral and subcutaneous adiposity. The aim of this study was to evaluate abdominal adiposity in children by the use of diagnostic medical sonography (DMS). Fifty-eight third graders were recruited for a 10-week interventional study. This cohort received baseline body composition and anthropometric measures, including height, weight, calculated BMI percentiles, blood pressure, bioelectric impedance, and DMS. The resulting data analysis provided a set of descriptive statistics. DMS may be a reliable, practical, and cost-effective method for measuring visceral and subcutaneous adiposity across varied body compositions of children.