bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics and outcomes of accidental hypothermia in Japan: the J-Point registry
Authors: Matsuyama Tasuku , Morita Sachiko , Ehara Naoki , Miyamae Nobuhiro , Okada Yohei , Jo Takaaki , Sumida Yasuyuki , Okada Nobunaga , Watanabe Makoto , Nozawa Masahiro , Tsuruoka Ayumu , Fujimoto Yoshihiro , Okumura Yoshiki , Kitamura Tetsuhisa , Ohta Bon
Published: June 2018

Background

Accidental hypothermia (AH) has higher incidence and mortality in geriatric populations. Japan has a rapidly ageing population, and little is known about the epidemiology of hypothermia in this country.

Methods

We created an AH registry based on retrospective review of patients visiting the ED of 12 institutions with temperature ≤35°C between April 2011 and March 2016. The severity of AH was classified as mild (≤35, ≥32°C), moderate (<32, ≥28°C) or severe (<28°C). The relationship between in-hospital mortality and severity of AH was assessed using a multivariable logistic regression analysis.

Results

A total of 572 patients were registered in this registry and 537 patients were eligible for our analysis. The median age was 79 (IQR 66–87) years and the proportion of men was 51.2% (273/537). AH was more likely to occur in elderly patients aged ≥65 years (424/537, 80.0%) and in indoor settings (418/537, 77.8%). The condition most frequently associated with AH, irrespective of severity, was acute medical illness. A lower mean outside temperature was associated with a higher prevalence of AH, and particularly severe AH (p for trend <0.001). The overall proportion of cases resulting in in-hospital death was 24.4% (131/537), with no significant difference between severity levels observed in a multivariable logistic regression analysis (severe group (37/118, 31.4%) vs mild group (42/192, 21.9%), adjusted OR (AOR) 1.01, 95% CI 0.61 to 1.68; and moderate group (52/227, 22.9%) vs mild group, AOR 1.11, 95% CI 0.58 to 2.14).

Conclusion

Active prevention and intervention should occur for this important public health issue.
Fatal peripartum haemorrhage in a white‐naped mangabey (Cercocebus lunulatus) associated with placenta previa
Authors: Schoening Janne M , Sargent Emma , Foley Mairead , Bainbridge John , Cassidy Joseph
Published: June 2018

A 20‐year‐old zoo‐born female gravid white‐naped mangabey (Cercocebus lunulatus) was found dead adjacent to a pool of blood. The uterus contained one female fetus in breech malposition that was developed to term. The cervix was fully dilated and fetal membranes had ruptured indicating early parturition. The placenta was located ventrally within the posterior uterus and fully blocked the os cervix. It showed multiple areas of acute haemorrhage, and was considered the source of fatal peripartum maternal haemorrhage. These findings are consistent with a diagnosis of placenta previa, an abnormal implantation of the placenta in the lower uterine segment in humans and other primates. Risk factors reported in humans, which were also present in this monkey, include pluriparity, increased maternal age and the possibility of dystocia during previous pregnancies. To our knowledge, this is the first report of placenta previa in mangabeys.
Dark matter direct detection of a fermionic singlet at one loop
Authors: Herrero-García Juan , Molinaro Emiliano , Schmidt Michael A.
Published: June 2018

The strong direct detection limits could be pointing to dark matter – nucleus scattering at loop level. We study in detail the prototype example of an electroweak singlet (Dirac or Majorana) dark matter fermion coupled to an extended dark sector, which is composed of a new fermion and a new scalar. Given the strong limits on colored particles from direct and indirect searches we assume that the fields of the new dark sector are color singlets. We outline the possible simplified models, including the well-motivated cases in which the extra scalar or fermion is a Standard Model particle, as well as the possible connection to neutrino masses. We compute the contributions to direct detection from the photon, the Z and the Higgs penguins for arbitrary quantum numbers of the dark sector. Furthermore, we derive compact expressions in certain limits, i.e., when all new particles are heavier than the dark matter mass and when the fermion running in the loop is light, like a Standard Model lepton. We study in detail the predicted direct detection rate and how current and future direct detection limits constrain the model parameters. In case dark matter couples directly to Standard Model leptons we find an interesting interplay between lepton flavor violation, direct detection and the observed relic abundance.
Ticagrelor Use in Acute Myocardial Infarction: Insights From the National Cardiovascular Data Registry
Authors: Basra Sukhdeep S. , Wang Tracy Y. , Simon DaJuanicia N. , Chiswell Karen , Virani Salim S. , Alam Mahboob , Nambi Vijay , Denktas Ali E. , Deswal Anita , Bozkurt Biykem , Ballantyne Christie M. , Peterson Eric D. , Jneid Hani
Published: June 2018

Background

Ticagrelor is a P2Y
12
receptor inhibitor with superior clinical efficacy compared with clopidogrel. However, it is associated with reduced efficacy when combined with a high‐dose aspirin.

Methods and Results

Patients in the acute coronary treatment and intervention outcomes network (
ACTION
) Registry‐Get With The Guidelines (
GWTG
) with acute myocardial infarction from October 2013 through December 2014 were included in the study (167 455 patients; 622 sites). We evaluated temporal trends in the prescription of P2Y
12
inhibitors, and identified factors associated with ticagrelor use at discharge. Among patients discharged on ticagrelor and aspirin (21 262 patients), we evaluated the temporal trends and independent factors associated with high‐dose aspirin prescription at discharge. Ticagrelor prescription at discharge increased significantly from 12% to 16.7% (
P
<0.0001). Decreases in prasugrel and clopidogrel use at discharge (15.7%–13.9% and 54.2%–51.1%, respectively,
P
<0.0001) were also observed. Independent factors associated with preferential ticagrelor prescription at discharge over clopidogrel included younger age, white race, home ticagrelor use, invasive management, and in‐hospital re‐infarction and stroke (
P
<0.0001 for all), whereas older age, female sex, prior stroke, home ticagrelor use, and in‐hospital stroke (
P
<0.0001 for all) were associated with preferential ticagrelor prescription at discharge over prasugrel. High‐dose aspirin was used in 3.1% of patients discharged on ticagrelor. Independent factors associated with high‐dose aspirin prescription at discharge included home aspirin use, diabetes mellitus, previous myocardial infarction, previous coronary artery bypass graft, ST‐segment–elevation myocardial infarction, cardiogenic shock, and geographic region (
P
=0.01).

Conclusions

Our contemporary analysis shows a modest but significant increase in the use of ticagrelor and a high rate of adherence to the use of low‐dose aspirin at discharge.
Upward Shift and Steepening of the Blood Pressure Response to Exercise in Hypertensive Subjects at High Altitude
Authors: Caravita Sergio , Faini Andrea , Baratto Claudia , Bilo Grzegorz , Macarlupu Josè Luis , Lang Morin , Revera Miriam , Lombardi Carolina , Villafuerte Francisco C. , Agostoni Piergiuseppe , Parati Gianfranco
Published: June 2018

Background

Acute exposure to high‐altitude hypobaric hypoxia induces a blood pressure rise in hypertensive humans, both at rest and during exercise. It is unclear whether this phenomenon reflects specific blood pressure hyperreactivity or rather an upward shift of blood pressure levels. We aimed at evaluating the extent and rate of blood pressure rise during exercise in hypertensive subjects acutely exposed to high altitude, and how these alterations can be counterbalanced by antihypertensive treatment.

Methods and Results

Fifty‐five subjects with mild hypertension, double‐blindly randomized to placebo or to a fixed‐dose combination of an angiotensin‐receptor blocker (telmisartan 80 mg) and a calcium‐channel blocker (nifedipine slow release 30 mg), performed a cardiopulmonary exercise test at sea level and after the first night's stay at 3260 m altitude. High‐altitude exposure caused both an 8 mm Hg upward shift (
P
<0.01) and a 0.4 mm Hg/mL/kg per minute steepening (
P
<0.05) of the systolic blood pressure/oxygen consumption relationship during exercise, independent of treatment. Telmisartan/nifedipine did not modify blood pressure reactivity to exercise (blood pressure/oxygen consumption slope), but downward shifted (
P
<0.001) the relationship between systolic blood pressure and oxygen consumption by 26 mm Hg, both at sea level and at altitude. Muscle oxygen delivery was not influenced by altitude exposure but was higher on telmisartan/nifedipine than on placebo (
P
<0.01).

Conclusions

In hypertensive subjects exposed to high altitude, we observed a hypoxia‐driven upward shift and steepening of the blood pressure response to exercise. The effect of the combination of telmisartan/nifedipine slow release outweighed these changes and was associated with better muscle oxygen delivery.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01830530.
Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network
Authors: Aggarwal Brooke , Makarem Nour , Shah Riddhi , Emin Memet , Wei Ying , St‐Onge Marie‐Pierre , Jelic Sanja
Published: June 2018

Background

Insufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.

Methods and Results

Women who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20–79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow‐mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow‐mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders (
P
=0.04 and
P
=0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6;
P
=0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6;
P
=0.002 and β=8.26;
P
=0.02, respectively). No evidence was found for an association between sleep and flow‐mediated dilation.

Conclusions

These findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
02835261.
Inverse Association Between Serum Non–High‐Density Lipoprotein Cholesterol Levels and Mortality in Patients Undergoing Incident Hemodialysis
Authors: Chang Tae Ik , Streja Elani , Ko Gang Jee , Naderi Neda , Rhee Connie M. , Kovesdy Csaba P. , Kashyap Moti L. , Vaziri Nosratola D. , Kalantar‐Zadeh Kamyar , Moradi Hamid
Published: June 2018

Background

There is accumulating evidence that serum levels of non–high‐density lipoprotein cholesterol (non–
HDL
‐C) are a more accurate predictor of cardiovascular outcomes when compared with low‐density lipoprotein cholesterol. However, we recently found that higher serum concentrations of triglycerides are associated with better outcomes in patients undergoing hemodialysis. Therefore, we hypothesized that the association of serum levels of non–
HDL
‐C (which includes triglyceride‐rich lipoproteins) with outcomes may also be different in patients undergoing hemodialysis when compared with other patient populations.

Methods and Results

We studied the association of baseline and time‐dependent serum levels of non–
HDL
‐C with all‐cause and cardiovascular mortality using Cox proportional hazard regression models in a nationally representative cohort of 50 118 patients undergoing incident hemodialysis from January 1, 2007, to December 31, 2011. In time‐dependent models adjusted for case mix and surrogates of malnutrition and inflammation, a graded inverse association between non–
HDL
‐C level and mortality was demonstrated with hazard ratios (95% confidence intervals) of the lowest (<60 mg/dL) and highest (≥160 mg/dL) categories: 1.88 (1.72–2.06) and 0.73 (0.64–0.83) for all‐cause mortality and 2.07 (1.78–2.41) and 0.75 (0.60–0.93) for cardiovascular mortality, respectively (reference, 100–115 mg/dL). In analyses using baseline values, non–
HDL
‐C levels <100 mg/dL were also associated with significantly higher mortality risk across all levels of adjustment. Similar associations were found when evaluating non‐
HDL
/
HDL
cholesterol ratio and mortality, with the highest all‐cause and cardiovascular mortality being observed in patients with decreased non‐
HDL
/
HDL‐C
ratio (<2.5).

Conclusions

Contrary to the general population, decrements in non–
HDL
‐C and non‐
HDL
/
HDL
cholesterol ratio were paradoxically associated with increased all‐cause and cardiovascular mortality in patients undergoing incident hemodialysis. The underlying mechanisms responsible for these associations await further investigation.
Ventricular Arrhythmias in Young Competitive Athletes: Prevalence, Determinants, and Underlying Substrate
Authors: Zorzi Alessandro , De Lazzari Manuel , Mastella Giulio , Niero Alice , Trovato Domenico , Cipriani Alberto , Peruzza Francesco , Portolan Leonardo , Berton Giampaolo , Sciacca Federco , Tollot Saverio , Palermo Chiara , Bellu Roberto , D'ascenzi Flavio , Muraru Denisa , Badano Luigi Paolo , Iliceto Sabino , Schiavon Maurizio , Perazzolo Marra Martina , Corrado Domenico
Published: June 2018

Background

Whether ventricular arrhythmias (
VAs
) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of
VAs
in young competitive athletes.

Method and Results

We studied 288 competitive athletes (age range, 16–35 years; median age, 21 years) and 144 sedentary individuals matched for age and sex who underwent 12‐lead 24‐hour ambulatory electrocardiographic monitoring.
VAs
were evaluated in terms of number, complexity (ie, couplet, triplet, or nonsustained ventricular tachycardia), exercise inducibility, and morphologic features. Twenty‐eight athletes (10%) and 13 sedentary individuals (11%) showed >10 isolated premature ventricular beats (
PVB
s) or ≥1 complex
VA
(
P
=0.81). Athletes with >10 isolated
PVB
s or ≥1 complex
VA
were older (median age, 26 versus 20 years;
P
=0.008) but did not differ with regard to type of sport, hours of training, and years of activity compared with the remaining athletes. All athletes with >10 isolated
PVB
s or ≥1 complex
VA
had a normal echocardiographic examination; 17 of them showing >500 isolated
PVB
s, exercise‐induced
PVB
s, and/or complex
VA
underwent additional cardiac magnetic resonance, which demonstrated nonischemic left ventricular late gadolinium enhancement in 3 athletes with right bundle branch block
PVB
s morphologic features.

Conclusions

The prevalence of >10 isolated
PVB
s or ≥1 complex
VA
at 24‐hour ambulatory electrocardiographic monitoring did not differ between young competitive athletes and sedentary individuals and was unrelated to type, intensity, and years of sports practice. An underlying myocardial substrate was uncommon and distinctively associated with right bundle branch block
VA
morphologic features.
Clergy Use of Suicide Prevention Competencies
Authors: Mason Karen , Kim Esther , Martin W. Blake
Published: June 2018

This study examined clergy’s use of 15 suicide prevention competencies. Four hundred ninety-eight U.S. Catholic, Jewish, and Protestant clergy responded to an online survey regarding their use of these competencies. Analysis of variance, backward stepwise regression, and principal components analysis were used to determine clergy group differences, predictors of use of competencies, and a parsimonious summary of competencies. Some respondents reported infrequent opportunities to develop these competencies. Respondents reported using general pastoral competencies more than suicide-specific competencies. Protestant clergy reported that their congregants watch over each other significantly more than Jewish clergy. Catholic and Jewish clergy reported significantly more competence in conducting suicide funerals than Protestant clergy. Contacts by suicidal people and number of hours of suicide-specific training predicted the use of more competencies. Competency components included postvention following a suicide, nonjudgmental attitudes, talking with a suicidal person, and pastoral care. Findings suggest that clergy may benefit from consultation and suicide-specific training.
Factors Affecting Set Shot Goal-kicking Performance in the Australian Football League
Authors: Anderson Darren , Breed Ray , Spittle Michael , Larkin Paul
Published: June 2018

Set shot goal-kicking is recognized as an important skill in Australian Football (AF), accounting for over half of all goals kicked in the Australian Football League (AFL). However, as knowledge surrounding its performance is limited, this study described the frequency, types, and outcomes of set shots in the AFL and investigated the impact of task, personal, and environmental constraints on goal-kicking performance. We analyzed video footage of set shots from all 198 matches of the 2012 season, collecting data for kick distance, kick angle, player position, player experience (i.e., general and specific), kick outcome, and weather status. We found an average of 23.0 (standard deviation [ SD] = 4.5) set shots/match, with a mean accuracy of 55.0% ( SD = 0.7%). Kicking accuracy decreased with incremental increases in kick distance, with accuracy ranging from 97% (0–15 m) to 36% (≥50 m). Key forwards were more accurate kickers than other players. There was no significant effect of player experience. The number of set shots taken decreased by 13% in wet weather conditions. The primary determinant of elite set shot goal-kicking performance was the interaction of kick distance and angle (task difficulty). This research adds to an understanding of how personal, environmental, and match constraints influence this closed skill performance in AF match play.
Conversation Club: A Group Mentoring Model for Immigrant Youth
Authors: Pryce Julia M. , Kelly Michael S. , Lawinger Mary
Published: June 2018

This mixed-methods research evaluates Conversation Club (CC), a Canadian after-school group mentoring intervention for newcomer youth. The study’s main objectives are to examine the effects of CC on newcomer youth’s experiences of belonging, connectedness, hopefulness, and integration into Canadian society. Using a quasi-experimental design, CC ( n = 67) and a comparison group of immigrant youth ( n = 25) completed questionnaires focused on sense of ethnic identity, community, belonging, and hope for the future. In addition, a subset of CC participants ( n = 13) completed in-depth interviews focused on their experience of the Club. Interview findings suggest that participation in the Club results in an increased sense of belonging and connection for these young people. Implications for research and programs are discussed, focused on ways to enhance and expand innovative group mentoring programs to the important populations of immigrant and migrant young people across Canada and beyond.
Helping a Lost Tourist: The Effects of Metastereotypes on Resident Prosocial Behaviors
Authors: Tung Vincent Wing Sun
Published: June 2018

While previous research has explored stereotypes, few studies have investigated the effects of metastereotypes on residents’ prosocial behaviors; that is, how would residents react to tourists’ negative (or positive) stereotypes of them? Study 1 demonstrates that residents were more willing to help a lost tourist in the face of negative metastereotypes. Study 2 further shows that metastereotype valence (i.e., positive or negative) could influence residents’ prosocial behaviors. Finally, Study 3 shows that triggering a common social identity between residents and tourists may not mitigate the effects of metastereotypes that arise from outgroup distinctiveness. Taken together, this research suggests that metastereotypes could potentially influence prosocial behaviors through impression management motives. This research contributes to the literature on host-tourist relationships and provides practical relevance for destination management organizations and public policy planners involved in managing intergroup relations by connecting knowledge from metastereotypes with stereotype-reduction strategies.
“Fighting and Cutting and Shooting, and Carrying On”: Saloons, Dives, and the Black “Tough” in Manhattan’s Tenderloin, 1890-1917
Authors: Flowe Douglas J.
Published: June 2018

Most historical studies of early twentieth-century American saloons focus on white ethnic immigrants and largely neglect black drinking dives. To understand the significance of saloons to African Americans it is necessary to differentiate the black experience from the dominant historical narrative. Scrutinizing the media depiction of black male Tenderloin residents as “toughs” I question whether some black men refashioned masculinity with public acts of mayhem, a purposefully heedless perspective, and a willingness to disregard the law. Employing countless media accounts, prison case files, trial transcripts, and correspondence between saloon owners and progressive organizations I argue that black saloons became centers of licit and illicit economies and physical spaces where black men reimagined their masculine identities.
Potters Make Shorter Pots Under Conditions of Reduced Sensory Input
Authors: Ziat Mounia , Park Min , Kakas Brian , Rosenbaum David A.
Published: June 2018

Although people have made clay pots for millennia, little behavioral research has explored how they do so. We were specifically interested in potters’ use of auditory, haptic, and visual feedback. We asked what would happen if one or two of these sources of feedback were removed and potters tried to create pots of a given height, stopping when they thought they had reached that height. We asked students in a pottery class to build simple clay vessels either when they had full sensory feedback (in the control condition for all participants) or when they had reduced input from one modality (in Experiment 1) or two modalities (in Experiment 2). Participants were asked to stop building the vessels when they thought the vessels were 5 in. high. We found that participants produced shorter vessels when one or more forms of sensory feedback was reduced. The degree of shortening did not depend on the type or number of reduced sensory channels. The results are consistent with a control hypothesis where potters must have learned how to use sensory feedback from the modalities to help them control their ceramic creations. The results help highlight the importance of the intimate connections between perception and action.
The digital society: Occupational therapists need to act proactively to meet the growing demands of digital competence
Authors: Larsson-Lund Maria
Published: June 2018

This opinion piece discusses the importance of how occupational therapy practice, research and education responds to and acts proactively in relation to the growing requirement for digital competence placed on citizens. Digital competence will be outlined and scrutinized in relation to occupational therapy's core concerns and with regard to the role of occupational therapists and occupational justice. Changes in peoples’ occupations and occupational patterns due to digitalization will be exemplified. Finally, several questions and suggestions are posed as to how occupational therapy can build capacity and promote its role in the face of ongoing challenges.
Intimate Partner Violence, Police Involvement, and Women’s Trauma Symptoms
Authors: Rancher Caitlin , Jouriles Ernest N. , McDonald Renee
Published: June 2018

This study examined whether police involvement in intimate partner violence (IPV) incidents is associated with women’s trauma symptoms. Participants were 95 women recruited from domestic violence shelters. Women reported on their trauma symptoms, the frequency of IPV victimization, the use of a weapon during IPV, and police involvement over the year following shelter departure. Police involvement in IPV was associated with higher levels of reexperiencing trauma symptoms 1 year after shelter departure, even after controlling for baseline trauma symptoms, the frequency of IPV, and the use of a weapon during IPV. Women’s race and ethnicity did not moderate the results. These findings suggest police involvement in IPV incidents may be associated with higher levels of trauma symptoms experienced by women. Further investigation into law enforcement practices and policies to help reduce women’s distress is needed.
Individual Surgeon’s Contribution to Value
Authors: Turrentine Florence E. , Sohn Min-Woong , Tracci Margaret C. , Ramirez Adriana G. , Upchurch Gilbert R. , Jones R. Scott
Published: June 2018

Estimating surgeon-level value in health care remains relatively unexplored. American College of Surgeons National Surgical Quality Improvement Program Participant Use Files (2005-2013) were linked with total costs at a single institution. Random intercepts in 3-level random effects logistic regression models predicted 30-day postoperative mortality or morbidity for each surgeon each year. Value was defined as quality (morbidity or mortality) divided by costs for surgeons performing general surgery and vascular procedures. Forty-four surgeons performed 11 965 surgeries. Risk-adjusted costs trended down over time. For all surgeries, mortality value increased by 3.27 per year (95% confidence interval = 2.54-4.01; P < .001) on a 100-point scale, while morbidity value did not change. Of 21 surgeons with data for 5 years or longer, mortality value increased for all surgeons except one. Continuous increase in complication rates from 2008 contributed to decreased morbidity value. Value may assist surgeons in exploring performance opportunities better than morbidity or mortality alone.
Predictors of Quitting Attempts Among Tobacco Users in Bangladesh After a Communication Campaign to Launch Graphic Warning Labels on Packaging
Authors: Turk Tahir , Newton Fiona , Choudhury Sohel , Islam Md. Shafiqul
Published: June 2018

Background. Tobacco use contributes to an estimated 14.6% of male and 5.7% of female deaths in Bangladesh. Aims. We examine the determinants of tobacco-related quit attempts among Bangladeshis with and without awareness of the synergized “People Behind the Packs” (PBTP) communication campaign used to support the introduction of pack-based graphic warning labels (GWLs) in 2016. Method. Data from 1,796 adults were collected using multistage sampling and a cross-sectional face-to-face survey. Analyses used a normalized design weight to ensure representativeness to the national population of smokers within Bangladesh. Results. For the overall sample, the multivariable logistic regression model revealed quit attempts were associated with having seen the pack-based GWLs, recalling ≥1 PBTP campaign message, higher levels of self-efficacy to quit, and recognizing more potential side-effects associated with using tobacco products. Conversely, the likelihood of quitting attempts were lower among dual tobacco users (relative to smokers) and those using tobacco at least daily (vs. less than daily). The hierarchical multivariable logistic regression model among those aware of ≥1 PBTP campaign message indicated quitting attempts were positively associated with recalling more of the campaign messages and discussing them with others. Conclusion. This national evaluation of pack-based GWLs and accompanying PBTP campaign within Bangladesh supports the efficacy of using synergized communication messages when introducing such labels. That quit attempts are more likely among those discussing PBTP campaign messages with others and recalling more PBTP campaign messages highlights the importance of ensuring message content is both memorable and engaging.
Physical Activity and Related Psychosocial Outcomes From a Pilot Randomized Trial of an Interactive Voice Response System–Supported Intervention in the Deep South
Authors: Pekmezi Dori , Ainsworth Cole , Holly Taylor , Williams Victoria , Joseph Rodney , Wang Kaiying , Rogers Laura Q. , Marcus Bess , Desmond Renee , Demark-Wahnefried Wendy
Published: June 2018

Background. Physical activity exerts cancer-protective effects, yet most Americans are inactive, especially in the South, where cancer incidence rates are generally higher. Telephone-based approaches can help overcome physical activity intervention barriers in this region (literacy, costs, lack of transportation/technology, distance from facilities) and can be automated via interactive voice response (IVR) systems for improved reach and cost-effectiveness. Aims. To evaluate the Deep South IVR-supported Active Lifestyle (DIAL) intervention. Method. A pilot randomized controlled trial was conducted among 63 underactive adults in Birmingham, Alabama, from 2015 to 2017. Results. Retention was 88.9% at 12 weeks, and ≥75% adherence (IVR contact on at least 63 out of 84 days) was noted among 62.5% of intervention participants. Intervention participants reported larger increases in self-reported minutes of moderate-to-vigorous intensity physical activity from baseline to 12 weeks than the wait-list control arm (median change = 47.5 vs. 5.0 minutes, respectively, p = .09). Moreover, the intervention produced significantly greater increases in physical activity self-regulation ( p < .001) and social support from family ( p = .001) and friends ( p = .009) from baseline to 12 weeks, compared with the wait-list control. Significant decreases in self-reported sleep disturbance also were found in the intervention arm but not among the controls, p < .05. Overall, intervention participants reported being satisfied with the DIAL program (71.4%) and would recommend it to friends (92.9%). Discussion. Findings support the feasibility, acceptability, and preliminary efficacy of the DIAL intervention. Conclusion. Next steps include intervention refinement in preparation for a fully powered efficacy trial and eventual dissemination to rural counties.
Electron Microscopy Can Still Have a Role in the Diagnosis of Selected Inborn Errors of Metabolism
Authors: Taweevisit Mana , Thorner Paul S
Published: June 2018

Many anatomic pathology laboratories no longer have electron microscopy facilities. A retrospective review of autopsies was performed to identify cases of inborn errors of metabolism (IEM) and determine the contribution of electron microscopy in making the diagnosis in those cases. Over a period of 17 years, there were 900 perinatal and pediatric autopsies. There were 7 cases (1%) of IEM, including 4 cases of Pompe disease, 1 case of I-cell disease, 1 case of bile acid synthesis defect, and 1 case of mitochondrial disease (Leigh syndrome). Electron microscopy was important in the diagnosis of I-cell disease and Pompe disease in our series. This technique enabled a prenatal diagnosis to be made from a chorionic villus biopsy in 2 cases with a positive family history. In less developed countries where upfront genetic testing may be too expensive and may need international referral, electron microscopy can still be useful for diagnosis of IEM, providing an affordable alternative with a more rapid turnaround time compared to gene mutation analysis or enzyme assay. Results can be used both for patient management and as a screen for which cases might benefit from genetic testing.
Splenic artery embolisation in trauma: A five-year single-centre experience at a UK major trauma centre
Authors: Davies James , Wells David
Published: June 2018

Introduction

Since the introduction of major trauma centres and regional trauma networks in 2012, management of splenic injury has shifted, with non-operative management now favoured. For those requiring intervention, splenic artery embolisation is well established as a first-line treatment in all but the most severely injured. Follow-up is variable, with few guidelines, highlighting the paucity of data addressing the need for further imaging and antimicrobial prophylaxis. This review was undertaken to assess practice and outcomes at our centre in the context of the contemporary literature.

Methods

This retrospective study captured splenic embolisations over five years (January 2012–December 2016). CRIS interventional radiology codes were used to retrieve embolisation cases and Trauma Audit and Research Network and hospital event statistics data were used to identify all cases of traumatic splenic injury and to identify splenectomy and non-operative management patients. Outcomes were compared with available standards from different sources.

Results

Over the study period 176 splenic injuries were identified, of which 122 underwent non-operative management, 28 were laparotomy first, and 26 undergoing embolisation with an increased trend to an ‘embolisation-first’ approach over this time. In the embolisation group, the age range was 16–79 yr (mean 41), 18 were male and the median time to intervention was 2 h 9 min (range 1.1–171 h), with eight following failed non-operative management. The proportion of proximal versus selective embolisation versus both was 10:14:1 and the predominant mechanism was coiling. One patient was not embolised due to absence of contrast extravasation on initial angiogram and two proceeded to splenectomy due to failure of splenic artery embolisation. There were complications in six patients: five ongoing left upper quadrant pain, one infected haematoma requiring drainage, two chest infections with pleural effusions, one of which required drainage. There were two deaths from other injuries. Fifteen of the 25 patients who underwent splenic artery embolisation had follow-up imaging, seven did not and three were excluded due to splenectomy and/or death; five patients were vaccinated according to the hospital splenectomy protocol, and six received prophylactic antibiotics.

Conclusion

Our data show that non-operative management is the mainstay of treatment for the majority of splenic injury patients. Serious complications are not common but variation does exist in follow-up. The changing management trends are in line with national data. These findings will help to further implement and develop local protocols but more work is required to address splenic function after embolisation and the requirement for antimicrobial prophylaxis.
Vibration analysis of hard-coating laminated plate considering strain-dependent characteristic
Authors: Sun Wei , Liu Xiaozhou , Jiang Jixiang
Published: June 2018

An analytical modeling method of hard-coating laminated plate under base excitation was studied considering strain-dependent characteristic of coating material (i.e. a kind of material nonlinear behavior). For convenience, the strain-dependent characteristic of hard-coating material was characterized by polynomial, and the material parameters were divided into two parts: linearity and nonlinearity. Hard coating was regarded as a special layer in the analysis and Lagrange’s equation was used to acquire nonlinear equation of motion of the hard-coating laminated plate. Based on Newton–Raphson method, the procedure of solving resonant response and resonant frequency of composite plate was presented. Finally, a T300/QY89l1 laminated plate with NiCoCrAlY + YSZ hard coating was chosen to demonstrate the proposed method, the linear and nonlinear vibrations of the composite plate were solved, and only the linear results were validated by ANSYS software. The results reveal that there is a big difference between the calculation results considering the nonlinearity of coating material and the linear results, which means the laminated plate displays soft nonlinear phenomenon because of depositing coating.
Exploring ethnic differences in the post-university destinations of Russell Group graduates
Authors: Lessard-Phillips Laurence , Boliver Vikki , Pampaka Maria , Swain Daniel
Published: June 2018

The high aspirations of British ethnic minorities are evident in their high rates of participation in higher education. However, some ethnic minority groups remain strikingly under-represented in the most selective universities, and recent studies have shown that university graduates from ethnic minority backgrounds are less likely than otherwise comparable white graduates to gain employment in a higher salary, graduate-level job after their degree. This is likely to be due partly to the effects on graduate labour market outcomes of subject studied and university attended. However, no study to date has explored the graduate labour market outcomes for ethnic minority students in the UK’s most ‘prestigious’ universities, defined here as one of the 24 member institutions of the Russell Group. This article draws on data for recent graduates (2009–2013) from the Destinations of Leavers from Higher Education survey compiled by the UK’s Higher Education Statistics Agency. We explore ethnic differences in attainment in five distinct graduate destinations (employment in professional occupations; further study; employment in non-professional occupations; inactivity; and unemployment), controlling for educational and social background. Our results suggest that ethnic minority graduates of Russell Group are less likely than their white counterparts to fare well in the labour market and are more likely to adopt a compensatory strategy of further educational investment, that is a strategy of entering postgraduate education to avoid short-term unemployment or underemployment in a non-graduate job. Our findings challenge a key assumption of the government's social mobility policy agenda that graduating with a good degree from a highly selective university enables ethnic minorities to realise aspirations for upward social mobility.
Comparison of psychosocial and medical characteristics of patients with dementia and their primary informal caregivers between inpatient and day clinic treatment
Authors: Linnemann Alexandra , Hilsenbek Magdalena M , Lelieveld Irene , Geschke Katharina , Wolf Dominik , Fellgiebel Andreas
Published: June 2018

Background

Caregiver burden is one of the most common reasons for hospitalization of patients with dementia. However, changes of location are not recommended for patients with dementia and associated with negative outcomes for patients with dementia. As there is yet a lack of outpatient treatment options, this study explores psychiatric day clinic treatment as option for patients with dementia by comparing characteristics of voluntarily treated patients with dementia and their respective informal caregivers between an inpatient and day clinic setting.

Methods

A total of 92 patients with dementia (56 inpatient, 36 day clinic) and their informal caregiver provided information on psychosocial and clinical characteristics (Mini-Mental-Status-Test, Neuropsychiatric Inventory, Bayer Activities of Daily Living, Barthel Index, Geriatric Depression Scale-30, Beck’s Depression Inventory-II, caregiver burden, Short Form Health Survey-36) at the beginning of treatment and at follow-up (n = 48 patient caregiver dyads) six months after discharge.

Results

Patients with dementia did not differ in disease severity, neuropsychiatric symptoms, and depression depending on treatment setting. However, the higher the Bayer activities of daily living score, the more likely treatment in day clinic was. Caregivers from patients with dementia in the inpatient setting were younger and reported more financial burden, whereas caregivers from patients with dementia in the day clinic reported lower physical health and more burden due to practical caring responsibilities. Longitudinal data indicated no differences in characteristics of patients with dementia and caregivers depending on treatment setting, despite caregivers from patients in the day clinic reporting more depressive symptoms after six months.

Conclusion

Day clinic treatment for voluntarily treated patients with dementia might be an alternative to inpatient settings. Patients with dementia do not substantially differ depending on treatment setting, rather characteristics of the caregivers were associated with placement in inpatient or day clinic setting. The needs of caregivers deserve special attention when considering treatment for patients with dementia.
COPD360social Online Community: A Social Media Review
Authors: Stellefson Michael , Paige Samantha R. , Alber Julia M. , Stewart Margaret
Published: June 2018

People living with chronic obstructive pulmonary disease (COPD) commonly report feelings of loneliness and social isolation due to lack of support from family, friends, and health care providers. COPD360social is an interactive and disease-specific online community and social network dedicated to connecting people living with COPD to evidence-based resources. Through free access to collaborative forums, members can explore, engage, and discuss an array of disease-related topics, such as symptom management. This social media review provides an overview of COPD360social, specifically its features that practitioners can leverage to facilitate patient–provider communication, knowledge translation, and community building. The potential of COPD360social for chronic disease self-management is maximized through community recognition programming and interactive friend-finding tools that encourage members to share their own stories through blogs and multimedia (e.g., images, videos). The platform also fosters collaborative knowledge dissemination and helping relationships among patients, family members, friends, and health care providers. Successful implementation of COPD360social has dramatically expanded patient education and self-management support resources for people affected by COPD. Practitioners should refer patients and their families to online social networks such as COPD360social to increase knowledge and awareness of evidence-based chronic disease management practices.
“I’d Like Y’all to Get a Black Friend”: The Politics of Race in Friends
Authors: Cobb Shelley
Published: June 2018

When Aisha Taylor joined the Friends cast in as Charlie Wheeler, she crossed a prime-time boundary—the segregation of American television shows by race. At the same time, Charlie had to be co-opted into the show’s gender dynamics. This article argues that Charlie epitomizes the ongoing postracial politics of respectability and hyper-class mobility that construct black women’s limited entry into postfeminist womanhood, as well as into the, still, rarefied white world of the “mainstream” American sitcom. Charlie seems to trouble, if temporarily, these racial limits by being both Ross’s equal in terms of education and employment and by being a temporary part of the group through her relationships with Joey and Ross. Comparing her with Ross’s previous girlfriend Julie, this article will also consider the ways that the problematic representation of Ross’s girlfriends of color structure the postfeminist tropes of fate and retreatism central to Ross and Rachel’s happy ending.
Greater Cortical Thickness Is Associated With Enhanced Sensory Function After Arm Rehabilitation in Chronic Stroke
Authors: Pundik Svetlana , Scoco Aleka , Skelly Margaret , McCabe Jessica P. , Daly Janis J.
Published: June 2018

Objective. Somatosensory function is critical to normal motor control. After stroke, dysfunction of the sensory systems prevents normal motor function and degrades quality of life. Structural neuroplasticity underpinnings of sensory recovery after stroke are not fully understood. The objective of this study was to identify changes in bilateral cortical thickness (CT) that may drive recovery of sensory acuity. Methods. Chronic stroke survivors (n = 20) were treated with 12 weeks of rehabilitation. Measures were sensory acuity (monofilament), Fugl-Meyer upper limb and CT change. Permutation-based general linear regression modeling identified cortical regions in which change in CT was associated with change in sensory acuity. Results. For the ipsilesional hemisphere in response to treatment, CT increase was significantly associated with sensory improvement in the area encompassing the occipital pole, lateral occipital cortex (inferior and superior divisions), intracalcarine cortex, cuneal cortex, precuneus cortex, inferior temporal gyrus, occipital fusiform gyrus, supracalcarine cortex, and temporal occipital fusiform cortex. For the contralesional hemisphere, increased CT was associated with improved sensory acuity within the posterior parietal cortex that included supramarginal and angular gyri. Following upper limb therapy, monofilament test score changed from 45.0 ± 13.3 to 42.6 ± 12.9 mm ( P = .063) and Fugl-Meyer score changed from 22.1 ± 7.8 to 32.3 ± 10.1 ( P < .001). Conclusions. Rehabilitation in the chronic stage after stroke produced structural brain changes that were strongly associated with enhanced sensory acuity. Improved sensory perception was associated with increased CT in bilateral high-order association sensory cortices reflecting the complex nature of sensory function and recovery in response to rehabilitation.