bluuebunny/crossref_metadata_2025 huggingface dataset:
Reader response research in stylistics
Authors: Whiteley Sara , Canning Patricia
Published: May 2017

This article introduces the special issue. In it, we argue that research into reader response should be recognised as a vital aspect of contemporary stylistics, and we establish our focus on work which explicitly investigates such responses through the collection and analysis of extra-textual datasets. Reader response research in stylistics is characterised by a commitment to rigorous and evidence-based approaches to the study of readers’ interactions with and around texts, and the application of such datasets in the service of stylistic concerns, to contribute to stylistic textual analysis and/or wider discussion of stylistic theory and methods. We trace the influence of reader response criticism and reception theory on stylistics and discuss the productive dialogues which exist between stylistics and the related fields of the empirical study of literature and naturalistic study of reading. After offering an overview of methods available to reader response researchers and a contextualising survey of existing work, we argue that both experimental and naturalistic methods should be regarded as ‘empirical’, and that stylistics is uniquely positioned to embrace diverse approaches to readers and reading. We summarise contributions to the special issue and the valuable insights they offer into the historical context of reader response research and the way readers perceive and evaluate texts (either poetry or narrative prose). Stylistic reader response research enables both the testing and development of stylistic methods, in accordance with the progressive spirit of the discipline, and also the establishment of new and renewed connections between stylistic research and work in other fields.
Literature and readers’ empathy: A qualitative text manipulation study
Authors: Kuzmičová Anežka , Mangen Anne , Støle Hildegunn , Begnum Anne Charlotte
Published: May 2017

The alleged crisis of the humanities is currently fueling renewed interest in the affective benefits of literary reading. Several quantitative studies have shown a positive correlation between literary reading and empathy. However, the literary nature of the stimuli used in these studies has not been defined at a more detailed, stylistic level. In order to explore the stylistic underpinnings of the hypothesized link between literariness and empathy, we conducted a qualitative experiment in which the degree of stylistic foregrounding was manipulated. Subjects ( N = 37) read versions of Katherine Mansfield’s “The Fly,” a short story rich in foregrounding, while marking striking and evocative passages of their choosing. Afterwards, they were asked to select three markings and elaborate on their experiences in writing. One group read the original story, while the other read a ‘non-literary’ version, produced by an established author of suspense fiction for young adults, where stylistic foregrounding was reduced. We found that the non-literary version elicited significantly more ( p < 0.01) explicitly empathic responses than the original story. This finding stands in contradiction to widely accepted assumptions in recent research, but can be assimilated in alternative models of literariness and affect in literary reading. We present an analysis of the data with a view to offering more than one interpretation of the observed effects of stylistic foregrounding.
Public understanding of the purpose of cancer screening: A population-based survey
Authors: Chorley Amanda J , Hirst Yasemin , Vrinten Charlotte , von Wagner Christian , Wardle Jane , Waller Jo
Published: May 2017

Objectives

In examining informed choice in cancer screening, we investigated public awareness that some screening programmes aim to prevent cancer, while others seek to detect cancer at an early stage.

Methods

A population-based survey of adults aged 50–70 in England (n = 1433), including data on demographic characteristics and screening experience. Participants were asked to select the main purpose of cervical, breast, and colorectal cancer screening (both faecal occult blood testing and flexible sigmoidoscopy).

Results

Across all four screening programmes, most people thought the main aim was to catch cancer early (71–78%). Only 18 and 14% knew that cervical screening and flexible sigmoidoscopy, respectively, are primarily preventive. Knowledge of the preventive aspect of these two programmes was low across the board, with few demographic patterns. By contrast, 78 and 73% of the sample were aware that breast screening and the faecal occult blood test, respectively, predominantly aim to detect cancer early. For these programmes, accurate knowledge was socially graded, lower in ethnic minority groups, and positively associated with previous participation in the programmes.

Conclusions

Our findings suggest that although awareness of the purpose of early detection screening is high, awareness that screening can prevent cancer is low across all demographic groups. Understanding the purpose of screening is a key aspect of informed choice but despite current communication strategies highlighting these differences, people do not seem to have a nuanced understanding of these differing aims. Our findings may be indicative of a broader public scepticism about the preventability of cancer.
Cost-effectiveness of strategies to increase cervical screening uptake at first invitation (STRATEGIC)
Authors: Tsiachristas Apostolos , Gittins Matthew , Kitchener Henry , Gray Alastair
Published: May 2017

Objective

To assess the cost-effectiveness of strategies to increase cervical cancer screening uptake at first invitation (STRATEGIC trial).

Methods

We performed an economic analysis alongside the STRATEGIC trial, comparing each of seven novel interventions for improving cervical screening uptake with control general practices in Greater Manchester and Grampian (United Kingdom). A template was developed to measure the intervention costs. Trial estimates of screening uptake were combined with data from the literature to estimate healthcare costs of each intervention. The added lifetime costs and quality adjusted life years (QALYs) of attending cervical screening were estimated by a systematic literature review, with relevant results pooled and weighted by study quality. Trial results and estimated lifetime costs and benefits of screening were then combined in a decision analytic model, giving an incremental cost per QALY gained for each intervention. Uncertainty was addressed in probabilistic and univariate sensitivity analyses.

Results

Intervention costs per screening round per woman attending varied from about £1.20 (2014 UK) for the nurse navigator intervention to £62 for the unrequested HPV self-sampler kit. The meta-analysis revealed a lifetime discounted benefit from screening of 0.043 QALYs per woman attending, at an additional lifetime discounted cost of £234. The incremental cost per QALY gained in all interventions was below £13,000. Probabilistic sensitivity analyses suggested that only unrequested self-sampling and timed appointments have a high probability of being cost-effective.

Conclusions

Unrequested self-sampling and timed appointments are likely to be cost-effective interventions. Further research is required on the duration of effects and on implementing combinations of interventions.
Manipulative Apps to Support Students With Disabilities in Mathematics
Authors: Bouck Emily C. , Working Christopher , Bone Erin
Published: May 2017

Understanding mathematical concepts is important for all students, although often challenging for many students with disabilities. Historically, educators have used concrete manipulatives to support and build conceptual understanding. Mobile devices provide a valuable option to support students with disabilities in mathematics through app-based manipulatives. Although research is limited on app-based manipulatives, the emerging literature with virtual (i.e., digital) manipulatives more generally suggests student preference for virtual manipulatives without a loss of understanding. This column provides educators with information about app-based manipulatives and how to use them, with the goal of helping teachers make informed decisions about app-based manipulatives to support students.
Blood Pressure Monitor Usability Problems Detected Through Human Factors Evaluation
Authors: Cifter Abdusselam Selami
Published: May 2017

Blood pressure monitors are one of the most commonly used medical devices in the home environment. They are abundantly available and easily accessible in the consumer market at reasonable prices. However, it is not clear to what extent these devices comply with the needs and expectations of users with varying levels of capability. This article focuses on the usability aspect of blood pressure monitors from a universal design perspective. I present the results of a study in which three brands of blood pressure monitors were examined through a method that combines hierarchical task analysis and heuristic evaluation.
Downstream flat plate as the flow-induced vibration enhancer for energy harvesting
Authors: Maruai Nurshafinaz Mohd , Mat Ali Mohamed Sukri , Ismail Mohamad Hafiz , Shaikh Salim Sheikh Ahmad Zaki
Published: May 2017

The prospect of harvesting energy from flow-induced vibration using an elastic square cylinder with a detached flat plate is experimentally investigated. The feasibility of flow-induced vibration to supply an adequate base excitation for micro-scale electrical power generation is assessed through a series of wind tunnel tests. The current test model of a single square cylinder is verified through a comparable pattern of vibration amplitude response with previous experimental study and two-dimensional numerical simulations based on the unsteady Reynolds averaged Navier–Stokes (URANS). In addition, a downstream flat plate is included in the wake of the square cylinder to study the effects of wake interference upon flow-induced vibration. A downstream flat plate is introduced as the passive vibration control to enhance the magnitude of flow-induced vibration and simultaneously increases the prospect of harvesting energy from the airflow. The study is conducted by varying the gap separation between the square cylinder and flat plate for 0.1≤ G/ D ≤3. The highest peak amplitude is observed for the gap G/ D = 1.2 with yrms/ D = 0.46 at UR = 17, which is expected to harvest ten times more energy than the single square cylinder. The high amplitude vibration response is sustained within a relatively broader range of lock-in synchronization. Meanwhile, for G/ D = 2 the vibration is suppressed, which leads to a lower magnitude of harvested energy. Contrarily, the amplitude response pattern for G/ D = 3 is in agreement with the single square cylinder. Hence, the flat plate has no significance to the wake interference of the square cylinder when the gap separation is beyond 3 D.
Effect of Supplementation With Chitosan on Weight, Cardiometabolic, and Other Risk Indices in Wistar Rats Fed Normal and High-Fat/High-Cholesterol Diets Ad Libitum
Authors: Bahijri Suhad M , Alsheikh Lubna , Ajabnoor Ghada , Borai Anwar
Published: May 2017

The aim was to investigate effect of chitosan on markers of obesity and cardiometabolic risk in rats fed normal chow (NC) or high-fat/high-cholesterol diet (HF/HCD). Forty male rats were fed NC or HF/HCD for 3 months, then divided into 4 groups: group A fed NC, group B: NC + chitosan, group C: HF/HCD, and group D: HF/HCD + chitosan. Food intake and weight were recorded, and serum glucose, lipid profile, insulin, leptin, gamma glutamyl transferase (GGT), and tumor necrosis factor α were measured at beginning and after 12 weeks. Atherogenic index (AI), low-density lipoprotein cholesterol:high-density lipoprotein cholesterol (LDL-C:HDL-C), and homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. At the end of study, food intake was significantly increased in group B; mean values of triglycerides, total cholesterol, LDL-C, LDL-C:HDL-C, and AI were decreased in group B and group D; mean leptin was increased in group A and decreased in group B; and mean values of insulin, HOMA-IR, and GGT were increased in group C. The results from this study suggest that chitosan improved lipid profile, insulin sensitivity, and oxidative stress caused by HF/HCD.
Polymer spur gears behaviors under different loading conditions: A review
Authors: Singh Akant Kumar , Siddhartha  , Singh Prashant Kumar
Published: May 2017

The significance of polymer gears to transmit power and motion is increasing continuously due to their inherent characteristics. Polymer gears have established themselves as attractive alternatives to traditional metal gears in plethora applications. They are light in weight, have lower inertia, and run noiseless than their metal counterparts. This article presents a comprehensive review of the research on polymer spur gears operating under low (0–8 Nm) and moderate (>8 and ≤17 Nm) loading conditions. Different polymers and polymer composites used till date for the fabrication of such gears are included along with different operating conditions. Various design features of polymer gears and tooth modification techniques for the improvement of the performance and durability of these gears have also been included in this review. The aspects of the modeling and simulation studies of the polymer gears are also emphasized in this paper for completeness of the review. The concept of hybrid gears is discussed along with their tribological properties. Various methods of manufacturing of polymer gears and their failure modes are discussed so as to make the article useful for researchers.
Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial
Authors: Heine Martin , Verschuren Olaf , Hoogervorst Erwin LJ , van Munster Erik , Hacking Hub GA , Visser-Meily Anne , Twisk Jos WR , Beckerman Heleen , de Groot Vincent , Kwakkel Gert ,   on behalf of the TREFAMS-ACE study group
Published: May 2017

Background:

Evidence supporting the effectiveness of aerobic training, specific for fatigue, in severely fatigued patients with multiple sclerosis (MS) is lacking.

Objective:

To estimate the effectiveness of aerobic training on MS-related fatigue and societal participation in ambulant patients with severe MS-related fatigue.

Methods:

Patients ( N = 90) with severe MS-related fatigue were allocated to 16-week aerobic training or control intervention. Primary outcomes were perceived fatigue (Checklist Individual Strength (CIS20r) fatigue subscale) and societal participation. An improvement of ⩾8 points on the CIS20r fatigue subscale was considered clinically relevant. Outcomes were assessed by a blinded observer at baseline, 2, 4, 6 and 12 months.

Results:

Of the 89 patients that started treatment (median Expanded Disability Status Scale (interquartile range), 3.0 (2.0–3.6); mean CIS20r fatigue subscale (standard deviation (SD)), 42.6 (8.0)), 43 received aerobic training and 46 received the control intervention. A significant post-intervention between-group mean difference (MD) on the CIS20r fatigue subscale of 4.708 (95% confidence interval (CI) = 1.003–8.412; p  = 0.014) points was found in favour of aerobic training that, however, was not sustained during follow-up. No effect was found on societal participation.

Conclusion:

Aerobic training in MS patients with severe fatigue does not lead to a clinically meaningful reduction in fatigue or societal participation when compared to a low-intensity control intervention.
Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial
Authors: Blikman Lyan JM , van Meeteren Jetty , Twisk Jos WR , de Laat Fred AJ , de Groot Vincent , Beckerman Heleen , Stam Henk J , Bussmann Johannes BJ ,   TREFAMS-ACE study group
Published: May 2017

Background:

Fatigue is a frequently reported and disabling symptom in multiple sclerosis (MS).

Objective:

To investigate the effectiveness of an individual energy conservation management (ECM) intervention on fatigue and participation in persons with primary MS-related fatigue.

Methods:

A total of 86 severely fatigued and ambulatory adults with a definite diagnosis of MS were randomized in a single-blind, two-parallel-arm randomized clinical trial to the ECM group or the information-only control group in outpatient rehabilitation departments. Blinded assessments were carried out at baseline and at 8, 16, 26 and 52 weeks after randomization. Primary outcomes were fatigue (fatigue subscale of Checklist Individual Strength – CIS20r) and participation (Impact on Participation and Autonomy scale – IPA).

Results:

Modified intention-to-treat analysis was based on 76 randomized patients (ECM, n = 36; MS nurse, n=40). No significant ECM effects were found for fatigue (overall difference CIS20r between the groups = −0.81; 95% confidence interval (CI), −3.71 to 2.11) or for four out of five IPA domains. An overall unfavourable effect was found in the ECM group for the IPA domain social relations (difference between the groups = 0.19; 95% CI, 0.03 to 0.35).

Conclusion:

The individual ECM format used in this study did not reduce MS-related fatigue and restrictions in participation more than an information-only control condition.
Survey of adolescents’ stress in school life in Thailand: Implications for school health
Authors: Maritta Välimäki , Ruthaychonnee Sittichai , Minna Anttila
Published: May 2017

Stress among adolescents is a widely discussed topic. This study examined stress levels, stress-related factors, and the possible correlation between stress and depression in adolescents at high schools in Thailand. The survey measuring stress (T-PSS-10) and depression (PHQ-9) was conducted on 15- to 19-year-olds in three public urban schools ( n = 168, response rate 90%). The data were analysed with descriptive statistics followed by the analysis of the background factors and their associations with adolescent stress levels using χ2tests, or Pearson’s correlation coefficient, while the mean differences between groups were tested with a T-test or analysis of variance. Adolescent stress levels ranged from 6 to 34 points, 17 being the most typical score (mean 15.95, SD 4.95, n = 164); the higher the score, the more the respondents perceived their lives to be stressful. There were no significant differences in stress levels among adolescents relating to age, gender, regular school attendance or which school attended. However, adolescents’ high stress levels were associated with having a high number of depressive symptoms ( r = 0.69, p = < 0.001). Effective mechanisms and more studies need to be carried out in the school environment to monitor, identify and support adolescents’ health and well-being.
Housing quality, health and fuel poverty among U.S. seniors
Authors: Kwon Hyun Joo , Jang Miseon
Published: May 2017

Using the American Housing Survey (AHS), this study compared two groups of seniors, namely fuel poor (FP) households and non-fuel poor (NFP) households ( N = 6604). In this study, the FP group is defined as comprising households that must spend approximately 3.8% of its household income on heating, based on natural gas consumption on heating. The results show that seniors in the FP group paid significantly higher heating costs while earning much less in income compared to those in the NFP group. The respondents in the FP group were more likely to be older, females, widowed, comprising single-person households and in poorer health, compared to those in the NFP group. The FP households tend to live in houses that are 10 years older and 138 square foot (12.8206 m2) smaller with worse building envelope quality than the NFP households. The income of nearly half of these seniors suffering fuel poverty records just above the income standards of the energy support programmes, and hence they spend considerable amount of their income on heating. This is one of the main reasons why many seniors in the U.S. experience fuel poverty. The results of this study can help inform policy regarding future services for those U.S. seniors who experience FP.
Effect of clutch lining frictional characteristics on take-up judder
Authors: Gkinis T , Rahmani Ramin , Rahnejat H
Published: May 2017

Take-up judder is the first rigid body torsional mode of the clutch system, which occurs during clutch engagement. This phenomenon is induced by stick-slip oscillations at the friction lining interfaces between the clutch disc and flywheel, and the pressure plate. The phenomenon is influenced by the clutch lining friction characteristics, the topography of the mating-sliding surfaces, and the operational conditions during the engagement process. Therefore, the interfacial characteristics are affected by contact pressure, interfacial slip speed, and surface temperature. Take-up judder causes driver and vehicle occupant discomfort, as well as gradual wear of contacting surfaces. The response frequency of the system is reported to be in the range 5–20 Hz, depending on the clutch system and vehicle inertia.

In this paper, the measured interfacial friction characteristics together with clamp load variation (contact pressure) under different surface temperatures are included in a multi-degree of freedom dynamic analysis to obtain torsional vibrations of the system, pertaining to take-up judder conditions. Such an in-depth investigation has not hitherto been reported in literature. The paper shows that take-up judder is omnipresent under all clutch engagement conditions, but its poignancy is most evident at cold surface temperatures. It is also shown that the transient judder response has a broader spectral content that is generally acknowledged.
The social dimensions of gambling among street youth in Mumbai: Is it really an addiction?
Authors: Saldanha Kennedy , Madangopal Dakshayani
Published: May 2017

This mixed-methods, exploratory study investigates the gambling activities of street youth in Mumbai, India. Data from surveys and brief interviews of 70 youth aged 12–24, two focus groups, and ethnographic observations offer descriptive snapshots of the gambling behavior of participants. The article includes details about games played, popular venues, initiation patterns, time spent gambling, and interactions with the police.

Street youth gamble for social benefits, such as group membership and fun; it is also a leisure activity enabling time to go by quickly. Individual benefits include intermittent rewards and a high after winning or being referred to as a gambler. The inability to save, the lack of recreation options, living in groups, and the environment of the streets structure and sustain gambling. This study discusses the group and social dimension of gambling among street youth, and how this dimension makes their participation different from adolescent gambling in general and General Addictions Theory. It contributes to the literature by emphasizing that for street youth the social/group aspects of gambling predominate the psychological. The paper concludes with a discussion of the implications for practice, highlighting the need to develop recreational, income-saving, and educational awareness programs.
Chronic obstructive pulmonary disease associated with increased risk of bipolar disorder
Authors: Su Vincent Yi-Fong , Hu Li-Yu , Yeh Chiu-Mei , Chiang Huey-Ling , Shen Cheng-Che , Chou Kun-Ta , Chen Tzeng-Ji , Lu Ti , Tzeng Cheng-Hwai , Liu Chia-Jen
Published: May 2017

Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between COPD and subsequent bipolar disorder remains unclear. From January 1, 2000, we identified adult patients with COPD from the Taiwan National Health Insurance Research Database. A nationwide population-based study was conducted; 46,778 COPD patients and 46,778 age-, sex-, and comorbidity-matched subjects between 2000 and 2011 were enrolled. The two cohorts were followed up till December 31, 2011 and observed for occurrence of bipolar disorder. We observed the COPD and comparison cohorts for 263,020 and 267,895 person-years, respectively, from 2000 to 2011. The incidence rate for bipolar disorder was 1.6/1000 person-years in the COPD cohort and 1.2/1000 person-years in the comparison cohort ( p < 0.001). After multivariate adjustment, the hazard ratio (HR) for subsequent bipolar disorder among the COPD patients was 1.42 (95% confidence interval [CI], 1.22–1.64; p < 0.001). In the COPD patients, short-acting beta-agonists (SABAs) was associated with a significantly increased risk of bipolar disorder development (HR = 1.83, 95% CI = 1.25–2.69, p = 0.002). Other COPD medications were not associated with the risk of bipolar disorder development. The study results indicate that COPD may be an independent risk factor for the development of bipolar disorder. The regular use of SABAs might increase the risk of bipolar disorder in COPD patients.
Curative and adjunctive AVM Onyx embolization of AVMs through the choroidal arteries
Authors: Lv Xianli , Hu Xiulan , Li Wei , He Hongwei , Jiang Chuhan , Li Youxiang
Published: May 2017

Objective

The anterior or posterior choroidal artery is often recruited to supply deep location arteriovenous malformations (AVMs). This study is to report curative and adjunctive AVM Onyx embolization through these arteries.

Methods

This study retrospectively reviewed six patients with cerebral AVMs who underwent endovascular embolization through the choroidal arteries between October 2015 and October 2016. Embolization was performed as a curative procedure in five patients and adjunctive procedure in one patient.

Results

Four patients underwent embolization through the anterior choroidal artery (AchA), and two patients underwent embolization through the lateral posterior choroidal artery (LPchA). One of the four patients in whom embolization was from the AchA (distal to the plexal point) developed transient hemiparesis. Complete obliteration was confirmed by angiography at the last follow-up in five patients.

Conclusions

Onyx embolization of cerebral AVMs through the choroidal arteries is possible as a curative or adjunctive procedure.
In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease
Authors: Groot Jebbink Erik , Ter Mors Thijs G , Slump Cornelis H , Geelkerken Robert H , Holewijn Suzanne , Reijnen Michel MPJ
Published: May 2017

Objectives

Various configurations of kissing stent (KS) configurations exist and patency rates vary. In response the covered endovascular reconstruction of the aortic bifurcation configuration was designed to minimize mismatch and improve outcome. The aim of the current study is to compare geometrical mismatch of kissing stent with the covered endovascular reconstruction of the aortic bifurcation configuration in vivo.

Methods

Post-operative computed tomographic data and patient demographics from 11 covered endovascular reconstruction of the aortic bifurcation and 11 matched kissing stent patients were included. A free hand region of interest and ellipse fitting method were applied to determine mismatch areas and volumes. Conformation of the stents to the vessel wall was expressed using the D-ratio.

Results

Patients were mostly treated for Rutherford category 2 and 3 (64%) with a lesion classification of TASC C and D in 82%. Radial mismatch area and volume for the covered endovascular reconstruction of the aortic bifurcation group was significantly lower compared to the kissing stent configuration ( P < 0.05). The D-ratio did not significantly differ between groups. Measurements were performed with good intra-class correlation. There were no significant differences in the post-procedural aortoiliac anatomy.

Conclusions

The present study shows that radial mismatch exists in vivo and that large differences in mismatch exist, in favour of the covered endovascular reconstruction of the aortic bifurcation configuration. Future research should determine if the decreased radial mismatch results in improved local flow profiles and subsequent clinical outcome.
Digital masquerading: Feminist media activism in China
Authors: Tan Jia
Published: May 2017

In March 2015, five young feminists were detained and accused of “disturbing public order” through their plan to circulate messages against sexual harassment in public transportation. This article focuses on the feminist media practices before and after the detention of the Feminist Five to shed light on the dynamics between state surveillance and incrimination, media activism, and feminist politics in China. Exploring the practices of the Youth Feminist Action School, it argues that the role of media in this new wave of feminist activism can be better understood as a form of “digital masquerading” in three ways. First, this captures the self-awareness and agency of feminists in their tactical use of media to circumvent censorship. Masquerading in the digital era is an active and self-conscious act leveraging the specificity of media practice to set the media agenda, increase public influence, and avoid censorship. Second, masquerading refers to the digital alteration of images in order to tactically represent women’s bodies in public spaces while circumventing censorship and possible criminalization. It highlights the figurative and the corporeal in online digital activist culture, which are oftentimes overlooked in existing literature. Third, while the masquerade in psychoanalytic theory emphasizes individualized gendered identity, the notion of digital masquerade points to the interface between the medium and the subjects, which involves collective efforts in assembling activist activities and remaking publicness.
Propaganda, Persuasion, or Journalism?
Authors: Bard Mitchell T.
Published: May 2017

The scholarly literature on Fox News has largely focused on the network’s ideological disposition, assuming Fox News to be a journalistic operation. However, a handful of scholars have challenged those assumptions. Conway, Grabe, and Grieve found one of the network’s prime-time programs to be practicing propaganda, not journalism. This article seeks to further the work of Conway et al. by employing a qualitative textual analysis of Fox News’ prime-time coverage of health-care reform in 2009 and 2014 to determine whether the network’s programs worked within the traditional values of objective journalism, aside from the network’s ideological disposition, or whether the programs’ practices were more consistent with propaganda or the rhetorical concept of persuasion. The study finds that in both periods, Fox News’ prime-time programs employed multiple themes based on nonfactual premises to oppose health-care reform, which were more in line with propaganda than journalism or persuasion.
Promoting Sustainable Hotel Guest Behavior: A Systematic Review and Meta-Analysis
Authors: Nisa Claudia , Varum Celeste , Botelho Anabela
Published: May 2017

Unsustainable patterns of tourist behavior produce a massive environmental burden. Nevertheless, it is unknown which behavioral strategies can be implemented to foster resource-efficient behavior in customers of leisure and travel services. This article aims to identify and summarize the evidence about the interventions which have been tested to promote sustainable hotel guest behavior. Electronic searches were performed in the main databases from inception to September 2016. Papers deemed eligible for inclusion were experimental field studies, reporting factual changes in guest behavior. The final sample was composed of nine papers comprising 13 studies in a total of 5,859 hotel stays. Results showed that all included interventions targeted towel reuse. Five different types of interventions were identified including environmental appeals, messages prompting commitment for conservation, donation to charity, social norms, and nudges. Only the last two forms of interventions (social norms: effect size [ES] = −0.25, 95% confidence interval [CI] = [−0.39, −0.12], p = .004 and nudges: ES = −0.43, 95% CI = [−0.72, −0.13], p = .009) showed significant positive effects in promoting towel reuse. Particularly regarding social norms, our work shows an effect weaker than reported in previous meta-analyses but consistent (low between-study heterogeneity) in producing modest increases in the levels of towel reuse.
Insights Into the Chinese Pangolin’s (Manis pentadactyla) Diet in a Peri-Urban Habitat
Authors: Lee Roger Ho , Cheung Khan , Fellowes John R. , Guénard Benoit
Published: May 2017

Gut content analysis of a juvenile Chinese pangolin revealed eight ant and one termite species being preyed on. The identification of > 26,000 prey items and a comparison with local ant communities suggest a selective foraging behavior and a tendency for direct predation on arboreal or epigaeic ant nests within secondary forest and shrubland habitats.
The Role of Imaging in Clinical Stroke Scales That Predict Functional Outcome: A Systematic Review
Authors: Soliman Fatima , Gupta Ajay , Delgado Diana , Kamel Hooman , Pandya Ankur
Published: May 2017

Background and Purpose:

Numerous stroke scales have been developed to predict functional outcomes following acute ischemic stroke. The goal of this study was to summarize functional outcome scores in stroke that incorporate neuroimaging with those that don’t incorporate neuroimaging.

Methods:

Searches were conducted in Ovid MEDLINE, Ovid Embase, and the Cochrane Library Database from inception to January 23, 2015. Additional records were identified by employing the “Cited by” and “View References” features in Scopus. We included studies that described stroke prognosis models or scoring systems that predict functional outcome based on clinical and/or imaging data available on presentation. Score performance was evaluated based on area under the receiver operating characteristic curve (AUC).

Results:

A total of 3300 articles were screened, yielding 14 scores that met inclusion criteria. Half (7) of the scores included neuroimaging as a predictor variable. Neuroimaging parameters included infarct size on magnetic resonance diffusion-weighted imaging, infarct size defined by computed tomography hypodensity, and hemodynamic abnormality on perfusion imaging. The modified Rankin Scale at 3 months poststroke was the most common functional outcome reported (13 of 14 scores). The AUCs ranged from 0.64 to 0.84 for scores that included neuroimaging as a predictor and 0.64 to 0.94 for scores that did not include neuroimaging. External validation has been performed for 7 scores.

Conclusions:

Due to the marked heterogeneity in the scores and populations in which they were applied, it is unclear whether current imaging-based scores offer advantages over simpler approaches for predicting poststroke function.
Hormone replacement therapy in pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign disease: A review of practice
Authors: Richardson Alison , West Emily , Cust Mike
Published: May 2017

Introduction

The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of the menopause states that women who are likely to go through the menopause as a result of surgical treatment should be offered information about the menopause and the importance of starting hormonal replacement therapy before they have their treatment.

Objectives

To determine compliance with NICE guidelines at the Royal Derby Hospital.

Study design

We undertook a retrospective review of all pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign pathology between 1 January 2016 and 30 June 2016.

Results

Thirty-six cases were reviewed. Women were aged between 32.5 and 49.8 years old (median 45.13, inter-quartile range 42.6–47.6). The commonest indications for bilateral salpingo-oophorectomy were dysfunctional uterine bleeding (36.1%), chronic pelvic pain (30.5%), complex cyst (13.9%), and pre-menstrual syndrome (13.9%). Fifteen women (41.7%) did not have hormonal replacement therapy discussed. Only two (5.6%) had hormonal replacement therapy discussed pre-operatively. The remaining 19 had hormonal replacement therapy discussed post-operatively, either on the ward prior to discharge (n = 3) or, more commonly, in clinic six to eight weeks later. Although hormonal replacement therapy was only contraindicated in one woman (3%), it was only prescribed to five (24%). Results were slightly better for women under 40 but still only 28.6% had hormonal replacement therapy discussed with them pre-operatively.

Conclusion

This audit has demonstrated that compliance with the NICE guidelines is poor. We suspect similar results might be found in other gynaecology departments nationally. A hospital guideline to aid clinicians and a patient information sheet to educate women has been devised. A re-audit is planned six months after ratification of these documents.
Potential Role of Serum and Urinary Biomarkers in Diagnosis and Prognosis of Diabetic Nephropathy
Authors: Campion Carole G. , Sanchez-Ferras Oraly , Batchu Sri N.
Published: May 2017

Purpose of review:

Diabetic nephropathy (DN) is a progressive kidney disease caused by alterations in kidney architecture and function, and constitutes one of the leading causes of end-stage renal disease (ESRD). The purpose of this review is to summarize the state of the art of the DN-biomarker field with a focus on the new strategies that enhance the sensitivity of biomarkers to predict patients who will develop DN or are at risk of progressing to ESRD.

Objective:

In this review, we provide a description of the pathophysiology of DN and propose a panel of novel putative biomarkers associated with DN pathophysiology that have been increasingly investigated for diagnosis, to predict disease progression or to provide efficient personal treatment.

Methods:

We performed a review of the literature with PubMed and Google Scholar to collect baseline data about the pathophysiology of DN and biomarkers associated. We focused our research on new and emerging biomarkers of DN.

Key findings:

In this review, we summarized the critical signaling pathways and biological processes involved in DN and highlighted the pathogenic mediators of this disease. We next proposed a large review of the major advances that have been made in identifying new biomarkers which are more sensitive and reliable compared with currently used biomarkers. This includes information about emergent biomarkers such as functional noncoding RNAs, microRNAs, long noncoding RNAs, exosomes, and microparticles.

Limitations:

Despite intensive strategies and constant investigation, no current single treatment has been able to reverse or at least mitigate the progression of DN, or reduce the morbidity and mortality associated with this disease. Major difficulties probably come from the renal disease being heterogeneous among the patients.

Implications:

Expanding the proteomics screening, including oxidative stress and inflammatory markers, along with metabolomics approaches may further improve the prognostic value and help in identifying the patients with diabetes who are at high risk of developing kidney diseases.
In-hospital experiences of families of potential organ donors: A systematic review and qualitative synthesis
Authors: Dicks Sean Glenton , Ranse Kristen , van Haren Frank MP , Boer Douglas P
Published: May 2017

Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not well described with past research focusing on decision-making. To enhance understanding and improve service delivery, a systematic review was conducted. Inductive analysis and synthesis utilised Grounded Theory Methodology within a systems theory framework and contributed to a model proposing that family and staff form a System of Systems with shared responsibility for process outcomes. This model can guide evaluation and improvement of care and will be tested by means of a longitudinal study of family experiences.
Layers of sense: the sensory work of diagnostic sensemaking in digital health
Authors: Maslen Sarah
Published: May 2017

Sensory judgements have always been a part of medical practice and this sensory work is often entangled with technologies, from the stethoscope to digitised devices for advanced life support. This article investigates this sensory work and its entanglements with technological sensors in diagnostic practice. Based on semi-structured interviews, it presents a close analysis of practitioners’ use of anaesthetic monitoring and telemedicine. It argues that senses and sensors are recursively combined in the moment towards understanding. In this, digital technologies do not present self-evident data, but rather the practitioner must learn to sense the sensors to interpret health and illness. Sensory work (of both the senses and sensors) is not dispensable or entirely delegable because it is intimately entwined with sensemaking. The significance of sensory work to sensemaking reinforces the importance of its consideration in digital health sociotechnical assemblages.
Hypnotherapy to Reduce Hot Flashes: Examination of Response Expectancies as a Mediator of Outcomes
Authors: Sliwinski Jim R. , Elkins Gary R.
Published: May 2017

The mechanism of action responsible for hypnotherapy’s effect in reducing hot flashes is not yet known. The purpose of this study was to examine the role of response expectancies as a potential mediator. Hypnotizability was also tested as an effect moderator. Data were collected from a sample of 172 postmenopausal women, who had been randomized to receive either a 5-week hypnosis intervention or structured attention counseling. Measures of response expectancies were analyzed to determine if the relationship between group assignment and hot flashes frequency was mediated by expectancies for treatment efficacy. A series of simple mediation and conditional process analyses did not support mediation of the relationship between treatment condition and hot flash frequency through response expectancy. The effect of hypnotherapy in reducing hot flashes does not appear to be due to placebo effects as determined by response expectancies. Implications for clinical practice and future research are discussed.
Demographics and Injuries Associated With Knee Dislocation: A Prospective Review of 303 Patients
Authors: Moatshe Gilbert , Dornan Grant J. , Løken Sverre , Ludvigsen Tom C. , LaPrade Robert F. , Engebretsen Lars
Published: May 2017

Background:

Information on the incidence, injury mechanisms, ligament injury patterns, and associated injuries of knee dislocations is lacking in the literature. There is a need to characterize ligament injury patterns and associated injuries in knee dislocations to avoid missing common associated diagnoses and to plan surgical treatment.

Purpose:

To evaluate patient demographics, ligament injury patterns and associated injury patterns, and associated injuries in patients with knee dislocation.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 303 patients with knee dislocations treated at a single level 1 trauma center were followed prospectively. Injury mechanism; ligament injury patterns; associated neurovascular, meniscal, and cartilage injuries; and surgical complications were recorded. The Schenck knee dislocation classification was used to classify the ligament injury patterns.

Results:

The mean age at injury was 37.8 ± 15.3 years. Of the 303 patients included, 65% were male and 35% were female. There was an equal distribution of high-energy and low-energy injuries. Injury to 3 major ligaments was the most common, with Schenck classification type KD III-M constituting 52.4% of the injuries and KD III-L comprising 28.1%. Meniscal injuries and cartilage injuries occurred in 37.3% and 28.3% of patients, respectively. Patients with acute injuries had significantly lower odds of a cartilage injury than those with chronic injuries (odds ratio [OR], 0.28; 95% CI, 0.15-0.50; P < .001). Peroneal nerve injuries were recorded in 19.2% of patients (10.9% partial and 8.3% complete deficit), while vascular injuries were recorded in 5%. The odds of having a common peroneal nerve injury were 42 times greater ( P < .001) among those with posterolateral corner injury (KD III-L) than those without. The odds for popliteal artery injury were 9 times greater ( P = .001) among those with KD III-L injuries than other ligament injury types.

Conclusion:

Medial-sided bicruciate injuries were the most common injury pattern in knee dislocations. Cartilage injuries were common in chronically treated patients. There was a significant risk of peroneal nerve injury with lateral-sided injuries.
Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study
Authors: Borisov Sergey E. , Dheda Keertan , Enwerem Martin , Romero Leyet Rodolfo , D'Ambrosio Lia , Centis Rosella , Sotgiu Giovanni , Tiberi Simon , Alffenaar Jan-Willem , Maryandyshev Andrey , Belilovski Evgeny , Ganatra Shashank , Skrahina Alena , Akkerman Onno , Aleksa Alena , Amale Rohit , Artsukevich Janina , Bruchfeld Judith , Caminero Jose A. , Carpena Martinez Isabel , Codecasa Luigi , Dalcolmo Margareth , Denholm Justin , Douglas Paul , Duarte Raquel , Esmail Aliasgar , Fadul Mohammed , Filippov Alexey , Davies Forsman Lina , Gaga Mina , Garcia-Fuertes Julia-Amaranta , García-García José-María , Gualano Gina , Jonsson Jerker , Kunst Heinke , Lau Jillian S. , Lazaro Mastrapa Barbara , Teran Troya Jorge Lazaro , Manga Selene , Manika Katerina , González Montaner Pablo , Mullerpattan Jai , Oelofse Suzette , Ortelli Martina , Palmero Domingo Juan , Palmieri Fabrizio , Papalia Antonella , Papavasileiou Apostolos , Payen Marie-Christine , Pontali Emanuele , Robalo Cordeiro Carlos , Saderi Laura , Sadutshang Tsetan Dorji , Sanukevich Tatsiana , Solodovnikova Varvara , Spanevello Antonio , Topgyal Sonam , Toscanini Federica , Tramontana Adrian R. , Farokh Udwadia Zarir , Viggiani Pietro , White Veronica , Zumla Alimuddin , Migliori Giovanni Battista
Published: May 2017

Large studies on bedaquiline used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) are lacking. This study aimed to evaluate the safety and effectiveness of bedaquiline-containing regimens in a large, retrospective, observational study conducted in 25 centres and 15 countries in five continents.

428 culture-confirmed MDR-TB cases were analysed (61.5% male; 22.1% HIV-positive, 45.6% XDR-TB). MDR-TB cases were admitted to hospital for a median (interquartile range (IQR)) 179 (92–280) days and exposed to bedaquiline for 168 (86–180) days. Treatment regimens included, among others, linezolid, moxifloxacin, clofazimine and carbapenems (82.0%, 58.4%, 52.6% and 15.3% of cases, respectively).

Sputum smear and culture conversion rates in MDR-TB cases were 63.6% and 30.1%, respectively at 30 days, 81.1% and 56.7%, respectively at 60 days; 85.5% and 80.5%, respectively at 90 days and 88.7% and 91.2%, respectively at the end of treatment. The median (IQR) time to smear and culture conversion was 34 (30–60) days and 60 (33–90) days. Out of 247 culture-confirmed MDR-TB cases completing treatment, 71.3% achieved success (62.4% cured; 8.9% completed treatment), 13.4% died, 7.3% defaulted and 7.7% failed. Bedaquiline was interrupted due to adverse events in 5.8% of cases. A single case died, having electrocardiographic abnormalities that were probably non-bedaquiline related.

Bedaquiline-containing regimens achieved high conversion and success rates under different nonexperimental conditions.