bluuebunny/crossref_metadata_2025 huggingface dataset:
Willingness to pay for pharmacist-provided home telemonitoring among patients with chronic diseases in Enugu metropolis
Authors: Anosike Chibueze , Adibe Maxwell Ogochukwu , Isah Abdulmuminu , Ukoha-Kalu Onyinye Blessing
Published: June 2019

Home telemonitoring is a promising approach in the management of patients with chronic diseases. However, no study has assessed its acceptability and possible service charge in Nigeria. Therefore, this study aimed to evaluate willingness to pay for pharmacist-provided telemonitoring among patients with chronic diseases and to explore its determinants. Hence, using the contingent valuation method, a cross-sectional study was conducted among eligible patients visiting 15 selected community pharmacies in Enugu metropolis, over a period of 3 months. Of the 335 patients who participated in the study, about 40 percent (i.e. 39.4%) were willing to pay an average monthly fee of ₦915.91 ± 485.49 (US$2.99 ± 1.59) for home telemonitoring services. Significant predictors of willingness to pay for home telemonitoring were perceived insufficient income (odds ratio = 0.20, 95% confidence interval = 0.07–0.60, p = 0.040) and health insurance status (odds ratio = 0.39, 95% confidence interval = 0.18–0.86, p = 0.019). Our findings suggest a promising potential for adopting home telemonitoring services among patients with chronic diseases in Enugu metropolis.
Clinical decision support system to assess the risk of sepsis using Tree Augmented Bayesian networks and electronic medical record data
Authors: Gupta Akash , Liu Tieming , Shepherd Scott
Published: June 2019

Early and accurate diagnoses of sepsis enable practitioners to take timely preventive actions. The existing diagnostic criteria suffer from deficiencies, such as triggering false alarms or leaving conditions undiagnosed. This study aims to develop a clinical decision support system to predict the risk of sepsis using tree augmented naive Bayesian network by identifying the optimal set of biomarkers. The key feature of our approach is that we captured the dynamics among biomarkers. With an area under receiver operating characteristic of 0.84, the proposed model outperformed the competing diagnostic criteria (systemic inflammatory response syndrome = 0.59, quick sepsis-related organ failure assessment = 0.65, modified early warning system = 0.75, sepsis-related organ failure assessment = 0.80). The richness of our proposed model is measured not only by achieving high accuracy, but also by utilizing fewer biomarkers. We also propose a left-center-right imputation method suitable for electronic medical record data. This method uses the individual patient’s visit, instead of aggregated (mean or median) value, to impute the missing data.
New dynamics of social status and distinction
Authors: Eckhardt Giana M. , Bardhi Fleura
Published: June 2019

We explore emerging dynamics of social status and distinction in liquid consumption. The new logic of distinction is having the flexibility to embrace and adopt new identity positions, projects, and possibilities and the ability to attract attention. The importance of flexibility and attention as resources emerged from the social sciences literature in the domains of digital, access based, and urban consumption as being the most important for achieving distinction in the contemporary marketplace. We then conceptually reexamine conspicuous consumption and taste and show that status signaling now relies upon inconspicuousness, non-ownership including experiences, and authenticity based on knowledge and craftsmanship, all of which are difficult to emulate. Our contribution lies in integrating disparate literature on social status and consumption within one conceptual space. We also build upon the concept of liquid consumption by outlining exactly how liquidity affects status and distinction, an area which has not been explored to date.
Juvenile sanctions for young adults in the Netherlands: A developmental perspective
Authors: van der Laan André M. , Beerthuizen Marinus G.C.J. , Barendregt Charlotte S.
Published: June 2019

Since 2014 it has been possible to apply juvenile criminal law to young adults aged from 18 up to and including 22 years old in the Netherlands. This policy change is referred to as the Adolescent Criminal Law (ACL). According to the theory behind ACL, providing special treatment within the juvenile justice system to young adults during their transition into adulthood could reduce recidivism. In order to determine the relevance and impact of ACL regarding the application of juvenile sanctions to young adults, in this study a ‘Recently Introduced Policy instrument’ (RIPI) evaluation was conducted. The results suggest that applying juvenile justice sanctions to young adults could offer opportunities to cut short criminal careers and reduce crime amongst young adults. In addition, we found that the proportion of juvenile sanctions applied to young adults has increased despite the overall crime drop amongst young adults. Implications of our findings are discussed.
In Vivo Morphological Changes of the Femoropopliteal Arteries due to Knee Flexion After Endovascular Treatment of Popliteal Aneurysm
Authors: Spinella Giovanni , Finotello Alice , Pane Bianca , Salsano Giancarlo , Mambrini Simone , Kamenskiy Alexey , Gazzola Valerio , Cittadini Giuseppe , Auricchio Ferdinando , Palombo Domenico , Conti Michele
Published: June 2019

Purpose: To evaluate morphological changes of the femoropopliteal (FP) arteries due to limb flexion in patients undergoing endovascular treatment of popliteal artery aneurysms (PAAs). Materials and Methods: Seven male patients (mean age 68 years) underwent endovascular treatment of PAA with a Viabahn stent-graft between January 2013 and December 2017. During follow-up, one contrast-enhanced computed tomography angiography (CTA) scan of the lower limbs was acquired for each recruited patient. A standardized CTA protocol for acquisitions in both straight-leg and bent-leg positions was used to visualize changes in artery shape due to limb flexion. Three-dimensional reconstruction of the FP segment was performed to compute mean diameter and eccentricity of the vascular lumen and to measure length, tortuosity, and curvature of the vessel centerline in 3 arterial zones: (A) between the origin of the superficial femoral artery and the proximal end of the stent-graft, (B) within the stent-graft, and (C) from the distal end of the stent-graft to the origin of the anterior tibial artery. Results: After limb flexion, all zones of the FP segment foreshortened: 6% in zone A (p=0.001), 4% in zone B (p=0.001), and 8% in zone C (p=0.07), which was the shortest (mean 4.5±3.6 cm compared with 23.8±5.7 cm in zone A and 23.6±7.4 cm in zone B). Tortuosity increased in zone A (mean 0.03 to 0.05, p=0.03), in zone B (0.06 to 0.15, p=0.005), and in zone C (0.027 to 0.031, p=0.1). Mean curvature increased 15% (p=0.05) in zone A, 27% (p=0.005) in zone B, and 95% (p=0.06) in zone C. In all zones, the mean artery diameter and eccentricity were not significantly affected by limb flexion. Conclusion: Limb flexion induces vessel foreshortening and increases mean curvature and tortuosity of the FP segment both within and outside the area of the stent-graft.
Technical Assessment of an Automated Treatment Planning on Dose Escalation of Pancreas Stereotactic Body Radiotherapy
Authors: Wang Shuo , Zheng Dandan , Lin Chi , Lei Yu , Verma Vivek , Smith April , Ma Rongtao , Enke Charles A. , Zhou Sumin
Published: June 2019

Background:

Stereotactic body radiotherapy has been suggested to provide high rates of local control for locally advanced pancreatic cancer. However, the close proximity of highly radiosensitive normal tissues usually causes the labor-intensive planning process and may impede further escalation of the prescription dose.

Purpose:

The present study aims to evaluate the consistency and efficiency of Pinnacle Auto-Planning for pancreas stereotactic body radiotherapy with original prescription and escalated prescription.

Methods:

Twenty-four patients with pancreatic cancer treated with stereotactic body radiotherapy were studied retrospectively. The prescription is 40 Gy over 5 consecutive fractions. Most of patients (n = 21) also had 3 other different dose-level targets (6 Gy/fraction, 5 Gy/fraction, and 4 Gy/fraction). Two types of plans were generated by Pinnacle Auto-Planning with the original prescription (8 Gy/fraction, 6 Gy/fraction, 5 Gy/fraction, and 4 Gy/fraction) and escalated prescription (9 Gy/fraction, 7 Gy/fraction, 6 Gy/fraction, and 5 Gy/fraction), respectively. The same Auto-Planning template, including beam geometry, intensity-modulated radiotherapy objectives and intensity-modulated radiotherapy optimization parameters, were utilized for all the auto-plans in each prescription group. The intensity-modulated radiotherapy objectives do not include any manually created structures. Dosimetric parameters including percentage volume of PTV receiving 100% of the prescription dose, percentage volume of PTV receiving 93% of the prescription dose, and consistency of the dose-volume histograms of the target volumes were assessed. Dmax and D1 cc of highly radiosensitive organs were also evaluated.

Results:

For all the pancreas stereotactic body radiotherapy plans with the original or escalated prescriptions, auto-plans met institutional dose constraints for critical organs, such as the duodenum, small intestine, and stomach. Furthermore, auto-plans resulted in acceptable planning target volume coverage for all targets with different prescription levels. All the plans were generated in a one-attempt manner, and very little human intervention is necessary to achieve such plan quality.

Conclusions:

Pinnacle3 Auto-Planning consistently and efficiently generate acceptable treatment plans for multitarget pancreas stereotactic body radiotherapy with or without dose escalation and may play a more important role in treatment planning in the future.
The Utility of Smartphone Applications and Technology in Wound Healing
Authors: Shamloul Norhan , Ghias Mondana H. , Khachemoune Amor
Published: June 2019

Appropriate management of both acute and chronic wounds is a dynamic practice that consumes large amounts of time and financial resources within the health care system. Traditionally, wounds were measured clinically and subjectively, leading to inaccuracies in assessing wound progression and healing over time. The recent development of mobile applications and digital equipment in medicine provides an opportunity for significant improvement in wound care through the incorporation of “smart” technologies in clinical practice. The utility of these technologies has been assessed regarding the treatment of diabetic foot ulcers, burns, and general wounds. The focus of this review is to provide an update on the current status of mobile applications and digital technology in the management of wounds.
Never Underestimate a Concomitant Repairable Inflow Lesion in Buerger’s Disease!
Authors: Georgakarakos Efstratios , Koutsoumpelis Andreas , Koufopoulos Georgios , Tilkeridis Konstantinos
Published: June 2019

A case of Buerger’s disease is presented where percutaneous endovascular treatment of a concomitant focal stenosis in the superficial femoral artery led to immediate remission of symptoms and aided wound healing. The existence of such lesions should never be underestimated.
18F-FDG PET/CT Quantitative Parameters and Texture Analysis Effectively Differentiate Endometrial Precancerous Lesion and Early-Stage Carcinoma
Authors: Wang Tong , Sun Hongzan , Guo Yan , Zou Lue
Published: June 2019

Objective:

This study evaluated the metabolic parameters and texture features of fluorodeoxyglucose positron emission tomography–computed tomography (PET/CT) for the diagnosis and differentiation of endometrial atypical hyperplasia (EAH), EAH with field cancerization (FC), and stage 1A endometrial carcinoma (EC 1a).

Materials and Methods:

We retrospectively analyzed the metabolic parameters of PET/CT in 170 patients with diagnoses confirmed by pathology, including 57 cases of EAH (57/170, 33.53%), 45 cases of FC (45/170, 26.47%), and 68 cases of EC 1a (68/170, 40.0%). Then, the texture features of each tumor were extracted and compared with the metabolic parameters and pathological results using nonparametric tests and linear regression analysis. The diagnostic performance was assessed by the area under the curve (AUC) values obtained from receiver operating characteristic analysis.

Results:

There were moderate positive correlations between the PET standardized uptake values (SUVpeak, SUVmax, and SUVmean) and postoperative pathological features with correlation coefficients ( r s) of 0.663, 0.651, and 0.651, respectively ( P < .001). Total lesion glycolysis showed relatively low correlation with pathological characteristics ( r s = 0.476), whereas metabolic tumor volume and age showed the weakest correlations ( r s = 0.186 and 0.232, respectively). To differentiate between the diagnosis of EAH and FC, SUVmax displayed the largest AUC of 0.857 (sensitivity, 82.2%; specificity, 84.2%). Five texture features were screened out as Percentile 40, Percentile 45, InverseDifferenceMoment_AllDirection_offset 1, InverseDifferenceMoment_angle 45_offset 4, and ClusterProminence_angle 135_offset 7 ( P < .001) by linear model of texture analysis (AUC = 0.851; specificity = 0.692; sensitivity = 0.871). To differentiate between the diagnoses of FC and EC 1a, SUVpeak displayed the largest AUC of 0.715 (sensitivity, 67.6%; specificity, 77.8%), and 2 texture features were identified as Percentile 10 and CP_angle 135_offset 7 (AUC = 0.819; specificity = 0.871; sensitivity = 0.766; P < .001).

Conclusions:

SUVmax and SUVpeak had the highest diagnostic values for EAH, FC, and EC 1a compared with the other tested parameters. SUVmax, Percentile 40, Percentile 45, InverseDifferenceMoment_AllDirection_offset 1, InverseDifferenceMoment_angle 45_offset 4, and ClusterProminence_angle 135_offset 7 distinguished EAH from FC. SUVpeak, Percentile 10, and ClusterProminence_angle 135_offset 7 distinguished FC from EC 1a. This study showed that the addition of texture features provides valuable information for differentiating EAH, FC, and EC 1a diagnoses.
Ethical Considerations in Using Social Media to Engage Research Participants: Perspectives of Australian Researchers and Ethics Committee Members
Authors: Hokke Stacey , Hackworth Naomi J. , Bennetts Shannon K. , Nicholson Jan M. , Keyzer Patrick , Lucke Jayne , Zion Lawrie , Crawford Sharinne B.
Published: June 2019

Researchers increasingly use social media (SM) to recruit, retain, and trace participants, yet empirical literature investigating the ethics of engaging participants via SM is lacking. We conducted a survey of 401 Australian researchers and human research ethics committee (HREC) members to examine their experience, attitudes, and ethical concerns toward engaging participants via SM. Data revealed that researchers and HREC members share similar concerns and attitudes about using SM in general and in research. We identified a strong demand for additional support, training, and guidance on SM research ethics. This need reflects researchers’ and HREC members’ limited confidence and knowledge of ethical issues in this context and a lack of awareness of available SM-specific ethical guidelines.
The relationship between passion for coaching and the coaches’ interpersonal behaviors: The mediating role of coaches’ perception of the relationship quality with athletes
Authors: Kim Inwoo , Lee Keunchul , Kang Sangwook
Published: June 2019

According to Self-Determination Theory, sports coaches’ autonomy-supportive behaviors positively influence athletes’ different aspects, such as motivation, well-being, and performance, while controlling behaviors of coaches tend to diminish such variables. Although many researchers agree that autonomy-supportive coaching style should be promoted rather than a controlling style, there is scarce research investigating the antecedents of such behavioral styles. The aim of this study was to examine a model of potential determinants of coaches’ interpersonal behaviors by investigating the relationship between passion for coaching and their behavioral styles and verifying the mediating role of coaches’ perceived relationship quality with their athletes. A total of 172 coaches participated in the survey, and data sets were analyzed using structural model analysis. Results revealed that coaches’ harmonious passion positively predicted autonomy-supportive behaviors but negatively predicted controlling behaviors, and these pathways were mediated by coaches’ perception of the relationship with their athletes. The implications for coaches and researchers from those results are discussed.
Archive partisans: Forbidden histories and the promise of the future
Authors: Hegasy Sonja
Published: June 2019

Remembering past injustices has been regarded as central to overcoming intra-societal conflicts with the end of World War II. Since, memory has increasingly been charged as a means to achieve reconciliation. But only in recent years have archives, and here especially human rights archives, in the Mashreq and Maghreb moved from being semi-functional repositories for academics to become important loci for political activists to reappraise violence and injustice. The role of the archive in preserving or erasing personal memories is critically investigated by such activists. This article covers an emergent discourse on the memory milieus of violent conflict, war, and occupation extant in this region. In a selective overview covering Morocco, the Western Sahara, Lebanon, and Egypt, it asks what the visibility of violent experiences means for the wider social context and how traumatic pasts are re-socialized through private and public archiving initiatives. The author investigates the archive less as a place of storage than as a milieu around which various actors conceptualize the past and struggle over future justice.
Evidencing leadership and management challenges in early childhood in Australia
Authors: Alchin Ian , Arthur Leonie , Woodrow Christine
Published: June 2019

The Australian early childhood system is complex and constantly changing and poses challenges to centre director/managers. A major challenge is the difficulty in meeting the responsibilities of leading and managing both organisational and pedagogical goals within the legal and educational frameworks of the system. Preparing educators for a complex and changing role may also present challenges for both initial teacher education and postgraduate professional learning. Concern continues in the sector that such challenges lead to turnover in the role, affecting the quality of programmes provided for children. A national online questionnaire collected quantitative data from director/managers working in centre-based early childhood services in order to gain an understanding of the breadth and scope of the current challenges they experience. The findings from the research reported here suggest challenges are experienced in the organisational leadership domain with managing staff a particular concern.
Analysis of “Simple Post-Processing of Continuous Glucose Monitoring Measurements Improves Endpoints in Clinical Trials”
Authors: Schmelzeisen-Redeker Günther
Published: June 2019

Jensen et al used continuous glucose monitoring (CGM) data of the Dexcom G4 Platinum (DG4P) sensor obtained in a clinical efficacy and safety study of Novo Nordisk’s new insulin Fiasp® to calculate the CGM time delay versus plasma glucose (PG) and self-measured blood glucose (SMBG) measurements (9-10 min). Shifting the CGM signal by 9 min backward in time versus PG and SMBG data improved the analytical accuracy of the DG4P sensor and the reliability of clinical research endpoint (hypoglycemia, postprandial glucose increments) detection. Since this method takes advantage of post-processing of CGM data, it is particularly suited for the optimization of data processing in clinical studies. In contrast, real-time corrections of time delays need predictive algorithms.
Human Safety and Pharmacokinetics Study of Orally Administered Icariin: Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Brown E. Sherwood , Bice Collette , Putnam William C. , Leff Richard , Kulikova Alexandra , Nakamura Alyson , Ivleva Elena I. , Enkevort Erin Van , Holmes Traci , Miingi Nyokabi
Published: June 2019

Preclinical literature suggests that icariin, a flavonoid found in Epimedium, may have potential for medical and psychiatric conditions. The objective of this study was to examine the safety, tolerability, and pharmacokinetics of orally administered icariin at doses of 100 to 1,680 mg/day in 24 healthy adult participants. Cognition, mood, and side effects were assessed over 5 days. Multiple blood samples were obtained over 24 hours to assess bioavailability and pharmacokinetics. Data were analyzed using a Wilcoxon signed rank test and Mann-Whitney U test. At all doses, either very low or undetectable blood levels of icariin were observed, demonstrating the low bioavailability of the oral formulation and preventing a determination of pharmacokinetic properties. No significant between-group differences were observed on side effect scales, either by self-report, or on cognitive assessments. A statistically significant, but not clinically significant, increase in self-reported depressive symptom severity was observed with icariin relative to placebo. Tolerability of icariin was good except at the highest dose. Two participants receiving 1,680 mg of icariin discontinued the study drug due to gastrointestinal symptoms. Bioavailability of oral icariin appears to be low at all doses tested. Although icariin appears generally to have a favorable tolerability profile, the highest doses may be associated with gastrointestinal distress. Different drug formulation and delivery method may be needed to assess the pharmacokinetic profile of icariin adequately.
Developing Evidence-Based Design Guidelines for Medical/Surgical Hospital Patient Rooms That Meet the Needs of Staff, Patients, and Visitors
Authors: Lavender Steven A. , Sommerich Carolyn M. , Sanders Elizabeth B.-N. , Evans Kevin D. , Li Jing , Radin Umar Radin Zaid , Patterson Emily S.
Published: June 2019

Objectives:

This research investigated medical/surgical (Med/Surg) patient room design to accommodate the needs of hospital staff, while at the same time accommodating the needs of patients and their visitors.

Background:

Designing hospital patient rooms that provide a comfortable healing experience for patients, while at the same time meeting the needs of the hospital staff, is a challenging process. Prior research has shown that many hospital patient room designs adversely affect the ability of hospital staff to perform their tasks effectively, efficiently, and safely.

Method:

Twenty-seven design sessions were conducted in which 104 participants, representing 24 different occupations, worked in small mixed occupational groups to design an ideal single patient Med/Surg patient room to fit their collective needs using a full-scale mock-up. During analysis, the investigators reduced the resulting 27 room designs to 5 hybrid designs that were sequentially reviewed by patients and visitors and by staff to address design conflicts.

Results:

This design process identified 51 desirable room design features that were incorporated into 66 evidence-based design guidelines for the different areas within the Med/Surg patient room including the entry way (16 guidelines), the patient clinical area (22 guidelines), the bathroom (17 guidelines), the family area (8 guidelines), and storage areas for patients and their visitors (3 guidelines).

Conclusions:

The guidelines developed through this study identified many opportunities for improving the design of hospital Med/Surg rooms to allow staff to be more effective, efficient, and safer, while at the same time addressing the design needs of patients and their visitors.
Characteristics of Adults With Type 2 Diabetes Mellitus by Category of Chronic Kidney Disease and Presence of Cardiovascular Disease in Alberta Canada: A Cross-Sectional Study
Authors: Tonelli Marcello , Wiebe Natasha , Richard Jean-Francois , Klarenbach Scott W. , Hemmelgarn Brenda R.
Published: June 2019

Background:

Type 2 diabetes mellitus (T2DM) is associated with an excess risk of cardiovascular disease (CVD) and chronic kidney disease (CKD). Although CVD, CKD, and use of antihyperglycemic treatments are all key drivers of the costs and consequences experienced by people with diabetes, no recent Canadian data describe these characteristics among adults with diabetes.

Objective:

To describe prevalence of CVD, CKD, and use of antihyperglycemic treatments among adults with diabetes.

Design:

Retrospective population-based, cross-sectional study.

Setting:

Alberta, Canada.

Patients:

All adults with T2DM as of March 31, 2017.

Measurements:

We described the demographic and clinical characteristics by CKD stage and CVD status and type. CKD stage was categorized according to international guidelines and based on estimated glomerular filtration rate (eGFR) and severity of albuminuria.

Methods:

Clinical and demographic characteristics were defined using provincial administrative data; medication use was based on data from the provincial drug plan. Additional analyses examined subgroups based on demographic characteristics, clinical characteristics, and medication use.

Results:

There were 260 903 participants, all of whom had T2DM. Median age was 64 years; 53.6% were male; and 10.9% lived in rural communities. Median duration of diabetes was 7.7 years. Half of the participants had A1C <7%. Overall, 33.0% had CKD; among these most had eGFR <60 mL/min/1.73 m2; 11.1%, 5.6%, and 2.9% had CKD stages 3a, 3b, and 4/5, respectively. The overall prevalence of CVD (prior myocardial infarction, stroke/transient ischemic attack, or peripheral artery disease) was 22.5%; prevalence increased in parallel with the presence of CKD: 14.4%, 28.8%, 35.7%, 44.3%, and 50.9% for stages 1, 2, 3a, 3b, and 4/5, respectively. Prescriptions for antihyperglycemic medications were more common in people with CKD as compared with those without. However, the use of all antihyperglycemic medications except insulin and meglitinide was progressively lower in the presence of more severe CKD.

Limitations:

The study is based on administrative data; therefore, the findings could be influenced by measurement error (eg, accuracy of diagnostic and procedural codes and prescription drug codes used).

Conclusions:

These findings will be useful to policy makers seeking to understand the burden of diabetes-related kidney disease as well as the potential budget implications and potential clinical benefits of expanded use of antihyperglycemic use in this population.
Commodification of Politics: Party Funding and Electoral Contest in Nigeria
Authors: Ayeni Oluwadare O.
Published: June 2019

Globally, political parties have become unavoidable institutions playing pivotal roles in the public administration advancement of nations. The importance of these roles have made it a subject of debate and concern among stakeholders on the best ways to finance political parties that will maintain equality and equity during elections. This article argues that electoral success in Nigeria is expected to be influenced by personality values and traits. Despite the canonic belief in integrity, people of integrity, professionals, and retired civil servants appear to be abstaining from party politics as they do not see it as an avenue through which they can make their contribution to the building of a nation because of the presumption that politics is for those who have the wherewithal different from integrity and expertise. The political competition is always economically demanding with a lot of victories and failures against the backdrop of expectations and speculations. This article interrogates the key issues responsible for election victory and failure with special reference to party funding in Nigeria. It concludes by making policy options for electoral umpire handling elections in emerging democracy like Nigeria.
Development of a Japanese Version of the Mini-Cambridge Exeter Repetitive Thought Scale
Authors: Kambara Kohei , Kira Yugo , Ogata Akiko
Published: June 2019

Although repetitive thought is a risk factor for depression, it can also foster constructive consequences. One factor that determines whether repetitive thought is constructive is the processing mode. The Mini-Cambridge Exeter Repetitive Thought Scale (Mini-CERTS) is the only scale to evaluate such processing modes that relate to the abstractness of thoughts. However, there is no scale to evaluate processing modes in Japan. In this study, the Mini-CERTS was translated into Japanese, and we sought to establish a method of evaluating the processing modes of repetitive thoughts. We conducted exploratory factor analysis of data collected from 222 university students and examined internal consistency and criterion validity. Results showed that the Japanese version of the Mini-CERTS (CERTS-J) had only 12 items. These items loaded upon two factors: abstract analytical thinking (AAT) and concrete experiential thinking (CET). AAT showed sufficient criterion-related validity, but CET did not. Nevertheless, higher AAT predicted higher depression, whereas higher CET predicted lower depression. Thus, the CERTS-J can evaluate processing modes and the functionality of repetitive thoughts. Additional research is needed to assess whether the original English items suit the Japanese culture.
Managerial Empowerment and Firm Risk-Taking
Authors: Mirza Sultan Sikandar , Safdar Raheel , Yu Yan , Gulzar M. Awais
Published: June 2019

This study highlights the importance of political ties of top management on firm risk-taking preferences. This study divides the managerial powers into six categories and then tries to check the impact of those powers on firm risk-taking by considering internal and external input resources from 2011 to 2015. Interestingly, results show that firms with political ties are more risk-takers than nonpolitically connected firms. Managerial political ties empower them to control the internal and external resources of the firm and make them more authoritative to make investment decisions about risky projects. While expert power is the only source of authoritative decision-making power for managers regarding risk-taking in nonpolitically connected firms. These findings are of great importance for transitional economies, especially regarding Chinese unique business environment.
Size Matters After All: Experimental Evidence that SEM Consumption Influences Genital and Body Esteem in Men
Authors: Skoda Kaylee , Pedersen Cory L.
Published: June 2019

Previous research has found that images depicted in the mainstream media have a negative influence on self-esteem, particularly among women. With the ease of accessibility and distribution of sexually explicit material (SEM) in recent years, due largely to the rise of the Internet, it has been postulated that consumers of SEM may experience reduced self-esteem in an effect similar to that found in research on exposure to mainstream media imagery. This experimental investigation explored whether exposure to SEM influenced self-esteem in consumers and whether this effect was comparable with that of exposure to mainstream media. Male and female participants were randomly assigned to no imagery, mainstream media imagery, or SEM imagery conditions and asked to report levels of overall global self-esteem, as well as levels of body-specific and genital-specific self-esteem. Mean scores were significantly lower for female participants relative to males overall, but exposure to SEM imagery revealed a significant negative effect on body-specific and genital-specific self-esteem among men only. Implications and limitations of these findings are discussed.
A Rare Case of Multiple Myeloma Presenting as Evan’s Syndrome
Authors: Karapetians Anthony , Bajaj Tushar , Valdes Amanda , Heidari Arash
Published: June 2019

Multiple myeloma is defined as the neoplastic proliferation of plasma cells resulting in a monoclonal gammopathy. The classic presentation of a patient is someone who presents with bone pain, osteopenia, or new onset fractures. We present a case of multiple myeloma presenting as Evan’s syndrome (ES). Evan’s syndrome is autoimmune hemolytic anaemia with autoimmune thrombocytopenia. A 44-year-old female was referred from her primary physician to the hospital as laboratory testing revealed haemoglobin of 5 gm/dL. The patient reported a two-month history of fatigue and a sixty-pound weight loss. Laboratory results demonstrated autoimmune hemolytic anaemia, C3 positivity, elevated immunoglobulin (Ig)G, elevated lactate dehydrogenase (LDH), low haptoglobin, elevated reticulocyte count, elevated RDW-CV (red blood cell distribution width-corpuscular volume), positive direct Coombs test, thrombocytopenia, and proteinuria, all of which led to an underlying ES. The patient was started on intravenous steroids followed by oral steroids. A flow cytometry, serum protein electrophoresis, and cytogenetics were obtained. A bone marrow biopsy revealed multiple myeloma and she was started on Bortezomib treatment. We present the fifth reported case of Evan’s syndrome and multiple myeloma.
Physical Activity and Brain Health: An Analysis of Messages From Organizations and Caregiver Perceptions
Authors: Olscamp Kate , Tang Weizhou , Choi Seul Ki , Kannaley Kristie , Wilcox Sara , Friedman Daniela B.
Published: June 2019

Growing research suggests regular physical activity as a strategy for reducing risk of Alzheimer’s disease (AD); however, there is little research available regarding public messages about the connection between physical activity and brain health. This study aimed to (a) examine the volume and content of regular physical activity and brain health messages being distributed by national organizations, and (b) explore how informal caregivers perceive and comprehend brain health messages. Methods included (a) a content analysis of 155 online documents related to physical activity and aging that were located on national physical activity organizations’ websites, and (b) a thematic analysis of transcripts and observer notes from two focus groups with 10 informal caregivers recruited at a support organization for AD caregivers in the southeastern United States. Content analysis results revealed limited information about the physical activity and brain health connection. Focus group results revealed that caregivers had limited exposure to information about the physical activity and brain health connection and were concerned about the credibility of this information. Further research is needed regarding brain health and physical activity messages and the potential benefits of collaboration among physical activity organizations, researchers, and health care professionals in delivering consistent and credible messages to the public.
Impact of Routine Counseling on Breastfeeding Status in Hospitalized Infants Below 6 Months: Observation From a Large Diarrheal Disease Hospital in Bangladesh
Authors: Nuzhat Sharika , Islam Rafiqul , Ahmed Tahmeed , Sarker Shafiqul Alam , Khan Azharul Islam , Purkayastha Sutopa , Chisti Mohammod Jobayer
Published: June 2019

Background. Breastfeeding counseling (BFC) plays a crucial role in improving infant and young child feeding practices. To evaluate the impact of activities of BFC unit (BFCU) on breastfeeding practices of infants who were hospitalized for diarrheal illness through their regular counseling, assistance and support, and motivation. Methods. In this retrospective chart analysis conducted at Dhaka Hospital of icddr,b using an electronic database, data were collected from mothers of infants younger than 6 months of age who visited the BFCU from 2011 to 2015. Results. Among a total of 3420 infants enrolled during study period, 429 (12.5%) were predominantly breastfed, 2457 (71.8%) partially breastfed, 531 (15.5%) non-breastfed, and 3 (0.1%) exclusively breastfed (EBF) at home. Through counseling of BFCU (following 24-hour recall technique), 2212 (65%) infants became EBF and 1186 (35%) failed to be EBF during discharge. Logistic regression analysis after adjusting for potential covariates, such as maternal age <18 years and receiving breast milk with other liquid at home, revealed that infants having severe underweight, maternal perception of “baby does not suck,” and “there is not enough milk” were less likely to be associated with EBF during discharge. Among 531 non-breastfed infants, 455 (85.7%) became partial breastfeeding and only 23 (4.3%) became EBF. Conclusion. Counseling of mothers even during acute illness of infants in the hospital can help promote breastfeeding. Therefore, there is great importance of robust counseling on breastfeeding practices and may help establish re-lactation of acutely ill babies.
Under Prescription of Epinephrine to Medicaid Patients in the Pediatric Emergency Department
Authors: Owusu-Ansah Sylvia , Badaki Oluwakemi , Perin Jamie , Stevens Martha , Anders Jennifer , Wood Robert
Published: June 2019

Objective. To describe pediatric Medicaid patients with pediatric emergency department (PED) visits for anaphylaxis who received epinephrine auto-injector (EAI) prescriptions in the ED versus those who did not; and to compare patients who filled their prescriptions versus those who did not. Methods. We conducted a cross-sectional study of Medicaid patients aged 0 to 21 years presenting to 2 PEDs, with symptoms meeting the National Institute of Allergy and Infectious Diseases criteria for anaphylaxis, between July 2012 and July 2014. Results. We identified 86 patients across the 2 hospitals with a confirmed diagnosis of anaphylaxis in the PED. Of these, 55 (64%, 95% confidence interval [CI] = 53% to 74%) received a prescription for an EAI during their ED visit. Forty-two (68%; 95% CI = 56% to 80%) received a prescription for EAI in Hospital 1 versus 13 (54%; 95% CI = 33% to 74%) in Hospital 2. Medicaid prescription fill rates were available for Hospital 1. Of the 42 who received an EAI prescription, 36 (86%; 95% CI = 75% to 96%) filled these prescriptions with Medicaid. Of the 20 (32%) out of 62 patients with anaphylaxis who did not receive prescriptions for an EAI, only 5 had previously filled prescriptions for epinephrine. Conclusion. Previous Medicaid patient prescription adherence data suggested that these patients would have a low EAI prescription fill rate. We found Medicaid patients who received prescriptions for an EAI after the ED visit for anaphylaxis filled them; however, a considerable proportion of anaphylaxis visits had no EAI prescription provided at discharge.
Implementation of Parental Strategies to Improve Child Vegetable Intake: Barriers and Facilitators
Authors: Millen Lauren , Overcash Francine , Vickers Zata , Reicks Marla
Published: June 2019

Purpose. To qualitatively assess barriers and facilitators to implementing specific behavioral strategies to increase child vegetable intake during home dinner meals by low-income parents. Method. Parents (n = 49) of children (9-12 years) were asked to implement 1 behavioral strategy following each of 6 weekly cooking classes at community centers. Example strategies included serving vegetables first, serving 2 vegetables, and using a bigger spoon to serve vegetables. The following week, parents discussed how they used the strategy and barriers and facilitators to its use. Discussions were recorded, transcribed verbatim, and coded separately by strategy using NVivo Pro 11 software. Inductive, comparative thematic analyses were used to identify themes by strategy. Results. Most participants were multiethnic women aged 30 to 39 years with low food security. Time and scheduling conflicts limited involvement of children in vegetable preparation (Child Help strategy). The type of foods served and an unfamiliar serving style inhibited use of the MyPlate and Available/Visible strategies, respectively. Children’s dislike of vegetables limited use of the Serve Vegetables First and Serve 2 Vegetables strategies. Ease of use promoted use of the Bigger Spoon strategy. Conclusion. Educators could tailor application of specific parent strategies for low-income families based on child and environmental characteristics.
Context and Change: A Longitudinal Analysis of Attitudes about Immigrants in Adolescence
Authors: Mitchell Jeffrey
Published: June 2019

Research has explored many different relationships between contextual influences, such as levels of immigration or economic condition, and attitudes about immigrants, with mixed results. These have largely been international comparative studies using cross-sectional data, therefore they have been unable to make claims about changes in environmental context translating to changes in attitudes of respondents. Furthermore, the previous literature has almost exclusively tested these relationships using data from adults, despite research showing that attitudes are most subject to change during adolescence. This study addresses these issues by using a longitudinal data set of repeated measures of 2,328 German adolescents (about 14–18 years old) over four response waves (2010–2014). Using a multilevel analysis, results show that contextual changes, including the percentage of foreign-born people and unemployment rates within respondents’ states, correspond to changes in attitudes toward immigrants consistent with group threat theory. These results were stable even when controlling individual-level factors.
CyBorD-DARA is potent initial induction for MM and enhances ADCP: initial results of the 16-BCNI-001/CTRIAL-IE 16-02 study
Authors: O’Dwyer M. , Henderson R. , Naicker S. D. , Cahill M. R. , Murphy P. , Mykytiv V. , Quinn J. , McEllistrim C. , Krawczyk J. , Walsh J. , Lenihan E. , Kenny T. , Hernando A. , Hirakata G. , Parker I. , Kinsella E. , Gannon G. , Natoni A. , Lynch K. , Ryan A. E.
Published: June 2019

Daratumumab (DARA) has shown impressive activity in combination with other agents for the treatment of multiple myeloma (MM). We conducted a phase 1b study to assess the safety and preliminary efficacy, as well as potential mechanisms of action, of DARA (16 mg/kg) in combination with a weekly schedule of subcutaneous bortezomib (1.3-1.5 mg/m2), cyclophosphamide (150-300 mg/m2), and dexamethasone (40 mg) (CyBorD DARA) as initial induction before autologous stem cell transplantation (ASCT). Eligible patients were ≤70 years of age with untreated MM requiring treatment and who lacked significant comorbidities. A total of 18 patients were enrolled. Their median age was 56 years (range, 32-66 years), and all patients had Eastern Cooperative Oncology Group performance status ≤1. The International Staging System stages were I, II, and III in 78%, 17%, and 6% of patients, respectively; 28% of patients had high-risk genetic features. There was no dose-limiting toxicity, and the incidence of grade 3 or 4 infection or neutropenia was <10%. On an intention-to-treat basis, 94% achieved ≥very good partial response with ≥complete response in 44% of patients. Among 14 of 15 patients who underwent ASCT and were evaluable for response, all 14 achieved at least very good partial response, with 8 (57%) of 14 achieving complete response. After ASCT, 10 (83%) of 12 patients in whom minimal residual disease analysis was possible were negative at a sensitivity of 10−5 (56% on intention-to-treat/whole study population) according to next-generation sequencing. Flow cytometry analysis of patient samples indicated CyBorD DARA induced activation of macrophage-mediated antibody-dependent cellular phagocytosis. This trial was registered at www.clinicaltrials.gov as #NCT02955810.
Predictors of lower extremity amputation in patients with diabetic foot ulcer: findings from MEDFUN, a multi‐center observational study
Authors: Ugwu Ejiofor , Adeleye Olufunmilayo , Gezawa Ibrahim , Okpe Innocent , Enamino Marcelina , Ezeani Ignatius
Published: June 2019

Background

Lower extremity amputation (LEA) is a potential sequelae of diabetic foot ulceration (DFU) and is associated with huge morbidly and mortality. Low and middle income countries are currently at the greatest risk of diabetes‐related complications and deaths. We sought to identify demographic, clinical and laboratory variables that significantly predict LEA in patients hospitalized for DFU.

Methods

The Multi‐center Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN) was an observational study conducted between March 2016 and April 2017 in six tertiary healthcare institutions. We prospectively followed 336 diabetic patients hospitalized for DFU and managed by a multidisciplinary team until discharge or death. Demographic and diabetes‐related information and ulcer characteristics were documented. Patients were evaluated for neuropathy, peripheral arterial disease (PAD) and medical co‐morbidities while relevant laboratory and imaging tests were performed. The study end‐points were ulcer healing, LEA, duration of hospitalization and mortality. Here we present data on amputation.

Results

One hundred and nineteen subjects (35.4%) underwent LEA during the follow‐up period. Univariate predictors of LEA were ulcer duration more than 1 month prior to hospitalization (P <  0.001), PAD (P <  0.001), Wagner grade ≥ 4 (P <  0.001), wound infection (P 0.041), Proteinuria (P 0.021), leucocytosis (P 0.001) and osteomyelitis (P <  0.001). On multivariate regression, only three variables emerged as significant independent predictors of LEA and these include: ulcer duration more than 1 month (O.R. 10.3, 95% C.I. 4.055–26.132), PAD (O.R. 2.8, 95% C.I. 1.520–5.110) and presence of osteomyelitis (O.R. 5.6, 95% C.I. 2.930–10.776). Age, gender, diabetes type and duration, neuropathy, glycemic control and anemia did not predict LEA in the studied population.

Conclusion

We identified duration of ulcer greater than 1 month, PAD, Wagner grade 4 or higher, proteinuria, leucocytosis, wound infection and osteomyelitis as the significant predictors of LEA in patients hospitalized for DFU. Prompt attention to these risk factors may reduce amputation rate among these patients.