Clinical Inertia in Type 2 Diabetes: A Retrospective Analysis of Pharmacist-Managed Diabetes Care vs. Usual Medical Care

Background: Evidence suggests that patients with type 2 diabetes (T2DM) suffer from a high rate of “clinical inertia” or “recognition of the problem but failure to act.” Objective: The aim of this study is to quantify the rate of clinical inertia between two models of care: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical Care (UMC). Methods: Patients in a university based medical clinic with type 2 diabetes (T2DM) were analyzed in this retrospective cohort study. Patients were exposed to either PMDC or UMC. The difference in days to intervention in response to suboptimal laboratory values and time to achieve goal hemoglobin A1c (A1c), systolic blood pressure (SBP) and low-density lipoprotein (LDL) was compared in the two models of care. Results: A total of 113 patients were included in the analysis of this study, 54 patients were in the PMDC and 59 patients were in the UMC group. Median time (days) to intervention for A1c values \u3e7% was 8 days and 9 days in the PMDC and UMC groups, respectively (p\u3e0.05). In patients with baseline A1c values \u3e8%, median time to achieving A1c Conclusions: Rates of clinical inertia, defined as time to intervention of suboptimal clinical values, did not differ significantly between patients enrolled in a PMDC compared to patients with UMC with respect to A1c, SBP and LDL. Participation in PMDC, however, was associated with achieving goal A1c, SBP, and LDL levels sooner compared to UMC

Causal claims about correlations reduced in press releases following academic study of health news

Background: Exaggerations in health news were previously found to strongly associate with similar exaggerations in press releases. Moreover such exaggerations did not appear to attract more news. Here we assess whether press release practice changed after these reported findings; simply drawing attention to the issue may be insufficient for practical change, given the challenges of media environments. Methods: We assessed whether rates of causal over-statement in press releases based on correlational data were lower following a seminal paper on the topic, compared to an equivalent baseline period in the preceding year. Results: We found that over-statements in press releases reduced from 28% (95% confidence interval = 16% to 45%) in 2014 to 13% (95% confidence interval = 6% to 25%) in 2015. A corresponding numerical reduction in exaggerations in news was not significant. The association between over-statements in news and press releases remained strong. Conclusions: Press release over-statements were less frequent following publication of Sumner et al. (2014), indicating that press release practice is malleable. However, this is correlational evidence and the reduction may be due to other factors

Caveats in science-based news stories communicate caution without lowering interest

Science stories in the media are strongly linked to changes in health-related behavior. Science writers (including journalists, press officers, and researchers) must therefore frame their stories to communicate scientific caution without disrupting coherence and disengaging the reader. In this study we investigate whether caveats (“Further research is needed to validate the results”) satisfy this dual requirement. In four experiments participants read news reports with and without caveats. In Experiments 1 to 3, participants judged how cautious or confident researchers were, and how interesting or comprehensible they found the reports. News reports with caveats were judged as more cautious that those without, but levels of reader interest and comprehensibility were unaffected. In a fourth experiment, we created a mock newsroom and recruited journalism students to make judgments about which press releases should be published. Here, neither caveats nor the introduction of qualifying expressions in headlines had an effect on judgments of newsworthiness, consistent with Experiments 1 to 3. The reasons participants gave for rejecting a press release rarely referred to the caveat. Our results therefore suggest that science writers should include caveats in news reporting and that they can do so without fear of disengaging their readers or losing news uptak

Claims of causality in health news: a randomised trial

Background Misleading news claims can be detrimental to public health. We aimed to improve the alignment between causal claims and evidence, without losing news interest (counter to assumptions that news is not interested in communicating caution). Methods We tested two interventions in press releases, which are the main sources for science and health news: (a) aligning the headlines and main causal claims with the underlying evidence (strong for experimental, cautious for correlational) and (b) inserting explicit statements/caveats about inferring causality. The ‘participants’ were press releases on health-related topics (N = 312; control = 89, claim alignment = 64, causality statement = 79, both = 80) from nine press offices (journals, universities, funders). Outcomes were news content (headlines, causal claims, caveats) in English-language international and national media (newspapers, websites, broadcast; N = 2257), news uptake (% press releases gaining news coverage) and feasibility (% press releases implementing cautious statements). Results News headlines showed better alignment to evidence when press releases were aligned (intention-to-treat analysis (ITT) 56% vs 52%, OR = 1.2 to 1.9; as-treated analysis (AT) 60% vs 32%, OR = 1.3 to 4.4). News claims also followed press releases, significant only for AT (ITT 62% vs 60%, OR = 0.7 to 1.6; AT, 67% vs 39%, OR = 1.4 to 5.7). The same was true for causality statements/caveats (ITT 15% vs 10%, OR = 0.9 to 2.6; AT 20% vs 0%, OR 16 to 156). There was no evidence of lost news uptake for press releases with aligned headlines and claims (ITT 55% vs 55%, OR = 0.7 to 1.3, AT 58% vs 60%, OR = 0.7 to 1.7), or causality statements/caveats (ITT 53% vs 56%, OR = 0.8 to 1.0, AT 66% vs 52%, OR = 1.3 to 2.7). Feasibility was demonstrated by a spontaneous increase in cautious headlines, claims and caveats in press releases compared to the pre-trial period (OR = 1.01 to 2.6, 1.3 to 3.4, 1.1 to 26, respectively). Conclusions News claims—even headlines—can become better aligned with evidence. Cautious claims and explicit caveats about correlational findings may penetrate into news without harming news interest. Findings from AT analysis are correlational and may not imply cause, although here the linking mechanism between press releases and news is known. ITT analysis was insensitive due to spontaneous adoption of interventions across conditions

Expert quotes and exaggeration in health news: a retrospective quantitative content analysis

Background This research is an investigation into the role of expert quotes in health news, specifically whether news articles containing a quote from an independent expert are less often exaggerated than articles without such a quote. Methods Retrospective quantitative content analysis of journal articles, press releases, and associated news articles was performed. The investigated sample are press releases on peer-reviewed health research and the associated research articles and news stories. Our sample consisted of 462 press releases and 668 news articles from the UK (2011) and 129 press releases and 185 news articles from The Netherlands (2015). We hand-coded all journal articles, press releases and news articles for correlational claims, using a well-tested codebook. The main outcome measures are types of sources that were quoted and exaggeration of correlational claims. We used counts, 2x2 tables and odds ratios to assess the relationship between presence of quotes and exaggeration of the causal claim. Results Overall, 99.1% of the UK press releases and 84.5% of the Dutch press releases contain at least one quote. For the associated news articles these percentages are: 88.6% in the UK and 69.7% in the Netherlands. Authors of the study are most often quoted and only 7.5% of UK and 7.0% of Dutch news articles contained a new quote by an expert source, i.e. one not provided by the press release. The relative odds that an article without an external expert quote contains an exaggeration of causality is 2.6. Conclusions The number of articles containing a quote from an independent expert is low, but articles that cite an external expert do contain less exaggeration

"They go for gender first"

There have been many recent media reports about the online harassment of women journalists working in technology, particularly the video gaming industry. However, little research has focused on this aspect, by looking at specific occupations, or analysing the implications for women and society. This paper is a feminist study of the experiences of sexist abuse of a sample of women journalists writing about technology. It is a commentary on the results of a questionnaire-based study of 102 women (and their approximately 300 comments) that work in what has emerged as one of the frontlines of the struggle for gender equality. The research looks at the extent of the abuse, the harm it causes and how women are reacting to it. Most of the participants have experienced abuse, many have changed their working practices and some have disguised their identity to avoid it. An examination of their comments suggests that sexist abuse is now often normalised, alongside a new kind of "invisible" feminism. It also reveals a mood of defiance and an appetite for radical change to address the problems of exclusion and loss of identity. Overall, results indicate that the abuse is damaging women’s lives and impacting journalism and society in a negative way

Androgenic dependence of exophytic tumor growth in a transgenic mouse model of bladder cancer: a role for thrombospondin-1

<p>Abstract</p> <p>Background</p> <p>Steroid hormones influence mitogenic signaling pathways, apoptosis, and cell cycle checkpoints, and it has long been known that incidence of bladder cancer (BC) in men is several times greater than in women, a difference that cannot be attributed to environmental or lifestyle factors alone. Castration reduces incidence of chemically-induced BC in rodents. It is unclear if this effect is due to hormonal influences on activation/deactivation of carcinogens or a direct effect on urothelial cell proliferation or other malignant processes. We examined the effect of castration on BC growth in UPII-SV40T transgenic mice, which express SV40 T antigen specifically in urothelium and reliably develop BC. Furthermore, because BC growth in UPII-SV40T mice is exophytic, we speculated BC growth was dependent on angiogenesis and angiogenesis was, in turn, androgen responsive.</p> <p>Methods</p> <p>Flat panel detector-based cone beam computed tomography (FPDCT) was used to longitudinally measure exophytic BC growth in UPII-SV40T male mice sham-operated, castrated, or castrated and supplemented with dihydrotestosterone (DHT). Human normal bladder and BC biopsies and mouse bladder were examined quantitatively for thrombospondin-1 (TSP1) protein expression.</p> <p>Results</p> <p>Mice castrated at 24 weeks of age had decreased BC volumes at 32 weeks compared to intact mice (p = 0.0071) and castrated mice administered DHT (p = 0.0233; one-way ANOVA, JMP 6.0.3, SAS Institute, Inc.). Bladder cancer cell lines responded to DHT treatment with increased proliferation, regardless of androgen receptor expression levels. TSP1, an anti-angiogenic factor whose expression is inhibited by androgens, had decreased expression in bladders of UPII-SV40T mice compared to wild-type. Castration increased TSP1 levels in UPII-SV40T mice compared to intact mice. TSP1 protein expression was higher in 8 of 10 human bladder biopsies of normal versus malignant tissue from the same patients.</p> <p>Conclusion</p> <p>FPDCT allows longitudinal monitoring of exophytic tumor growth in the UPII-SV40T model of BC that bypasses need for chemical carcinogens, which confound analysis of androgen effects. Androgens increase tumor cell growth <it>in vitro </it>and <it>in vivo </it>and decrease TSP1 expression, possibly explaining the therapeutic effect of castration. This effect may, in part, explain gender differences in BC incidence and implies anti-androgenic therapies may be effective in preventing and treating BC.</p

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

Hydra Mesoglea Proteome Identifies Thrombospondin as a Conserved Component Active in Head Organizer Restriction

Thrombospondins (TSPs) are multidomain glycoproteins with complex matricellular functions in tissue homeostasis and remodeling. We describe a novel role of TSP as a Wnt signaling target in the basal eumetazoan Hydra. Proteome analysis identified Hydra magnipapillata TSP (HmTSP) as a major component of the cnidarian mesoglea. In general, the domain organization of cnidarian TSPs is related to the pentameric TSPs of bilaterians, and in phylogenetic analyses cnidarian TSPs formed a separate clade of high sequence diversity. HmTSP expression in polyps was restricted to the hypostomal tip and tentacle bases that harbor Wnt-regulated organizer tissues. In the hypostome, HmTSP- and Wnt3-expressing cells were identical or in close vicinity to each other, and regions of ectopic tentacle formation induced by pharmacological β-Catenin activation (Alsterpaullone) corresponded to foci of HmTSP expression. Chromatin immunoprecipitation (ChIP) confirmed binding of Hydra TCF to conserved elements in the HmTSP promotor region. Accordingly, β-Catenin knockdown by siRNAs reduced normal HmTSP expression at the head organizer. In contrast, knockdown of HmTSP expression led to increased numbers of ectopic organizers in Alsterpaullone-treated animals, indicating a negative regulatory function. Our data suggest an unexpected role for HmTSP as a feedback inhibitor of Wnt signaling during Hydra body axis patterning and maintenance