Standards for Reporting Qualitative Research (SRQR) checklist.

The table shows the Standards for Reporting Qualitative Research (SRQR) checklist, with status marked X indicating that the study follows the respective recommendation in the way and to the degree deemed appropriate by the authors. (DOCX)</p

Themes and sub-themes.

BackgroundLay online communication about health-related issues has in recent years largely been associated with the spread of misinformation and decreased trust in healthcare. Such communication has included claims about systemic side effects of the copper IUD. In Sweden, a social media group centered on this issue now gathers around 8,700 members. This study aimed to use the case of reported yet unestablished side effects of the copper IUD to investigate experiences of and reasoning about healthcare encounters between caregivers and patients contesting established medical knowledge.MethodsWe conducted qualitative, semi-structured, digital group interviews with members of the social media group (seven groups, n = 23) and with midwives and gynecologists (six groups, n = 15). We also gathered essays written by social media group members (n = 23). The material was analyzed thematically.ResultsThe participant accounts pointed towards tensions related to principles of evidence-based medicine, i.e., perceived insufficiency of research on the safety of the copper IUD and lack of clarity in routines for reporting and following up suspected side effects, and of patient-centered care, i.e., listening respectfully to patients. Tension between caregivers’ obligation to adhere to evidence-based medicine while also providing patient-centered care was noted.ConclusionHealthcare providers’ efforts to assess and address patient claims contesting established medical knowledge should include ensuring and communicating sufficient research, clarifying procedures for reporting suspected side effects, and improving person-centered care. This can increase the quality of care while contributing to the mitigation of distrust in healthcare and the spreading of health-related misinformation.</div

Rate of neutrophil survival and apoptosis.

<p>Neutrophils isolated from 60 HBD, 44 AASV patients, 8 PV patients, 18 TP, 21 SLE patients, and 20 RA patients were cultured in vitro in AIM-V medium. The percentage of surviving neutrophils (1a) and apoptotic neutrophils (1b) was measured after 20 hours. % Neutrophil survival = % of annexin-V negative and 7-AAD negative cells after 20 hour culture. % Neutrophil apoptosis = % of annexin-V positive and 7-AAD negative cells after 2o hour culture. HBD = healthy blood donors. AASV = ANCA-Associated Systemic Vasculitis. PV = Polycythemia Vera. TP = renal transplant recipients. SLE = Systemic Lupus Erythematosus. RA = Rheumatoid Arthritis.</p

Gene expression of pro-/anti-apoptotic factors in neutrophils.

<p>All results are expressed as median fold change relative to Cyclophilin A.</p>(*)<p>P value<0.05, according to Mann-Whitney test and as compared to HBD.</p><p>HBD = healthy blood donors. AASV = ANCA-associated Systemic Vasculitis. PV = Polycythemia Vera. TP = renal transplant recipients. RA = Rheumatoid Arthritis.</p

Demographic data for the AASV patients and controls.

<p>AASV = ANCA-associated Systemic Vasculitis. GPA = Granulomatosis with polyangiitis. MPA = Microscopic polyangiitis. N = Number of subjects. F = Female. M = Male. HBD = healthy blood donors. PV = Polycythemia Vera. TP = renal transplant recipients. SLE = Systemic Lupus Erythematosus. RA = Rheumatoid Arthritis. BVAS = Birmingham Vasculitis Activity Score. DAS = Disease activity score. SLEDAI = SLE disease activity index. IQR = Interquartile range.</p

Gene expression of transcription factors in neutrophils.

<p>All results are expressed as median fold change relative to Cyclophilin A.</p>(*)<p>P value<0.01,</p>(**)<p>p value<0.001, and</p>(***)<p>p value<0.0001, according to Mann-Whitney test and as compared to HBD.</p><p>HBD = healthy blood donors. AASV = ANCA-associated Systemic Vasculitis. PV = Polycythemia Vera. TP = renal transplant recipients. RA = Rheumatoid Arthritis.</p

Neutrophil survival among patients with high G-CSF levels.

<p>% Neutrophil survival = % of annexin-V negative and 7-AAD negative cells after 20 hour culture. AASV = ANCA-associated Systemic Vasculitis. RA = Rheumatoid Arthritis. GM-CSF = Granulocyte-Colony Stimulating Factor. UD = Undetectable (<2 pg/ml).</p>*/**/***<p>Are signals for the common patients between <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032439#pone-0032439-t002" target="_blank">table 2</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032439#pone-0032439-t003" target="_blank">3</a>.</p

Neutrophil survival among patients with high GM-CSF levels.

<p>% Neutrophil survival = % of annexin-V negative and 7-AAD negative cells after 20 hour culture. AASV = ANCA-associated Systemic Vasculitis. RA = Rheumatoid Arthritis. GM-CSF = Granulocyte Macrophage-Colony Stimulating Factor. UD = Undetectable (<2 pg/ml).</p>*/**/***<p>Are signals for the common patients between <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032439#pone-0032439-t002" target="_blank">table 2</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032439#pone-0032439-t003" target="_blank">3</a>.</p