The role of perceived organizational support, distributive justice and motivation in reactions to new information technology

Despite tremendous investments in information technology (IT), many technological interventions in organizations fail because employees do not fully accept and use IT. The present study explored how perceived organizational support and distributive justice affect employee reactions to new IT from a motivational point of view. Self-determination theory was used to understand how different motivational styles, varying in degree of self-determination, mediate the relationship of perceived organizational support and distributive justice with reactions to new IT. Results showed that perceived organizational support and distributive justice were associated with intrinsic and identified motivation to use the IT, but only POS was related to enjoyment and acceptance of the IT. Intrinsic and extrinsic motivation were both associated with IT usage, but IT usage was associated with enjoyment and acceptance only when people were intrinsically motivated. Intrinsic motivation also mediated the effects of POS on enjoyment and acceptance. Moreover, intrinsically motivated users were less likely to use a paper-based appointment booking alternative than those who were not. Implications for managing IT implementations are discussed

SynthoPlate: A platelet-inspired hemostatic nanotechnology for treatment of bleeding complications

Platelet transfusions are routinely used in the clinic to treat bleeding complications stemming from trauma, surgery, malignancy-related bone marrow dysfunctions, and congenital or drug-related defects platelet defects. These transfusions primarily use allogeneic platelet concentrates (PCs) that pose issues of limited availability and portability, high risk of bacterial contamination, very short shelf life (~3-5 days), need for antigen matching and several biologic side effects. While robust research is being directed at resolving some of these issues, there is in parallel a significant clinical interest in synthetic platelet substitutes that can render efficient hemostasis by leveraging and amplifying endogenous clotting mechanisms while avoiding the above issues. To this end, we have developed a unique platelet-inspired synthetic hemostat technology called the SynthoPlate® (US Patent 9107845). Since platelets promote primary hemostasis via adhesion to vWF and collagen at the injury site and concomitant aggregation via fibrinogen binding to integrin GPIIb-IIIa on active platelets, we have mimicked and integrated these key hemostatic mechanisms on the SynthoPlate® by heteromultivalent surface-engineering of a liposomal platform with vWF-binding peptides (VBP), collagen-binding peptides (CBP) and fibrinogen-mimetic peptides (FMP). These ~150nm diameter SynthoPlate® vesicles are sterilizable and can be stored as lyophilized powder for long periods of time. We demonstrated, in vitro, that this platelet-mimetic integrative design renders hemostatically relevant functions at levels significantly higher than designs that mimic platelet’s adhesion function only or aggregation function only. We further demonstrated in vitro that SynthoPlate®-mediated site-selective amplification of primary hemostatic mechanisms (active platelet recruitment and aggregation) in effect results in site-selective enhancement of secondary hemostatic function (fibrin generation). We also established that SynthoPlate® does not activate and aggregate resting platelets or trigger coagulation mechanisms in plasma, suggesting that this technology will not have systemic pro-thrombotic and coagulatory risks. The hemostatic efficacy of SynthoPlate® was tested in appropriate tail-transection and liver bleeding models in mice, as well as, pilot studies in arterial bleeding model in pigs. In tail-transection bleeding model in normal as well as thrombocytopenic mice, prophylactically administered SynthoPlate® was able to significantly reduce bleeding time by 60-70%. In laparotomy traumatic bleeding model in mice, prophylactically administered SynthoPlate® was able to reduce blood volume loss by ~30%, reduced hypotension effects and increased survival by \u3e80%. In pilot pig models of arterial bleeding, emergency administration of SynthoPlate® has shown substantial reduction in blood volume loss. Immunohistological evaluation of tissues from various treated animals have shown marked co-localization of red fluorescent SynthoPlate® with green fluorescent platelets localized at the clot site. Biodistribution studies in animals indicate that SynthoPlate® is cleared primarily by liver and spleen, similar to clinically known liposomal technologies. We have also demonstrated that the platelet-mimetic heteromultivalent surface-decoration approach can be adapted to other biomedically relevant particle platforms. Altogether, our studies establish the promise of SynthoPlate® nanotechnology as a platelet-mimetic intravenous hemostat for treatment of bleeding complications in prophylactic and emergency scenarios. Ongoing studies are focused on evaluating this technology in clinically motivated large animal bleeding models, with a vision for translation

Playing safe: Assessing the risk of sexual abuse to elite child athletes

Young athletes frequently suffer from being seen as athletes first and children second. This has consequences for their legal, civil and human rights as children (Kelly et al., 1995) and for the way in which sport organisations choose to intervene on their behalf to protect them from physical, psychological and sexual abuses (Brackenridge, 1994). Sport careers peak at different ages depending on the sport: in some, children as young as 12 or 13 may reach the highest levels of competitive performance; in others, full maturity as an athlete may come late into adulthood or even middle age. Recognition of this variation has given rise to the concept of ‘sport age’ (Kirby, 1986) referring to sport-specific athlete development. This concept is of significance in helping to identify the developmental process in terms of athletic, rather than chronological, maturity. The risk of sexual abuse in sport, formerly ignored or denied, has now been documented in a number of studies, using both quantitative and qualitative methods (Kirby & Greaves, 1996; Brackenridge, 1997; Volkwein, 1996). Drawing on data from these studies and from the previous work on sport age and athletic maturation, this paper proposes a possible means of identifying and assessing relative risk of sexual abuse to elite young athletes in selected sports. The concept of a ‘stage of imminent achievement’ (SIA) is proposed as the period of peak vulnerability of young athletes to sexual abuse

Aged Human Stored Red Blood Cell Supernatant Inhibits Macrophage Phagocytosis in an HMGB1 Dependent Manner After Trauma in a Murine Model:

Red blood cell transfusions in the setting of trauma is a double edged sword, as it is a necessary component for life-sustaining treatment in massive hemorrhagic shock, but also associated with increased risk for nosocomial infections and immune suppression. The mechanisms surrounding this immune suppression are unclear. Using supernatant from human packed red blood cell (RBC), we demonstrate that clearance of E. coli by macrophages is inhibited both in vitro and in vivo using a murine model of trauma and hemorrhagic shock. We further explore the mechanism of this inhibition by demonstrating that human stored RBCs contain soluble high mobility group box 1 protein (HMGB1) which increases throughout storage. HMGB1 derived from the supernatant of human stored RBCs was shown to inhibit bacterial clearance, as neutralizing antibodies to HMGB1 restored the ability of macrophages to clear bacteria. These findings demonstrate that extracellular HMGB1 within stored RBCs could be one factor leading to immune suppression following transfusion in the trauma setting

The Mini-Mental State Examination (MMSE) as a diagnostic and screening test for delirium: Systematic review and meta-analysis

Objective: To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults. Method: Two authors searched MEDLINE, PsychINFO and EMBASE from inception till 3/2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted. Results: Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and 82.8% in a subgroup analysis involving robust high quality studies. Sensitivity was unchanged but specificity was 68.4% (95% CI = 50.9% to 83.5%) in studies using a predefined cut-off of < 24 to signify a case. In high-risk samples where delirium was present in 25% of patients, then the Positive predictive value and Negative predictive value would be 50.9% (48.3% - 66.2%) and 93.2% (90.0% - 96.5%). Conclusion: The MMSE cannot be recommended as a case-finding confirmatory test of delirium, but may be used as an initial screen to rule out high scorers who are unlikely to have delirium with approximately 93% accuracy

A Redneck Head on a Nazi Body:Subversive Ludo-Narrative Strategies in Wolfenstein II: The New Colossus

This article argues that Wolfenstein: The New Colossus, a AAA First-Person Shooter, is not only politically themed, but presents in itself a critical engagement with the politics of its genre and its player base. Developed at the height of #Gamergate, the game is interpreted as a response to reactionary discourses about gender and ability in both mainstream games and the hardcore gamer community. The New Colossus replaces affirmation of masculine empowerment with intersectional ambiguities, foregrounding discourses of feminism and disability. To provoke its players without completely alienating them, the game employs strategies of carnivalesque aesthetics&#8212;especially ambivalence and grotesque excess. Analyzing the game in the light of Bakhtinian theory shows how The New Colossus reappropriates genre conventions pertaining to able-bodiedness and masculinity and how it &#8220;resolves&#8222; these issue by grafting the player character&#8217;s head on a vat-grown Nazi supersoldier-body. The breaches of genre conventions on the narrative level are supported by intentionally awkward and punishing mechanics, resulting in a ludo-narrative aesthetic of defamiliarization commensurate to a grotesque story about subversion and revolt. Echoing the ritualistic cycle of death and rebirth at the heart of carnivalesque aesthetics, The New Colossus is nothing short of an ideological re-invention of the genre

SF‐CORNER (splenic flexure colorectal cancer): an international survey of operative approaches and outcomes for cancers of the splenic flexure

Aim The optimum surgical approach to splenic flexure cancers (SFCs) remains uncertain. The aim of this survey was to explore the opinions of an international surgical community on the management and outcomes of SFC. Method A questionnaire was constructed comprising five sections (information about respondents; definition and prognosis of SFC; operative approach; approach in specific scenarios; outcomes) and circulated through an international dissemination committee and social media. Results The survey received 576 responses over 4 weeks across 50 countries. There was no consensus regarding the definition of the splenic flexure, whilst the proportion of respondents who did and did not think that patients with SFC had a worse outcome was equal. The overall preferred operative approach was left hemicolectomy [203 (35.2%)], followed by segmental resection [167 (29%)], extended right hemicolectomy [126 (21.9%)] and subtotal colectomy [7 (12%)]. The stated pedicles for ligation varied between resection types and also within the same resection. One hundred and sixty-six (28.8%) respondents thought a segmental resection was associated with the worst survival and 190 (33%) thought it was associated with the best quality of life. Conclusion This survey confirms a lack of consensus across all aspects SFC treatment. The differing approaches described are likely to represent different beliefs around the variable anatomy of this region and the associated lymphatic drainage. Future studies are required to address such inconsistencies and identify the optimum surgical strategy, whilst also incorporating quality-of-life metrics and patient-reported outcomes. A one-size-fits-all approach is probably not appropriate with SFC, and a more bespoke approach is required

On the algorithmic complexity of twelve covering and independence parameters of graphs

The definitions of four previously studied parameters related to total coverings and total matchings of graphs can be restricted, thereby obtaining eight parameters related to covering and independence, each of which has been studied previously in some form. Here we survey briefly results concerning total coverings and total matchings of graphs, and consider the aforementioned 12 covering and independence parameters with regard to algorithmic complexity. We survey briefly known results for several graph classes, and obtain new NP-completeness results for the minimum total cover and maximum minimal total cover problems in planar graphs, the minimum maximal total matching problem in bipartite and chordal graphs, and the minimum independent dominating set problem in planar cubic graphs