Spending All Your Money on Me: Influencer Marketing’s Impact on Engagement

Influencer marketing has been around for a few years and is rapidly approaching a $15 billion industry by 2022. In its nascency, the research is limited which investigates factors that substantiate the growth and popularity of advertising tools. In this study, we propose and explicate how two different types of influencers, namely mega- and macro-influencers, impact their audience\u27s engagement with sponsored posts. Utilizing secondary data from more than 650 Instagram posts, our results suggest mega-influencers are able to mitigate the negative effect of utilizing various post attributes, including meta-tags and product prominence

Implicit and explicit stigma towards mental health treatment

In order to better understand stigma associated with mental health treatment, 118 Clemson University students completed Implicit Association Tasks (IAT) and self-report surveys. The IAT presented terms associated with either medical or psychological treatments or patients, paired with additional positive or negative terms (e.g., good vs. bad). Survey items assessed attitudes towards mental health and medical treatment, as well as mental health and medical patients. Responses from the IAT and survey were compared regarding mental health versus medical treatments and mental health versus medical patients. The IAT results revealed a significant negative implicit bias toward mental health treatment and mental health patients. Explicit survey measures also showed more negative responses toward mental health treatment and patients. Our findings provide both implicit and explicit evidence of stigma associated with mental health treatment and patients. Through better understanding these biases, researchers can work to reduce the stigma associated with mental health treatment

Management of late-onset fetal growth restriction: pragmatic approach

OBJECTIVES: International guidelines recommend delivery from 37 weeks in small for gestational age (SGA) fetuses mostly because of stillbirth concerns. Differentiating SGA from late-onset fetal growth restriction (FGR) is challenged by the limited prospective evidence to guide management. We prospectively assessed a novel protocol that used ultrasound criteria to classify women with suspected late FGR into two groups: low-risk with expectant management until the expected date of delivery and high-risk with delivery soon after 37 weeks. Furthermore, we compared the outcome of this prospective cohort with a historical cohort of women similarly presenting with suspected late FGR, to evaluate the impact of implementation of the new protocol. METHODS: This was a prospective study in women with a singleton non-anomalous fetus at ≥32 weeks with any of the following inclusion criteria: estimated fetal weight (EFW) ≤10th centile, ≥50 centiles decrease of the abdominal circumference (AC) from previous scans, umbilical artery Doppler pulsatility index >95th centile or cerebroplacental ratio <5th centile. Women were stratified into low- or high-risk late FGR. Women in the low-risk group were delivered by 41 weeks unless meeting high-risk criteria for delivery later on, whereas women in the high-risk group (PAPP-A <0.4MoM, EFW <3rd centile, or EFW ≥3rd and ≤10th centile with AC drop or abnormal Dopplers) were delivered at 37 weeks. The primary outcome was adverse neonatal outcome including hypothermia, hypoglycemia, neonatal unit admission, jaundice requiring treatment, suspected infection, feeding difficulties, Apgar score <7 at 1 minute, hospital readmission and any of the severe adverse neonatal outcome (perinatal death, resuscitation using inotropes or mechanical ventilation, Apgar score <7 at 5 minutes, metabolic acidosis, sepsis, cerebral, cardiac or respiratory morbidity). Secondary outcomes were adverse maternal outcome (operative delivery for abnormal fetal heart rate) and severe adverse neonatal outcome. Women managed according with the new protocol were compared with a historical cohort where management was guided by individual clinician's expertise. RESULTS: Over 18 months (2018-2019), 321 women were included. Adverse neonatal outcome was significantly less common in low- (n=156) compared with high-risk fetus (n=165): 45 vs 57%; aOR, 0.6; 95% CI, 0.4-0.9; P=0.022. There was no significant difference in adverse maternal outcome (18% vs 24%; aOR, 0.7; 95% CI, 0.4-1.2; P=0.142) and severe adverse neonatal outcome (3.8% vs 8.5%; aOR: 0.5; 95% CI, 0.2-1.3; P=0.153) between low and high-risk group. Compared to women delivered prior to the implementation of the new protocol and classified retrospectively into low- and high-risk late FGR (n=323), there was a lower adverse neonatal outcome (45% vs 58%; aOR, 0.6; 95% CI, 0.4-0.9; P=0.026) in the low-risk late FGR clinic group. CONCLUSIONS: Appropriate risk classification to define management in low- and high-risk FGR groups was associated with reduced adverse neonatal outcome in the low-risk group. In clinical practice a policy of expectantly managing women with late-onset low-risk FGR pregnancies at term could improve neonatal and long-term development. Randomized controlled trials are needed to assess the effect of an evidence based conservative management protocol of late FGR on perinatal morbidity, mortality and long-term neurodevelopment

A multimodal iPSC platform for cystic fibrosis drug testing

Cystic fibrosis is a monogenic lung disease caused by dysfunction of the cystic fibrosis transmembrane conductance regulator anion channel, resulting in significant morbidity and mortality. The progress in elucidating the role of CFTR using established animal and cell-based models led to the recent discovery of effective modulators for most individuals with CF. However, a subset of individuals with CF do not respond to these modulators and there is an urgent need to develop novel therapeutic strategies. In this study, we generate a panel of airway epithelial cells using induced pluripotent stem cells from individuals with common or rare CFTR variants representative of three distinct classes of CFTR dysfunction. To measure CFTR function we adapt two established in vitro assays for use in induced pluripotent stem cell-derived airway cells. In both a 3-D spheroid assay using forskolin-induced swelling as well as planar cultures composed of polarized mucociliary airway epithelial cells, we detect genotype-specific differences in CFTR baseline function and response to CFTR modulators. These results demonstrate the potential of the human induced pluripotent stem cell platform as a research tool to study CF and in particular accelerate therapeutic development for CF caused by rare variants

The medical student

The Medical Student was published from 1888-1921 by the students of Boston University School of Medicine

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

BMC 48--A Plan of the Compact Part of the Town of Exeter at the Head of the Southerly Branch of Piscataqua River, 1802

Map of Exeter, Rockingham County, New Hampshire drawn by Phinehas Merrill. Oriented with north to the right. Buildings (some labeled) shown pictorially.https://digitalmaine.com/arc_baxter/1060/thumbnail.jp

BMC 48--A Plan of the Compact Part of the Town of Exeter at the Head of the Southerly Branch of Piscataqua River, 1802

Map of Exeter, Rockingham County, New Hampshire drawn by Phinehas Merrill. Oriented with north to the right. Buildings (some labeled) shown pictorially.https://digitalmaine.com/arc_baxter/1060/thumbnail.jp

Searching for new banana cultivars to overcome production constraints in the Australian subtropics

Growing bananas in the diverse range of climatic and geographic conditions of the Australian subtropics has many challenges. Some of these include long periods of low temperatures, regular strong winds and often lack of irrigation. The presence of Fusarium oxysporum f. sp. cubense race 1 and subtropical race 4 in the subtropics further limits the ability of growers to plant alternative cultivars which have market acceptance in Australia. These challenges result in low overall production and significant impacts on achieving consistent quality throughout the year. Another challenge for subtropical growers is that they must compete in an open market with fruit from tropical regions where growers experience less of these constraints. Nevertheless, subtropical banana production has some advantages over tropical regions, including reduced pest and disease pressure, especially leaf disease, and smaller, sweeter fruit. New opportunities for niche markets are emerging due to the experience of Australian travellers in Africa, Asia and Central and South America where they are exposed to a wide array of local banana cultivars. At the same time, multicultural migration is creating demand for cultivars other than Cavendish. Overcoming the many challenges faced by the subtropical industry in Australia will require the development of new cultivars to improve resilience in the production sector and also to meet the increasing demand for greater consumer choice. Fusarium wilt-resistant dessert and cooking cultivars are under evaluation in the Australian subtropics for suitable agronomic characteristics and favourable prospects in the marketplace