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Climate change communication spans multiple disciplines which in many cases have insufficient understanding of each other’s research traditions and, therefore, there has not been a solid interdisci...

Traumatic brain injury (TBI) contributes to almost one third of all trauma-related deaths, and those that survive often suffer from long-term physical and cognitive deficits. Ciclosporin (cyclosporine, cyclosporin A) has shown promising neuroprotective properties in pre-clinical TBI models. The Copenhagen Head Injury Ciclosporin (CHIC) study was initiated to establish the safety profile and pharmacokinetics of ciclosporin in patients with severe TBI, using a novel parenteral lipid emulsion formulation. Exploratory pharmacodynamic study measures included microdialysis in brain parenchyma and protein biomarkers of brain injury in the cerebrospinal fluid (CSF). Sixteen adult patients with severe TBI (Glasgow Coma Scale 4–8) were included, and all patients received an initial loading dose of 2.5 mg/kg followed by a continuous infusion for 5 days. The first 10 patients received an infusion dosage of 5 mg/kg/day whereas the subsequent 6 patients received 10 mg/kg/day. No mortality was registered within the study duration, and the distribution of adverse events was similar between the two treatment groups. Pharmacokinetic analysis of CSF confirmed dose-dependent brain exposure. Between- and within-patient variability in blood concentrations was limited, whereas CSF concentrations were more variable. The four biomarkers, glial fibrillary acidic protein, neurofilament light, tau, and ubiquitin carboxy-terminal hydrolase L1, showed consistent trends to decrease during the 5-day treatment period, whereas the samples taken on the days after the treatment period showed higher values in the majority of patients. In conclusion, ciclosporin, as administered in this study, is safe and well tolerated. The study confirmed that ciclosporin is able to pass the blood–brain barrier in a TBI population and provided an initial biomarker-based signal of efficacy.

All phase III trials evaluating medical treatments for traumatic brain injury (TBI), performed to date, have failed. To facilitate future success there is a need for novel outcome metrics that can bridge pre-clinical studies to clinical proof of concept trials. Our objective was to assess diffusion tensor imaging (DTI) and biofluid-based biomarkers as efficacy outcome metrics in a large animal study evaluating the efficacy of cyclosporine in TBI. This work builds on our previously published study that demonstrated a reduced volume of injury by 35% with cyclosporine treatment based on magnetic resonance imaging (MRI) results. A focal contusion injury was induced in piglets using a controlled cortical impact (CCI) device. Cyclosporine in a novel Cremophor/Kolliphor EL-free lipid emulsion, NeuroSTAT, was administered by continuous intravenous infusion for 5 days. The animals underwent DTI on day 5. Glial fibrillary acidic protein (GFAP), as a measure of astroglia injury, and neurofilament light (NF-L), as a measure of axonal injury, were measured in blood on days 1, 2, and 5, and in cerebrospinal fluid (CSF) on day 5 post-injury. Normalized fractional anisotropy (FA) was significantly (

Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) reportedly elevates arterial blood pressure (ABP) during non-traumatic cardiac arrest. Objectives This randomized, blinded trial of cardiac arrest in pigs evaluated the effect of automated REBOA two minutes after balloon inflation on ABP (primary endpoint) as well as arterial blood gas values and markers of cerebral haemodynamics and metabolism. Methods Twenty anesthetized pigs were randomized to REBOA inflation or sham-inflation (n = 10 in each group) followed by insertion of invasive monitoring and a novel, automated REBOA catheter (NEURESCUE® Catheter & NEURESCUE® Assistant). Cardiac arrest was induced by ventricular pacing. Cardiopulmonary resuscitation was initiated three min after cardiac arrest, and the automated REBOA was inflated or sham-inflated (blinded to the investigators) five min after cardiac arrest. Results In the inflation compared to the sham group, mean ABP above the REBOA balloon after inflation was higher (inflation: 54 (95%CI: 43–65) mmHg; sham: 44 (33–55) mmHg; P = 0.06), and diastolic ABP was higher (inflation: 38 (29–47) mmHg; sham: 26 (20–33) mmHg; P = 0.02), and the arterial to jugular oxygen content difference was lower (P = 0.04). After return of spontaneous circulation, mean ABP (inflation: 111 (95%CI: 94–128) mmHg; sham: 94 (95%CI: 65–123) mmHg; P = 0.04), diastolic ABP (inflation: 95 (95%CI: 78−113) mmHg; sham: 78 (95%CI: 50−105) mmHg; P = 0.02), CPP (P = 0.01), and brain tissue oxygen tension (inflation: 315 (95%CI: 139−491)% of baseline; sham: 204 (95%CI: 75−333)%; P = 0.04) were higher in the inflation compared to the sham group. Conclusion Inflation of REBOA in a porcine model of non-traumatic cardiac arrest improves central diastolic arterial pressure as a surrogate marker of coronary artery pressure, and cerebral perfusion. Institutional protocol number 2017-15-0201-01371.

Background Hyperoxia during cardiopulmonary resuscitation (CPR) may lead to oxidative injury from mitochondrial‐derived reactive oxygen species, despite guidelines recommending 1.0 inspired oxygen during CPR . We hypothesized exposure to 1.0 inspired oxygen during CPR would result in cerebral hyperoxia, higher mitochondrial‐derived reactive oxygen species, increased oxidative injury, and similar survival compared with those exposed to 21% oxygen. Methods and Results Four‐week‐old piglets (n=25) underwent asphyxial cardiac arrest followed by randomization and blinding to CPR with 0.21 (n=10) or 1.0 inspired oxygen (n=10) through 10 minutes post return of spontaneous circulation. Sham was n=5. Survivors received 4 hours of protocolized postarrest care, whereupon brain was obtained for mitochondrial analysis and neuropathology. Groups were compared using Kruskal‐Wallis test, Wilcoxon rank‐sum test, and generalized estimating equations regression models. Both 1.0 and 0.21 groups were similar in systemic hemodynamics and cerebral blood flow, as well as survival (8/10). The 1.0 animals had relative cerebral hyperoxia during CPR and immediately following return of spontaneous circulation (brain tissue oxygen tension, 85% [interquartile range, 72%–120%] baseline in 0.21 animals versus 697% [interquartile range, 515%–721%] baseline in 1.0 animals; P =0.001 at 10 minutes postarrest). Cerebral mitochondrial reactive oxygen species production was higher in animals treated with 1.0 compared with 0.21 ( P P P Conclusions Exposure to 1.0 inspired oxygen during CPR caused cerebral hyperoxia during resuscitation, and resultant increased mitochondrial‐derived reactive oxygen species and oxidative injury following cardiac arrest.

Background Despite controversies, epinephrine remains a mainstay of cardiopulmonary resuscitation (CPR). Recent animal studies have suggested that epinephrine may decrease cerebral blood flow (CBF) and cerebral oxygenation, possibly potentiating neurological injury during CPR. We investigated the cerebrovascular effects of intravenous epinephrine in a swine model of pediatric in-hospital cardiac arrest. The primary objectives of this study were to determine if (1) epinephrine doses have a significant acute effect on CBF and cerebral tissue oxygenation during CPR and (2) if the effect of each subsequent dose of epinephrine differs significantly from that of the first. Methods One-month-old piglets (n = 20) underwent asphyxia for 7 min, ventricular fibrillation, and CPR for 10–20 min. Epinephrine (20 mcg/kg) was administered at 2, 6, 10, 14, and 18 min of CPR. Invasive (laser Doppler, brain tissue oxygen tension [PbtO2]) and noninvasive (diffuse correlation spectroscopy and diffuse optical spectroscopy) measurements of CBF and cerebral tissue oxygenation were simultaneously recorded. Effects of subsequent epinephrine doses were compared to the first. Results With the first epinephrine dose during CPR, CBF and cerebral tissue oxygenation increased by > 10%, as measured by each of the invasive and noninvasive measures (p p p Conclusions This model suggests that epinephrine increases CBF and cerebral tissue oxygenation, but that effects wane following the third dose. Noninvasive measurements of neurological health parameters hold promise for developing and directing resuscitation strategies.

Transparency has emerged as an ethical principle in contemporary journalism and is contended to improve accountability and credibility by journalists and scholars alike. However, to date, few attempts have been made to record the public’s views on transparency. This study enriches current knowledge by using data from an experiment, survey and focus groups in Sweden collected between 2013 and 2015. Overall, the results suggest that the respondents are not particularly moved by transparency in any form; it does not produce much effect in the experiments and is not brought up in the focus groups. While that is the key finding of this study, it should also be noted that various forms of user participation are evaluated negatively, while providing hyperlinks, explaining news selection and framing, and correcting errors are viewed positively. Implications for journalism practice and research are discussed.

Many in-hospital cardiac arrests are precipitated by hypotension, often associated with systemic inflammation. These patients are less likely to be successfully resuscitated, and novel approaches to their treatment are needed.To determine if the addition of inhaled nitric oxide (iNO) to hemodynamic-directed cardiopulmonary resuscitation (HD-CPR) would improve short-term survival from cardiac arrest associated with shock and systemic inflammation.In 3-month-old swine (n = 21), LPS was intravenously infused, inducing systemic hypotension. Ventricular fibrillation was induced, and animals were randomized to blinded treatment with either: 1) HD-CPR with iNO, or 2) HD-CPR without iNO. During HD-CPR, chest compression depth was titrated to peak aortic compression pressure of 100 mm Hg, and vasopressor administration was titrated to coronary perfusion pressure greater than or equal to 20 mm Hg. Defibrillation attempts began after 10 minutes of resuscitation. The primary outcome was 45-minute survival.The iNO group had higher rates of 45-minute survival (10 of 10 vs. 3 of 11; P = 0.001). During cardiopulmonary resuscitation, the iNO group had lower pulmonary artery relaxation pressure (mean ± SEM, 10.9 ± 2.4 vs. 18.4 ± 2.4 mm Hg; P = 0.03), higher coronary perfusion pressure (21.1 ± 1.5 vs. 16.9 ± 1.0 mm Hg; P = 0.005), and higher aortic relaxation pressure (36.6 ± 1.6 vs. 30.4 ± 1.1 mm Hg; P 0.001) despite shallower chest compressions (5.88 ± 0.25 vs. 6.46 ± 0.40 cm; P = 0.02) and fewer vasopressor doses in the first 10 minutes (median, 4 [interquartile range, 3-4] vs. 5 [interquartile range, 5-6], P = 0.03).The addition of iNO to HD-CPR in LPS-induced shock-associated cardiac arrest improved short-term survival and intraarrest hemodynamics.

OBJECTIVESControversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia–reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model.METHODSTwenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia. 4 remained on normothermic CPB throughout. Fresh brain tissue was harvested while on CPB and assessed for mitochondrial respiration and reactive oxygen species generation. Cerebral microdialysis samples were collected throughout the analysis.RESULTSDHCA animals had significantly decreased mitochondrial complex I respiration, maximal oxidative phosphorylation, respiratory control ratio and significantly increased mitochondrial reactive oxygen species (P CONCLUSIONSDHCA is associated with disruption of mitochondrial bioenergetics compared with deep hypothermic continuous perfusion. Preserving mitochondrial health may mitigate brain injury in cardiac surgical patients. Further studies are needed to better understand the mechanisms of neurological injury in neonatal cardiac surgery and correlate mitochondrial dysfunction with neurological outcomes.

Purpose of Review Cardiopulmonary resuscitation is performed on greater than 6000 hospitalized children every year. Our goal is to highlight current knowledge regarding the epidemiology and pathophysiology of pediatric in-hospital cardiac arrest, as well as the therapeutic approach during and after cardiopulmonary resuscitation for children.

One of the main debates within journalism research during the last decade has been the role of citizens as contributors or, conversely, as threats to the practice of journalism. While participation has been explored from many different theoretical, empirical, and methodological perspectives, one perspective remains noticeably underexplored – the perspective of the citizens themselves. Using social contract theory as a backdrop, this study draws on a representative survey ( N = 2091) and focus groups ( N = 82) in Sweden. The results show that although citizens do not bring up participation as an important element of journalism, they become more skeptical the more participation affects journalism. Furthermore, they expect journalists to moderate citizen contributions according to established journalistic standards. From the perspective of social contract theory, participation in journalism appears to be more of a problem than a benefit to citizens.

OBJECTIVES Less than half of the thousands of children who suffer in-hospital cardiac arrests annually survive, and neurologic injury is common among survivors. Hemodynamic-directed cardiopulmonary resuscitation improves short-term survival, but its impact on longer term survival and mitochondrial respiration-a potential neurotherapeutic target-remains unknown. The primary objectives of this study were to compare rates of 24-hour survival with favorable neurologic outcome after cardiac arrest treated with hemodynamic-directed cardiopulmonary resuscitation versus standard depth-guided cardiopulmonary resuscitation and to compare brain and heart mitochondrial respiration between groups 24 hours after resuscitation. DESIGN Randomized preclinical large animal trial. SETTING A large animal resuscitation laboratory at a large academic children's hospital. SUBJECTS Twenty-eight 4-week-old female piglets (8-11 kg). INTERVENTIONS Twenty-two swine underwent 7 minutes of asphyxia followed by ventricular fibrillation and randomized treatment with either hemodynamic-directed cardiopulmonary resuscitation (n = 10; compression depth titrated to aortic systolic pressure of 90 mm Hg, vasopressors titrated to coronary perfusion pressure ≥ 20 mm Hg) or depth-guided cardiopulmonary resuscitation (n = 12; depth 1/3 chest diameter, epinephrine every 4 min). Six animals (sham group) underwent anesthesia and instrumentation without cardiac arrest. The primary outcomes were favorable neurologic outcome (swine Cerebral Performance Category ≤ 2) and mitochondrial maximal oxidative phosphorylation utilizing substrate for complex I and complex II (OXPHOSCI+CII) in the cerebral cortex and hippocampus. MEASUREMENTS AND MAIN RESULTS Favorable neurologic outcome was more likely with hemodynamic-directed cardiopulmonary resuscitation (7/10) than depth-guided cardiopulmonary resuscitation (1/12; p = 0.006). Hemodynamic-directed cardiopulmonary resuscitation resulted in higher intra-arrest coronary perfusion pressure, aortic pressures, and brain tissue oxygenation. Hemodynamic-directed cardiopulmonary resuscitation resulted in higher OXPHOSCI+CII (pmol oxygen/s × mg/citrate synthase) in the cortex (6.00 ± 0.28 vs 3.88 ± 0.43; p < 0.05) and hippocampus (6.26 ± 0.67 vs 3.55 ± 0.65; p < 0.05) and higher complex I respiration (pmol oxygen/s × mg) in the right (20.62 ± 1.06 vs 15.88 ± 0.81; p < 0.05) and left ventricles (20.14 ± 1.40 vs 14.17 ± 1.53; p < 0.05). CONCLUSIONS In a model of asphyxia-associated pediatric cardiac arrest, hemodynamic-directed cardiopulmonary resuscitation increases rates of 24-hour survival with favorable neurologic outcome, intra-arrest hemodynamics, and cerebral and myocardial mitochondrial respiration.

Traditional news outlets are on the decline and journalism has embraced digital media in its struggle to survive. New models of delivering news to the public are being explored in order to increase the levels of readership and user engagement.The narrative of this chapter focuses on the future of journalism and media, and the potential benefits and dangers of gamifying journalism. Since gamification is a new trend, a thorough look at the intersection between the enhancements of public mobility, the digitalization of news services, and the engagement of gamified systems can bring better understanding of future channels of reading news to the users, to researchers, and to the industry. This chapter aims to bridge the gap between gamification as an emerging practice in news distribution and yet a vastly uncharted area or research.

Objective Cerebral mitochondrial dysfunction is a key mediator of neurologic injury following cardiac arrest (CA) and is regulated by the balance of fusion and fission (mitochondrial dynamics). Under stress, fission can decrease mitochondrial mass and signal apoptosis, while fusion promotes oxidative phosphorylation efficiency. This study evaluates mitochondrial dynamics and content in brain tissue 24 h after CA between two cardiopulmonary resuscitation (CPR) strategies. Interventions Piglets (1 month), previously randomized to three groups: (1) Std-CPR (n = 5); (2) HD-CPR (n = 5; goal systolic blood pressure 90 mmHg, goal coronary perfusion pressure 20 mmHg); (3) Shams (n = 7). Std-CPR and HD-CPR groups underwent 7 min of asphyxia, 10 min of CPR, and standardized post-resuscitation care. Primary outcomes: (1) cerebral cortical mitochondrial protein expression for fusion (OPA1, OPA1 long to short chain ratio, MFN2) and fission (DRP1, FIS1), and (2) mitochondrial mass by citrate synthase activity. Secondary outcomes: (1) intra-arrest haemodynamics and (2) cerebral performance category (CPC) at 24 h. Results HD-CPR subjects had higher total OPA1 expression compared to Std-CPR (1.52; IQR 1.02–1.69 vs 0.67; IQR 0.54−0.88, p = 0.001) and higher OPA1 long to short chain ratio than both Std-CPR (0.63; IQR 0.46−0.92 vs 0.26; IQR 0.26−0.31, p = 0.016) and shams. Citrate synthase activity was lower in Std-CPR than sham (11.0; IQR 10.15–12.29 vs 13.4; IQR 12.28–15.66, p = 0.047), but preserved in HD-CPR. HD-CPR subjects had improved intra-arrest haemodynamics and CPC scores at 24 h compared to Std-CPR. Conclusions Following asphyxia-associated CA, HD-CPR exhibits increased pro-mitochondrial fusion protein expression, preservation of mitochondrial mass, improved haemodynamics and superior neurologic scoring compared to Std-CPR. Institutional protocol number IAC 16-001023.

Cooperation and communication play an important role for environmental governance. This holds true for the Baltic Sea in Northern Europe, one of the most disturbed ecosystems in the world, where insufficient cooperation between different stakeholders is one reason for goal failure. This article addresses the linkages between (media) framing on the one hand, and cooperation on the other. The case in focus is a set of negotiations related to the Baltic Sea Action Plan, the most central governance strategy in the Baltic Sea region. Our results show that in order to influence political decision-making, key stakeholders compete over the power to define and interpret problems, causes and solutions to an extent impeding cooperation. We focus the analysis on eutrophication, which we show to be a complex and controversial topic, framed in incompatible ways by different stakeholders.

The accelerating news cycle means there is a risk that errors become more common, but digital media also allow for correcting errors continuously and being transparent about this. In this study, we investigate Swedish citizens’ attitudes toward errors and corrections. The results demonstrate that citizens have strong expectations that news media publish correct information and they have little tolerance for errors. People’s background and media use do not affect attitudes toward errors and corrections to any large extent, but media trust explains a small fraction of the results—It is only those who already trust the media that appreciate corrections. First Published online June 23, 2016

Introduction: Neurologic morbidity is common after pediatric cardiac arrest and inhaled nitric oxide (iNO) may be protective. RNA sequencing may have a role in identifying differences in gene expression related to neurologic injury following cardiac arrest and the neuroprotective mechanism of iNO. Hypothesis: We hypothesized that genes related to energetically intensive functions such as synaptic vesicle trafficking would be downregulated after cardiac arrest and that this finding would be less prominent with iNO therapy. Methods: One-month old piglets underwent sham anesthesia or 7 minutes of asphyxia, induction of VF, and randomized and blinded therapy with AHA guideline-based CPR with iNO (iNO + ) or without iNO (iNO - ). Four hours post-ROSC, animals were euthanized and RNA was extracted from cerebral cortical tissue and sequenced on an Illumina HiSeq instrument. STAR was used to align reads to the SusScrofa11.1 reference followed by quantification with sub-reads. Normalization and differential expression analyses were performed using DESeq2 with RIN, RNA concentration, shocks delivered, epinephrine doses, post-ROSC epinephrine use, cerebral blood flow, ETCO 2 , and blood gas values as covariates. Benjamini-Hochberg-adjusted p values Results: Sham animals (n=5) and cardiac arrest animals with ROSC (iNO+ n=9; iNO- n=6) were included in analyses. 817 genes were differentially expressed between cardiac arrest and sham. 798 genes were differentially expressed between iNO + and iNO - . 24 genes were differentially expressed in opposite directions in the two comparisons, making them candidates for protective mechanisms of iNO. These included genes related to synaptic vesicle function (RAB27B, PACSIN1, DOC2A) and maintenance of synaptic structure (SH2D5, CA10). Cardiac arrest induced downregulation of synaptic vesicle genes including SNAP25 and synaptophysin, while iNO induced upregulation of others in the same ontology, including synapsins and synaptogamins. Conclusions: Piglets subjected to asphyxial cardiac arrest exhibited downregulation of genes related to synaptic vesicle trafficking. This was partially prevented by treatment with iNO.

Introduction: Pulmonary hypertension may play a role in preventing ROSC during prolonged CPR. Targeted pulmonary vasodilation with inhaled nitric oxide (iNO) during CPR may improve pulmonary blood flow and improve outcomes. The purpose of this study was to study the effects of iNO in a randomized, blinded, placebo controlled, pediatric swine model of asphyxial cardiac arrest. Hypothesis: Animals treated with iNO will have lower pulmonary artery pressure, improved systemic hemodynamics, and increased cerebral blood flow during prolonged CPR compared to control. Methods: Four-week-old piglets (n=10) that underwent seven minutes of asphyxia, induction of VF, and 10 minutes of CPR were randomized to either iNO (20 ppm) or placebo in a blinded fashion starting one min into CPR and needed more than 1 defibrillation attempt. Defibrillation was attempted after 10 minutes of CPR. Animals that did not achieve ROSC by 20 minutes were euthanized. Invasive pulmonary and systemic hemodynamics, and both invasive and noninvasive cerebral hemodynamics were continuously measured. Data described as mean ± SD and compared using a generalized estimating equation regression model. Results: All 5 iNO-treated animals and 2/5 placebo-treated animals achieved ROSC. Those treated with iNO had lower mean pulmonary artery pressures (29.5 ± 9.1 vs. 48.3 ± 5.6 mmHg, p=0.04); higher mean aortic pressures (51.9 ± 6.4 vs. 35.5 ± 4.4 mmHg, p=0.01); higher cerebral blood flow (invasive: 230.4 ± 57.4 vs. 28.7 ± 42.1 % baseline, p Conclusions: Treatment with iNO during prolonged CPR results in lower pulmonary artery pressure, improved systemic hemodynamics, and increased cerebral blood flow and oxygenation. Pulmonary vasodilation may have an important role during prolonged CPR for asphyxial cardiac arrests.

In this article, we argue that digital media pose such challenges for analysing media content adequately that the established approach does not work as intended, reflecting underlying assumptions inherited from analogue media formats. We review two relatively new forms of the content analysis method—big data and liquid content analysis—and juxtapose these with established content analysis. In addition, we detail how these two methods tackle content analysis pillars such as mode of analysis, sampling, sampling size, variable design, unit of analysis, measuring point(s), access/capture/storing, conclusions/generalizability and the key agent doing the actual work. We summarize the article by arguing that established content analysis is insufficient for digital media but that common standards, protocols and procedures are yet to be developed for these new approaches to digital journalism research.

A contemporary debate in media studies concerns participation and empowerment, and to what extent digital media shift power to the citizens. This study assesses the long-term viability of participatory journalism using Swedish content and user data. Inclusion of comments and blog-links on news sites increased from 2007 to 2010, and decreased rather dramatically from 2011 onward. Posting user comments or writing blogs have never been activities that have appealed to a majority of the Swedes. Participatory journalism seems to have decreasing value to producers and little appeal to users. A shift in how power is distributed in the public sphere is absent. This is not primarily a problem of reluctant producers but, more importantly, a lack of interest from users.

Importance Mitochondrial disease is being diagnosed with increasing frequency. Although children with mitochondrial disease often have severe, life-limiting illnesses, many survive into adulthood. There is, however, limited information about the impact of mitochondrial disease on healthcare utilization in the U.S. across the lifespan. Objectives To describe the characteristics of inpatient hospitalizations related to mitochondrial disease in the U.S., to identify patient-level clinical factors associated with in-hospital mortality, and to estimate the burden of hospitalizations on individual patients. Design Cross-sectional and longitudinal observational studies. Setting U.S. hospitals. Participants Individuals with hospital discharges included in the triennial Healthcare Cost and Utilization Project (HCUP) Kids Inpatient Database (KID) and the National Inpatient Sample (NIS) in 2012 (cross-sectional analysis); individuals with hospital discharges included in the HCUP California State Inpatient Database from 2007 to 2011, inclusive (longitudinal analysis). Exposure Hospital discharge associated with a diagnosis of mitochondrial disease. Main outcome measures Total number and rate of hospitalizations for individuals with mitochondrial disease ( International Classification of Diseases, 9th revision, Clinical Modification code 277.87, disorder of mitochondrial metabolism); in-hospital mortality. Results In the 2012, there were approximately 3200 inpatient pediatric hospitalizations (1.9 per 100,000 population) and 2000 inpatient adult hospitalizations (0.8 per 100,000 population) for mitochondrial disease in the U.S., with associated direct medical costs of $113million. In-hospital mortality rates were 2.4% for children and 3.0% for adults, far exceeding population averages. Higher socioeconomic status was associated with both having a diagnosis of mitochondrial disease and with higher in-hospital mortality. From 2007 to 2011 in California, 495 individuals had at least one admission with a diagnosis of mitochondrial disease. Patients had a median of 1.1 hospitalizations (IQI, 0.6–2.2) per calendar year of follow-up; infants under 2y were hospitalized more frequently than other age groups. Over up to five years of follow up, 9.9% of participants with any hospitalization for mitochondrial disease were noted to have an in-hospital death. Conclusions and relevance Hospitalizations for pediatric and adult mitochondrial diseases are associated with serious illnesses, substantial costs, and significant patient time. Identification of opportunities to prevent or shorten such hospitalizations should be the focus of future studies.

Hyperlinks are considered vital to both the Web and to digital journalism. This study utilizes a longitudinal content analysis of hyperlinking practices in Swedish online news from 2007 to 2013 to see how hyperlinking evolves over time. It also compares if and to what extent publishing tradition shapes journalistic practice. The findings primarily show that the overall impact of hyperlinks remains largely unchanged over time but that internal links, while still being most common, decrease in relative importance while external links increase. The general conclusion is that hyperlinks, so far, are not an important aspect of online journalism practice.

In this study, the results from a content analysis of four Swedish online citizen journalism outlets are presented and discussed. The analysis focuses on new digital venues for news-making in theory and the question of the political relevance of citizen journalism in reality. This broad question is operationalized by asking more specifically how citizen journalists tell the news, according to established distinctions between variations in topic dimensions, focus, and presentational style. Our results show that citizen journalists tend to tell soft news. They rarely report on policy issues, local authorities, or people affected by decisions being made by them. Furthermore, the news focuses on individual relevance and is mostly episodic in nature. The style of writing is predominantly impersonal and unemotional. In sum, our results suggest that citizen journalism in Sweden is not yet at a stage where it can be considered a plausible alternative to traditional journalism.

In this study, situated in Sweden, citizen community journalism in 290 municipalities is evaluated. The results reveal that there are very few cases of citizen journalism at a community level, and that the existing citizen journalists focus on business news, entertainment and sports. When sources are used, they are few and originate from social institutions such as business, media, authorities and politics rather than citizens. Furthermore, there are only a few occasions when local authorities are included at all, even less so scrutinised, in the news stories. All in all, the study indicates that Swedish citizen community journalism has trouble either providing information that maintains the community or being the watchdog of that community.

Digital media allow for instant tracking of audience behaviour, thus enabling a potential negotiation between journalists’ traditional authority and professional news values, on the one hand, and the audience’s power in terms of ignoring or paying attention to the journalistic outcome, on the other. The present study investigates whether clicks change news values and have an impact on news routines in tabloid, broadsheet and public service newsrooms. The findings indicate that audience metrics bring a new dimension to the news evaluation process regardless of publishing tradition, but that the commercial media seem to keep a closer tab on traffic. In general, journalists strive for a “good mix” between customization to achieve audience satisfaction and a desire for editorial independence.

In the early 21st century, almost everyone takes journalism on the web for granted. However, it was not many years ago that journalism moved online and a distinct form of journalism began to develop. Ranging from online doubles of the paper editions to publications exclusively produced for the web, the evolvement of web journalism has entailed both dramatic and not-so-dramatic changes in the way that journalistic products are produced, disseminated, and received. Online journalism has usually been demarcated from traditional journalism by four traits: interactivity, immediacy, hypertextuality, and multimodality. These characteristics are generally identified by scholars as points where journalism on the web brings added value in comparison to the old print newspapers. Interactivity involves various aspects of user activity and participation in the processes of consuming, contributing to, and disseminating news afforded by the web. Immediacy refers to the nature and consequences of the faster pace of publication in web news. Hypertextuality has to do with the possibilities of linking journalistic texts to other texts, which makes the text more transparent and open. Multimodality denotes the telling of news with the use of many different modes at the same time. When studying research about these aspects of web journalism, three general observations can be made. First, researchers have approached these characteristics unevenly in terms of scope and interest. The interactive aspects of web journalism are by far the most investigated. Second, the four characteristics have been studied through the lenses of different theoretical frameworks. Third, empirical research shows that change in journalism is slow and not always as radical as many predicted when journalism on the web was in its infancy.

Over the last decades, media environments have become radically transformed. Among the most significant changes is the rise of interactive media technologies, which raise new questions about how influence over media content has changed. At the same time, changes in media technologies and how they may change the influence over the news should not be understood in isolation from other changes in media environments. Against this background, the purpose of this paper is to investigate how much influence journalists ascribe to different sets of actors; how they perceive changes over time; and whether journalists working with online publishing differ in these respects from other journalists. Among other things, the study shows that the most influential group is perceived to be journalists, followed by the audience and media owners. The group that is perceived to have increased their influence the most is media owners. All investigated groups—except journalists—are perceived to have increased their influence at ...

Transparency has been emphasized as a new norm within journalism and has received a great deal of attention. The credo of transparency is openness, and the interactive potential of digital media has been identified as one key element in achieving openness. In this essay it is argued that by exposing previously hidden journalistic processes, the high speed of online news plays a part in this orientation towards transparency in journalism.

Research concerning user participation in online news has demonstrated that news websites offer a wide range of participatory features, but largely permit users only to comment on already- publishe ...

Although participatory journalism involves publishing content created by users, editorial influence is an important aspect of participatory online media. Editors shape the conditions under which user generated content is produced, the context of publication and the perceived prominence of the content. It is still unclear how this influence manifests itself, and how it can be related to the discussion about participatory media's potential for revitalising democracy. In this paper, three online news media in Sweden are analysed comparatively: Sourze - the first Swedish participatory newspaper; Newsmill - a social media focusing on news and debate; and DN - the online version of the largest Swedish morning paper Dagens Nyheter. The question is how participation is affected by editorial influence. The findings suggest that participatory arenas are constrained by the logic of their context of production. People from different categories in society participate on different terms. Furthermore, editors influence the agenda by suggesting topics, and by rewarding articles that follow their suggestions. These fi ndings do not challenge assumptions about participatory newspapers as more accessible channels for citizens and therefore interesting as possible means of allowing a more democratically involved citizenry, but it challenges assumptions about freedom from constraints related to traditional mass media, such as agenda setting, gate-keeping and media logic. Čeprav državljansko novinarstvo pomeni objavljanje vsebin, ki jih ustvarjajo uporabniki, je uredniški vpliv v državljanskem spletnem mediju pomemben. Uredniki določajo pogoje, pod katerimi uporabniki ustvarjajo vsebine, kontekst objave in dojemanje pomembnosti vsebin. Kljub temu ostaja nejasno, kako se ta vpliv kaže navzven in v kakšnem odnosu je do razprav o participativnem potencialu medijev za oživljanje demokracije. Članek primerja tri švedske spletne medije: Sourze - prvi švedski državljanski časopis, Newsmill - družabni medij, ki temelji na novicah in razpravi, in DN - spletno različico največjega švedskega jutranjega časopisa Dagens Nyheter. Avtorja zastavljata vprašanje, kakšen učinek ima uredniški vpliv na udeležbo. Rezultati nakazujejo, da je polje udeležbe zamejeno z logiko lastnega konteksta produkcije. Članom različnih družbenih kategorij se sodelovanje različno pogojuje. Še več kot to, uredniki oblikujejo agendo tako, da sugerirajo teme in nagrajujejo članke, ki upoštevajo njihove sugestije. Rezultati ne oporekajo domnevi, da so državljanski časopisi bolj dostopni kanali za državljane in zaradi tega tudi zanimivi kot možni načini za oblikovanje bolj demokratičnega udejstvovanja državljanov, a kljub temu zavračajo domnevo o svobodi pred omejitvami, ki so značilne za tradicionalne medije, kot so npr. prednostno tematiziranje, funkcije odbiratelja in medijska logika.

Transparency has been suggested as a new norm in journalism. However, few studies have investigated how the overarching notion of transparency is utilized in everyday news. The purpose of this study is to identify and compare how leading mainstream online news media in the United States, United Kingdom and Sweden make use of transparency techniques in news items. The results show that transparency has begun to affect online news but that current journalism practice is a long way from a fully fledged transparency norm.

Background Although advances in cardiopulmonary resuscitation have improved survival from cardiac arrest ( CA ), neurologic injury persists and impaired mitochondrial bioenergetics may be critical for targeted neuroresuscitation. The authors sought to determine if excellent cardiopulmonary resuscitation and postresuscitation care and good traditional survival rates result in persistently disordered cerebral mitochondrial bioenergetics in a porcine pediatric model of asphyxia‐associated ventricular fibrillation CA . Methods and Results After 7 minutes of asphyxia, followed by ventricular fibrillation, 5 female 1‐month‐old swine (4 sham) received blood pressure–targeted care: titration of compression depth to systolic blood pressure of 90 mm Hg and vasopressor administration to a coronary perfusion pressure >20 mm Hg. All animals received protocol‐based vasopressor support after return of spontaneous circulation for 4 hours before they were killed. The primary outcome was integrated mitochondrial electron transport system ( ETS ) function. CA animals displayed significantly decreased maximal, coupled oxidative phosphorylating respiration ( OXPHOS CI + CII ) in cortex ( P P P P II –driven respiration were both significantly decreased after CA (cortex: OXPHOS CI P ETS CII P OXPHOS CI P ETS CII P ETS CI + CII ), as well as a 30% reduction in citrate synthase activity ( P Conclusions Mitochondria in both the cortex and hippocampus displayed significant alterations in respiratory function after CA despite excellent cardiopulmonary resuscitation and postresuscitation care in asphyxia‐associated ventricular fibrillation CA . Analysis of integrated ETS function identifies mitochondrial bioenergetic failure as a target for goal‐directed neuroresuscitation after CA . IACUC Protocol: IAC 13‐001023.

Transparency has been proposed to both change the way journalism is being produced and increase its credibility. However, little research has been conducted to assess the connection between transparency and credibility. This study utilizes an experimental setting (N=1320) to measure what impact transparency have on source and message credibility from the user perspective. The results reveals an almost absence of any transparency effect on both source and message credibility although some small significant effects could be observed primarily regarding internal hyperlinks, comments and contextual information. Although further research is desperately needed in this area the study suggest that transparency does not affect the credibility of journalism in the eyes of the contemporary audience and thus have limited appeal as a new norm in journalism. Transparens och journalistisk trovärdighet

Coronagraphy is a powerful technique to achieve high contrast imaging and hence to image faint companions around bright targets. Various concepts have been used in the visible and near-infrared regimes, while coronagraphic applications in the mid-infrared remain nowadays largely unexplored. Vector vortex phase masks based on concentric subwavelength gratings show great promise for such applications. We aim at producing and validating the first high-performance broadband focal plane phase mask coronagraphs for applications in the mid-infrared regime, and in particular the L band with a fractional bandwidth of ~16% (3.5-4.1 \mu m). Based on rigorous coupled wave analysis, we designed an annular groove phase mask (AGPM) producing a vortex effect in the L band, and etched it onto a series of diamond substrates. The grating parameters were measured by means of scanning electron microscopy. The resulting components were then tested on a mid-infrared coronagraphic test bench. A broadband raw null depth of 2 x 10^{-3} was obtained for our best L-band AGPM after only a few iterations between design and manufacturing. This corresponds to a raw contrast of about 6 x 10^{-5} (10.5 mag) at 2\lambda/D. This result is fully in line with our projections based on rigorous coupled wave analysis modeling, using the measured grating parameters. The sensitivity to tilt and focus has also been evaluated. After years of technological developments, mid-infrared vector vortex coronagraphs finally become a reality and live up to our expectations. Based on their measured performance, our L-band AGPMs are now ready to open a new parameter space in exoplanet imaging at major ground-based observatories., Comment: 8 pages, 11 figures