bluuebunny/crossref_metadata_2025 huggingface dataset:
Frames of decision‐making in prenatal consultations in England and France. Towards a sociological, relational, and processual approach to autonomy
Authors: Ville Isabelle , Lafarge Caroline
Published: February 2020

Rationale, aims, and objectives

The article looks at how, during consultations, pregnant women identified as presenting an increased risk of giving birth to a child with an impairment, and practitioners in the field of prenatal diagnosis, decide whether or not to accept the risk of a miscarriage and proceed with a diagnostic examination.

Methods

We conducted 63 observations of consultations in France and 22 in England. Participants were women for whom an elevated risk of abnormality had been identified and the practitioners involved in their care.

Our analytical approach consisted in suspending the normative concepts of nondirectiveness and autonomy, and in drawing on Goffman's (1974) notion of “frame” to take account of the experiential and structural aspects that the protagonists bring into the (inter)actions.

Results

We identified four frames: medico‐scientific expertise, medical authority, religious authority, and compassion. Observation of the ways in which the frames intertwine during consultations revealed configurations that facilitate or hinder the fluidity of the interactions and the decision‐making process. The medico‐scientific expertise frame, imposed by the guidelines, heavily dominated our observations, but frequently caused distress and misunderstanding. Temporary or sustained use of the compassion and/or medical authority frames could help to repair the discussion and create the conditions that enable women/couples to reach a decision. Variations in configuration highlighted the differences between practitioners in the two countries.

Conclusions

Combining frames allows protagonists to exert reflective abilities and to maintain/restore interactions. The frame analysis promotes a vision of autonomy that is sociological, relational, and processual. The frames are anchored in different structural conditions in England and France.
Taxonomical study of Trichomycterus (Siluriformes: Trichomycteridae) from the Ribeira de Iguape River basin reveals a new species recorded in the early 20th century
Authors: Donin Laura M. , Ferrer Juliano , Carvalho Tiago P.
Published: February 2020

A new species of Trichomycterus endemic to the Ribeira de Iguape River basin, southeastern Brazil, was studied based on morphological and molecular evidence. This species had an outer layer of coloration composed of scattered, round, black or dark‐brown spots smaller or equivalent in size to the circumference of the eye; eight pectoral‐fin rays; 28–29 opercular odontodes; 54–56 interopercular odontodes; and supraorbital line of the laterosensory system not interrupted, with pores s2 absent. Two other species of Trichomycterus from the Ribeira de Iguape River basin are recorded, and their taxonomic status is discussed: Trichomycterus alternatus and Trichomycterus jacupiranga were not differentiated using molecular analysis but may be consistently distinguished based on morphology. The phylogenetic relationships of the co‐occurring species, T. alternatus and Cambeva zonata, were inferred using mitochondrial data, reinforcing the taxonomic status of these recently revised species that have a complex taxonomy. In addition, a new combination for Trichomycterus taroba with its inclusion in the genus Cambeva is recommended.
Nursing Staff Needs in Providing Palliative Care for Persons With Dementia at Home or in Nursing Homes: A Survey
Authors: Bolt Sascha R. , Meijers Judith M.M. , van der Steen Jenny T. , Schols Jos M.G.A. , Zwakhalen Sandra M.G.
Published: February 2020

Purpose

This study aimed to evaluate what types and forms of support nursing staff need in providing palliative care for persons with dementia. Another aim was to compare the needs of nursing staff with different educational levels and working in home care or in nursing homes.

Design

A cross‐sectional, descriptive survey design was used.

Methods

A questionnaire was administered to a convenience sample of Dutch nursing staff working in the home care or nursing home setting. Data were collected from July through October 2018. Quantitative survey data were analyzed using descriptive statistics. Data from two open‐ended survey questions were investigated using content analysis.

Findings

The sample comprised 416 respondents. Nursing staff with different educational levels and working in different settings indicated largely similar needs. The highest‐ranking needs for support were in dealing with family disagreement in end‐of‐life decision making (58%), dealing with challenging behaviors (41%), and recognizing and managing pain (38%). The highest‐ranking form of support was peer‐to‐peer learning (51%). If respondents would have more time to do their work, devoting personal attention would be a priority.

Conclusions

Nursing staff with different educational levels and working in home care or in nursing homes endorsed similar needs in providing palliative care for persons with dementia and their loved ones.

Clinical Relevance

It is critical to understand the specific needs of nursing staff in order to develop tailored strategies. Interventions aimed at increasing the competence of nursing staff in providing palliative care for persons with dementia may target similar areas to support a heterogeneous group of nurses and nurse assistants, working in home care or in a nursing home.
Assessing Cerebrovascular Hemodynamics Using Transcranial Doppler in Patients with Mechanical Circulatory Support Devices
Authors: Melmed Kara R. , Schlick Konrad H. , Rinsky Brenda , Dumitrascu Oana M. , Volod Oksana , Nezhad Mani , Padrick Matthew M. , Runyan Carmelita , Arabia Francisco A. , Moriguchi Jaime D. , Lyden Patrick D. , Song Shlee S
Published: February 2020

BACKGROUND AND PURPOSE

Mechanical circulatory support (MCS) devices are commonly used in heart failure patients. These devices carry risk for presumably embolic and additionally hemorrhagic stroke. Alterations in blood flow play a key role in stroke pathophysiology, and we aimed to learn more about hemodynamic compromise. In this study, we used transcranial Doppler (TCD) ultrasound to define hemodynamics of commonly used nonpulsatile MCS devices, as well as pulsatile devices, with special attention to the total artificial heart (TAH).

METHODS

From 2/2013 through 12/2016, we prospectively enrolled patients with MCS who underwent TCD imaging. We analyzed TCD parameters, including peak systolic velocity, end‐diastolic velocity, pulsatility indices (PIs), and number of high‐intensity transient signals. Waveform morphologies were compared between various MCS devices.

RESULTS

We performed 132 TCD studies in 86 MCS patients. Waveforms in patients supported by venoarterial‐extracorporeal membrane oxygenation demonstrated continuous flow without clear systolic peaks with an average (±SD) PI of .43 (±.2). PIs were low in patients with continuous‐flow left ventricular assist devices with a mean PI of .32 (±.13). Impella patients had morphologically distinct pulsatile waveforms and a higher mean PI of .65 (±.24). In intra‐arterial balloon pump patients, mean PI was 1.01 (±.16) and diastolic upstrokes were pronounced. In TAH patients, mean middle cerebral artery velocity of 79.69 (±32.33) cm/seconds and PI of .74 (±.14) approached normal values.

CONCLUSION

TCD can detect characteristic waveforms in patients supported by various MCS devices. These device‐specific TCD patterns are recognizable and reproducible.
Ischemic Core Volume Combined with the Relative Perfusion Ratio for Stroke Outcome Prediction after Endovascular Thrombectomy
Authors: Rotkopf Lukas T. , Tiedt Steffen , Puhr‐Westerheide Daniel , Herzberg Moriz , Reidler Paul , Kellert Lars , Feil Katharina , Thierfelder Kolja M. , Dorn Franziska , Liebig Thomas , Wollenweber Frank A. , Kunz Wolfgang G.
Published: February 2020

BACKGROUND AND PURPOSE

Imaging‐based selection of stroke patients for endovascular thrombectomy (EVT) remains an ongoing challenge. Our aim was to determine the value of a combined parameter of ischemic core volume (ICV) and the relative degree of cerebral blood flow in the penumbra for morphologic and clinical outcome prediction.

METHODS

In this Institutional Review Board (IRB)‐approved prospective observational study, 221 consecutive patients with large vessel occlusion anterior circulation stroke within 6 hours of symptom onset and subsequent EVT were included between June 2015 and August 2017. Admission computed tomography perfusion was analyzed using automated threshold‐based algorithms. Perfusion‐weighted ICV (pw‐ICV) was calculated by multiplying ICV with the relative cerebral blood flow reduction within the penumbra. Functional outcome was assessed by standardized assessment of the modified Rankin scale (mRS) after 3 months.

RESULTS

In multivariate analyses, pw‐ICV was significantly associated with final infarction volume (FIV) (β = .38, P < .001) after adjustment for penumbra volume, age, sex and time from symptom onset. In separate multivariate analysis with either pw‐ICV or ICV, pw‐ICV outperformed ICV for the prediction of FIV (Akaike's information criterion: 1,072 vs. 1,089; conditional variable importance: 1,494 vs. 955). There was also a highly significant association between FIV and clinical outcome as measured by an mRS score of 2 or less (odds ratio per 10 mL = .78, P < .001). Both pw‐ICV and ICV were significantly associated with NIHSS improvement (both P<.05).

CONCLUSION

In EVT‐treated stroke patients, pw‐ICV outperforms the more commonly used ICV in the prediction of morphological and functional outcome.
The Žďár nad Sázavou meteorite fall: Fireball trajectory, photometry, dynamics, fragmentation, orbit, and meteorite recovery
Authors: Spurný Pavel , Borovička Jiří , Shrbený Lukáš
Published: February 2020

We report a comprehensive analysis of the instrumentally observed meteorite fall Žďár nad Sázavou, which occurred in the Czech Republic on December 9, 2014, at 16:16:45–54 UT. The original meteoroid with an estimated initial mass of 150 kg entered the atmosphere with a speed of 21.89 km s−1 and began a luminous trajectory at an altitude of 98.06 km. At the maximum, it reached −15.26 absolute magnitude and terminated after a 9.16 s and 170.5 km long flight at an altitude of 24.71 km with a speed of 4.8 km/s. The average slope of the atmospheric trajectory to the Earth's surface was only 25.66°. Before its collision with Earth, the initial meteoroid orbited the Sun on a moderately eccentric orbit with perihelion near Venus orbit, aphelion in the outer main belt, and low inclination. During the atmospheric entry, the meteoroid severely fragmented at a very low dynamic pressure 0.016 MPa and further multiple fragmentations occurred at 1.4–2.5 MPa. Based on our analysis, so far three small meteorites classified as L3.9 ordinary chondrites totaling 87 g have been found almost exactly in the locations predicted for a given mass. Because of very high quality of photographic and radiometric records, taken by the dedicated instruments of the Czech part of the European Fireball Network, Žďár nad Sázavou belongs to the most reliably, accurately, and thoroughly described meteorite falls in history.
Metabolic compartmentalization between astroglia and neurons in physiological and pathophysiological conditions of the neurovascular unit
Authors: Takahashi Shinichi
Published: February 2020

Astroglia or astrocytes, the most abundant cells in the brain, are interposed between neuronal synapses and microvasculature in the brain gray matter. They play a pivotal role in brain metabolism as well as in the regulation of cerebral blood flow, taking advantage of their unique anatomical location. In particular, the astroglial cellular metabolic compartment exerts supportive roles in dedicating neurons to the generation of action potentials and protects them against oxidative stress associated with their high energy consumption. An impairment of normal astroglial function, therefore, can lead to numerous neurological disorders including stroke, neurodegenerative diseases, and neuroimmunological diseases, in which metabolic derangements accelerate neuronal damage. The neurovascular unit (NVU), the major components of which include neurons, microvessels, and astroglia, is a conceptual framework that was originally used to better understand the pathophysiology of cerebral ischemia. At present, the NVU is a tool for understanding normal brain physiology as well as the pathophysiology of numerous neurological disorders. The metabolic responses of astroglia in the NVU can be either protective or deleterious. This review focuses on three major metabolic compartments: (i) glucose and lactate; (ii) fatty acid and ketone bodies; and (iii) D‐ and L‐serine. Both the beneficial and the detrimental roles of compartmentalization between neurons and astroglia will be discussed. A better understanding of the astroglial metabolic response in the NVU is expected to lead to the development of novel therapeutic strategies for diverse neurological diseases.
Causes of impaired biventricular pacing in cardiac resynchronization devices with left ventricular sensing
Authors: Haeberlin Andreas , Ploux Sylvain , Noel Antoine , Chauvel Rémi , Welte Nicolas , Marchand Hugo , Haïssaguerre Michel , Ritter Philippe , Eschalier Romain , Bordachar Pierre
Published: February 2020

Background

Loss of biventricular stimulation can result in nonresponse to cardiac resynchronization therapy (CRT). Problems associated with the left ventricular (LV) lead and LV sensing can be challenging to detect and their incidence is unclear. The purpose of this study was to investigate mechanisms of loss of biventricular pacing due to LV lead‐ and LV sensing‐associated problems.

Methods

In this bicentric study, CRT patients were surveilled using a novel remote monitoring algorithm from Biotronik (Germany) that registers LV electrograms (EGMs) during intermittent loss of resynchronization. The episodes were analyzed to assess the mechanisms of resynchronization interruptions.

Results

We analyzed 582 EGMs from 61 patients. During a median follow‐up of 6 months, 59% of the patients had such episodes. The majority of the episodes (61%) were related to inappropriate inhibition of LV pacing, mostly due to upper rate lock‐in caused by LV sensing (58%). In contrast, 8% of episodes showed intermittent loss of LV capture, which was identified thanks to LV sensing. The remaining 31% of episodes were due to physiological reasons for resynchronization interruptions (eg, supraventricular tachycardia [18%], premature beats [8%], and others [5%]). Patients with CRT interruption episodes had lower resynchronization rates (median: 98.5% vs 100%, P = .044).

Conclusions

Inadequate programming (active LV sensing with T‐wave protection) is the main cause of impaired resynchronization in devices with LV sensing. In general, we recommend the deactivation of the LV T‐wave protection function.
Aplasia cutis congenita in Korea: Single center experience and literature review
Authors: Yang Min‐Young , Ha Dae‐Lyong , Kim Hoon‐Soo , Ko Hyun‐Chang , Kim Byung‐Soo , Kim Moon‐Bum
Published: February 2020

Background

Aplasia cutis congenita (ACC) is a rare congenital malformation characterized by a localized absence of skin. which most commonly affects the scalp. We performed the present study to elucidate the basic clinical data regarding ACC in Korea, including demographics, clinical features, radiological and therapeutic results.

Methods

Fifty‐nine patients (70 lesions) with ACC (35 from our department and 24 from a Koreamed database search) were enrolled. We assessed demographics, family and obstetrical histories, clinical features (multiplicity, subtype, size, shape, hair collar sign, location, and Frieden's classification), and radiologic and therapeutic results.

Results

The mean age of patients was 2.62 years, with a male‐to‐female ratio of 1.03. A minority of patients had a family history (three patients), birth trauma (one patient), maternal drug use (two patients), or human immunodeficiency virus infection (one patient) during pregnancy, and fetus papyraceus of placental infarcts (two patients). Six patients (6/59, 10.17%) had multiple lesions. Scarring was the most common manifestation (39/70, 55.71%). The scalp was the most commonly affected site (50 cases, 71.43%). Thirty‐nine patients (66.10%) met Frieden's type I classification (scalp ACC without multiple anomalies). Radiological investigations were performed in 30 patients (30/59, 50.85%) with abnormal findings in eight patients. Twenty‐five patients (42.37%) were managed conservatively, and 17 patients (28.81%) were treated with local wound care.

Conclusions

This is the first and largest study assessing the basic clinical data of ACC in Korea. The results of the present study could be useful for pediatricians and dermatologists who routinely manage ACC.
Rationalize or reappraise? How envy and cognitive reappraisal shape unethical contagion
Authors: Thiel Chase E. , Bonner Julena , Bush John T. , Welsh David T. , Pati Rakesh
Published: February 2020

Reducing unethical employee behavior is a complex challenge for organizations given that such behavior is often highly contagious. Yet, although many employees imitate the unethical behavior of their coworkers, some adhere to ethical standards in spite of their coworkers’ unethical behavior. Drawing on social cognitive theory, we propose an expanded model of unethical social influence that sheds light on the processes and boundary conditions associated with unethical contagion within organizations. Specifically, we argue that observing others engage in unethical behavior evokes feelings of envy that, in turn, facilitate moral disengagement and unethicality. We then integrate research on cognitive reappraisal with the moral disengagement literature to propose that cognitive reappraisal attenuates the experience of envy in those who observe unethical behavior. Across two field studies and an experimental study, we build a model in which envy mediates the relationship between observed unethical behavior and moral disengagement with downstream consequences in the form of unethical behavior. Additionally, both cognitive reappraisal orientation (Studies 1 & 2) and cognitive reappraisal training (Study 3) attenuate this mediated effect. Given the substantial costs of unethical contagion within organizations, these findings have implications for both scholars and managers.
Invasive breast cancer: Current perspectives and emerging views
Authors: Shea Eric Ka Ho , Koh Valerie Cui Yun , Tan Puay Hoon
Published: February 2020

Invasive breast cancer constitutes a heterogeneous group of tumors. They comprise various histological types that differ in clinical presentation, imaging features, histopathological characteristics, biomarker profiles, prognostic and predictive parameters. The current classification of invasive breast cancer is based primarily on histopathological features. Invasive carcinoma of no special type accounts for the majority, with some rare entities also being described. With recent research and advances, there are emerging concepts, including new genetic insights of invasive breast cancer and the role of the stromal microenvironment. With greater understanding of the pathogenesis of invasive breast cancer, changes based on the correlation of histologic and genetic findings have been incorporated in the latest World Health Organization classification of breast tumors. Medullary carcinomas are subsumed as invasive carcinoma of no special type with basal‐like and medullary features, regarded as part of the spectrum of tumor infiltrating lymphocyte‐rich breast cancers. Tall cell carcinoma with reversed polarity is proposed as a distinct entity in recognition of unique IDH2 mutations. This article reviews conventional prognostic parameters, new histological entities, and updates on breast cancer classification, with inclusion of some genetic insights into breast cancer and the role of tumor infiltrating lymphocytes.
Clinical impact of TROP2 in non‐small lung cancers and its correlation with abnormal p53 nuclear accumulation
Authors: Mito Remi , Matsubara Eri , Komohara Yoshihiro , Shinchi Yusuke , Sato Kensaku , Yoshii Daiki , Ohnishi Koji , Fujiwara Yukio , Tomita Yusuke , Ikeda Koei , Sakagami Takuro , Suzuki Makoto
Published: February 2020

Tumor‐associated calcium signal transducer 2 (TROP2) is a cell‐surface glycoprotein involved in the high malignant potential of several cancers. Antibody‐drug conjugates that target TROP2 represent a promising approach for the treatment of TROP2‐expressing cancers including lung cancer and breast cancer. TROP2 expression was tested by immunohistochemistry in lung adenocarcinoma (ADC) and squamous cell carcinoma samples, and its correlation with clinicopathological factors, including survival rate and p53 mutation, was statistically analyzed. We found that increased TROP2 expression was significantly associated with a poor clinical course in patients with ADC, but not in patients with squamous cell carcinoma. A more significant association with poor outcome was seen in ADC cases with a high histological grade as well as those without the epidermal growth factor receptor (EGFR) mutation. A significant correlation between TROP2 expression and abnormal p53 nuclear accumulation/expression was also found in ADC. In the present study, we discovered a significant correlation between TROP2 expression and p53 mutation in ADC, and that TROP2 expression was a prognostic factor in ADC cases with a high histological grade as well as those without the EGFR mutation. Signals mediated by mutated p53 might influence TROP2 expression in ADC.
Warehouse Location in An Emerging Country: A Win–Win Proposition?
Authors: Zhang Ying , Swaminathan Jayashankar M.
Published: February 2020

Warehouse solutions in emerging countries near suppliers have been adopted to achieve cost efficiency in offshore procurement. Previous academic literature ignores logistics operations costs in supply chain contracting. In this paper, we study contracting between a retailer in a developed country and a supplier in an emerging country while incorporating total landed cost (including logistics operations costs) in contracting. The retailer faces stochastic demand and stochastic lead time and determines the warehousing strategy. She can hold cycle stock and safety stock at the retail location (developed country warehousing) or allow the supplier to hold second‐tier cycle stock at a warehouse in the emerging country in addition to her holding inventory at the retail location (emerging country warehousing). We study the retailer’s optimal warehousing strategy in a centralized supply chain and a decentralized supply chain with the retailer as the Stackelberg leader. When emerging country warehousing is adopted in the decentralized supply chain, the retailer and supplier could achieve a win–win or a win–lose outcome compared to developed country warehousing. Our results show that the retailer’s warehousing strategies in the centralized and decentralized supply chains could be different. We further study the retailer’s optimal warehousing strategy under the Nash bargaining framework where the wholesale price and logistics decisions are negotiated simultaneously given the warehousing strategy. We compare this contract to that where logistics costs are excluded from contract negotiation. Our results show that by including logistics costs into contract negotiation the retailer and supplier could achieve lose–win, win–win and win–lose outcomes.
Estimated cardiorespiratory fitness in childhood and cardiometabolic health in adulthood: 1970 British Cohort Study
Authors: Hamer Mark , O’Donovan Gary , Batty G. David , Stamatakis Emmanuel
Published: February 2020

Background

Associations of cardiorespiratory fitness in childhood and adulthood with adult cardiometabolic risk factors are poorly understood, not least because of the paucity of studies.

Objectives

We investigated associations between nonexercise testing cardiorespiratory fitness (NETCRF) in childhood/adulthood and cardiometabolic risk factors in adulthood.

Methods

Based on an established algorithm comprising gender, age, body mass index, resting heart rate, and self‐reported physical activity at age 10, we computed NETCRF. Risk factors were assessed at age 46 in 5009 participants when NETCRF was again calculated. Linear regression was used to summarize associations between NETCRF in childhood and risk factors in adulthood and, additionally, the relationship between NETCRF in adulthood and risk factors in adulthood after adjusting for childhood NETCRF.

Results

Inconsistent associations were observed between childhood NETCRF and adult risk factors. NETCRF in adulthood was associated with blood pressure [−5.8 (−6.7, −4.9)], glycated hemoglobin [−3.41 (−4.06, −2.76)], total cholesterol [−0.16 (−0.24, −0.08)], HDL cholesterol [0.19 (0.16, 0.22)], triglycerides [−0.68 (−0.85, −0.50)], and C‐reactive protein [−0.29 (−0.35, −0.22)] in adult males. Similar associations were observed in adult females. Compared to those with low estimated fitness in both childhood and adulthood, participants with low fitness in childhood and high fitness in adulthood had a lower risk of two or more cardiometabolic risk factors (odds ratio: 0.25; 95% confidence interval: 0.19, 0.31).

Conclusion

Associations between estimated fitness and risk factors are stronger in adulthood than from childhood to adulthood. Adults with previously sedentary childhoods may still gain benefits from improving their fitness.
Learner perceptions of family‐centred rounds
Authors: Goodrich Nathaniel , Naslund Rachel , Bossert Whitney , Johnson Stephanie , Salcedo Stacy , Lyden Liz , Dallaghan Gary Beck
Published: February 2020

Background

Family‐centred rounds (FCRs) are common in paediatric inpatient medicine. FCRs lead to shorter hospital stays, improved communication, and improved patient and family satisfaction. Rounding structures can differ between institutions based on participants, the location of rounds and the role of trainees. The aim of our study was to compare walking hallway rounds with a new conference‐room rounding style, as measured by learner perceptions of FCRs.

Methods

All students participating in FCRs on two hospitalist teams were included in this study. In October 2017, a family‐centred conference‐room rounding model was developed. Team A adopted conference‐room rounds whereas team B continued to use hallway rounds. Student and resident evaluations were constructed using a nine‐point Likert scale (1, strongly disagree; 9, strongly agree). Evaluations assessed various perceived components of rounding.

Results

There were statistically significant differences between the evaluation responses from student team A (n = 21) versus student team B (n = 32) regarding perceived comfort in presenting (A = 7.86, B = 6.56, t = 3.42, p ≤ 0.001), confidence talking to families about medical decision making (A = 7.19, B = 6.32, t = 2.57, p = 0.013), educational value of rounds (A = 8.05, B = 6.16, z = –4.39, p ≤ 0.0001), value as a team member (A = 7.38, B = 6.34, z = –2.22, p = 0.013) and preparedness to round (A = 7.76, B = 6.34, z = –3.67, p ≤ 0.0001). Among residents, there were statistically significant differences regarding the perceived efficiency of rounds (A = 6.69, B = 4.89, t = 2.09, p = 0.048) and family engagement (A = 7.81, B = 5.89, z = –2.67, p = 0.003).

Discussion

Compared with hallway rounds, students and residents had improved learner perceptions of FCRs when participating in conference‐room rounds. Some component of conference room rounding may be beneficial to learners while maintaining family‐centered care.
Willingness of volunteers from Canadian Blood Service's Stem Cell Registry to donate blood, marrow, and other tissues for regenerative therapy
Authors: Liao Gary , Gilmore Karen , Steed Anthony , Elmoazzen Heidi , Allan David S.
Published: February 2020

BACKGROUND

As research surrounding cell‐based regenerative therapy advances toward human trials, greater demand for cell products sourced from healthy donors will arise. The extent to which volunteers in Canadian Blood Services Stem Cell Registry would be willing to donate cells to support regenerative therapy is not known and warrants exploration.

METHODS

We conducted a Web‐based survey to assess factors that would influence donor willingness to donate various tissues (blood, skin, fat, and bone marrow) for regenerative therapy. The survey was provided to 15,000 randomly selected donors who registered between 2013 and 2018. Data from the 1118 respondents were analyzed.

RESULTS

Despite a mixed degree of familiarity with regenerative medicine, potential donors were very supportive of donating for direct patient care and for research, and increasing their familiarity by reading a brief paragraph of information on regenerative medicine increased willingness to donate. Canadian Blood Servicesʼ stem cell registrants greatly preferred supporting nonprofit groups in research and development in comparison to entities that represent profit‐seeking industry involvement. The most important factors influencing donor willingness to donate were having an impact on patients, safety of donation, advancing knowledge in regenerative medicine, a manageable time commitment, and tolerable pain that could be managed. Donors were most willing to donate blood and had mixed responses to donating other tissue types.

CONCLUSIONS

Adult volunteers from a national stem cell registry are willing to support donation of biospecimens for regenerative therapy.
El paisaje sonoro como Arte Sonoro
Authors: Botella Nicolás Ana María
Published: February 2020

El concepto de paisaje sonoro o soundscape acuñado por primera vez por el canadiense R. Murray Schafer en 1933 se basa en la defensa del valor del silencio y del sonido por sí mismo como fuente de creatividad. El objetivo principal del artículo es reflexionar sobre el concepto de paisaje sonoro como arte sonoro y reseñar las sinergias entre naturaleza y paisaje a través de la concepción de estos en la historia. Se plantea la paradoja del ruido como música y la incógnita del orden primigenio del sonido. Se incide en el valor emocional del paisaje sonoro y su utilidad como herramienta didáctica. Cuando se comprende la noción de Pauline Oliveros (1932-2016) con la escucha profunda y la falta de práctica de la escucha activa, se pone de manifiesto la pérdida de instintos naturales de los humanos. También se pone en valor la utilidad para monitorear la naturaleza, de estricta necesidad en los últimos tiempos. Y, en especial, se refleja el arte que proviene de ese marco natural. Para ello, se ha utilizado el análisis del discurso como metodología, apoyada en artistas sonoros como Murray Schafer o John Cage, pero también en José Val del Omar o en Llorenç Barber, músicos que abrieron nuevas formas y percepciones del sonido, por ende, ajenos a cánones clásicos y academicistas. Las conclusiones apuntan a que no es fácil encontrar el nuevo arte transversal en auditorios de programación regular, pero sí en festivales específicos y, en especial, a nuestro alrededor, en la naturaleza.
Relatar es tejer acciones y deseos que interactúan con imágenes
Authors: Allina Bloch Trixi , Jaramillo Hoyos Alejandro
Published: February 2020

La Huerta, proyecto de arte relacional, viene realizándose desde 2004 en la vereda Peñas del municipio de Tinjacá, Boyacá, Colombia. Este relato presenta los alcances del arte promotor de relaciones sensibles que deriva de los encuentros con una comunidad campesina convocada a interactuar alrededor de una mesa instalada en una huerta donde los temas abordados permiten mediante la documentación originar una experiencia instalativa con la imagen. Huerta y mesa, dispositivos que constituyen el espacio relacional, remiten a una casa como continente que alberga memorias, prácticas, narrativas y procesos comunicativos de la vida cotidiana, de ahí emerge una conciencia sobre el cuerpo, el entorno y la cultura. Aquí, se describe una observación reflexiva sobre la imagen que, al ser devuelta a los actores, estructura un giro trófico, movilizado por el reconocimiento de sí en fricción con la incidencia urbana en el entorno rural. La metodología, guiada por los criterios de intercambio, reciprocidad y circulación de relatos, procesos y acciones, pone al descubierto huellas, voces, memorias y costumbres rurales que habitan el territorio. El arte colaborativo centrado en prácticas hortelanas como ejes estructurantes de los encuentros permite que las operaciones con la fotografía, los audios, los videos y los textos dibujen un horizonte de la memoria y su inconsciente, expresado en el retrato y en la imagen en movimiento, y pongan de manifiesto maneras de ser y habitar el paisaje; devolver una imagen de sí a la comunidad constituye un doble encadenamiento, que opera la reflexividad desde la experiencia.
Numerical Analysis of a Surface Ship in Waves
Authors: Aram Shawn
Published: February 2020

Ship's resistance and engine power to sustain ship's speed in seaways are augmented due to complex non-linear interactions between the ship and the ambient sea (waves). Ship designers, in early design stage, use an ad hoc "sea margin" to account for the effects of seaways in selecting propeller and engine. A numerical tool capable of accurately predicting added resistance and power of a ship cruising in waves would greatly help select its powering (margin) requirement and determine the optimal operating point that can maximize the energy efficiency.

For seakeeping analysis, strip theory-based methods have long been used. More recently, nonlinear time-domain three-dimensional (3D) panel methods have started being used widely. A more physics-based avenue to seakeeping analysis is offered by coupled solutions of two-phase unsteady Reynolds-Averaged Navier-Stokes equations and six degrees-of-freedom rigid-body motion (RBM) equations. The URANS approach also avails itself of including the effects of propulsors, either explicitly or approximately. By accounting for all the nonlinear effects in hydrodynamic forces and moments and the resulting ship motions, and the effects of fluid viscosity and turbulence, the coupled URANS-RBM method is believed not only able to predict added resistance and speed loss more accurately, but also to provide valuable insights into the physical mechanisms underlying added resistance and power. The objectives of this study are: (1) to validate a coupled URANS-RBM solver developed for high-fidelity prediction of added resistance, speed loss and added power on ships cruising in regular head sea and irregular waves, and (2) to conduct a detailed analysis of the interactions among ship hull, propeller and waves for a 1/49 scaled model of the ONR Tumblehome (ONRT) (Model 5613) in order to shed light on the physical mechanisms leading to added resistance, speed loss and added power. Figure 1 depicts the ONRT self-propellers with two 4-bladed propellers in regular waves. The main flow features such as the free surface, the hub vortices and blade-tip vortices from the propeller, as well as vortices generated by the sonar dome, shafts, shaft brackets and bilge keels are captured.
Pore-Level Investigation of Heavy Crude Oil–Water/Chemicals Displacements in Heterogeneous Porous Media in the Presence of Ultrasounds
Authors: Kanani Mojtaba , Mohammadi Alamooti Amir Hossein , Ghazanfari Mohammad Hossein , Ghotbi Cyrus
Published: February 2020

Despite numerous studies, fundamental understanding of how pore-level displacements in heavy crude oil–water/chemicals systems are controlled by ultrasonic radiation is not well understood, especially for heterogeneous porous media. In this study, a series of water/chemical flooding were performed on a heterogeneous rock-look-alike micromodel, which was initially saturated with the crude oil, and the pore-level displacements in the presence of ultrasounds are investigated. It has been observed that although the ultrasounds improve the recovery of oil adhered to the pores’ walls, the bypassed oil in the case of injection of surfactant and polymer solutions is relatively high. For the case of water injection, depending on frequency, the ultrasounds can profoundly improve the recovery efficiency up to 17% in comparison to the absence of ultrasounds by peristaltic movement of oil on the walls and forming the ganglia in invading phase, which first affect the minor fingers and then influence the major fingers by developing them through the untouched pores. In addition, some analyses on fingers development during water/chemical injections are presented. The results of this work help to better understand the role of ultrasound on displacement patterns in crude oil–water/chemical systems.
Perspective of United States Judo Coaches on Concussion: A National Survey
Authors: Yannetsos Christina , Pacheco Mario C. , Thomas Danny G.
Published: February 2020

Concussions among athletes in contact sports are a prevalent health concern in the United States. There are few studies that have assessed concussion from the perspective of judo coaches. This is a descriptive study of a survey sent to 1,056 United States judo coaches assessing their attitudes, knowledge, and practices toward concussion. The survey had a response rate of 21%, with 215 total responses. Though most coaches could accurately identify common symptoms of concussion from a case presentation, many also misidentified nonconcussion and red flags (e.g., facial droop) as symptoms of concussion. A minority of coaches reported any formal training in concussion management. USA Judo coaches are receptive to and would benefit from a sport-specific standardized concussion training program.
Pseudomonas orientalis F9 Pyoverdine, Safracin, and Phenazine Mutants Remain Effective Antagonists against Erwinia amylovora in Apple Flowers
Authors: Santos Kron Amanda , Zengerer Veronika , Bieri Marco , Dreyfuss Vera , Sostizzo Tanja , Schmid Michael , Lutz Matthias , Remus-Emsermann Mitja N. P. , Pelludat Cosima
Published: February 2020

Pseudomonas orientalis
F9 is an antagonist of the economically important phytopathogen
Erwinia amylovora
, the causal agent of fire blight in
pomme
fruit. On King’s B medium,
P. orientalis
F9 produces a pyoverdine siderophore and the antibiotic safracin.
P. orientalis
F9 transposon mutants lacking these factors fail to antagonize
E. amylovora
, depending on the
in vitro
assay. On isolated flowers and in soil microcosms, however, pyoverdine, safracin, and phenazine mutants control phytopathogens as clearly as their parental strains.
Universal Dermal Microbiome in Human Skin
Authors: Bay Lene , Barnes Christopher James , Fritz Blaine Gabriel , Thorsen Jonathan , Restrup Marlene Elise Møller , Rasmussen Linett , Sørensen Johan Kløvgaard , Hesselvig Anne Brun , Odgaard Anders , Hansen Anders Johannes , Bjarnsholt Thomas
Published: February 2020

Human skin microbiota is thought to be unique according to the individual's lifestyle and genetic predisposition. This is true for the epidermal microbiota, while our findings demonstrate that the dermal microbiota is universal between healthy individuals. The preserved dermal microbial community is compositionally unique and functionally distinct to the specific environment in the depth of human skin. It is expected to have direct contact with the immune response of the human host, and research in the communication between host and microbiota should be targeted to this cutaneous compartment. This novel insight into specific microbial adaptation can be used advantageously in the research of chronic disorders and infections of the skin. It can enlighten the alteration between health and disease to the benefit of patients suffering from long-lasting socioeconomic illnesses.
Both ADP-Ribosyl-Binding and Hydrolase Activities of the Alphavirus nsP3 Macrodomain Affect Neurovirulence in Mice
Authors: Abraham Rachy , McPherson Robert L. , Dasovich Morgan , Badiee Mohsen , Leung Anthony K. L. , Griffin Diane E.
Published: February 2020

Viral encephalomyelitis is an important cause of long-term disability, as well as acute fatal disease. Identifying viral determinants of outcome helps in assessing disease severity and developing new treatments. Mosquito-borne alphaviruses infect neurons and cause fatal disease in mice. The highly conserved macrodomain of nonstructural protein 3 binds and can remove ADP-ribose (ADPr) from ADP-ribosylated proteins. To determine the importance of these functions for virulence, recombinant mutant viruses were produced. If macrodomain mutations eliminated ADPr-binding or hydrolase activity, viruses did not grow. If the binding and hydrolase activities were impaired, the viruses grew less well than the wild-type virus, induced similar innate responses, and caused less severe disease, and most of the infected mice recovered. If binding was improved, but hydrolase activity was decreased, the virus replicated well and induced greater innate responses than did the WT, but clearance from the nervous system was impaired, and mice remained paralyzed. Therefore, macrodomain function determined the outcome of alphavirus encephalomyelitis.
Structure of an Inner Membrane Protein Required for PhoPQ-Regulated Increases in Outer Membrane Cardiolipin
Authors: Fan Junping , Petersen Erik M. , Hinds Thomas R. , Zheng Ning , Miller Samuel I.
Published: February 2020

Gram-negative bacteria cause many types of infections and have become increasingly resistant to available antibiotic drugs. The outer membrane serves as an important barrier that protects bacteria against antibiotics and other toxic compounds. This outer membrane barrier function is regulated when bacteria are in host environments, and the protein PbgA contributes significantly to this increased barrier function by transporting cardiolipin to the outer membrane. We determined the crystal structure of PbgA in complex with cardiolipin and propose a model for its function. Knowledge of the mechanisms of outer membrane assembly and integrity can greatly contribute to the development of new and effective antibiotics, and this structural information may be useful in this regard.
Novel mutation in the CD27 gene in a patient presenting with hypogammaglobulinemia, bronchiectasis and EBV-driven lymphoproliferative disease
Authors: Kishore Rashmi , Gupta Aditya , Gupta Aditya Kumar , Kabra Sushil Kumar
Published: February 2020

CD27 deficiency is a rare primary immune deficiency which affects T cells, B cells and NK cells and is associated with hypogammaglobulinemia. Clinical presentation varies from asymptomatic disease to life-threatening Epstein Barr Virus (EBV)-driven complications including malignancy. Delay in diagnosis and late presentation adversely affects the clinical outcome and survival. We report a 10-year-old girl who had been symptomatic since 3 years of age with recurrent infections, developed bronchiectasis and was found to have hypogammaglobulinemia. Initially diagnosed as common variable immune deficiency, she had persistent lymphadenopathy, hepatosplenomegaly and pancytopenia, raising a clinical suspicion of a lymphoproliferative condition. On investigation, she was found to have a novel mutation involving the CD27 gene with very high EBV load. She was given rituximab injections to which she showed partial response and later developed non-Hodgkin’s lymphoma .
Quantity of hemoperitoneum is associated with need for intervention in patients with stable blunt splenic injury
Authors: Salottolo Kristin , Madayag Robert M , O'Brien Michael , Yon James , Tanner Allen , Topham Andrew , Lieser Mark , Carrick Matthew M , Mains Charles W , Bar-Or David
Published: February 2020

Background

In patients with hemodynamically stable blunt splenic injury (BSI), there is no consensus on whether quantity of hemoperitoneum (HP) is a predictor for intervention with splenic artery embolization (SAE) or failing nonoperative management (fNOM). We sought to analyze whether the quantity of HP was associated with need for intervention.

Methods

This retrospective cohort study included adult trauma patients with hemodynamically stable BSI admitted to six trauma centers between 2014 and 2016. Quantity of HP was defined as small (perisplenic blood or blood in Morrison’s pouch), moderate (blood in one or both pericolic gutters), or large (additional finding of free blood in the pelvis). Multivariate logistic regression was performed to identify predictors of intervention with SAE or fNOM versus successful observation.

Results

There were 360 patients: hemoperitoneum was noted in 214 (59%) patients, of which the quantity was small in 92 (43%), moderate in 76 (35.5%), and large in 46 (21.5%). Definitive management was as follows: 272 (76%) were observed and 88 (24%) had intervention (83 SAE, 5 fNOM). The rate of intervention was univariately associated with quantity of HP, even after stratification by American Association for the Surgery of Trauma (AAST) grade. After adjustment, larger quantities of HP significantly increased odds of intervention (p=0.01). Compared with no HP, the odds of intervention were significantly increased for moderate HP (OR=3.51 (1.49 to 8.26)) and large HP (OR=2.89 (1.03 to 8.06)), with similar odds for small HP (OR=1.21 (0.46 to 2.76)). Other independent predictors of intervention were higher AAST grade, older age, and presence of splenic vascular injury.

Conclusion

Greater quantity of HP was associated with increased odds of intervention, with no difference in risk for moderate versus large HP. These findings suggest quantity of HP should be incorporated in the management algorithm of BSI as a consideration for angiography and/or embolization to maximize splenic preservation and reduce the risk of splenic rupture.

Level of evidence

III, retrospective epidemiological study.
Insights into irr and rirA gene regulation on the virulence of Brucella melitensis M5-90
Authors: Zhang Huan , Wang Benben , Wu Wenxing , Deng Xiaoyu , Shao Zhiran , Yi Jihai , Wang Zhen , Yang Ningning , Wang Yong , Wang Yuanzhi , Chen Chuangfu
Published: February 2020

Iron is a fundamental element required by most organisms, including Brucella. Several researchers have suggested that the iron response regulator (irr) and rhizobial iron regulator (rirA) genes regulate iron acquisition by Brucella abortus, influencing heme synthesis by and virulence of this pathogen. However, little is known about another Brucella species, Brucella melitensis. In this research, we successfully constructed two mutants: M5-90Δirr and M5-90ΔrirA. The adhesion, invasion, and intracellular survivability of these two mutants were evaluated in RAW264.7 cells infected with 1 × 106 CFU of M5-90Δirr, M5-90ΔrirA, or M5-90. We also tested the sensitivity of cells to hydrogen peroxide and their ability to grow. In addition, the virulence of these two mutants was evaluated in BALB/c mice. The results showed that the ability of these two mutants to invade and adhere inside the murine macrophages RAW264.7 was attenuated but their ability to replicate intracellularly was strengthened, enhancing the resistance to hydrogen peroxide. The M5-90Δirr mutant showed stronger growth ability than the parental strain under iron-limiting conditions. No differences were observed in the number of bacteria in spleen between M5-90 and M5-90Δirr at 7 or 15 days postinfection. However, the number of M5-90ΔrirA in spleen reduced significantly at 15 days postinfection. The splenic index of the M5-90Δirr group is evidently lower than that of M5-90. This is the first report that irr and rirA genes of B. melitensis are associated not only with virulence but also with growth ability. Together, our data suggest that M5-90Δirr is a promising Brucella vaccine candidate.