A case of crescentic glomerulonephritis associated with relapsing polychondritis

Relapsing polychondritis (RP) is a rare autoimmune disease, characterized by recurrent inflammatory episodes affecting various carttilageus structures. Renal involvement in RP is unusual. Our case was a 42-year old woman presented with nephretic syndrome. Diagnosis of RP was made because of recurrent chondritis of both auricles, chondritis of costovertebral joints, non-erosive inflammatory arthritis of knees, and inflammation of ocular structures. Renal biopsy findings revealed diffuse crescentic and sclerotic glomerulonephritis, pauciimmune type. The diagnosis of RP may be missed when the destructive cartilage feature is not apparent or rare presentation of disease such as ocular or renal involvement preceded other manifestations. In this case we found that the irregular prednisolone use may prevent destructive cartilage damage but not renal failure of patient. We concluded that the association of crescentic glomerulonephritis in a patient with RP was assumed to be a rare manifestation of this disease. © 2019 The Author(s)

Supply chain reconfiguration for new product development through risk management approach

Nowadays, innovation is increasingly growing and the lifetime of products is decreasing. In this situation, New Product Development (NPD) is an advantage that makes it possible to survive in the competitive market. However, risks are unavoidable in NPD in any industry. Therefore, identifying, management, and mitigation of risks are considered of high significance for companies. By taking risk management into account, this study introduces a new multi-objective mathematical model for Supply Chain (SC) configuration in the presence of a new product. The considered SC is multi-echelon, multi-resource, multi-period, and multi-product. In order to manage the risk in this SC, appropriate mitigation strategies were chosen among various risk response strategies considering their cost and effectiveness. Furthermore, inuence of each choice on SC was accounted for in the mathematical model. The assumed model explored the optimum tactical and operational Supply Chain Management (SCM) decisions. The ability of the model was assessed by solving a numerical example. The result showed that the choice of various response strategies as well as new product production inuenced SC configuration

Synthesis of a novel heterocyclic system: Oxazolo[2,3-c][1,2,4]benzotriazine

585-58

An observational study of secondary task engagement while driving on urban streets in Iranian Safe Communities

In Iran the prevalence of traffic injuries and death from vehicle collisions are high. Driver engagement in non-driving-related tasks has been previously identified as an important contributing factor to crashes. Therefore, the objective of the present study was to investigate the prevalence of drivers’ engagement in potentially distracting activities in Kashmar, Khalilabad and Bardaskan, which are three Iranian International Safe Communities. Observations took place at 12 randomly selected roadside locations in each city, which were comprised of six main streets and six side streets. In total 7979 drivers were observed. The prevalence rates of potentially distracting activities in Kashmar, Khalilabad and Bardaskan were 24.3%, 26% and 24.9%, respectively. In both Kashmar and Khalilabad the most frequently observed secondary tasks were drivers talking to passengers (10.6% and 11.5%, respectively) followed by mobile phone use (3.4% and 4.0%, respectively). Although in Bardaskan the most commonly observed secondary task was also talking to passengers (12.7%), the second most common was reaching for an object (3.2%). In all three cities younger drivers were significantly more likely to be observed engaged in a secondary task while driving. Furthermore, involvement in secondary tasks while driving was significantly higher amongst females and those driving on a working day. The percentage of drivers identified as potentially distracted in these three Safe Communities was worryingly high. Thus, interventions should be integrated into the WHO Safe Community network in these cities, including: education regarding the risks associated with engaging in secondary activities while driving, law enforcement, tougher legislation, periodic assessment, raising public awareness, as well as attracting political and social support

I love being a midwife; it\u27s who I am : A Glaserian Grounded Theory Study of why midwives stay in midwifery

Aims and objectives: To understand why Western Australian (WA) midwives choose to remain in the profession. Background: Midwifery shortages and the inability to retain midwives in the midwifery profession is a global problem. The need for effective midwifery staff retention strategies to be implemented is therefore urgent, as is the need for evidence to inform those strategies. Design: Glaserian grounded theory (GT) methodology was used with constant comparative analysis. Methods: Fourteen midwives currently working clinically area were interviewed about why they remain in the profession. The GT process of constant comparative analysis resulted in an overarching core category emerging. The study is reported in accordance with Tong and associates’ (2007) Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: The core category derived from the data was labelled—“I love being a midwife; it\u27s who I am.” The three major categories that underpin the core category are labelled as follows: “The people I work with make all the difference”; “I want to be ‘with woman’ so I can make a difference”; and “I feel a responsibility to pass on my skills, knowledge and wisdom to the next generation.” Conclusion: It emerged from the data that midwives’ ability to be “with woman” and the difference they feel they make to them, the people they work with and the opportunity to “grow” the next generation together underpin a compelling new middle‐range theory of the phenomenon of interest. Relevance to clinical practice: The theory that emerged and the insights it provides will be of interest to healthcare leaders, who may wish to use it to help develop midwifery workforce policy and practice, and by extension to optimise midwives’ job satisfaction, and facilitate the retention of midwives both locally and across Australia

Bone Marrow Transplantation Results in Human Donor Blood Cells Acquiring and Displaying Mouse Recipient Class I MHC and CD45 Antigens on Their Surface

Background: Mouse models of human disease are invaluable for determining the differentiation ability and functional capacity of stem cells. The best example is bone marrow transplants for studies of hematopoietic stem cells. For organ studies, the interpretation of the data can be difficult as transdifferentiation, cell fusion or surface antigen transfer (trogocytosis) can be misinterpreted as differentiation. These events have not been investigated in hematopoietic stem cell transplant models. Methodology/Principal Findings: In this study we investigated fusion and trogocytosis involving blood cells during bone marrow transplantation using a xenograft model. We report that using a standard SCID repopulating assay almost 100 % of the human donor cells appear as hybrid blood cells containing both mouse and human surface antigens. Conclusion/Significance: Hybrid cells are not the result of cell-cell fusion events but appear to be due to efficient surface antigen transfer, a process referred to as trogocytosis. Antigen transfer appears to be non-random and includes all donor cells regardless of sub-type. We also demonstrate that irradiation preconditioning enhances the frequency of hybrid cell