Challenges in decision-making support processes regarding living kidney donation: A qualitative study

Wada Y., Ueno T., Umeshita K., et al. Challenges in decision-making support processes regarding living kidney donation: A qualitative study. Journal of Renal Care , (2024); https://doi.org/10.1111/jorc.12494.Background: Previous studies on decision-making of living kidney donors have indicated issues regarding donors' autonomy is inherent in decision-making to donate their kidney. Establishing effective decision-making support that guarantees autonomy of living kidney donor candidates is important. Objectives: The aim of this study was to identify the difficulties in the decision-making support when clinical transplant coordinators advocating for the autonomy of donor candidates of living donor kidney transplantation and to identify the methods to deal with these difficulties. Design: A qualitative descriptive study. Participants: Ten clinical transplant coordinators supporting living kidney donors. Approach: Semi-structured interviews were conducted using an interview guide. The modified grounded theory approach was utilised to analyse. Results: Three categories related to difficulties were as follows: issues inherent to the interaction between coordinators, donor candidates and their families; issues regarding the environment and institutional background in which coordinators operate; and emotional labour undertaken by coordinators in the decision-making support process. Additionally, five categories related to methods were as follows: assessing the autonomy of donor candidates based on the coordinators nursing experience; interventions for the donor candidates and their family members based on the coordinators nursing experience; smooth coordination with medical staff; clarifying and asserting their views as coordinators; and readiness to protect the donor candidates. Conclusion: The involvement of highly experienced coordinators with excellent and assertive communication skills as well as the ability to reflect on their own practices is essential. Moreover, we may need to fundamentally review the transplant community, where power domination is inherent

Signatures of Nucleon Disappearance in Large Underground Detectors

For neutrons bound inside nuclei, baryon instability can manifest itself as a decay into undetectable particles (e.g., $\it n \to \nu \nu \bar{\nu}$), i.e., as a disappearance of a neutron from its nuclear state. If electric charge is conserved, a similar disappearance is impossible for a proton. The existing experimental lifetime limit for neutron disappearance is 4-7 orders of magnitude lower than the lifetime limits with detectable nucleon decay products in the final state [PDG2000]. In this paper we calculated the spectrum of nuclear de-excitations that would result from the disappearance of a neutron or two neutrons from $^{12}$C. We found that some de-excitation modes have signatures that are advantageous for detection in the modern high-mass, low-background, and low-threshold underground detectors, where neutron disappearance would result in a characteristic sequence of time- and space-correlated events. Thus, in the KamLAND detector [Kamland], a time-correlated triple coincidence of a prompt signal, a captured neutron, and a $\beta^{+}$ decay of the residual nucleus, all originating from the same point in the detector, will be a unique signal of neutron disappearance allowing searches for baryon instability with sensitivity 3-4 orders of magnitude beyond the present experimental limits.Comment: 13 pages including 6 figures, revised version, to be published in Phys.Rev.

Estudo das características morfológicas das hemácias de felinos (Felis cati, L., 1758) normais

Some morphologic aspects of healthy cats erythrocytes were studied. In 20 cats, the values obtained were the following, expressed by mean and standard deviation: Red blood cells diameter (µ) .................................................................................... 5,58 ±0,23 Mean corpuscular thickness (µ) ............................................................................... 1,81 ±0,23 Reticulocytes (%) ...................................................................................................... 0,02 ± 0,01 Reticulocytes (thousand/cu mm)................................................................................. 0,15 ±0,07 Red blood cells containing Howell-Jolly bodies (%) ............................................... 0,1 7 ± 0,08 Red blood cells containing Howell-Jolly bodies (thousand /cu mm) ........................ 1,24 +0,69 Diameter of red blood cells containing Howell-Jolly bodies (µ) ................................5,43 ± 0,35 Howell-Jolly bodies diameter (µ) ............................................................................. 0,87 ± 0,1 6 The Price-Jones curve demonstrated that there is a light anisocythosis in cat peripheral blood. The minimum and maximum osmotic fragility to hipotonic saline were observed, respectively at 0,76% and 0,52%.Foram analisados alguns aspectos morfológicos dos elementos sanguíneos da linhagem vermelha de felinos normais, estabelecendo o número de reticulócitos no sangue periférica, o número de hemácias contendo corpusculos de Howetl-Jolly em seu interior, o diâmetro médio das hemácias, a curva de Price-Jones padrao para a espécie e a curva de fragilidade osmótica das hemácias

Global millimeter VLBI array survey of ultracompact extragalactic radio sources at 86 GHz

Context. Very long baseline interferometry (VLBI) observations at 86 GHz (wavelength, λ = 3 mm) reach a resolution of about 50 μas, probing the collimation and acceleration regions of relativistic outflows in active galactic nuclei (AGN). The physical conditions in these regions can be studied by performing 86 GHz VLBI surveys of representative samples of compact extragalactic radio sources. Aims: To extend the statistical studies of compact extragalactic jets, a large global 86 GHz VLBI survey of 162 compact radio sources was conducted in 2010-2011 using the Global Millimeter VLBI Array (GMVA). Methods: The survey observations were made in a snapshot mode, with up to five scans per target spread over a range of hour angles in order to optimize the visibility coverage. The survey data attained a typical baseline sensitivity of 0.1 Jy and a typical image sensitivity of 5 mJy beam-1, providing successful detections and images for all of the survey targets. For 138 objects, the survey provides the first ever VLBI images made at 86 GHz. Gaussian model fitting of the visibility data was applied to represent the structure of the observed sources and to estimate the flux densities and sizes of distinct emitting regions (components) in their jets. These estimates were used for calculating the brightness temperature (Tb) at the jet base (core) and in one or more moving regions (jet components) downstream from the core. These model-fit-based estimates of Tb were compared to the estimates of brightness temperature limits made directly from the visibility data, demonstrating a good agreement between the two methods. Results: The apparent brightness temperature estimates for the jet cores in our sample range from 2.5 × 109 K to 1.3 × 1012 K, with the mean value of 1.8 × 1011 K. The apparent brightness temperature estimates for the inner jet components in our sample range from 7.0 × 107 K to 4.0 × 1011 K. A simple population model with a single intrinsic value of brightness temperature, T0, is applied to reproduce the observed distribution. It yields T0 = (3.77-0.14+0.10) × 1011 K for the jet cores, implying that the inverse Compton losses dominate the emission. In the nearest jet components, T0 = (1.42-0.19+0.16) × 1011 K is found, which is slightly higher than the equipartition limit of ̃5 × 1010 K expected for these jet regions. For objects with sufficient structural detail detected, the adiabatic energy losses are shown to dominate the observed changes of brightness temperature along the jet. The reduced images and visibility tables (FITS files) and the full Tables 5-7 are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz- bin/qcat?J/A+A/622/A9

Differences among epitopes recognized by neutralizing antibodies induced by SARS-CoV-2 infection or COVID-19 vaccination

SARS-CoV-2 has gradually acquired amino acid substitutions in its S protein that reduce the potency of neutralizing antibodies, leading to decreased vaccine efficacy. Here, we attempted to obtain mutant viruses by passaging SARS-CoV-2 in the presence of plasma samples from convalescent patients or vaccinees to determine which amino acid substitutions affect the antigenicity of SARS-CoV-2. Several amino acid substitutions in the S2 region, as well as the N-terminal domain (NTD) and receptor-binding domain (RBD), affected the neutralization potency of plasma samples collected from vaccinees, indicating that amino acid substitutions in the S2 region as well as those in the NTD and RBD affect neutralization by vaccine-induced antibodies. Furthermore, the neutralizing potency of vaccinee plasma samples against mutant viruses we obtained or circulating viruses differed among individuals. These findings suggest that genetic backgrounds of vaccinees influence the recognition of neutralizing epitopes

Acute Necrotizing Encephalopathy of Childhood due to Influenza Type A Virus

A 1 year and 11 month-old boy developed convulsions and disturbance of consciousness after an antipyretic was administered. Influenza type A virus reaction was positive on rapid antigen test of nasal discharge. Although no significant abnormality was found by brain CT on admission, abnormal densities were observed in the bilateral thalami, brain stem and tegmentum on brain CT performed 12 hours later, so the patient was diagnosed with acute necrotizing encephalopathy (ANE) of childhood due to influenza type A virus. In spite of we diagnosed and performed methylprednisolone pulse and antithrombin III therapy in the early stage of this encephalopathy, which resulted in serious neurologic sequelae remaining. The clinical course of our case suggests that the early diagnosis and these treatments for ANE may not be effective. At present, we have no established therapy for this encephalopathy, so the vaccination is only a method for prevention of ANE due to influenza type A virus