User Experience (UX) in the Cultural Field

This commentary paper aims to pro-mote the acknowledgment of user experience (UX) research principles in the cultural field. As discussed in the preceding dissertation, The Meaning of Participation: Detecting the space for inclusive strategies in the Finnish and German museum context (2022), efforts to get to know one’s audience (or users) should not be ignored. What is the meaning of UX research, why should it be used sustainably, and how can it be ben-eficial? This paper aims to answer these questions by explaining and unfolding the reasons for conducting such research and proposing it to the cultural audience development work

THE MEANING OF PARTICIPATION Detecting the space for inclusive strategies in the Finnish and German museum context

Museoiden yleisötyöstrategioissa osallisuus, moninaisuus ja inkluusio ovat yleisiä käsitteitä. Ne sanallistavat museoiden motivaation ja tarpeen täyttää niihin kohdistuvan yhteiskunnallisen odotuksen olla kaikille avoimia. Jokainen saa käydä museossa ja osallistua aktiviteetteihin. Mutta onko tämän osallistuminen sellaista, joka edistää strategioissa mainittua osallisuutta tai inkluusiota? Kriittisen ja etnografisen tarkastelun kautta kattotermi ”yleisötyö” suomalaisella ja saksalaisella museokentällä paljastaa, että osallisuuden ja inkluusion käsitteet voidaan ymmärtää eri tasoilla. Ne voivat viitata esteettömään tiedonsaantiin ja tiloissa kulkemiseen tai ennalta suunniteltujen aktiviteettien toteuttamiseen. Museoalan kirjallisuus toteaa tämänkaltaisen osallistamisen riittämättömäksi museoiden tavoitteen ollessa osallistujien kuuluvuuden tunne. Siten, museota tarkastellaan kriittisesti käsitteenä, jossa osallistavan yleisötyön yleisimpiä käytäntöjä teoretisoidaan ja kyseenalaistetaan. Kuuluvuuden tunteeseen sisältyvät merkityksellisyys, samaistuttavuus ja omistajuus, joiden saavuttaminen yleisötyön kontekstissa kaipaa ohjenuoria. Tarjonta, jonka odotetaan edistävän strategioissa esiintyvää osallisuutta museoissa, esiintyy kahden ääripään, ennalta suunniteltujen aktiviteettien ja jaetun vallan näyttelysuunnittelussa välillä. Tämä synnyttää tarpeen tarkastella yleisötyössä käytettyjen termien, kuten osallistumisen, inkluusion, moninaisuuden ja saavutettavuuden sisältöjä. Käytettyjen käsitteiden ymmärtämistä voidaan parantaa, kun niitä tarkastellaan niiden käytännön merkityksen tasolla ja arvioidaan, toteutuvatko nämä odotukset nykyisillä yleisötyön vakiometodeilla. Ymmärtämisen kautta voidaan luoda uusia tekemisen tapoja ja siten todellista osallisuutta, joka voi mahdollistaa osallistujan inkluusion museossa. Koska suurinosa museokokemuksista luodaan näyttelysaleissa ja vastaanotossa työskentelevän henkilökunnan myötävaikutuksesta, ymmärtäminen voi edistää myös asiakaspalveluhenkilökunnan arvostusta, joka ei yleensä ole osallinen näyttelysuunnitteluprosessien ensimmäisissä vaiheissa. Pohdinta kumuloituu museon ja yleisön välisen suhteen käsitteeseen, jota havainnoillistetaan museo-yleisö-suhteen kaaviossa (museum-audience relationship blueprint). Tässä suhteessa osallistujien valta määritellä ja päättää omien kokemustensa ehdot ja puitteet on jakautunut kentällä jokseenkin epätasaisesti. Todellisen osallisuuden ja inkluusion nimissä tätä suhdetta tulee voida avata. Kysymys on lopulta osallistujien todellisesta osallisuudesta ja omistajuudesta, museoiden sidosryhmien tuntemuksesta, ylläpidetyistä suhteista entisten osallistujien ja museoiden välillä ja näkymättöminen esteiden tunnistamisesta ja tunnustamisesta yleisötyön kontekstissa. Tämä väitöskirja ehdottaa inkluusio-orientoitunutta osallistumismallia (inclusiondirected participation model), joka perustuu palvelumuotoiluun pohjautuvaan lähestymistapaan. Osallistumismallissa yhdistyvät museokentän odotukset osallistumiseen liittyvästä yleisötyöstä ja palvelumuotoilun teoria ja filosofia. Osallistumisen viiden osa-alueen – tutkimuksen; yhteistyön ja kommunikoinnin; kestävyyden; mielekkyyden ja omistajuuden; sekä vastoinkäymisten – kautta konsepti ehdottaa osallistumisen iteratiivista sykliä, joka mahdollistaa osallistujien vallan yhteissuunnitteluprosessissa, edistää kävijätutkimusta yksittäisissä instituutioissa ja huomioi kehittämishankkeiden avoimen luonteen. Tämän ehdotuksen tavoitteena on siis edistää palvelumuotoilun syvällisempää tunnustamista ohjenuoraksi museoille, kun tavoitteena on saavuttaa uuden museologian (New Museology) asettamat vaatimukset osallistumiselle ja edistää museoiden yhteiskunnallisen vastuun toteutumista meille kaikille kuuluvasta kulttuuriperinnöstä.In museums’ strategies for Audience Development, concepts such as participation, diversity, and inclusion are common. They state the museums’ initial motivations and need to fulfill their societal xpectations, which is to be “open for all.” Everyone is welcome to visit museums and take part in the activities therein. However, does this participation promote the type of participation or inclusion mentioned in their strategies? Through a critical and ethnographic exploration of the umbrella term “Audience Development” in the Finnish and German museum domains, it becomes evident that the very meanings of the concepts of participation and inclusion are understood on differing levels. They can indicate barrier-free information and access to spaces or the realization of pre-designed activities. The literature on the museum field states this type of participation insufficient when museums aim for the feeling of belonging among participants. The critical examination discusses the museum as a concept and theorizes and questions the most common practices in participative Audience Development. The “feeling of belonging” includes meaningfulness, relevancy, and ownership. Notably, achieving these within the context of Audience Development still lacks specific guidelines. Moreover, the offerings expected to promote participation in museums occur at two extremes: pre-designed activities and shared power in exhibition design. A need to examine the contents of the terms used in the strategies such as “participation,” “inclusion,” “diversity,” and “accessibility” is evident. The understanding of these terms can be improved when they are examined on the level of their practical functions and evaluated as to whether the standard methods of Audience Development realize these practical expectations. The emerging understanding promotes new ways of doing and, thus, “real” participation, which can lead to the participants’ inclusion in museums. Most museum experiences are created with the influence of frontline staff, so this understanding can also promote the value laid on this portion of the staff that is usually not included in the first phases of the exhibition planning processes. This discussion evolves to focus on the museum-audience relationship, which will be exemplified in the form of a museum-audience blueprint. In this relationship, the participants’ power over the terms and circumstances of their experiences is divided unevenly in the field. In the name of “real” participation and inclusion, this relationship should be able to be opened. The issue eventually concerns participants’ involvement and ownership, the museums’ knowledge about stakeholders, sustainable relationships with former participants, and recognizing and acknowledging the invisible barriers in Audience Development. By leveraging the Service Design-based approach, this dissertation proposes an inclusion-directed participation model that combines the participatory expectations of the museum field with the tools and philosophy of Service Design. Through the five parts of participation, namely, research, collaboration and communication, sustainability, meaningfulness and ownership, and obstacles, the concept proposes an iterative cycle of participation that would allow participants to influence the codesign process, promote visitor research in individual institutions, and acknowledge the open-ended nature of developmental projects. This proposal aims to promote the acknowledgment of Service Design as a guideline in the museum field more profoundly when the goal is to achieve the participatory aims of New Museology and promote the fulfillment of the museums’ societal responsibilities concerning access to and participation in culture

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Alpha-Toxin Contributes to Biofilm Formation among Staphylococcus aureus Wound Isolates

Biofilms complicate treatment of Staphylococcus aureus (SA) wound infections. Previously, we determined alpha-toxin (AT)-promoted SA biofilm formation on mucosal tissue. Therefore, we evaluated SA wound isolates for AT production and biofilm formation on epithelium and assessed the role of AT in biofilm formation. Thirty-eight wound isolates were molecularly typed by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (ST), and spa typing. We measured biofilm formation of these SA isolates in vitro and ex vivo and quantified ex vivo AT production. We also investigated the effect of an anti-AT monoclonal antibody (MEDI4893*) on ex vivo biofilm formation by methicillin-resistant SA (USA 300 LAC) and tested whether purified AT rescued the biofilm defect of hla mutant SA strains. The predominant PFGE/ST combinations were USA100/ST5 (50%) and USA300/ST8 (33%) for methicillin-resistant SA (MRSA, n = 18), and USA200/ST30 (20%) for methicillin-susceptible SA (MSSA, n = 20). Ex vivo AT production correlated significantly with ex vivo SA wound isolate biofilm formation. Anti-alpha-toxin monoclonal antibody (MEDI4893*) prevented ex vivo biofilm formation by MRSA USA300 strain LAC. Wild-type AT rescued the ex vivo biofilm defect of non-AT producing SA strains. These findings provide evidence that AT plays a role in SA biofilm formation on epithelial surfaces and suggest that neutralization of AT may be useful in preventing and treating SA infections

De Novo Missense Mutations in TNNC1 and TNNI3 Causing Severe Infantile Cardiomyopathy Affect Myofilament Structure and Function and Are Modulated by Troponin Targeting Agents

Rare pediatric non-compaction and restrictive cardiomyopathy are usually associated with a rapid and severe disease progression. While the non-compaction phenotype is characterized by structural defects and is correlated with systolic dysfunction, the restrictive phenotype exhibits diastolic dysfunction. The molecular mechanisms are poorly understood. Target genes encode among others, the cardiac troponin subunits forming the main regulatory protein complex of the thin filament for muscle contraction. Here, we compare the molecular effects of two infantile de novo point mutations in TNNC1 (p.cTnC-G34S) and TNNI3 (p.cTnI-D127Y) leading to severe non-compaction and restrictive phenotypes, respectively. We used skinned cardiomyocytes, skinned fibers, and reconstituted thin filaments to measure the impact of the mutations on contractile function. We investigated the interaction of these troponin variants with actin and their inter-subunit interactions, as well as the structural integrity of reconstituted thin filaments. Both mutations exhibited similar functional and structural impairments, though the patients developed different phenotypes. Furthermore, the protein quality control system was affected, as shown for TnC-G34S using patient's myocardial tissue samples. The two troponin targeting agents levosimendan and green tea extract (-)-epigallocatechin-3-gallate (EGCg) stabilized the structural integrity of reconstituted thin filaments and ameliorated contractile function in vitro in some, but not all, aspects to a similar degree for both mutations