In Situ Capture and Real-Time Enrichment of Marine Chemical Diversity.

Analyzing the chemical composition of seawater to understand its influence on ecosystem functions is a long-lasting challenge due to the inherent complexity and dynamic nature of marine environments. Describing the intricate chemistry of seawater requires optimal in situ sampling. Here is presented a novel underwater hand-held solid-phase extraction device, I-SMEL (In Situ Marine moleculELogger), which aims to concentrate diluted molecules from large volumes of seawater in a delimited zone targeting keystone benthic species. Marine benthic holobionts, such as sponges, can impact the chemical composition of their surroundings possibly through the production and release of their specialized metabolites, hence termed exometabolites (EMs). I-SMEL was deployed in a sponge-dominated Mediterranean ecosystem at a 15 m depth. Untargeted MS-based metabolomics was performed on enriched EM extracts and showed (1) the chemical diversity of enriched seawater metabolites and (2) reproducible recovery and enrichment of specialized sponge EMs such as aerothionin, demethylfurospongin-4, and longamide B methyl ester. These EMs constitute the chemical identity of each targeted species: Aplysina cavernicola, Spongia officinalis, and Agelas oroides, respectively. I-SMEL concentrated sponge EMs from 10 L of water in a 10 min sampling time. The present proof of concept with I-SMEL opens new research perspectives in marine chemical ecology and sets the stage for further sustainable efforts in natural product chemistry.

Patient Case Formulations and Oppressive Disability Discourses in Occupational Therapy Education.

BACKGROUND.: Patient case formulations have become a standard feature in occupational therapy (OT) education. Despite their demonstrated benefits in optimizing student learning, patient case formulations may unintentionally convey oppressive disability discourses. PURPOSE.: The purpose of this paper is to illustrate and invite critical reflection on the use of patient case formulations in reinforcing ableist discourses and assumptions in OT education and practice. KEY ISSUES.: Through the lens of critical disability theory and Crip theory, the author demonstrates how patient case formulations are often reflective of institutionalized ableism that functions to support oppressive disability discourses in the profession, contributing to harmful healthcare practices. IMPLICATIONS.: The ongoing use of patient case formulations rooted in oppressive disability discourses perpetuates oppressive constructions of disabled people in OT education and practice. A radical shift towards pedagogical materials and practices that support identity-affirming disability discourses would be more aligned with the profession's expressed values.

Current Landscape of Teaching Diversity in Occupational Therapy Education: A Scoping Review.

IMPORTANCE: Critical research in health professions education makes clear the role of educational institutions in perpetuating problematic discourses related to diversity, as well as their potential role in dismantling and rebuilding those discourses to reflect the realities of power relations that create systemic injustice. OBJECTIVE: To provide a comprehensive overview of current pedagogical practices and educational paradigms used by occupational therapy educators to teach concepts of, and skills for, equity and diversity. DATA SOURCES: Seven education and health care databases were searched for articles published between 2007 and 2018. STUDY SELECTION AND DATA COLLECTION: Consensually developed criteria were refined until an agreement rate of >80% was achieved among the authors. Inclusion criteria focused on entry-level occupational therapy education across the world and explicitly examined approaches to teaching diversity. All articles meeting the criteria were kept for full-text review (N = 87). FINDINGS: Diversity in professional occupational therapy education programs is taught within five main underlying educational paradigms and theories: competency-based (44%), social justice (29%), critical (11%), social accountability (10%), and constructivism (6%). Within these paradigms, 14 key pedagogical practices were applied, with community service learning (37%), international service learning (25%), and didactic or course-based practices (23%) making up the majority of pedagogical practices. CONCLUSIONS AND RELEVANCE: Although current occupational therapy research demonstrates a trend toward critical paradigms and practices, problematic cultural competency theories and uncritical international service learning practices continue to dominate occupational therapy education for diversity. Educators should implement pedagogies and approaches within critical educational paradigms. WHAT THIS ARTICLE ADDS: This article highlights the importance to occupational therapy education of attending to coherence across educational ethics, paradigms, and learning outcomes in teaching for diversity and health equity.

New cave-dwelling Plakina (Plakinidae, Homoscleromorpha, Porifera) from Martinique Island (French Antilles).

Knowledge of homoscleromorph sponge biodiversity has greatly improved during the last decade thanks to the increasing use of integrative taxonomy and extensive exploration of remote ecosystems. Indeed, recently described species have mostly been small sponges living in dark and near-impenetrable habitats. This work integrates morphological, cytological, ecological and molecular data to describe a new species belonging to the Plakina genus. Plakina doudou sp. nov. was found first during close inspection of photographs taken previously in a submarine cave on Martinique Island, where several new species had already been revealed. The new species lives in syntopy with P. arletensis. It is thinly encrusting, whitish in vivo, and its skeleton harbors a unique composition of diods, triods, monolophose triods and monolophose, dilophose and trilophose calthrops. Sequencing of a portion of the mitochondrial gene cox-1 indicates that the new species belongs to a well-supported clade containing the Mediterranean P. crypta and P. trilopha. However, at the time of publication of this work, we have not yet managed to identify synapomorphies that would support the different clades of Plakina. This genus includes a total of 39 species to date, of which 10 have been recorded in the Western Tropical Atlantic, and 4 in Caribbean submarine caves.

The use of static progressive and serial static orthoses in the management of elbow contractures after complex fracture dislocation injuries: A pediatric case study.

INTRODUCTION: Contractures are the most common complication after traumatic injury to the elbow. Although evidence supporting the use of static progressive and serial static orthoses to help recover range of motion after these complex injuries is growing, there is currently a paucity of literature exploring its efficacy in pediatric populations. CASE DESCRIPTION: The following case study presents the results of the use of static progressive and serial static orthoses with a young patient who presented with both elbow extension and flexion contractures after a complex fracture dislocation injury. RESULTS: A noted and consistent improvement in both elbow extension and flexion can be observed after commencement of the static progressive and serial static orthoses. These results are consistent with the literature exploring the efficacy of these orthoses with adult populations with traumatic elbow injuries. DISCUSSION: Further studies evaluating the use of static progressive and serial static orthoses in the management of elbow contractures after traumatic injuries in pediatric populations is needed to establish best practices with this particular patient population.

The Use of Dynamic Assist Orthosis for Muscle Reeducation following Brachial Plexus Injury and Reconstruction.

Therapeutic management of brachial plexus injuries remains complex. The impact of brachial plexus injuries on everyday human functioning should not be underestimated. Early active-assisted range of motion following such injuries may prevent myostatic contractures, minimize muscle atrophy, facilitate muscle fiber recruitment, and enable a faster return to baseline strength levels. The dynamic assist elbow flexion orthosis proposed is designed to provide patients with a graded system for muscle reeducation and function. No clinical data are currently available on the use of this orthosis design; however, this article presents a treatment option based on sound clinical reasoning to facilitate rehabilitation following this devastating injury.

Sponge inventory of the French Mediterranean waters, with an emphasis on cave-dwelling species.

Mediterranean sponges represent about 10 % of the world sponge biodiversity, with these sessile organisms dominating in terms of diversity and biomass in most of the rocky bottoms shaded from light. After 60 years of intensive study of the sponge diversity along the French coast, we present the first comprehensive reference-list for this biogeographic area. A total of 389 sponge species was recorded, of which 222 known in the Marseille region. In this area, special attention was paid to species from underwater caves. Although this particular habitat appeared as one of the richest, a wealth of hidden diversity still requires description. About 37 % of the sponge diversity can be found in underwater caves, most of these species being also distributed in other habitats. However, 23 % of this sponge diversity is cave-exclusive. An easy and rapid assessment method was developed with a selection of 65 representative sponge species, for the monitoring of semi-dark cave communities. This method, based on data acquisition with photoquadrats and their processing using a DataBase built with ACCESS, was deployed in 13 studied sites. Altogether, this study represents a useful contribution for marine environment managers who might refer to this French reference list and apply the rapid and easy assessment method in the framework of several European Directives and international Conventions.

Survey highlights the need for specific interventions to reduce frequent conflicts between healthcare professionals providing paediatric end-of-life care.

AIMS: This study explored how paediatric healthcare professionals experienced and coped with end-of-life conflicts and identified how to improve coping strategies. METHODS: A questionnaire was distributed to all 2300 professionals at a paediatric university hospital, covering the frequency of end-of-life conflicts, participants, contributing factors, resolution strategies, outcomes and the usefulness of specific institutional coping strategies. RESULTS: Of the 946 professionals (41%) who responded, 466 had witnessed or participated in paediatric end-of-life discussions: 73% said these had led to conflict, more frequently between professionals (58%) than between professionals and parents (33%). Frequent factors included professionals' rotations, unprepared parents, emotional load, unrealistic parental expectations, differences in values and beliefs, parents' fear of hastening death, precipitated situations and uncertain prognosis. Discussions with patients and parents and between professionals were the most frequently used coping strategies. Conflicts were frequently resolved by the time of death. Professionals mainly supported designating one principal physician and nurse for each patient, two-step interdisciplinary meetings - between professionals then with parents - postdeath ethics meetings, bereavement follow-up protocols and early consultations with paediatric palliative care and clinical ethics services. CONCLUSION: End-of-life conflicts were frequent and predominantly occurred between healthcare professionals. Specific interventions could target most of the contributing factors.

Prevention of Left Ventricular Thrombus Formation and Systemic Embolism After Anterior Myocardial Infarction: A Systematic Literature Review.

BACKGROUND: Anterior myocardial infarction (MI) with apical dysfunction is associated with an increased risk of left ventricular thrombus (LVT) formation and systemic embolism (SE). However, the role for prophylactic anticoagulation in current practice is a matter of debate. METHODS: We conducted a systematic review of peer-reviewed original articles in either English or French on the benefit of combining anticoagulation with standard therapy for the prevention of LVT/SE after MI by searching PubMed, Ovid/MedLine/Embase, the Cochrane Library, and Google Scholar. RESULTS: Of 7382 identified records, 14 were retained for analysis. Nine articles addressed anticoagulation for patients not treated with percutaneous coronary intervention (PCI). Another 5 included at least some patients treated with PCI. Only 1 study specifically addressed exclusively a primary PCI population. Some studies showed a benefit for combining anticoagulation with standard therapy in patients not treated with PCI, but results were inconsistent. No evidence of benefit was reported when PCI patients were included and 1 study reported a signal for net harm. There was important interstudy heterogeneity and methodological limitations. Studies were likely individually underpowered. CONCLUSIONS: The available studies of LVT/SE prevention after MI lacked statistical power and are heterogeneous in terms of treatments, revascularization methods, background medical therapy, and study design. We conclude that there is presently no compelling evidence for or against combining anticoagulation with standard therapy for post-MI patients with apical dysfunction after primary PCI, and inconsistent evidence supporting prophylaxis after thrombolysis. An appropriately powered randomized trial is required to answer this clinically relevant question.

The effectiveness of orthoses in the conservative management of thumb CMC joint osteoarthritis: An analysis of functional pinch strength.

STUDY DESIGN: The study was a retrospective cohort analysis for a 19-month period from May 2013 to December 2014. INTRODUCTION: Although the use of orthoses has long been a staple of conservative treatment measures for individuals with osteoarthritis of the thumb carpometacarpal (CMC) joint, there remains little evidence exploring its effectiveness in improving functional outcomes for this client population. PURPOSE OF THE STUDY: The purpose of this study was to assess the effectiveness of 3 frequently used orthoses in improving the functional pinch strength of adults with a diagnosis of thumb CMC joint osteoarthritis. METHODS: A retrospective cohort analysis was conducted to determine whether pinch strength improved after orthotic fabrication, and fitting in patients referred to a hand therapy clinic. RESULTS: Patients who received a Colditz design orthosis had a mean increase of 2.64 lb with regard to functional pinch strength after orthotic fabrication and fitting. Patients who received a Comfort Cool orthosis (North Coast Medical, Morgan Hill, CA) had a mean increase of 2.47 lb, whereas patients who received a Thumb Spica orthosis had a mean increase of 3.25 lb. There was no evidence of any statistically significant difference in the average improvements in pinch strength between the Colditz design orthosis and the Comfort Cool orthosis. CONCLUSIONS: Results from this study demonstrate that orthosis wear consistently increases the functional pinch strength of individuals with thumb CMC joint osteoarthritis. Large-scale multisite research studies comparing various orthotic designs are necessary to help therapists determine best practice interventions for the conservative management of thumb CMC joint osteoarthritis. LEVEL OF EVIDENCE: 2(c).

Facilitators and Barriers to Learning in Occupational Therapy Fieldwork Education: Student Perspectives.

PURPOSE: The purpose of this study was to gain a comprehensive understanding of the facilitators of and barriers to learning within occupational therapy fieldwork education from the perspective of both Canadian and American students. METHOD: A qualitative study using an online open survey format was conducted to gather data from 29 occupational therapy students regarding their fieldwork experiences. An inductive grounded theory approach to content analysis was used. RESULTS: Individual, environmental, educational, and institutional facilitators of and barriers to learning within occupational therapy fieldwork education were identified. CONCLUSION: This study's findings suggest that learning within fieldwork education is a highly individual and dynamic process that is influenced by numerous factors. The new information generated by this study has the potential to positively affect the future design and implementation of fieldwork education.

[Technical recommendations and best practice guidelines for May-Grünwald-Giemsa staining: literature review and insights from the quality assurance]. / Recommandations techniques et règles de bonne pratique pour la coloration de May-Grünwald-Giemsa : revue de la littérature et apport de l'assurance qualité.

May-Grünwald-Giemsa (MGG) stain is a Romanowsky-type, polychromatic stain as those of Giemsa, Leishman and Wright. Apart being the reference method of haematology, it has become a routine stain of diagnostic cytopathology for the study of air-dried preparations (lymph node imprints, centrifuged body fluids and fine needle aspirations). In the context of their actions of promoting the principles of quality assurance in cytopathology, the French Association for Quality Assurance in Anatomic and Cytologic Pathology (AFAQAP) and the French Society of Clinical Cytology (SFCC) conducted a proficiency test on MGG stain in 2013. Results from the test, together with the review of literature data allow pre-analytical and analytical steps of MGG stain to be updated. Recommendations include rapid air-drying of cell preparations/imprints, fixation using either methanol or May-Grünwald alone for 3-10minutes, two-step staining: 50% May-Grünwald in buffer pH 6.8 v/v for 3-5minutes, followed by 10% buffered Giemsa solution for 10-30minutes, and running water for 1-3minutes. Quality evaluation must be performed on red blood cells (RBCs) and leukocytes, not on tumour cells. Under correct pH conditions, RBCs must appear pink-orange (acidophilic) or buff-coloured, neither green nor blue. Leukocyte cytoplasm must be almost transparent, with clearly delineated granules. However, staining may vary somewhat and testing is recommended for automated methods (slide stainers) which remain the standard for reproducibility. Though MGG stain remains the reference stain, Diff-Quik(®) stain can be used for the rapid evaluation of cell samples.

Intracystic papillary carcinoma of the breast: a diagnostic challenge with major clinical impact.

BACKGROUND: Intracystic papillary carcinoma (IPC) is a ductal carcinoma of papillary variety that develops in a cystic space surrounded by a fibrous capsule. It is a rare clinicopathological entity, the in situ or invasive character of which is difficult to establish, particularly on biopsy. The treatment is surgical and breast conservation depends on the tumor size. Lymph node exploration is still debated. The diagnosis of IPC is a challenge for the pathologist: the negativity of the basement membrane markers and of myoepithelial cells carries a risk of over-diagnosis on biopsy that can lead to over-treatment. CASE REPORT: To illustrate this risk, we report the case of a breast mass of 8 cm; its biopsy evoked invasive papillary carcinoma (no hormone receptors and overexpression of Human Epidermal Receptor-2 (HER-2) and for which neoadjuvant chemotherapy associated with trastuzumab was firstly proposed. RESULTS: The analysis of all anatomical radio-clinical data in a multidisciplinary context, however, allowed suspecting IPC, thus leading to first-line surgery (mastectomy with negative sentinel lymph nodes). With this diagnosis being confirmed on surgical specimen, no systemic treatment was then necessary. After 48 months, the patient is in complete remission.

Rehabilitation following thumb CMC, radiocarpal, and DRUJ arthroplasty.

Hand therapy is essential after arthroplasty around the wrist. This article includes therapy guidelines and goals after surgical reconstruction of the thumb carpometacarpal joint, radiocarpal joint, and distal radioulnar joint. Typical concerns and treatment options are addressed. Tables and figures are included to guide the hand therapist in the process of returning this patient population to pain-free function.

Static progressive orthosis for patients with limited radial and/or ulnar deviation: an innovative orthotic design.

After injury to the wrist and forearm, therapists and patients frequently work to regain the motions of wrist flexion/extension and forearm pronation/supination. Although these motions play a vital role in everyday functioning, for some, limitations in wrist radial/ulnar deviation can also present functional challenges. These authors describe the creation and utilization of a static progressive orthosis to assist a patient in regaining wrist radioulnar deviation

Evaluation of the DG29 test for early detection of pregnancy in cattle.

The objective of this study was to evaluate a commercial blood test (DG29) for pregnancy in cattle. Compared with ultrasound, the sensitivity of the assay for detecting pregnancy around day 30 post-insemination was 99.4% [95% confidence interval (CI): 96.1-100]. The specificity was 100% (95% CI: 84.7-100) in non-inseminated cattle, and 66.7%; (95% CI: 49.7-80.4) in inseminated nonpregnant cattle. Positive and negative predictive values were 92.6% and 96.3%, respectively, in a sample of inseminated cattle in which 80% were pregnant.

[Breast cytopathology bestiary]. / Le monde animalier en cytopathologie mammaire.

Breast cytopathology of tubular and lobular carcinomas may be very difficult. Indeed, the classical morphological signs of malignancy are often scarce or absent; the identification of special patterns of cell clusters may therefore be very useful to reach a diagnosis. Following the review of many cases of cytological smears with histological confirmation, a series of peculiar cytological aspects (often mimicking little animals such as butterfly, eagle, dog, lizard, fish, rabbit...) were identified and found helpful to report here from a diagnostic point of view.