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Many participants persist through the living kidney donation process, although it is challenging, multifaceted, and burdensome, particularly during the predonation evaluation (PDE) phase. This study uses a constructivist grounded theory approach to analyze the experiences of living kidney donors (LKDs) undergoing evaluation who shared their perspectives in blog reflections. One hundred five (105) blog posts met the inclusion criteria. They generated three overarching themes: (1) Facilitators to completing the PDE qualification process, (2) Burdens experienced during the PDE qualification process, and (3) Tools to mitigate burdens or enhance facilitators. Internal facilitators, such as the desire to help and other motivating emotions, emerged as key drivers for LKDs to persist through the donation process. Religious belief or faith, an external facilitator, is also crucial in motivating donors. Conversely, internal burdens, such as doubts, fears, financial concerns, and health risks, posed challenges to the donation process. External burdens also included recipient relationship management, delays and setbacks, poor communication, qualification testing, lack of support, and being denied as a donor. This study's findings shed light on the complex interplay between burdens, facilitators, and tools in shaping the experiences of LKDs during the PDE, which enabled their persistence through the process and highlights a potential persistence spectrum. The insights gained from this research can inform interventions to better support living kidney donors throughout their donation journey, enhancing the overall donor experience and potentially increasing the number of living kidney donations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)

In this autoethnographic account of my experiences as a parent who discovers and attempts to respond to the abuse of her child, I highlight the ways trauma can remove access to storytelling as a sensemaking and healing tool in a crisis. I narrate how I experienced secondary trauma as a meaning-making black hole that blocked language's healing capacities, blinded me to important sensemaking turning points, and hampered my and my child's ability to ask for help. These experiences caused me to question many foundational assumptions I made as a health communication scholar and to see an interdisciplinary bias toward narrative resiliency. Narrating the inhibiting effects trauma has on emplotment, help-seeking, and meaning-making points to the uniquely communicative nature of trauma which enables narrative theory and health communication research to make strong theoretical contributions to better understand trauma and support appropriate trauma-informed practices.

Background: A need exists to recruit and retain nursing faculty of differing generations, races/ethnicities, and genders., Purpose: The purpose of this study was to examine whether generational cohort, race/ethnicity, and gender predicted job satisfaction, life satisfaction, or work-life balance for full-time faculty teaching in prelicensure, baccalaureate nursing programs., Methods: Faculty (N = 363) from multiple schools of nursing in the United States completed a survey that included demographics, the Job Satisfaction Scale, the Satisfaction with Life Scale, and the Work-Life Balance Self-Assessment., Results: Significant relationships and differences were noted for nursing faculty. Faculty of color reported lower job and life satisfaction than their White counterparts., Conclusions: As calls to increase diversity among nursing faculty increase, continued research should focus on differences in the experience of faculty of color., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Aim: This study explored how full-time, prelicensure baccalaureate nursing faculty members described their experiences with work-life balance., Background: With increasing shortages of nursing faculty and practicing nurses, schools of nursing are developing faculty recruitment and retention efforts. It is imperative to understand the experiences of nursing faculty with regard to balancing their work and personal lives., Method: A web-based survey including two open-ended questions related to work-life balance was disseminated to deans of nursing programs, who disseminated the survey to nursing faculty. Thematic analysis was used to analyze the data., Results: The sample (n = 320) was representative of current nursing faculty demographics. Three themes emerged: Relationship With Administration, Nursing Faculty Workload, and Boundary Setting. Opposing subthemes were noted in each theme., Conclusion: Administrators may use the findings from this study to create administrator and faculty development opportunities and mentorship programs that promote work-life balance of nursing faculty., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2022 National League for Nursing.)

Background: Gender and sexual minorities are more likely to report unfavourable experiences with primary care. Aside from being refused care, additional challenges include stigma, discrimination, social and societal rejection, and violence., Aims: The purpose of this study was to determine which aspects of the client-provider relationship affected perceived satisfaction with the quality of mental healthcare received., Methods: Data was collected via electronic survey, which yielded 177 responses. Univariate and ordinal logistic regression were used to determine if a significant relationship existed between the variables of interest., Results: Results indicate that clients who felt less trust for their providers, reported inadequate time spent in therapeutic encounters, and felt their providers looked down on or judged them were less satisfied with the quality of mental healthcare they received. In addition, LGBTQ+ clients who were less satisfied with the quality of care they received were significantly less confident in their ability to receive adequate future mental healthcare., Conclusions: Results of this study highlight the importance of provider awareness, attitude, and access to information regarding the mental health needs of the LGBTQ+ population because these support culturally competent care, which potentially encourages future care-seeking behaviors.

Competitive rowing highly values boat position and velocity data for real-time feedback during training, racing and post-training analysis. The ubiquity of smartphones with embedded position (GPS) and motion (accelerometer) sensors motivates their possible use in these tasks. In this paper, we investigate the use of two real-time digital filters to achieve highly accurate yet reasonably priced measurements of boat speed and distance traveled. Both filters combine acceleration and location data to estimate boat distance and speed; the first using a complementary frequency response-based filter technique, the second with a Kalman filter formalism that includes adaptive, real-time estimates of effective accelerometer bias. The estimates of distance and speed from both filters were validated and compared with accurate reference data from a differential GPS system with better than 1 cm precision and a 5 Hz update rate, in experiments using two subjects (an experienced club-level rower and an elite rower) in two different boats on a 300 m course. Compared with single channel (smartphone GPS only) measures of distance and speed, the complementary filter improved the accuracy and precision of boat speed, boat distance traveled, and distance per stroke by 44%, 42%, and 73%, respectively, while the Kalman filter improved the accuracy and precision of boat speed, boat distance traveled, and distance per stroke by 48%, 22%, and 82%, respectively. Both filters demonstrate promise as general purpose methods to substantially improve estimates of important rowing performance metrics., Competing Interests: We have the following competing interests: R. Paul Crawford’s company, Hegemony Technologies, has financial interests in the reported technology and may pursue commercial use of the reported findings. There are no patents or further products currently in development or marketed products to declare related directly to the results presented in this paper. Additionally, there are no current plans to pursue patents related to the work presented in this paper. Hegemony Technologies has no further products in development or marketed products to declare. None of these potentially competing interests alter our adherence to all the PLOS ONE policies on sharing data and materials.

Study Design: The authors studied the mechanical behavior of vertebrae through the use of finite element analyses., Objectives: To determine the relation between axial and bending rigidity, and to determine the geometric and densitometric factors that affect this relation., Summary of Background Data: Metrics of vertebral body mechanical properties in bending have not been established despite evidence that anterior bending loads play a significant role in osteoporotic vertebral fracture., Methods: Voxel-based finite element models were generated using quantitative computed tomography (QCT) scans of 18 human cadaveric vertebral bodies, and both axial and bending rigidities of the vertebra were computed. Both rigidity measures and their ratio were correlated with vertebral geometric and densitometric factors obtained from the QCT scans., Results: Bending rigidity was moderately correlated with axial rigidity (r2 = 0.69) and strongly correlated with the product of axial rigidity and vertebral anteroposterior depth squared (r2 = 0.88). The ratio of bending to axial rigidity was independent of bone mineral density (P = 0.20) but was moderately correlated with the square of vertebral depth (r2 = 0.69)., Conclusions: Vertebral anteroposterior depth plays an important role in bending rigidity. The scatter in the correlation between bending and axial rigidity suggests that some individuals can have vertebrae with a normal axial stiffness but an abnormally low bending stiffness. Because whole-bone stiffness is indicative of bone strength, these results support the concept that use of more than one metric of vertebral strength, for example, compression and bending strengths, may improve osteoporotic fracture risk prediction.

The correlation between bone mineral density and vertebral strength is not based on mechanical principles and thus the method cannot reflect the effects of subtle geometric features and densitometric inhomogeneities that may substantially affect vertebral strength. Finite element models derived from quantitative computed tomography (QCT) scans overcome such limitations. The overall goal of this study was to establish that QCT-based "voxel" finite element models are better predictors of vertebral compressive strength than QCT measures of bone mineral density with or without measures of cross-sectional area. QCT scans were taken of 13 vertebral bodies excised from 13 cadavers (L1-L4; age: 37-87 years; M = 6, F = 7) and used to calculate bone mineral density (BMD(QCT)). The QCT voxel data were converted into linearly elastic finite element models of each vertebra, from which measures of vertebral stiffness and strength were computed. The vertebrae were biomechanically tested in compression to measure strength. Vertebral strength was positively correlated with the finite element measures of strength (r(2) = 0.86, P < 0.0001) and stiffness (r(2) = 0.82, P < 0.0001), the product of BMD(QCT) and vertebral minimum cross-sectional area (r(2) = 0.65, P = 0.0008), and BMD(QCT) alone (r(2) = 0.53, P = 0.005). These results demonstrate that highly automated "voxel" finite element models are superior to correlation-based QCT methods in predicting vertebral compressive strength and therefore offer great promise for improvement of clinical fracture risk assessment.

This study investigated the numerical convergence characteristics of specimen-specific "voxel-based" finite element models of 14 excised human cadaveric lumbar vertebral bodies (age: 37-87; M = 6, F = 8) that were generated automatically from clinical-type CT scans. With eventual clinical applications in mind, the ability of the model stiffness to predict the experimentally measured compressive fracture strength of the vertebral bodies was also assessed. The stiffness of "low"-resolution models (3 x 3 x 3 mm element size) was on average only 4% greater (p = 0.03) than for "high"-resolution models (1 x 1 x 1.5 mm) despite interspecimen variations that varied over four-fold. Damage predictions using low- vs high-resolution models were significantly different (p = 0.01) at loads corresponding to an overall strain of 0.5%. Both the high (r2 = 0.94) and low (r2 = 0.92) resolution model stiffness values were highly correlated with the experimentally measured ultimate strength values. Because vertebral stiffness variations in the population are much greater than those that arise from differences in voxel size, these results indicate that imaging resolution is not critical in cross-sectional studies of this parameter. However, longitudinal studies that seek to track more subtle changes in stiffness over time should account for the small but highly significant effects of voxel size. These results also demonstrate that an automated voxel-based finite element modeling technique may provide an excellent noninvasive assessment of vertebral strength.

The yielding, plastic flow, and fracture behavior of UHMWPE plays an important role in wear and failure mechanisms of total joint replacement components. The primary objective of this study was to compare the yielding, plastic flow, and fracture behavior of two implantable grades of UHMWPE (GUR 1120 vs 4150 HP). The first part of this work explored the hypothesis that up to the polymer yield point, the monotonic loading behavior of UHMWPE displays similar true stress strain behavior in tension and compression. Uniaxial tension and compression tests were conducted to compare the equivalent true stress vs strain response of UHMWPE up to 0.12 true strain. During monotonic loading, the equivalent true stress strain behavior was similar in tension and compression up to the yield point. However, investigation of the unloading behavior and permanent plastic deformations showed that classical deviatoric rate independent plasticity theory may dramatically overpredict the permanent strains in UHMWPE. A secondary goal of this study was to determine the ultimate true stress and strain for UHMWPE and to characterize the fracture surfaces after failure. Using a fracture mechanics approach, the critical flaw sizes were used in combination with the true ultimate stresses to predict the fracture toughness of the two resins. A custom video-based strain measurement system was developed and validated to characterize the true stress-strain behavior up to failure and to verify the accuracy of the incompressibility assumption in calculating the true stress-strains up to failure. In a detailed uncertainty analysis, theoretical expressions were derived for the relative uncertainty in digital video-based estimates of nominal strain, true strain, homogeneous stress, and true stress. Although the yielding behavior of the two UHMWPE resins was similar, the hardening and plastic flow behavior clearly discriminated between the GUR 1120 and 4150 HP. A statistically significant difference between the fracture toughness of the two resins was also evident. The long-term goal of this research is to provide detailed true stress strain data for UHMWPE under uniaxial tension and compression for future numerical simulations and comparison with more complex multiaxial loading conditions.

We sought to quantify the systematic and random errors associated with end-artifacts in the platens compression test for trabecular bone. Our hypothesis was that while errors may depend on anatomic site, they do not depend on apparent density and therefore have substantial random components. Trabecular bone specimens were first tested nondestructively using newly developed accurate protocols and then were tested again using the platens compression test. Percentage differences in modulus between the techniques (bovine proximal tibia [n = 18] and humerus [n = 17] and human lumbar spine, [n = 9]) were in the range of 4-86%. These differences did not depend on anatomic site (p = 0.21) and were only weakly dependent on apparent density and specimen aspect ratio (r2 < 0.10). The mean percentage difference in modulus was 32.6%, representing the systematic component of the end-artifact error. Neglecting the minor variations explained by density and specimen size (approximately 10%), an upper bound on the random error from end-artifacts in this experiment was taken as the SD of the modulus difference (+/-18.2%). Based on a synthesis of data taken from this study and from the literature, we concluded that the systematic underestimation error in the platens compression test can be only approximated and is in the range of 20-40%; the substantial random error (+/-12.5%) confounds correction, particularly when the sample size is small. These errors should be considered when interpreting results from the platens test, and more accurate testing techniques should be used when such errors are not acceptable.

Objective: To compare results of 6 serologic tests with results of bacteriologic culture for Brucella suis in swine., Design: Prospective study., Animals: Two hundred twenty-one swine from 39 naturally infected herds., Procedure: Blood samples and lymph nodes were collected at slaughter. Serologic tests conducted were the particle concentration fluorescence immunoassay, the automated complement fixation assay, the card test, the buffered acidified plate antigen assay, the standard tube test, and the rivanol test. Lymph nodes were plated on Farrell's medium and serum-enriched agar for bacteriologic culture., Results: Sensitivities ranged from 57 (automated complement fixation assay) to 83% (standard tube test). Specificities ranged from 62 (standard tube test) to 95% (rivanol test). Brucella suis was isolated from 46 of the 221 (21%) pigs. For 8 of the 46 culture-positive pigs, results of all 6 tests were negative., Clinical Implications: Data illustrate the difficulty of eliminating brucellosis by means of a test-and-removal program and support the policy of slaughtering infected herds.

Seventy-nine cattle in all stages of gestation were inoculated with a low dose (2.5 x 10(8) colony-forming units) of Brucella abortus strain 19, then challenge exposed with pathogenic B abortus strain 2308 during the subsequent gestation. A brucellosis case was defined by isolation of strain 2308 from dam or calf samples. Cumulative incidence of brucellosis cases was 48, 33, 25, or 47% for cattle that were, respectively, not pregnant, or 19 to 87, 100 to 167, or 190 to 253 days in gestation at vaccination. The cumulative incidence was 56% in 27 nonvaccinated controls. The 95% confidence intervals for risk ratios included 1 in all cattle, except those that were 100 to 167 days in gestation at vaccination (ie, second trimester); the confidence interval for this group was 0.21 to 0.97. The prevented fraction (1-risk ratio) attributed to strain 19, in ascending order, was 0.14, 0.16, 0.4, or 0.55, respectively, for cattle that were not pregnant, or were 190 to 253, 19 to 87, or 100 to 167 days in gestation at vaccination. Potential confounders of breed, pen effect, and gestation days at challenge exposure did not significantly affect results. Results supported the hypothesis that stage of gestation at vaccination will affect the prevented fraction of brucellosis, or efficacy of strain 19, in cattle vaccinated with a low dose and, therefore, is one factor that may explain variation in strain 19-induced protection.

Eighty-eight cattle were injected SC with 2.5 x 10(8) viable cells of Brucella abortus strain 19. All but 1 heifer became seropositive on the basis of the results of 7 brucellosis tests, and the proportion positive decreased with time. The proportion of cattle that were seropositive during a 20- to 67-week period after vaccination was as follows, in decreasing order: hemolysis-in-gel, 59%; buffered-acid plate antigen, 39%; ELISA, 16%; card, 10%; rivanol, 8%; cold complement-fixation, 7%; and automated complement-fixation, 5%. Using the serologic classification in Uniform Methods and Rules for brucellosis eradication, 7 cattle tested brucellosis-positive (2 suspects and 5 reactors). None of the 27 nonpregnant heifers tested positive. Of 18 heifers that were 84 to 135 days in gestation when vaccinated, 6 (33%) tested positive for brucellosis, compared with 0 of 13 and 1 (3%) of 30 heifers that were 11 to 78 and 145 to 253 days in gestation at vaccination, respectively (X2 = 12.07; 2 df; P less than 0.01). Neither breed (Angus, Hereford, Jersey, and Brahman) nor calf survival was related to brucellosis-positive results. Postpartum milk samples from 61 heifers and 24 tissues from 2 reactor cattle were culture-negative for B abortus.

Initial and cumulative reactor rates for strain 19 vaccinates and nonvaccinates were significantly (P less than 0.001) lower for beef herds containing variable proportions of vaccinates, compared with reactor rates in nonvaccinated herds. In addition, significant (P less than 0.005) reduction in cumulative incidence was observed in nonvaccinated and strain 19-vaccinated cattle as the proportion of vaccinates within the herd increased from 1 to 19%, 20 to 39%, 40 to 59%, and 60 to 100%. Duration of quarantine and number of herd tests were not reduced in herds with strain 19-vaccinated cattle. In herds released from quarantine, duration of quarantine and number of tests were positively correlated to proportion of the herd vaccinated. In nonvaccinated herds released from quarantine, effect of herd size was documented by strong positive (P = 0.042) correlation with duration of quarantine and slightly weaker correlation (P = 0.095) with number of tests.

Yearling heifers were given SC injections of 10(8) (n = 40), 10(9) (n = 44), or 10(10) (n = 44) colony-forming units of Brucella abortus strain 19 (S19). The proportion of heifers with positive serologic test results at 1 month following vaccination increased as the dose of S19 increased. These proportions decreased with time, and all heifers had negative card, rivanol, and complement fixation test results within 4 months. Positive ELISA results persisted beyond 4 months in all three S19 dose groups; however, all heifers were ELISA-negative within 9 months after vaccination. Comparable lymphocyte transformation activity was stimulated by S19 dose of 10(9) or 10(10) and approximately half of the heifers in both groups had a positive stimulation index at 9 months. Immunity of the pregnant heifers was challenged 9 months after vaccination with 10(7) B abortus strain 2308 as follows: diluent controls (n = 69); 10(8) B abortus S19 (n = 40); 10(9) B abortus S19 (n = 39); and 10(10) B abortus S19 (n = 39). Tissue specimens from heifers were obtained at parturition and necropsy for culturing of B abortus. The proportion of heifers that developed brucellosis, ie, had positive culture results, increased as gestation days at challenge exposure increased. The effect of gestational age was controlled in the analysis using logistic regression. The relative risk of brucellosis was reduced to 0.38, 0.15, and 0.06 for B abortus S19 doses of 10(8), 10(9), and 10(10), respectively, compared with diluent controls at 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Three hundred sixty cattle at risk in 6 beef herds known to include cows infected with Brucella abortus field strains were vaccinated with 3 x 10(9) colony-forming units of strain 19. Field strain exposure after vaccination was estimated by the number of cows with brucellosis that calved or aborted in the herd. As the number of exposures increased, the number of cows developing brucellosis increased, and 19 exposures in the 6 herds resulted in 9 new cases. The ratio of exposures to new cases varied from 1.0 to 2.0 in the 4 herds with new cases, whereas 2 herds with 1 and 3 exposures, respectively, did not have new cases of brucellosis. The correlation coefficient between the number of exposures and the number of new cases was 0.85, and the coefficient of determination suggested that 73% of the variation in new cases could be explained by the number of exposures in strain 19-vaccinated herds.

Fifty-six heifers were weaned from dams that were card-test positive for brucellosis. Forty-four dams were positive by rivanol and complement-fixation tests and Brucella abortus field strain was isolated from 14. Numbers of expected pregnancies following natural breeding and numbers of viable calves produced were not reduced in the heifers. Persistent B abortus infection was documented in 2 of 37 parturient heifers from reactor dams. The frequency of infection was 1 of 10 in strain 19-vaccinated heifers, and 1 of 27 in nonvaccinated heifers. The 2 persistently infected heifers had atypical serologic reaction patterns before normal parturitions.

A total of 4551 sera from 863 Strain 19 vaccinated and non-vaccinated adult cattle, independent of disease status, were tested by five serological methods to detect the presence of antibodies to B. abortus. Results from Standard Agglutination Tube (SAT), Buffered Brucella Antigen or card (CT), Complement Fixation (CF), Enzyme Linked Immunosorbent Assay (ELISA) and Rivanol (Riv) methods were compared. There was a 95% probability for agreement among CT negative sera, between serological methods, for all groups of vaccinated and non-vaccinated cattle. The agreement between tests with Riv Positive sera, excluding the calfhood and adult vaccinated group tested by the CF method, was 91-100%. The probability of a serum which was serologically negative by other methods being Riv negative was 98%. The usefulness of serological results from Riv (greater than or equal to 1/50) tests for classifying the reactor status of cattle are of doubtful supplemental value to confirm card test positive results. Vaccination history is an important consideration when evaluating serological data on cattle sera particularly from SAT and CF methods.

Four hundred sixty-eight wild mammals were collected from four ranches in Texas where Brucella-infected cattle herds are maintained, and examined as possible reservoir hosts for Brucella abortus. Seventy-one serums from five species were tested for Brucella antibodies. Liver and spleen from 453 mammals (14 species) were cultured for B. abortus. Results of the serologic and bacteriologic examination of rodents, opossums (Didelphis virginiana), raccoons (Procyon lotor) and white-tailed deer (Odocoileus virginianus) did not provide evidence of an extrabovine reservoir of B. abortus.

Four Texas cattle herds containing cows infected with either Brucella abortus biotype 1, 2, or 4 were studied to determine the probability of transmission of Brucella between adjacent cattle herds, the most probable means by which Brucella was introduced into the herds, and the relative frequency of strain 19 isolation from vaccinated cattle. A total of 1,935 cattle in the four herds were tested for brucellosis; 339 reactors were identified, and isolations of B abortus were made from 143. The biotype of B abortus was used to determine that purchased cattle or reentry of bred heifers into the herds was probably responsible for introducing B abortus and that the biotype was not readily transmitted to adjacent herds. Three (9%) of 32 B abortus isolations from adult-vaccinated cattle were strain 19. The data supported the hypothesis that biotypes can be useful in determining the source of B abortus for cattle and in differentiating field and vaccine strain infections in adult-vaccinated cattle.

Pregnant heifers were exposed by a conjunctival inoculation with 1 X 10(7) colony-forming units of Brucella abortus strain 2308. At parturition, milk and uterine samples from dams plus samples from dead calves were cultured bacteriologically for Brucella. The logistic regression probability of B abortus isolation increased from 0.22 to 0.90, as fetal age at exposure of heifers increased from 60 to 150 gestation days. Strain 2308 was recovered at parturition from 14 (64%) of 22, 17 (71%) of 24, and all 28 (100%) heifers that were at gestation days less than 127, 127 to 157, and greater than 157, respectively, at time of exposure. The number of infected heifers and the number of samples positive for B abortus were significantly increased as fetal age at exposure of heifers increased from gestation days less than 127 to greater than 157 (chi 2 greater than 10, P less than 0.005).

Heifers injected with 10(8) (n = 40), 10(9) (n = 39), or 10(10) (n = 39) colony-forming units of Brucella abortus strain 19 were conjunctivally exposed to 10(7) colony-forming units of strain 2308 during gestation. At parturition, milk from each quarter of the udder, a piece of placenta, and 2 swab specimens of the uterus from the dam plus a swab specimen of the rectum from each calf were cultured for Brucella. If the calf was dead or died, additional specimens of lung, stomach contents, and a mediastinal lymph node also were cultured. Days in gestation was determined for each heifer, using data from rectal palpation after breeding and crown-rump length and weight of calf at parturition, with the median value used for data analysis. In each vaccine dosage group, the proportion (%) of heifers developing brucellosis increased as days in gestation at exposure increased. Strain 2308 was isolated from 3 (11%) of 26, 16 (25%) of 64, and 18 (64%) of 28 heifers that were grouped as less than 121, 121 to 150, and greater than 150 days in gestation at time of exposure, respectively. Thirty-two (86%) of the 37 infected heifers were less than 260 days in gestation at parturition, and calves were premature. Heifers with premature calves were more likely to be infected, and tissues were more likely to yield multiple isolations of strain 2308, regardless of days in gestation at exposure or of days after exposure to parturition. Days after exposure to premature parturition of infected heifers ranged from 35 to 110.