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Objective: The DanGer Shock trial test the hypothesis that left ventricular (LV) mechanical circulatory support with Impella CP transvalvular microaxial flow pump improves survival in patients with ST segment elevation acute myocardial infarction complicated by cardiogenic shock (AMICS) compared to conventional guideline-driven treatment. This paper describes the rationale and design of the randomized trial, in addition to the baseline characteristics of the population screened and enrolled so far., Methods: The DanGer Shock study is a prospective, multicenter, open-label trial in patients with AMICS randomized 1:1 to Impella CP or current guideline-driven therapy with planned enrollment of 360 patients. Patients comatose after out of hospital cardiac arrest are excluded. Eligible patients are randomized immediately following shock diagnosis. Among patients randomized to receive Impella CP, the device is placed prior to angioplasty. The primary endpoint is all-cause mortality at 180 days. Baseline characteristics of patients screened and randomized in the DanGer Shock as of June 2018 are compared with 2 contemporary AMICS studies., Results: As of end of June 2018, 314 patients were screened and 100 patients were randomized. Patients had median arterial lactate of 5.5 mmol/L (interquartile range 3.7-8.8 mmol/L), median systolic blood pressure of 76 mmHg (interquartile range 70-88 mmHg), and median LV ejection fraction of 20% (interquartile range 10%-30%)., Conclusion: The DanGer Shock trial will be the first adequately powered randomized trial to address whether mechanical circulatory LV support with Impella CP can improve survival in AMICS. Baseline characteristics of the first 100 randomized patients indicate a population in profound cardiogenic shock., (Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: The goal of the OSCAR programme is to evaluate the performances of genotypic HIV-1 tropism testing in clinical practice using the enhanced sensitivity version of Trofile (ESTA) as reference-assay., Methods: HIV-1 coreceptor-usage was assessed using plasma samples from 406 HIV-1 infected patients by ESTA and by gp120 V3 population-sequencing followed by Geno2pheno (set at a False Positive Rate [FPR] of 10% and 5%)., Results: ESTA was successful in 365 (89.9%) samples indicating R5 in 254 (69.6%), and DM/X4 in 111 (30.4% of samples (104 [28.5%] DM and 7 [1.9%] X4). Genotypic-testing successfully assessed viral tropism for all 406 samples, including the 41 with undetermined result by ESTA. Genotypic-tropism testing at a FPR of 5% and 10% was 81.1% and 78.4% concordant with ESTA, respectively. Despite a sensitivity of 48.7% and 55.9% at a FPR of 5% and 10%, respectively, a high concordance (specificity: 95.3% for FPR of 5% and 88.2% for FPR of 10%) between genotypic-tropism testing and ESTA was reached in the detection of R5-tropic viruses., Conclusion: Our results are in line with other European studies, and support the routine use of genotypic tropism testing in clinical-settings for monitoring of HIV-1 infected patients candidate to or failing CCR5-antagonists.

Little attention has been directed towards investigating how senior managers and boards approach strategic decision-making when dealing with shock events as compared to strategic decision-making in a stable environment. This paper presents evidence to suggest that strategic decision-making following a shock event involves a more intuitive, less analytical and less consultative approach, while decision-making in a stable environment is characterised by a more cooperative, formal and analytical process. Decision-making following a shock event tends to be simplified and fast, whereas decision-making in a stable environment tends to be comprehensive and slow. Furthermore, the strategic role of the board transforms following a shock event from a limited involvement in strategy setting to a strong involvement in the setting of strategy. This research has important management implications signifying that crisis management must increasingly focus on building an organisation's ability to reach swift decisions in crisis situations and avoid analysis paralysis., (Copyright © 2006 Elsevier Ltd. All rights reserved.)

Using soft-x-ray absorption spectroscopy at the Co L(2,3) and O K edges, we demonstrate that the Co3+ ions with the CoO5 pyramidal coordination in the layered Sr2CoO3Cl compound are unambiguously in the high spin state. Our result questions the reliability of the spin state assignments made so far for the recently synthesized layered cobalt perovskites and calls for a reexamination of the modeling for the complex and fascinating properties of these new materials.

Concepts of the basic case reproduction rate of malaria, or the vectorial capacity of malaria vectors, tend to assume that the behaviour of infected and non-infected mosquitoes will be similar. However, recent years have seen a series of studies demonstrating that mosquitoes infected with malaria or other parasites show many pathological features with important effects on their behaviour and on the transmission dynamics of the parasite. Parasitology Today will be featuring a series of reports discussing these effects and attempting to unravel the expected effects on parasite transmission dynamics; this article sets the scene.