Abstract
Background
Caregivers play an essential role in supporting people living with Alzheimer’s disease globally. Cross‐country research on caregivers’ experiences of coping is a prerequisite to ...developing useful trans‐cultural guidelines for support organisations. While some coping strategies of caregivers globally have been identified, these are neither well understood or elaborated, nor linked effectively into carer support offerings.
Methods
In partnership with Alzheimer’s Disease International (ADI) and Roche, we conducted in‐depth qualitative interviews with photo‐elicitation with 34 caregivers from UK, US, Brazil, and South Africa to understand critical factors in coping during and after the pandemic. Inductive narrative analysis of data and participant generated images coded to dominant themes (Relationships and Caring role) were developed with input from global and national charity and industry sectors.
Results
We uncovered four caregiving styles:
Empaths
used emotion‐focused strategies to construct their caring role ('put yourself in that person’s shoes’). They tended to develop strong coping skills, but needed psychosocial support and time specific information.
Organisers
used problem‐focused strategies and sought information and training early on ('I’m a pretty good expert now’). They developed strong narratives of organisation, advocacy and expertise.
Non‐identifiers
managed some aspects of the caring role but felt isolated and lacked knowledge and expertise ('do everything I can…there’s nobody else’). They sought others to manage disease related support.
Reluctants
struggled with unwanted caring duties ('I didn’t sign up for this’). They needed support in coming to terms with their loved one’s diagnosis and professional help with the day‐to‐day caring role.
Conclusion
Our findings highlight the need for tailored user‐driven support offerings, that begin with the individual carer’s experiences and needs. Our typology will be used in the communication and development of findings and best practice guidelines to inform charities and policy makers about cost effective ways of tailoring support to fit individual carer circumstances globally.
Background
Wireless motility capsule (WMC) findings are incompletely defined in suspected gastroparesis. We aimed to characterize regional WMC transit and contractility in relation to scintigraphy, ...etiology, and symptoms in patients undergoing gastric emptying testing.
Methods
A total of 209 patients with gastroparesis symptoms at NIDDK Gastroparesis Consortium centers underwent gastric scintigraphy and WMCs on separate days to measure regional transit and contractility. Validated questionnaires quantified symptoms.
Key Results
Solid scintigraphy and liquid scintigraphy were delayed in 68.8% and 34.8% of patients; WMC gastric emptying times (GET) were delayed in 40.3% and showed 52.8% agreement with scintigraphy; 15.5% and 33.5% had delayed small bowel (SBTT) and colon transit (CTT) times. Transit was delayed in ≥2 regions in 23.3%. Rapid transit was rarely observed. Diabetics had slower GET but more rapid SBTT versus idiopathics (P ≤ .02). GET delays related to greater scintigraphic retention, slower SBTT, and fewer gastric contractions (P ≤ .04). Overall gastroparesis symptoms and nausea/vomiting, early satiety/fullness, bloating/distention, and upper abdominal pain subscores showed no relation to WMC transit. Upper and lower abdominal pain scores (P ≤ .03) were greater with increased colon contractions. Constipation correlated with slower CTT and higher colon contractions (P = .03). Diarrhea scores were higher with delayed SBTT and CTT (P ≤ .04).
Conclusions & Inferences
Wireless motility capsules define gastric emptying delays similar but not identical to scintigraphy that are more severe in diabetics and relate to reduced gastric contractility. Extragastric transit delays occur in >40% with suspected gastroparesis. Gastroparesis symptoms show little association with WMC profiles, although lower symptoms relate to small bowel or colon abnormalities.
Wireless motility capsule (WMC) findings in suspected gastroparesis and relations to symptoms have been poorly defined. Evaluation of patients with gastroparesis symptoms revealed gastric emptying delays with WMCs that were similar to scintigraphy, were related to reduced contractility, and were often associated with extragastric or generalized transit delays; symptoms correlated poorly with WMC profiles. These findings provide insight into motor abnormalities in gastroparesis pathogenesis and form a basis for future investigations studying the impact of WMC testing on clinical care.
The intracellular protein p120 catenin aids in maintenance of cell–cell adhesion by regulating E-cadherin stability in epithelial cells. In an effort to understand the biology of p120 catenin in ...pancreas development, we ablated p120 catenin in mouse pancreatic progenitor cells, which resulted in deletion of p120 catenin in all epithelial lineages of the developing mouse pancreas: islet, acinar, centroacinar, and ductal. Loss of p120 catenin resulted in formation of dilated epithelial tubules, expansion of ductal epithelia, loss of acinar cells, and the induction of pancreatic inflammation. Aberrant branching morphogenesis and tubulogenesis were also observed. Throughout development, the phenotype became more severe, ultimately resulting in an abnormal pancreas comprised primarily of duct-like epithelium expressing early progenitor markers. In pancreatic tissue lacking p120 catenin, overall epithelial architecture remained intact; however, actin cytoskeleton organization was disrupted, an observation associated with increased cytoplasmic PKCζ. Although we observed reduced expression of adherens junction proteins E-cadherin, β-catenin, and α-catenin, p120 catenin family members p0071, ARVCF, and δ-catenin remained present at cell membranes in homozygous p120f/f pancreases, potentially providing stability for maintenance of epithelial integrity during development. Adult mice homozygous for deletion of p120 catenin displayed dilated main pancreatic ducts, chronic pancreatitis, acinar to ductal metaplasia (ADM), and mucinous metaplasia that resembles PanIN1a. Taken together, our data demonstrate an essential role for p120 catenin in pancreas development.
•We examine the consequences of deletion of p120 catenin in mouse pancreas development.•p120 is required for proper pancreatic tubulogenesis and branching morphogenesis.•p120 deletion results in induction of inflammation in developing and adult pancreas.•Despite p120 loss, E-cadherin, β-catenin, and α-catenin are retained in development.•Family members ARVCF, δ-catenin, and p0071 might partially compensate for p120 loss.
Modelling and numerical simulations play a vital role in the design and optimization of electrochemical energy storage devices. In this study, a general physics-based model is developed to describe ...Hybrid Asymmetric Capacitors (HACs). A one-dimensional cell is constructed with one faradaic electrode, a separator and a capacitive electrode. The model is validated using a commercial Lithium Ion Capacitor (LIC). Galvanostatic charge and discharge processes are simulated with a maximum mean relative error of 7.8%. This suggest that this simple Ohmic model captures the key electrochemical phenomena occurring inside the LIC cell.
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•A general physics-based model is developed in 1D to simulate HAC.•A commercial LIC is used to validate the general ohmic model.•Numerical results reproduce accurately experimental electrical features of the LIC.•Maximum mean relative error achieved in galvanostatic processes is less than 7.8%.
High quality 16S ribosomal RNA (rRNA) gene sequences from the type strains of all species with validly published names, as defined by the International Code of Nomenclature of Bacteria, are a ...prerequisite for their accurate affiliations within the global genealogical classification and for the recognition of potential new taxa. During the last few years, the Living Tree Project (LTP) has taken care to create a high quality, aligned 16S and 23S rRNA gene sequence database of all type strains. However, the manual curation of the sequence dataset and type strain information revealed that a total of 552 “orphan” species (about 5.7% of the currently classified species) had to be excluded from the reference trees. Among them, 322 type strains were not represented by an SSU entry in the public sequence repositories. The remaining 230 type strains had to be discarded due to bad sequence quality. Since 2010, the LTP team has coordinated a network of researchers and culture collections in order to improve the situation by (re)-sequencing the type strains of these “orphan” species. As a result, we can now report 351 16S rRNA gene sequences of type strains. Nevertheless, 201 species could not be sequenced because cultivable type strains were not available (121), the cultures had either been lost or were never deposited in the first place (66), or it was not possible due to other constraints (14). The International Code of Nomenclature of Bacteria provides a number of mechanisms to deal with the problem of missing type strains and we recommend that due consideration be given to the appropriate mechanisms in order to help solve some of these issues.
Voice identification parades can be unreliable, as earwitness responses are error-prone. In this paper we tested performance across serial and sequential procedures, and varied pre-parade ...instructions, with the aim of reducing errors. The participants heard a target voice and later attempted to identify it from a parade. In Experiment 1 they were either warned that the target may or may not be present (standard warning) or encouraged to consider responding "not present" because of the associated risk of a wrongful conviction (strong warning). Strong warnings prompted a conservative criterion shift, with participants less likely to make a positive identification regardless of whether the target was present. In contrast to previous findings, we found no statistically reliable difference in accuracy between serial and sequential parades. Experiment 2 ruled out a potential confound in Experiment 1. Taken together, our results suggest that adapting pre-parade instructions provides a simple way of reducing the risk of false identifications.
Unfamiliar voice identification is error-prone. Whilst the investigation of system variables may indicate ways of boosting earwitness performance, this is an under-researched area. Two experiments ...were conducted to investigate how methods of presenting voices during a parade affect accuracy and self-rated confidence. In each experiment participants listened to a target voice, and were later asked to identify that voice from a nine-person target present or target absent parade. In Experiment 1, accuracy did not vary across parades comprising 15 or 30 s sample durations. Overall, when the target was present, participants correctly identified the target voice with 39% accuracy. However, when the target was absent, participants correctly rejected the parade 6% of the time. There was no relationship between accuracy and confidence. In Experiment 2, performance with a serial procedure, in which participants responded after hearing all nine voices, was compared with a sequential procedure, in which participants made a decision after listening to each voice. Overall accuracy was higher with the sequential procedure. These results highlight the importance of system variable research in voice identification. Different methods of presenting voices have the potential to support higher levels of accuracy than the procedure currently recommended in England and Wales.
Context. It is generally agreed upon that stars form in open clusters (OCs) and stellar associations, but little is known about structures in the Galactic OC population; whether OCs and stellar ...associations are born isolated or if they prefer to form in groups, for example. Answering this question provides new insight into star and cluster formation, along with a better understanding of Galactic structures. Aims. In the past decade, studies of OC groupings have either been based solely on spatial criteria or have also included tangential velocities for identifications. In contrast to previous approaches, we assumed that real OC groupings occupy a well defined area in the sky and show similar velocity vectors. For the first time, we have used 6D phase-space information, including radial velocities from the RAdial Velocity Experiment (RAVE) and other catalogues, for the detection of OC groupings. We also checked the age spread of potential candidates to distinguish between genuine groupings and chance alignments. Methods. We explored the Catalogue of Open Cluster Data (COCD) and determined 6D phase-space information for 432 out of 650 listed OCs and compact associations. The group identification was performed using an adapted version of the Friends-of-Friends algorithm, as used in cosmology, with linking lengths of 100 pc and 10-20 km s super(-1). For the verification of the identified structures, we applied Monte Carlo simulations with randomised samples. Results. For the linking lengths 100 pc and 10 km s super(-1), we detected 19 groupings, including 14 pairs, 4 groups with 3-5 members, and 1 complex with 15 members. The Monte Carlo simulations revealed that, in particular, the complex is most likely genuine, whereas pairs are more likely chance alignments. A closer look at the age spread of the complex and the comparison between spatial distributions of young and old cluster populations suggested that OC groupings likely originated from a common molecular cloud.
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