During lung fibrosis, the epithelium induces signaling to underlying mesenchyme to generate excess myofibroblasts and extracellular matrix; herein, we focus on signaling in the mesenchyme. Our ...studies indicate that platelet-derived growth factor receptor (PDGFR)-β
cells are the predominant source of myofibroblasts and Kruppel-like factor (KLF) 4 is upregulated in PDGFR-β
cells, inducing TGFβ pathway signaling and fibrosis. In fibrotic lung patches, KLF4 is down-regulated, suggesting KLF4 levels decrease as PDGFR-β
cells transition into myofibroblasts. In contrast to PDGFR-β
cells, KLF4 reduction in α-smooth muscle actin (SMA)
cells non-cell autonomously exacerbates lung fibrosis by inducing macrophage accumulation and pro-fibrotic effects of PDGFR-β
cells via a Forkhead box M1 to C-C chemokine ligand 2-receptor 2 pathway. Taken together, in the context of lung fibrosis, our results indicate that KLF4 plays opposing roles in PDGFR-β
cells and SMA
cells and highlight the importance of further studies of interactions between distinct mesenchymal cell types.
The role of serum response factor (Srf), a central mediator of actin dynamics and mechanical signaling, in cell identity regulation is debated to be either a stabilizer or a destabilizer. We ...investigated the role of Srf in cell fate stability using mouse pluripotent stem cells. Despite the fact that serum-containing cultures yield heterogeneous gene expression, deletion of Srf in mouse pluripotent stem cells leads to further exacerbated cell state heterogeneity. The exaggerated heterogeneity is detectible not only as increased lineage priming but also as the developmentally earlier 2C-like cell state. Thus, pluripotent cells explore more variety of cellular states in both directions of development surrounding naïve pluripotency, a behavior that is constrained by Srf. These results support that Srf functions as a cell state stabilizer, providing rationale for its functional modulation in cell fate intervention and engineering.
Female stress urinary incontinence (SUI) is common and has a profound impact on quality of life. Suburethral slings are the most common treatment for SUI in this population. These can be placed with ...synthetic mesh or autologous fascia. Mesh-related complications after midurethral sling procedures are documented in the literature but the risk of complications and reoperation is lower than the use of transvaginal mesh for pelvic organ prolapse repair. In this study, we sought to evaluate local practice patterns of management of female SUI with specific emphasis on mesh use.
A survey created by an expert panel was disseminated to respective provincial societies.
Sixty-eight percent of respondents offer midurethral slings in their practice but only 60.6% of these respondents would offer surgical removal of the sling if there were complications, such as mesh erosion or pain. The majority (39.4%) of respondents are performing transobturator slings as compared to retropubic midurethral slings (36.3%) and only 8.5% have removed the leg component associated with the transobturator sling in their practice. Furthermore, compared to most respondents offering midurethral slings (64.8%), only a minority of surgeons offer alternatives: 23.9% of respondents offer periurethral bulking agent injections, 15.5% offer pubovaginal slings, and 12.7% offer retropubic urethropexies.
Our study supports that surgeons should continue to review surgical risks and alternative treatment options as part of the surgical consent process. As such, surgeons should be able to offer a variety of surgical approaches to manage female SUI.
Efforts to promote full participation in parasport are vital not only for the potential physical and psychosocial benefits, but also as a means of enacting social justice. Until recently, there has ...been little empirical consideration of the experiential aspects that make participation satisfying or meaningful throughout the life-course. The purpose of this study was to explore the meanings that athletes with physical disabilities attribute to their participation in parasport over time.
Two-part life history interviews were conducted with 21 current or former athletes with a physical disability. Interviews were transcribed verbatim and subjected to a dialogical narrative analysis, which enabled an in-depth examination of the common stories told by athletes and the effects of these stories on their past, present, and future participation.
Five distinct narrative types were identified, representing differential developmental trajectories and meanings of participation in parasport. Athletes drew on existing narratives of disability (i.e., restitution, quest) and sport involvement (i.e., performance, discovery, relational) to frame these narrative types. The core of each narrative type was formed by the specific meaning or value associated with parasport participation (e.g., sense of purpose, social acceptance).
The resulting narratives offer a unique understanding of the developmental pathways of parasport athletes and what it means for these athletes to participate. The narratives are useful for informing strategies and programmes that optimize participation and enhance participation rates.
•Five distinct narratives of parasport participation are identified.•The narratives support and extend existing conceptualizations of participation.•Elements that contribute to quality participation are diverse, dynamic, and fluid over time.•Diverse meanings of participation lead to different ways of achieving quality in parasport.•Narratives that challenge or expand dominant discourse may increase quantity and quality of participation.
Arbour-Nicitopoulos KP, Martin Ginis KA, Latimer AE. Planning, leisure-time physical activity, and coping self-efficacy in persons with spinal cord injury: a randomized controlled trial.
To examine ...the effects of action and coping planning (ACP) on leisure-time physical activity (LTPA) and coping self-efficacy in exercise initiates living with spinal cord injury (SCI).
Ten-week, single-blind randomized controlled trial.
General community.
Adults (N=44) with SCI (mean age +/- SD, 49.70+/-12.71y) were randomly assigned to either an action planning only (APO; n=22) or an ACP (n=22) condition.
Participants in the APO condition formed action plans for LTPA at weeks 1 and 5, and self-monitored their LTPA behavior. Those in the ACP condition formed coping plans for managing self-identified activity barriers, in addition to forming action plans and self-monitoring.
Measures of intentions, coping self-efficacy, and behavior were assessed at weeks 1, 5, and 10.
Intention-to-treat analyses indicated that persons in the ACP condition reported significantly greater LTPA, scheduling, and general barriers self-efficacy at weeks 5 and 10, in comparison with those in the APO condition. Scheduling self-efficacy mediated the effects of the intervention on LTPA, accounting for 38% of the total effect of the intervention on week 5 LTPA.
These findings illustrate the effectiveness of supplementing action plans with coping plans for enhancing LTPA and coping self-efficacy beliefs among exercise initiates living with SCI.
This study investigated the impact of listening to music during exercise on perceived enjoyment, attitudes and intentions towards sprint interval training (SIT). Twenty men (24.8 ± 4.5 years) and ...women (20.1 ± 2.6 years) unfamiliar with SIT exercise completed two acute sessions of SIT, one with and one without music. Perceived enjoyment, attitudes and intentions towards SIT were measured post-exercise for each condition. Attitudes and intentions to engage in SIT were also measured at baseline and follow-up. Post-exercise attitudes mediated the effects of enjoyment on intentions in the music condition (95% confidence interval CI: 0.01, 0.07, κ
2
= 0.36) and in the no music condition (95% CI: 0.01, 0.08, κ
2
= 0.37). Attitudes towards SIT were significantly more positive following the music than no music condition (P = 0.004), while intentions towards SIT were not (P = 0.29). Further, attitudes and intentions towards SIT did not change from baseline to follow-up (Ps > 0.05). These findings revealed that participants had relatively positive attitudes and intentions towards SIT, which did not become more negative despite experiencing intense SIT protocols. This study highlights the importance of acute affective responses to SIT exercise for influencing one's attitudes and intentions towards participating in SIT exercise. Such factors could ultimately play a key role in determining whether an individual engages in SIT exercise in the long term.
To use structural equation modeling to test research- and theory-informed models of potential predictors and outcomes of subjective experiences of employment and mobility participation in a national ...sample of people with physical disabilities.
Cross-sectional survey.
Canada.
English or French-speaking adults with a physical impairment affecting mobility and restricting activities or participation, and who participated in employment (n=457) or mobility (n=711) life domains.
N/A.
Participants completed standardized measures of perceived health, and employment-specific and/or mobility-specific measures of perceived abilities, social support, accessibility and policies (predictor variables); the Measure of Experiential Aspects of Participation (MeEAP) in employment and/or mobility; and standardized measures of emotional well-being, social well-being and life satisfaction (outcome variables).
Analyses using structural equation modeling showed that in both employment and mobility domains, perceived health, abilities, social support, and accessibility were positively related to experiential aspects of participation. Participation experiences were positively related to social well-being, emotional well-being, and life satisfaction.
Results support and extend current theorizing on participation experiences among adults with physical disabilities. Intrapersonal and environmental factors may play a role in optimizing participation experiences in employment and mobility which, in turn, may lead to better well-being and life satisfaction. These results emphasize the importance of conceptualizing participation from an experiential perspective and provide a basis for advancing theory and practice to understand and improve the participation experiences and well-being of adults living with physical disabilities.
ObjectiveYoung adulthood is an important transitional life phase where careers are established. Young adults with chronic disabling health conditions are underrepresented in the labour market. Our ...study aims to examine the effectiveness of work-focused interventions that support the labour market transition of young adults with chronic disabling health conditions; and to examine whether the effectiveness of work-focused interventions differ across work transition phase (eg, preparation, entry and sustaining work, employment advancement) and disability type.MethodsA systematic review of articles published between January 1990 and July 2018 was conducted. Medline, EMBASE and PsycInfo were searched, and titles/abstracts and full texts of articles were reviewed for eligibility. Relevant articles were appraised for methodological quality. A best evidence synthesis was applied to medium-quality/high-quality studies to develop recommendations.Results5816 articles were identified; 10 articles were relevant and of moderate–high methodological quality. Six intervention categories were identified which focused on young adults with mental health or intellectual/learning disabilities (n=3) and addressed employment preparation (n=10) and/or work entry (n=9). No interventions addressed at-work issues or career advancement. Strong evidence existed for tailored supported employment (SE) interventions having a positive impact on preparation and entry into competitive employment. Also, moderate evidence existed for the positive impact of SE on preparation and entry into competitive employment for young adults with mental health conditions.ConclusionsTailored SE is recommended to foster preparation and entry into the labour market. Evidence-based interventions are needed to facilitate sustained work and career advancement of young adults living with different disabling health conditions.
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