Aphasia disrupts usual care: "I'm not mad, I'm not deaf" - the experiences of individuals with aphasia and family members in hospital.

Purpose: Communication difficulties are highly prevalent in the stroke population, with implications for patient experience, safety and outcomes. This study explores the experiences of people with aphasia and family members regarding healthcare communication in acute and subacute stroke settings.

Methods And Materials: A phenomenological approach was used to understand participants' experiences.

Effect of initial anesthetic technique on fetal cord blood gas pH for cesarean deliveries performed for the indication of fetal heart rate abnormalities.

Background: We hypothesized that parturients who had general anesthesia as the initial anesthetic technique for cesarean deliveries performed for fetal heart rate abnormalities would have a lower fetal cord blood gas pH compared to parturients who had regional anesthesia as the initial anesthetic technique.

Methods: We searched our electronic medical record for patients who had cesarean deliveries for the indication of fetal heart rate abnormalities from July 1, 2019, to June 30, 2021, at our hospital. An obstetrics resident and a maternal fetal medicine physician determined if the fetal heart tracing was category 2 or 3.

Understanding the cumulative socioenvironmental impacts of energy transition-induced extractivism in Mozambique: The role of mixed methods.

The global energy transition is very resource intense, and scholarship is rapidly increasing to show its impacts in various resource extraction frontiers in the global South. These emerging studies are clarifying the social and environmental impacts of extracting particular energy transition resources (ETRs). However, there is still limited attention on the cumulative socioenvironmental impacts of extracting multiple ETRs from the same region.

LGI3/2-ADAM23 interactions cluster Kv1 channels in myelinated axons to regulate refractory period.

Along myelinated axons, Shaker-type potassium channels (Kv1) accumulate at high density in the juxtaparanodal region, directly adjacent to the paranodal axon-glia junctions that flank the nodes of Ranvier. However, the mechanisms that control the clustering of Kv1 channels, as well as their function at this site, are still poorly understood. Here we demonstrate that axonal ADAM23 is essential for both the accumulation and stability of juxtaparanodal Kv1 complexes.

Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia.

Background: While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity.

Methods: We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial.

Biotic interactions drive ecosystem responses to exotic plant invaders.

Ecosystem process rates typically increase after plant invasion, but the extent to which this is driven by (i) changes in productivity, (ii) exotic species' traits, or (iii) novel (non-coevolved) biotic interactions has never been quantified. We created communities varying in exotic plant dominance, plant traits, soil biota, and invertebrate herbivores and measured indicators of carbon cycling. Interactions with soil biota and herbivores were the strongest drivers of exotic plant effects, particularly on measures of soil carbon turnover.

Aphasia disrupts usual care: the stroke team's perceptions of delivering healthcare to patients with aphasia.

Purpose: Communication disability, including aphasia, is prevalent in the stroke population and impacts service delivery. This study explored the experiences of the multidisciplinary stroke team in delivering healthcare to patients with aphasia.

Materials And Methods: A phenomenological approach was used to understand the experiences of delivering healthcare services in the presence of aphasia.

Measuring the interactions of people with dementia and their conversation partners: a preliminary adaption of the Kagan measures of support and participation in conversation.

Objective: While dementia can negatively affect communication, positive interactions can be facilitated by the conversation partners of people with dementia. There are few assessment tools designed to evaluate the support provided by the conversation partner and the resulting participation of the person with dementia. This study reports on an adaptation of the Measure of Support in Conversation (MSC) and Measure of Participation in Conversation (MPC) scales for use with people with dementia and their conversation partners (the MSC Dementia and MPC Dementia, respectively) and investigates the inter-and intra-rater reliability of these adapted measures.

Homozygous deletion in MYL9 expands the molecular basis of megacystis-microcolon-intestinal hypoperistalsis syndrome.

Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a severe disease characterized by functional obstruction in the urinary and gastrointestinal tract. The molecular basis of this condition started to be defined recently, and the genes related to the syndrome (ACTG2-heterozygous variant in sporadic cases; and MYH11 (myosin heavy chain 11), LMOD1 (leiomodin 1) and MYLK (myosin light chain (MLC) kinase)-autosomal recessive inheritance), encode proteins involved in the smooth muscle contraction, supporting a myopathic basis for the disease. In the present article, we described a family with two affected siblings with MMIHS born to consanguineous parents and the molecular investigation performed to define the genetic etiology.

Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study.

South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance.

Neuregulin 3 Knockout Mice Exhibit Behaviors Consistent with Psychotic Disorders.

Neuregulin 3 (NRG3) is a paralog of NRG1. Genetic studies in schizophrenia demonstrate that risk variants in NRG3 are associated with cognitive and psychotic symptom severity, and several intronic single nucleotide polymorphisms in NRG3 are associated with delusions in patients with schizophrenia. In order to gain insights into the biological function of the gene, we generated a novel Nrg3 knockout (KO) mouse model and tested for neurobehavioral phenotypes relevant to psychotic disorders.

The Production of Complement Clauses in Children With Language Impairment.

Purpose: The purpose of this research was to provide a comprehensive description of complement-clause production in children with language impairment. Complement clauses were examined with respect to types of complement structure produced, verb use, and both semantic and syntactic accuracy.

Method: A group of 17 children with language impairment (mean age = 6;10 [years; months]) was compared with a group of 17 younger children with typical language development (mean age = 4;6).

Linked circadian outputs control elongation growth and flowering in response to photoperiod and temperature.

Clock-regulated pathways coordinate the response of many developmental processes to changes in photoperiod and temperature. We model two of the best-understood clock output pathways in Arabidopsis, which control key regulators of flowering and elongation growth. In flowering, the model predicted regulatory links from the clock to cycling DOF factor 1 (CDF1) and flavin-binding, KELCH repeat, F-box 1 (FKF1) transcription.

An anadysplasia-like, spontaneously remitting spondylometaphyseal dysplasia secondary to lamin B receptor (LBR) gene mutations: further definition of the phenotypic heterogeneity of LBR-bone dysplasias.

We describe a boy who has an anadysplasia-like spondylometaphyseal dysplasia. By whole exome sequencing he was shown to have compound heterozygous mutations of LBR that codes for the lamin B receptor. He shares many similarities with a case previously described, but in whom the early natural history could not be established [Borovik et al.

The HY5-PIF regulatory module coordinates light and temperature control of photosynthetic gene transcription.

The ability to interpret daily and seasonal alterations in light and temperature signals is essential for plant survival. This is particularly important during seedling establishment when the phytochrome photoreceptors activate photosynthetic pigment production for photoautotrophic growth. Phytochromes accomplish this partly through the suppression of phytochrome interacting factors (PIFs), negative regulators of chlorophyll and carotenoid biosynthesis.

Strengthening pharmacovigilance in South Africa.

This report outlines findings and recommendations of a national pharmacovigilance workshop held in August 2012 in South Africa (SA). A survey of current pharmacovigilance activities, conducted in preparation for the meeting, identified multiple programmes collecting drug safety data in SA, with limited co-ordination at national level. The meeting resolved that existing pharmacovigilance programmes need to be strengthened and consolidated to ensure that important local safety issues are addressed, data can be pooled and compared and outputs shared more widely.

Novel licensure pathways for expeditious introduction of new tuberculosis vaccines: a discussion of the adaptive licensure concept.

The ultimate goal of vaccine development is licensure of a safe and efficacious product that has a well-defined manufacturing process resulting in a high quality product. In general, clinical development and regulatory approval occurs in a linear, sequential manner: Phase 1 - safety, immunogenicity; Phase 2 - immunogenicity, safety, dose ranging and preliminary efficacy; Phase 3 - definitive efficacy, safety, lot consistency; and, following regulatory approval, Phase 4 - post-marketing safety and effectiveness. For candidate TB vaccines, where correlates of protection are not yet identified, phase 2 and 3 efficacy of disease prevention trials are, by necessity, very large.

HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENES1 is required for circadian periodicity through the promotion of nucleo-cytoplasmic mRNA export in Arabidopsis.

Cold acclimation has been shown to be attenuated by the degradation of the INDUCER OF CBF EXPRESSION1 protein by the E3 ubiquitin ligase HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENES1 (HOS1). However, recent work has suggested that HOS1 may have a wider range of roles in plants than previously appreciated. Here, we show that hos1 mutants are affected in circadian clock function, exhibiting a long-period phenotype in a wide range of temperature and light environments.

Hydrolysis of ibuprofenoyl-CoA and other 2-APA-CoA esters by human acyl-CoA thioesterases-1 and -2 and their possible role in the chiral inversion of profens.

Ibuprofen and related 2-arylpropanoic acid (2-APA) drugs are often given as a racemic mixture and the R-enantiomers undergo activation in vivo by metabolic chiral inversion. The chiral inversion pathway consists of conversion of the drug to the coenzyme A ester (by an acyl-CoA synthetase) followed by chiral inversion by α-methylacyl-CoA racemase (AMACR; P504S). The enzymes responsible for hydrolysis of the product S-2-APA-CoA ester to the active S-2-APA drug have not been identified.

Sleep patterns during an antarctic field expedition.

Unlabelled: Extreme conditions in Antarctica pose a significant challenge to members of field parties, stationed military personnel, and civilian support personnel. One of the key issues noted in anecdotal evidence during expeditions is the presence of sleep disturbances, that can lead to a marked loss in the ability to cognitively respond to unusual or dangerous situations.

Method: A study was conducted using 14 volunteers who traveled to Antarctica and spent several days in a field camp in Windless Bight (Ross Sea Region).

Assessment of complement clauses: a comparison between elicitation tasks and language sample data.

The aim of this study was to determine whether data from specifically designed elicitation tasks and commonly-used language sampling techniques provided the same information about children's production of complement clauses. It was predicted that elicitation tasks would yield more examples of complement clauses and children would use a wider range of verbs to form complement clauses in elicitation tasks than in language samples. A group of 20 pre-school children aged between 3;11-5;3 years were investigated.

Arteriovenous fistula and pseudoaneurysm of the anterior spinal artery caused by an epidural needle in a 5-year-old patient.

Authors present the case of a 5-year-old patient with a spinal arteriovenous fistula (AVF) and pseudoaneurysm of the anterior spinal artery (ASA) caused by a traumatic epidural needle stick injury. A discussion and relevant review of the literature follow. The boy had a remote history of a liver transplant and required neuraxial blockade for an unrelated abdominal surgical procedure.

Designing an adaptive phase II/III trial to evaluate efficacy, safety and immune correlates of new TB vaccines in young adults and adolescents.

This article summarises the consensus arrived at a meeting of South African and international stakeholders on specific late phase clinical trial design issues integrating the investigation of immune correlates as an integral part of a phase III protocol for a preventative TB vaccine in an adolescent/adult population. The challenge ahead is to optimize the planning for phase 3 TB vaccine preventative trials, under resource constraints, given that there are no known correlates of protection to shorten and increase the efficiencies of efficacy trials. An adaptive, multi-arm, group sequentially designed trial protocol is proposed incorporating design features that address uncertainties arising from both advances in the field and dynamic study populations and disease states.