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Objective Cognitive impairment (CI) in systemic lupus erythematosus (SLE) negatively impacts health‐related quality of life leading to activity limitations. This qualitative study aimed to (1) explore the effect of SLE‐related CI on activities of daily living and life role participation and (2) describe factors influencing activity restriction and life role participation. Methods Semistructured, in‐depth interviews of lived experience of CI in SLE were conducted with 24 participants with SLE. Sociodemographic and clinical data, and objective and subjective cognitive function, were collected to characterize participants. A qualitative thematic content analysis was undertaken guided by a framework analytical approach. Results Participants reported problems in multiple cognitive domains, with multiple perceived causes. CI was felt to impact work, social, domestic, and family life, health, and independence. Five overarching themes were represented in the data: (1) characterization of SLE‐reported CI, (2) perceived cause of CI, (3) perceived impact of CI on activities of daily living and life role participation, (4) adaptations for managing CI, and (5) influence of CI adaptations on activities of daily living and life role participation. Conclusion This study provides a better understanding of the patient experience of CI in SLE, how it impacts their lives, and what coping strategies they employ. It highlights the long‐term challenges those with CI in SLE undergo and provides evidence for the urgent need to implement multidisciplinary treatment options. When managing CI, it may be beneficial to evaluate and understand available psychosocial support resources to help identify and reinforce relevant adaptations to improve health‐related quality of life.

Objective: To describe the financial capability (FC) and financial well-being (FWB) of adults living with acquired brain injury (ABI) from a lived experience perspective. Design: People living with ABI completed a 32-item and close others a 22-item anonymous survey using either online or print/mail-in options. Setting: Responses were collected from adults in the province of Manitoba (Canada) during August-October 2021. Participants: Respondents were adults (18+) living with ABI (n=38) or close others of ABI survivors (n=19). Adults living with ABI experienced traumatic brain injury (n=22; 58%), stroke (n=8; 21%), or other ABI mechanisms (n=8; 21%). Nineteen (50%) respondents with ABI were men, 17 (45%) were women, and 1 (2.5%) was nonbinary; 95% were more than 1-year post-ABI. Close others were spouses/partners, parents, other family, and paid caregivers. Three of the 19 close others self-reported as men and 16 as women. Interventions: n/a. Main Outcome Measure(s): n/a. Results: For key FC indicators, 13 (34%) people living with ABI felt their current knowledge and skills were insufficient, and 26 (70%) felt that ABI had affected their ability to make financial decisions or complete financial activities. Fourteen of the 19 close others have worried about the finance-related choices, skills, or behaviors of the person living with ABI, and 17 felt that ABI symptoms had affected the FC of the person living with ABI. For key FWB indicators, 22 (58%) adults living with ABI felt stressed or anxious about finances at least some of the time. Seventeen (45%) of the adults living with ABI reported having trouble making ends meet at least some of the time. Conclusions: Respondents reported FC limitations and FWB challenges for people living with ABI, which can be indicative of financial vulnerabilities and unmet needs. Future research should explore optimal ways to address these financial-related challenges after ABI.

BackgroundThe COVID-19 pandemic created new difficulties for people living with brain injury, their families, and caregivers while amplifying the challenges of community-based associations that support them. We aimed to understand the effects of the pandemic on clients who live with brain injury, as well as on the provision of community brain injury services/programs in Canada.MethodsOnline cross-sectional survey conducted in January 2022. Representatives of brain injury associations across Canada completed the 31 open- and closed-ended questions about meeting clients’ needs, addressing public health guidelines, and sustaining the association. Data were analyzed using descriptive statistics (close-ended questions) and qualitative content analysis (open-ended questions).ResultsOf the 45 key representatives from associations in Pacific/Western (40%), Central (56%), and Atlantic Canada (4%), the majority were paid executive directors (67%). Participants reported that the most frequent psychosocial challenges experienced by their clients during the pandemic were social isolation (98%), loneliness (96%), and anxiety (93%). To alleviate these challenges, associations implemented wellness checks and psychosocial support. Most respondents (91%) affirmed that clients faced multiple technological barriers, such as a lack of technological knowledge and financial resources for devices and/or internet. In the open-ended questions, twenty-nine (64%) associations reported providing clients with devices, technology training, and assistance. Regarding public health measures, thirty (67%) respondents reported that clients had challenges understanding and/or following public health guidelines. Forty-two associations (93%) provided tailored information to help clients understand and comply with public health measures. Although associations (67%) received pandemic-related funding from the Canadian government they still struggled with the association’s sustainability. Thirty-four (76%) lost funding or financial resources that prevented them from delivering programs or required the use of reserve funds to continue to do so. Only 56% reported receiving sufficient funding to address additional COVID-19-related expenses.ConclusionAlthough the pandemic added further challenges to the sustainability of brain injury associations across Canada, they quickly adapted services/programs to respond to the increasing and varied needs of clients, while complying with protective measures. To ensure community associations’ survival it is essential to aptly recognize the vital role played by these associations within the brain injury care continuum.

The COVID-19 pandemic has increased challenges for people living with brain injury and community associations to support this vulnerable population. This study aimed to gain an in-depth understanding of the challenges faced by brain injury survivors during the first year of the pandemic and how community brain injury associations adapted their services to respond to these needs. Findings from seven focus-group with 31 representatives of Canadian brain injury associations revealed 4 main themes: (1) Addressing evolving client needs; (2) Keeping clients safe; (3) Challenges and opportunities navigating the digital world; and (4) Sustaining brain injury associations in the face of uncertainties and disruptions. To comply with public health measures, associations reported pivoting their service delivery online, despite recognizing the difficulties this could create for many brain injury survivors in accessing and using technology. Our findings also highlight concrete directions for not-profit organizations providing instrumental help with activities, acting as a liaison and interpreter of public health guidelines, and in connecting with clients using technology while handling potential cognitive and technological challenges. Addressing these issues has the potential to protect people living with brain injury and community associations from external threats, like pandemics, in the future.

Abstract Background Cognitive impairment is a common and frequently under-recognized complication of chronic kidney disease (CKD). Although there is extensive literature on cognitive interventions that can ameliorate cognitive impairment or associated negative outcomes in the general literature, the breadth and characteristics of cognitive interventions that have been studied in people with CKD are currently unclear. The objective of this scoping review is to identify and describe the literature on cognitive interventions for adults with CKD, including end-stage kidney disease (ESKD). Methods A scoping review following Joanna Briggs Institute methodology will be conducted. With assistance from an information specialist, we will search 5 electronic databases (MEDLINE [OVID], EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and CINAHL Plus) using search terms that represent the target population (CKD) and concept (cognition), and conduct backward citation searching for additional literature. Eligible sources will be primary research studies (quantitative or qualitative) that investigate any intervention targeting cognition in adults (≥ 18 years) with CKD or ESKD, including those treated with dialysis. We will extract data about characteristics of interventions (e.g., type, underlying theory, design, location, and provider), populations (e.g., stage of CKD, age, sex, and type of cognitive impairment), and studies (e.g., authors, location, design, and reported findings). Article screening and data extraction will be performed by two to three reviewers. Data will be analyzed using descriptive statistics and narrative syntheses to characterize the literature on cognitive interventions for people with CKD. Discussion This study will provide a comprehensive overview of the cognitive interventions that have been studied for people with CKD. It will help identify research gaps within this population (e.g., types of interventions that have yet to be investigated; best practices in cognition research that have not been implemented) and inform the direction of future research in this field.

Due to their metabolic versatility in substrate utilization, acetogenic bacteria represent industrially significant production platforms for biotechnological applications such as syngas fermentation, microbial electrosynthesis or transformation of one-carbon substrates. However, acetogenic strains from the genera Terrisporobacter and Acetoanaerobium remained poorly investigated for biotechnological applications. We report the isolation and characterization of four acetogenic Terrisporobacter strains and one Acetoanaerobium strain. All Terrisporobacter isolates showed a characteristic growth pattern under a H2 + CO2 atmosphere. An initial heterotrophic growth phase was followed by a stationary growth phase, where continuous acetate production was indicative of H2-dependent acetogenesis. One of the novel Terrisporobacter isolates obtained from compost (strain COMT) additionally produced ethanol besides acetate in the stationary growth phase in H2-supplemented cultures. Genomic and physiological characterizations showed that strain COMT represented a novel Terrisporobacter species and the name Terrisporobacter vanillatitrophus is proposed (=DSM 116160T = CCOS 2104T). Phylogenomic analysis of the novel isolates and reference strains implied the reclassification of the T. petrolearius/T. hibernicus phylogenomic cluster to the species T. petrolearius and of the A. noterae/A. sticklandii phylogenomic cluster to the species A. sticklandii. Furthermore, we provide first insights into active prophages of acetogens from the genera Terrisporobacter and Acetoanaerobium.

Background: The diet of toddlers is often not in accordance with dietary recommendations, putting them at risk of poor health outcomes later in life. Parents can struggle to provide their toddler with a healthy diet and interventions are needed. Helping parents to form healthy feeding habits may facilitate healthy feeding behaviours. Therefore, the aim of this study was to establish the feasibility of a 6-week online intervention to build healthy feeding behaviours in parents of toddlers.Methods: Parents and primary caregivers of children aged 2–3 (N = 75) were recruited to complete a 6-week online intervention consisting of 6 modules targeting habit formation, planning, goal setting, self-efficacy, interpersonal influences and picky eating. Demographics and feeding behaviours were measured with self-report at baseline and follow-up. Intervention acceptability and feasibility ratings were also gathered post-intervention.Results: Most participants were recruited online, highly educated and in a relationship. After 6-weeks, 17 participants completed the follow-up questionnaire, 11 of whom indicated that they had completed the whole intervention. Improvements were found for some feeding behaviours. Generally, participants who completed the programme reported that they found it acceptable.Conclusions: This study provides insights for future intervention development. Firstly, an online healthy feeding intervention seems to be acceptable but may need to focus on fewer change techniques. Further, engagement should be improved by including target group members and compulsory reminders. The target behaviours seem to be relevant. Online recruitment seems to be preferable and reaches parents and primary caregivers nationwide.

Future sustainable energy production can be achieved using mass cultures of photoautotrophic microorganisms such as cyanobacteria, which are engineered to synthesize valuable products directly from CO2 and sunlight. For example, strains of the model organism Synechocystis sp. PCC 6803 have been generated to produce ethanol. Here, we performed a study to prove the hypothesis that carbon flux in the direction of pyruvate is one bottleneck to achieve high ethanol titers in cyanobacteria. Ethanol-producing strains of the cyanobacterium Synechocystis sp. PCC 6803 were generated that bear mutation in the gene pirC aiming to increase carbon flux towards pyruvate. The strains were cultivated at different nitrogen or carbon conditions and the ethanol production was analysed. Generally, a clear correlation between growth rate and ethanol production was found. The mutation of pirC, however, had only a positive impact on ethanol titers under nitrogen depletion. The increase in ethanol was accompanied by elevated pyruvate and lowered glycogen levels indicating that the absence of pirC indeed increased carbon partitioning towards lower glycolysis. Metabolome analysis revealed that this change in carbon flow had also a marked impact on the overall primary metabolism in Synechocystis sp. PCC 6803. Deletion of pirC improved ethanol production under specific conditions supporting the notion that a better understanding of regulatory mechanisms involved in cyanobacterial carbon partitioning is needed to engineer more productive cyanobacterial strains.

Nitric oxide (NO) is a bioactive gas produced by one of the three NO synthases: neuronal NOS (nNOS), inducible (iNOS), and endothelial NOS (eNOS). NO has a relevant modulatory role in muscle contraction; this takes place through two major signaling pathways: (i) activation of soluble guanylate cyclase and, thus, protein kinase G or (ii) nitrosylation of sulfur groups of cysteine. Although it has been suggested that nNOS-derived NO is the responsible isoform in muscle contraction, the roles of eNOS and iNOS and their signaling pathways have not yet been clarified. To elucidate the action of each pathway, we optimized the generation of myooids, an engineered skeletal muscle tissue based on the C2C12 cell line. In comparison with diaphragm strips from wild-type mice, 180 myooids were analyzed, which expressed all relevant excitation–contraction coupling proteins and both nNOS and iNOS isoforms. Along with the biochemical results, myooids treated with NO donor (SNAP) and unspecific NOS blocker (L-NAME) revealed a comparable NO modulatory effect on force production as was observed in the diaphragm strips. Under the effects of pharmacological tools, we analyzed the myooids in response to electrical stimulation of two possible signaling pathways and NO sources. The nNOS-derived NO exerted its negative effect on force production via the sGG-PKG pathway, while iNOS-derived NO increased the excitability in response to sub-threshold electrical stimulation. These results strengthen the hypotheses of previous reports on the mechanism of action of NO during force production, showed a novel function of iNOS-derived NO, and establish the myooid as a novel and robust alternative model for pathophysiological skeletal muscle research.

Abstract Human hepatitis delta virus (HDV) causes the most severe form of viral hepatitis. Approximately 15–25 million people are chronically infected with HDV. As a satellite virus of the human hepatitis B virus (HBV), HDV uses the HBV-encoded envelope proteins for egress from and de novo entry into hepatocytes. So far, in vitro production of HDV particles is restricted to co-transfection of cells with HDV/HBV encoding cDNAs. This approach has several limitations. In this study, we established HuH7-END cells, which continuously secrete infectious HDV virions. The cell line was generated through stepwise stable integration of the cDNA of the HDV antigenome, the genes for the HBV envelope proteins and the HBV/HDV receptor NTCP. We found that HuH7-END cells release infectious HDV particles up to 400 million copies/milliliter and support virus spread to co-cultured cells. Due to the expression of NTCP, HuH7-END cells are also susceptible to de novo HDV entry. Virus production is stable for >16 passages and can be scaled up for preparation of large HDV virus stocks. Finally, HuH7-END cells are suitable for screening of antiviral drugs targeting HDV replication. In summary, the HuH7-END cell line provides a novel tool to study HDV replication in vitro.

Importance: Occupational therapists often address financial occupations of clients with acquired functional impairments who experience challenges with financial capability (FC)., Objective: To explore the intervention literature aimed at improving FC in five diagnostic adult populations., Data Sources: MEDLINE, CINAHL, PsycInfo, EconLit, and EMBASE; researchers also completed backward and forward citation searching and contacted expert authors., Study Selection and Data Collection: Two independent reviewers completed article screening, selection, and extraction using a scoping review approach; a priori inclusion criteria were peer-reviewed articles, written in English, involving adults with one of five diagnostic conditions, describing any intervention to improve FC., Findings: Twenty-four articles met the inclusion criteria. Most articles were aimed at substance use or mental health populations (n = 20); fewer focused on brain injury (n = 2), multiple sclerosis (n = 1), or mixed-diagnosis (n = 1) populations. Only 4 were randomized controlled trials (RCTs). Interventions were heterogeneous and complex, including components of skills training (n = 21), individualized budgeting (n = 18), representative payeeship (n = 11), education (n = 10), structured goal setting (n = 7), savings building (n = 5), metacognitive strategies (n = 2), and assistive technology (n = 1)., Conclusions and Relevance: Despite growth in the area, the literature regarding FC intervention is limited, with few RCTs and many populations unrepresented. The literature for a systematic review of FC intervention efficacy for these populations is insufficient, particularly because included studies used varied components, limiting comparison. Further research is imperative to guide evidence-based practice. Plain-Language Summary: This study is an overview of literature about interventions to address the financial occupations of clients with acquired functional impairments. The findings give occupational therapy researchers and clinicians the information they need to begin analyzing, using, and building the evidence to support the use of interventions to improve clients' financial capability and well-being., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

Objective: This pilot study explored the experiences of brain injury survivors after a change in financial management (FM) independence., Method: Using a qualitative descriptive design, 6 participants with acquired brain injury were recruited from a community brain injury organization and participated in semistructured interviews. Data were analyzed using thematic analysis., Results: Three themes emerged from the interviews: (1) trajectory of FM change, involving family members as key change agents; (2) current FM situation, involving FM strategies such as automatic deposits and restricted budgets; and (3) the struggle for control, in which survivors desired control while also accepting supports for FM., Conclusion: This study identifies some of the challenges brain injury survivors face in managing their finances and the adjustment associated with a loss of FM independence. Occupational therapists should be aware of clients' experiences when supporting them through a change in independence., (Copyright © 2016 by the American Occupational Therapy Association, Inc.)