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Abstract Background Native Hawaiian and Pacific Islanders (NHPI) are disproportionately burdened by pregnancy-related deaths in the United States and have the lowest engagement in prenatal care compared to all other US racial groups. Aside from access barriers, studies suggest that NHPI face challenges with patient-clinician communication, perceived discrimination, and cultural conflicts within healthcare settings. This paper describes the cultural adaptation of the 14-item Mothers On Respect index for NHPI, originally developed by Vedam et al. (2017) for diverse communities in British Columbia, Canada, and reports the findings of the preliminary psychometric assessment of the adapted measure. Methods Data from 26 interviews with NHPI women, expert, and cognitive interviews were conducted to inform the adaptation. An online survey was administered to a sample of 90 NHPI women to assess construct validity, convergent validity, and internal reliability of the adapted measure using exploratory and confirmatory factor analyses. Results The adaptation resulted in substantial changes to the original measure, mainly by the addition of items related to ‘feeling cared for by and connected to the provider’ and ‘perceived threats hindering communication.’ The psychometric analyses identified a three-factor structure for the culturally adapted index and confirmatory factor analyses were employed to refine the measure. The result was a 25-item index with acceptable goodness of fit indices, high internal reliability (Cronbach’s alpha of 0.96, 95% CI = .94-.97) and convergent validity with a related scale. Overall, participants in this sample indicated high levels of respectful care; however, people who received

Abstract Background Urgency-type urinary incontinence affects one in four older community-dwelling women and overlaps with other common aging-associated health syndromes such as cognitive impairment, physical mobility impairment, and depression. Observational studies have raised concern about potentially higher rates of delirium and dementia in older adults taking anticholinergic bladder medications, but few prospective data are available to evaluate the effects of these and other pharmacologic treatments for urgency incontinence on cognition and other multisystem functional domains important to older women. Methods The TRIUMPH study is a randomized, double-blinded, 3-arm, parallel-group trial comparing the multisystem effects of anticholinergic versus beta-3-adrenergic agonist bladder therapy and versus no active bladder anti-spasmodic pharmacotherapy in older women with urgency incontinence. Women aged 60 years and older (target N = 270) who have chronic urgency-predominant urinary incontinence and either normal or mildly impaired cognition at baseline are recruited from the community by investigators based in northern California, USA. Participants are randomized in equal ratios to take identically encapsulated oral anticholinergic bladder therapy (in the form of tolterodine 2 mg extended release [ER]), oral beta-3 adrenergic agonist bladder therapy (mirabegron 25 mg ER), or placebo daily for 24 weeks, with the option of participant-directed dose titration (to tolterodine 4 mg ER, mirabegron 50 mg ER, or matching placebo daily). Participants also receive patient-oriented information and instructions about practicing first-line behavioral management strategies for incontinence. The primary outcome is change in composite cognitive function over 24 weeks assessed by a comprehensive battery of cognitive tests, with a secondary exploration of the persistence of change at 36 weeks. Secondary outcomes include changes over 24 and 36 weeks in domain-specific cognitive function; frequency, severity, and impact of urgency-associated urinary symptoms; physical function and balance; sleep quality and daytime sleepiness; psychological function; and bowel function. Discussion The TRIUMPH trial addresses the need for rigorous evidence to guide counseling and decision-making for older women who are weighing the potential multisystem benefits and risks of pharmacologic treatments for urgency incontinence in order to preserve their day-to-day functioning, quality of life, and independence in older age. Trial registration ClinicalTrials.gov NCT05362292. Registered on May 5, 2022.

ImportancePregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy may also have long-term ramifications for exposed offspring, and it is critical to evaluate the health outcomes of exposed children. The National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC aims to evaluate the long-term sequelae of SARS-CoV-2 infection in various populations. RECOVER-Pregnancy was designed specifically to address long-term outcomes in maternal-child dyads.MethodsRECOVER-Pregnancy cohort is a combined prospective and retrospective cohort that proposes to enroll 2,300 individuals with a pregnancy during the COVID-19 pandemic and their offspring exposed and unexposed in utero, including single and multiple gestations. Enrollment will occur both in person at 27 sites through the Eunice Kennedy Shriver National Institutes of Health Maternal-Fetal Medicine Units Network and remotely through national recruitment by the study team at the University of California San Francisco (UCSF). Adults with and without SARS-CoV-2 infection during pregnancy are eligible for enrollment in the pregnancy cohort and will follow the protocol for RECOVER-Adult including validated screening tools, laboratory analyses and symptom questionnaires followed by more in-depth phenotyping of PASC on a subset of the overall cohort. Offspring exposed and unexposed in utero to SARS-CoV-2 maternal infection will undergo screening tests for neurodevelopment and other health outcomes at 12, 18, 24, 36 and 48 months of age. Blood specimens will be collected at 24 months of age for SARS-CoV-2 antibody testing, storage and anticipated later analyses proposed by RECOVER and other investigators.DiscussionRECOVER-Pregnancy will address whether having SARS-CoV-2 during pregnancy modifies the risk factors, prevalence, and phenotype of PASC. The pregnancy cohort will also establish whether there are increased risks of adverse long-term outcomes among children exposed in utero.Clinical trials.gov identifierClinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT05172011.

Microencapsulation is an advanced technique used to improve the viability of probiotics and minimize sensitivity during processing, storage, and in the gastrointestinal environment. Two dietary treatments including a control and an encapsulated probiotic, Bacillus subtilis E20 (EP), were used to evaluate the efficacy in improving the intestinal microbiome of white shrimp, Penaeus vannamei, after a 60-feeding trial. The 16S rDNA next-generation sequencing (NGS) analysis indicated that shrimp fed the EP diet generated higher amplicon reads than shrimp fed the control diet. No significant differences were observed in the α-diversity index of the intestinal microbiota of shrimp that were fed the control and EP diet. At the phylum level, Proteobacteria was relatively abundant in the microbiota of shrimp fed both the control and EP diet. The treatment with EP increased the expression of Tenericutes, Bacteroidetes, and Firmicutes, more than the control. The PC analysis revealed that the EP diet altered the bacterial profile in shrimp’s intestines into forming different clusters. Unique genera such as Luteolibacter, Simkaniaceae, Haemophilus, Pirellulaceae, Filomicrobium, Sphingomonas, and Erysipelotrichaceae UCG-003 along with well-known probiotic genera Bacillus and Lactobacillus were found in the intestine of shrimp fed the EP diet. The PCA eigenvector plots indicated a higher abundance of Bacillus in shrimp fed with EP diet, but a higher abundance of Vibrio in shrimp fed with control diet. These results suggest that encapsulated B. subtilis E20 can be beneficial to shrimp microbiota.

The Democratic Republic of the Congo (DRC) has a high measles incidence despite elimination efforts and has yet to introduce rubella vaccine. We evaluated the performance of a prototype rapid digital microfluidics powered (DMF) enzyme-linked immunoassay (ELISA) assessing measles and rubella infection, by testing for immunoglobulin M (IgM), and immunity from natural infection or vaccine, by testing immunoglobulin G (IgG), in outbreak settings. Field evaluations were conducted during September 2017, in Kinshasa province, DRC. Blood specimens were collected during an outbreak investigation of suspected measles cases and tested for measles and rubella IgM and IgG using the DMF-ELISA in the field. Simultaneously, a household serosurvey for measles and rubella IgG was conducted in a recently confirmed measles outbreak area. DMF-ELISA results were compared with reference ELISA results tested at DRC's National Public Health Laboratory and the US Centers for Disease Control and Prevention. Of 157 suspected measles cases, rubella IgM was detected in 54% while measles IgM was detected in 13%. Measles IgG-positive cases were higher among vaccinated persons (87%) than unvaccinated persons (72%). In the recent measles outbreak area, measles IgG seroprevalence was 93% overall, while rubella seroprevalence was lower for children (77%) than women (98%). Compared with reference ELISA, DMF-ELISA sensitivity and specificity were 82% and 78% for measles IgG; 88% and 89% for measles IgM; 85% and 85% for rubella IgG; and 81% and 83% for rubella IgM, respectively. Rubella infection was detected in more than half of persons meeting the suspected measles case definition during a presumed measles outbreak, suggesting substantial unrecognized rubella incidence, and highlighting the need for rubella vaccine introduction into the national schedule. The performance of the DMF-ELISA suggested that this technology can be used to develop rapid diagnostic tests for measles and rubella.

AbstractIntroduction:There are few longitudinal studies about South Asians (SAs) and little information about recruitment and retention approaches for this ethnic group.Methods:We followed 906 SAs enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort for 5 years. Surviving participants were invited for a second clinical exam from 2015 to 2018. A new wave of participants was recruited during 2017–2018. We assessed the yields from different methods of recruitment and retention.Results:A total of 759 (83%) completed the second clinical exam, and 258 new participants were enrolled. Providing a nearby community hospital location for the study exam, offering cab/shared ride reimbursement, and conducting home visits were the most effective methods for enhancing retention. New participant recruitment targeted women and individuals with lower socioeconomic status, and we found that participant referrals and active community engagement were most effective. Mailing invitational letters to those identified by electronic health records had very low yield.Conclusion:Recruitment and retention strategies that address transportation barriers and increase community engagement will help increase the representation of SAs in health research.

In Taiwan, the mushroom Antrodia camphorata (AC) is used for medicinal purposes, including cancer prevention and treatment. This study aimed to investigate the effect of AC-supplemented diets on the innate immunity and disease resistance of the orange-spotted grouper Epinephelus coioides against two bacterial infections—Vibrio alginolyticus and Streptococcus iniae. Orange-spotted groupers were fed AC-supplemented diets at 0 (control), 1.5, 3.0, 4.5, and 6.0 g kg−1 for 28 days and examined for innate immune responses and survival rates against V. alginolyticus and S. iniae. The results showed that the innate cellular and humoral immune parameters, including respiratory burst, phagocytic activity, and lysozyme activity of leukocytes, along with serum alternative complement activity (ACH50) and superoxide dismutase activity, as well as interleukin (IL)-4 and IL-6, were all significantly increased in groupers fed AC-supplemented diets. Groupers fed diets containing AC at doses higher than 3.0 g kg−1 had better survival rates than the control group 3–18 days after V. alginolyticus or S. iniae challenge. The enhanced disease resistance may be attributable to AC-induced innate immunity, suggesting that utilizing AC as a dietary supplement at 3.0 g kg−1 may enhance the disease resistance of orange-spotted groupers against Vibrio or Streptococcus infection.

The essay proposes to study a recurring theme of love and loss in Edna O’Brien’s love stories in which women in a state of abjection become obsessive and hysterical in pursuit of a love which is ultimately unattainable within the sexually colonised cultural environment in which the stories are set. The study analyses the factors underlying the apparent emotional desolation of the heroines in five stories by Edna O’Brien – “The Love Object” (1967), “Paradise” (1968), “Number 10” (1976), “Mrs. Reinhardt” (1978) and “The Doll” (1979). Women’s despair in these stories is manifested symptomatically through hysterical responses such as vomiting, insomnia, or sleepwalking and the ultimately self-destructive consequences of these symptoms. O’Brien tends to intertwine religious symbolism and metaphors with issues of sensuality and sexuality which have traditionally been taboo within a conservative traditional Irish context, in the process creating dark and twisted tales appearing to parody the biblical “paradise lost”. O’Brien’s heroines are often tragically attracted to a doomed love or gain a kind of gratification from the obsessive reliving of their personal afflictions. Rarely presenting any rosy fairy-tale prospect for women in her love stories as outcome of romantic encounters, Edna O’Brien seeks to demonstrate how women’s ongoing struggle and difficulties are manifested through physical neurosis and unrest within a culture in which women are colonised.

(1) Background: There are persistent racial/ethnic disparities in cesarean delivery in the United States (U.S.), yet the causes remain unknown. One factor could be provider bias. We examined medical indications for cesarean delivery that involve a greater degree of physician discretion (more subjective) versus medical indications that involve less physician discretion (more objective) to better understand factors contributing to the higher rate among Micronesian, one of the most recent migrant groups in the state, compared to White women in Hawai‘i. (2) Methods: A retrospective chart review was conducted to collect data on 620 cesarean deliveries (N = 296 White and N = 324 Micronesian) at the state’s largest maternity hospital. Multivariate regression models were used to examine associations between maternal and obstetric characteristics and (1) subjective indication defined as non-reassuring fetal heart tracing (NRFHT) and arrest of labor disorders, and (2) objective indication defined as all other indications (e.g., malpresentation). (3) Results: We found that Micronesian women had significantly higher odds of cesarean delivery due to a subjective indication compared to White women (aOR: 4.17; CI: 2.52-6.88; P < 0.001; N = 619) after adjusting for multiple covariates. (4) Conclusion: These findings suggest unmeasured factors, possibly provider bias, may influence cesarean delivery recommendations for Micronesian women in Hawai‘i.

Understanding memory formation, storage and retrieval requires knowledge of the underlying neuronal circuits. In Drosophila, the mushroom body (MB) is the major site of associative learning. We reconstructed the morphologies and synaptic connections of all 983 neurons within the three functional units, or compartments, that compose the adult MB’s α lobe, using a dataset of isotropic 8 nm voxels collected by focused ion-beam milling scanning electron microscopy. We found that Kenyon cells (KCs), whose sparse activity encodes sensory information, each make multiple en passant synapses to MB output neurons (MBONs) in each compartment. Some MBONs have inputs from all KCs, while others differentially sample sensory modalities. Only 6% of KC>MBON synapses receive a direct synapse from a dopaminergic neuron (DAN). We identified two unanticipated classes of synapses, KC>DAN and DAN>MBON. DAN activation produces a slow depolarization of the MBON in these DAN>MBON synapses and can weaken memory recall.

This essay examines the issue of a dual nature of mother and mother-daughter relationship in Edna O’Brien’s “Cords” (1968), “A Rose in the Heart” (1978) and “Sister Imelda” (1981). O’Brien’s mother-daughter scenario uncovers a distressing picture of a dilemma between mother and daughter concerning intimacy and separation or oneness and individuation. The “phantomic” presence of a mother/maternal figure in three stories serves as, paradoxically, a source of both empowerment and disempowerment resulting from women’s role of subservience under patriarchy. As identified by Heather Ingman or Helen Thompson, an approach to evaluating women’s psychological developmental process may be useful in this respect to illuminate such problematic mother-daughter complex in a motif presented with O’Brien’s typical negative narrative of domestic romance. This familiar yet alien, the Freudian uncanny, metaphoric mother appears powerless yet monstrous to the daughter who has attempted every effort to bury alive the ghosts in the past memories intertwined with this mother in her struggle towards individuation. The dual conflicting image of a loving and devouring mother is perhaps associated with an inherent culture of women’s abjection and individuation under patriarchy in western society.

Resveratrol (RSV) is a natural polyphenol with anti-diabetic effects and has been reported to ameliorate diabetes-induced metabolic disorders through regulating activities of the mTOR signaling pathway. To delineate the effects of RSV treatment on the mTOR signaling pathway, hyperglycemic HepG2 cells were used for the following experiments. Cellular glucose uptake assays showed that high-glucose levels in the culture medium decelerate the glucose uptake of cultured cells. Co-immunoprecipitation showed that high-glucose culture promotes the interaction between mTOR and Rheb-GTP, which is the active form of Rheb. RSV treatment of the cells suppressed this interaction and accelerated the glucose uptake. Western blotting revealed that RSV down-regulated members of the mTOR signaling pathway, namely SREBP1, p70, and S6. Additionally, RSV ameliorated the metabolic disorders, including the decreased levels of AMPK, glycogen synthase, and glucose-6-phosphatase, in hyperglycemic HepG2 cells. These results indicate that RSV inhibits the Rheb/mTOR interaction and ameliorates metabolic disorders associated with high-glucose levels. [ABSTRACT FROM AUTHOR]

Accent is known to cause comprehension difficulty, but empirical interpreting studies on its specific impact have been sporadic. According to Mazzetti (1999), an accent is composed of deviated phonemics and prosody, both discussed extensively in the TESL discipline. The current study seeks to examine, in the interpreting setting, the applicability of Anderson-Hsieh, Johnson and Koehler’s (1992) finding that deviated prosody hinders comprehension more than problematic phonemics and syllable structure do. Thirty-seven graduate-level interpreting majors, assigned randomly to four groups, rendered four versions of a text read by the same speaker and then filled out a questionnaire while playing back their own renditions. Renditions were later rated for accuracy by two freelance interpreters, whereas the questionnaires analyzed qualitatively. Results of analyses indicated that 1) both phonemics and prosody deteriorated comprehension, but prosody had a greater impact; 2) deviated North American English post-vowel /r/, intonation and rhythm were comprehension problem triggers. The finding may prove useful to interpreting trainers, trainees and professionals by contributing to their knowledge of accent.