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People relate to other people [empathetically]; not to simplified types [stereotypes] or segments ... [This work] covers issues from interaction design within IT through issues surrounding product design, communication, and marketing.-- Project developers need to understand how users approach their product from the product's infancy. Developers should be able the user via vivid depictions [\"scenarios\"], as if they -- with their different attitudes, desires, and habits -- were already using the product. [Includes] contributions from professionals from Australia, Brazil, [etc.] presenting real-world examples of the persona method.-- Back cover.

Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract infections, and that may impact the quality of life for urinary catheter users. Examples of such parameters include, urine flowrate, occurrence of flow-stops, and residual urine left in the bladder after flow-stop. Reliable in-vitro and/or ex-vivo laboratory models represent a strong asset to assess the performance of urinary catheters, preceding and guiding in-vivo animal studies and/or human clinical studies. Existing laboratory models are generally simplified, covering only portions of the catheterization process, or poorly reflect clinical procedures. In this work, we developed an ex-vivo porcine lower urinary tract model that better reflects the catheterization procedure in humans and allows to investigate the performance of standard of care catheters. The performance of three standard of care catheters was investigated in the developed model showing significant differences in terms of flowrate. No differences were detected in terms of residual volume in the bladder at first flow-stop also when tuning the abdominal pressure to mimic a sitting down and standing up position. A newly discovered phenomenon named hammering was detected and measured. Lastly, mucosal suction was observed and measured in all standard of care catheters, raising the concern for microtrauma during catheterization and a need for new and improved urinary catheter designs. Results obtained with the ex-vivo model were compared to in-vivo studies, highlighting similar concerns.

Improved Pregnancy Outcome in Type 1 Diabetic Women With Microalbuminuria or Diabetic Nephropathy Effect of intensified antihypertensive therapy? Lene Ringholm Nielsen , MD, PHD 1 2 , Peter Damm , MD, DMSC 1 3 and Elisabeth R. Mathiesen , MD, DMSC 1 2 1 Center for Pregnant Women with Diabetes, Rigshospitalet, Faculty of Health Sciences, Copenhagen, Denmark 2 Department of Endocrinology, Rigshospitalet, Faculty of Health Sciences, Copenhagen, Denmark 3 Department of Obstetrics, Rigshospitalet, Faculty of Health Sciences, Copenhagen, Denmark Corresponding author: Lene Ringholm Nielsen, enel{at}dadlnet.dk Abstract OBJECTIVE —To describe pregnancy outcome in type 1 diabetic women with normoalbuminuria, microalbuminuria, or diabetic nephropathy after implementation of an intensified antihypertensive therapeutic strategy. RESEARCH DESIGN AND METHODS —Prospective study of 117 pregnant women with type 1 diabetes. Antihypertensive therapy, mainly methyldopa, was given to obtain blood pressure <135/85 mmHg and urinary albumin excretion <300 mg/24 h. Blood pressure and A1C were recorded during pregnancy. The pregnancy outcome was compared with recently published studies of pregnant women with microalbuminuria or diabetic nephropathy. RESULTS —Antihypertensive therapy was given in 14 of 100 women with normoalbuminuria, 5 of 10 women with microalbuminuria, and all 7 women with diabetic nephropathy. Mean systolic blood pressure during pregnancy was 120 mmHg (range 101–147), 122 mmHg (116–135), and 135 mmHg (111–145) in women with normoalbuminuria, microalbuminuria, and diabetic nephropathy, respectively ( P = 0.0095). No differences in mean diastolic blood pressure or A1C were detected between the groups. No women with microalbuminuria developed preeclampsia. The frequency of preterm delivery was 20% in women with normoalbuminuria and microalbuminuria in contrast to 71% in women with diabetic nephropathy ( P < 0.01) where the median gestational age was 258 days (220–260). Compared with previous studies using less stringent antihypertensive therapeutic strategy and less strict metabolic control, gestational age was longer and birth weight was larger in our study. CONCLUSIONS —With intensified antihypertensive therapy and strict metabolic control, comparable pregnancy outcome was seen in type 1 diabetic women with microalbuminuria and normoalbuminuria. Although less severe than in previous studies, diabetic nephropathy was associated with more adverse pregnancy outcome. Footnotes Published ahead of print at http://care.diabetesjournals.org on 22 October 2008. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. Accepted October 10, 2008. Received August 19, 2008. DIABETES CARE

Scalesia (Asteraceae) is the largest endemic plant genus of the Galápagos archipelago and an example of adaptive radiation. While Scalesia species are highly varied in habit and morphology, most remarkable is their variety of leaf shapes, especially in the differential presence of leaf lobing/serration, a derived trait that evolved multiple times as a likely adaptation to the islands’ hot and dry equatorial climate. Using population-level genomic data from 396 individuals representing all 15 recognized Scalesia species, we characterize this young radiation (around 1 million years ago), and reveal that their substantial morphological divergence and ecological specialization are primarily based on shared genetic variation. To further elucidate the repeated adaptive evolution of leaf lobing in Scalesia , we integrate genomic and leaf morphometric data, with transcriptomes from different developmental stages, and conclude that leaf lobing evolved through diversifying selection. Natural selection occurs independently on different regulators in the pathway controlling development of adaxial-abaxial leaf polarity, highlighting the importance of the founder populations’ high genetic diversity maintained via allopolyploidy. Finally, our findings have implications for the conservation of Scalesia ’s threatened biodiversity, as unexpectedly high intra-specific genetic structure and long-term isolation among populations indicate widespread nascent speciation. The Scalesia plant radiation displays striking leaf-shape variation within Galápagos microclimates. Genome-wide analyses shows that lobed leaves evolved repeatedly through diversifying selection on diverse developmental regulators.

ObjectiveAtherosclerotic cardiovascular disease (ASCVD) is the main cause of death globally, but is by and large a preventable disease. We wished to identify, categorise and map adherence measurements of preventative treatment strategies in patients with ASCVD.Design and data sourcesWe conducted a scoping review according to the Joanna Briggs Institue (JBI) methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search was performed in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and EMBASE (Elsevier Biomedical Research database). The search was conducted in May 2023 and updated in November 2024.Eligibility criteriaObservational studies pertaining to major types of ASCVD and related preventive treatment with reported adherence measures in adults over the age of 18 were included in this review.Data extraction and synthesisTitle and abstract and subsequent full-text review were performed by two independent reviewers in duplicate. We presented data from the included 108 studies and synthesised the results in an overview of the most commonly used adherence measurements according to ASCVD category.ResultsA total of 108 records met the inclusion criteria. ASCVD populations included ranged in age from 40 to 91 years, with a male predominance (85%). Medication adherence was mostly reported by the proportion of patients taking their medication (15 studies, 14%) or the proportion of days covered (12 studies, 11%). Among the 108 included studies, 67 (62%) reported on medication adherence, 65 (60%) on smoking cessation, 39 (36%) on low-density lipoprotein cholesterol guideline adherence, 39 (36%) on exercise, 17 (16%) on diet and 11 (10%) on alcohol abstinence. Unspecified patient-reported outcome measures (PROMs) were the most used method for assessing medication adherence, reported in 15 studies (22%).ConclusionMedication adherence was the most frequently assessed domain in secondary prevention of ASCVD, with unspecified PROMs being the most applied measurement approach. Lack of a gold standard combined with inconsistent adherence measures across studies of ASCVD continues to pose a significant challenge for evaluating treatment quality.

We report a case of Cryptosporidium sp. OTUi identified in a tourist from Denmark who recently traveled to Indonesia. Previous detections include a traveler from Australia returning from Bali, a bat from the Philippines, and a patient from Australia. On the basis of those findings, we believe zoonotic transmission is plausible.

Objective The endophytic mycobiome is present in all studied plant compartments, including fruits and seeds. Here, we studied the mycobiome of seed wings as they are transferred with seeds in common ash and tested whether the mycobiome differs among trees. To achieve this, we used ITS1-based amplicon sequencing and two genotypes of F. excelsior as a model to compare the mycobiome of mother trees and their wings. Results We compared the mycobiome of 57 seed wings to the seed stalks (57) collected from two genotypes of F. excelsior using three ramets of each genotype. Alpha diversity indices (ACE, Fisher and Observed OTUs) suggested a higher richness of the mycobiome associated with the seed wing than the seed stalk within each genotype. However, there were neither significant differences in Shannon diversity between the mycobiomes from the two tissue types nor the two genotypes. PERMANOVA revealed significant differences in the mycobiome composition between tissue types ( P  < 0.001). It also showed a significant difference between seed wings ( P  = 0.04), but not between seed stalks of the two genotypes. Our results suggest that Fraxinus excelsior mother trees disperse different sets of mycobiomes with their seed wings, which may be important for germination and seedling establishment—especially in the light of ash dieback.

The repeated, rapid and often pronounced patterns of evolutionary divergence observed in insular plants, or the ‘plant island syndrome’, include changes in leaf phenotypes, growth, as well as the acquisition of a perennial lifestyle. Here, we sequence and describe the genome of the critically endangered, Galápagos-endemic species Scalesia atractyloides Arnot., obtaining a chromosome-resolved, 3.2-Gbp assembly containing 43,093 candidate gene models. Using a combination of fossil transposable elements, k -mer spectra analyses and orthologue assignment, we identify the two ancestral genomes, and date their divergence and the polyploidization event, concluding that the ancestor of all extant Scalesia species was an allotetraploid. There are a comparable number of genes and transposable elements across the two subgenomes, and while their synteny has been mostly conserved, we find multiple inversions that may have facilitated adaptation. We identify clear signatures of selection across genes associated with vascular development, growth, adaptation to salinity and flowering time, thus finding compelling evidence for a genomic basis of the island syndrome in one of Darwin’s giant daisies. Many island plant species share a syndrome of characteristic phenotype and life history. Cerca et al. find the genomic basis of the plant island syndrome in one of Darwin’s giant daisies, while separating ancestral genomes in a chromosome-resolved polyploid assembly.

PURPOSE: To explore whether patients with multiple myeloma changed their construct of health-related quality of life during treatment. PARTICIPANTS & SETTING: 14 participants were selected from 10 hematology-oncology departments in Denmark. METHODOLOGIC APPROACH: This interview study used a prospective, longitudinal, exploratory design. Semistructured interviews were conducted while participants were undergoing active treatment for multiple myeloma and six months after the baseline interview. Interviews were analyzed using systematic text condensation. FINDINGS: The overall theme at baseline was insecurity, and the overall theme at six months was coping. The following subthemes were also identified based on participants' description of their health-related quality of life: concerns about having a meaningful life, dealing with everyday limitations, and maintaining social networks; adjusting expectations to abilities; expanding social networks; and exploring a meaningful life. IMPLICATIONS FOR NURSING: Patients' ability to use coping strategies should be considered when screening for rehabilitation needs. During systematic in-depth symptom screening, unmet rehabilitation needs (e.g., physical functioning, fatigue, pain) may become apparent.

The genus Dalbergia contains many valuable timber species threatened by illegal logging and deforestation, but knowledge on distributions and threats is often limited and accurate species identification difficult. The aim of this study was to apply DNA barcoding methods to support conservation efforts of Dalbergia species in Indochina. We used the recommended rbcL, matK and ITS barcoding markers on 95 samples covering 31 species of Dalbergia, and tested their discrimination ability with both traditional distance-based as well as different model-based machine learning methods. We specifically tested whether the markers could be used to solve taxonomic confusion concerning the timber species Dalbergia oliveri, and to identify the CITES-listed Dalbergia cochinchinensis. We also applied the barcoding markers to 14 samples of unknown identity. In general, we found that the barcoding markers discriminated among Dalbergia species with high accuracy. We found that ITS yielded the single highest discrimination rate (100%), but due to difficulties in obtaining high-quality sequences from degraded material, the better overall choice for Dalbergia seems to be the standard rbcL+matK barcode, as this yielded discrimination rates close to 90% and amplified well. The distance-based method TaxonDNA showed the highest identification rates overall, although a more complete specimen sampling is needed to conclude on the best analytic method. We found strong support for a monophyletic Dalbergia oliveri and encourage that this name is used consistently in Indochina. The CITES-listed Dalbergia cochinchinensis was successfully identified, and a species-specific assay can be developed from the data generated in this study for the identification of illegally traded timber. We suggest that the use of DNA barcoding is integrated into the work flow during floristic studies and at national herbaria in the region, as this could significantly increase the number of identified specimens and improve knowledge about species distributions.