Agreement of Clinician-Administered and Modified Parent-Administered House-Brackmann Scales in Children with Bell's Palsy

Objective. Currently there is no parent administered scale for facial nerve function in children. We set out to assess the agreement between a newly developed parent-administered modified version of the House-Brackmann (HB) scale and the standard clinician-administered HB scale in children with Bell's palsy. Study Design. Secondary analysis of a triple-blind, randomized, placebo-controlled trial of corticosteroids to treat idiopathic facial paralysis (Bell's palsy) in children (6 months to <18 years). Setting. Multicenter study at pediatric hospitals with recruitment in emergency departments. Methods. Children were recruited within 72 hours of symptom onset and assessed using the clinicianadministered and the parent-administered modified HB scales at baseline, and at 1, 3, and 6 months until recovered. Agreement between the 2 scales was assessed using intraclass coefficient (ICC) and a Bland-Altman plot. Results. Data were available for 174 of the 187 children randomized from at least 1 study time point. The mean ICC between clinician and parent HB scores across all time points was 0.88 (95% confidence interval, CI: 0.86, 0.90). The ICC for the data collected at baseline was 0.53 (95% CI: 0.43, 0.64), at 1 month was 0.88 (95% CI: 0.84, 0.91), at 3 months was 0.80 (95% CI: 0.71, 0.87) and at 6 months was 0.73 (95% CI: 0.47, 0.89). A Bland-Altman plot indicated a mean difference between the 2 scores (clinician-reported minus parent-reported) of only −0.07 (95% limits of agreement −1.37 to 1.23). Conclusion. There was good agreement between the modified parent-administered and the clinician-administered HB scales.Franz E. Babl, Nitaa Eapen, David Herd, Meredith L. Borland, Amit Kochar, Michael Zhang, Ed Oakley, Sandy M. Hopper, Robert G. Berkowitz, Catherine L. Wilson, Amanda Williams, Mark T. Mackay, Katherine J. Lee, Stephen Hearps, and the PREDICT (Paediatric Research in Emergency Departments International Collaborative) research networ

Reframing gender and feminist knowledge construction in marketing and consumer research: missing feminisms and the case of men and masculinities

Gender has been theorised and studied in many ways and across different disciplines. Although a number of these theorisations have been recognised and adopted in marketing and consumer research, the significance of feminism in knowledge construction has largely remained what we would call ‘unfinished’. Based on a critical reframing of gender research in marketing and consumer research, in dialogue with feminist theory, this article offers theoretical and practical suggestions for how to reinvigorate these research efforts. The analysis highlights dominant theorisations of gender, relating to gender as variable, difference and role; as fundamental difference and structuring; and as cultural and identity constructions. This reframing emphasises various neglected or ‘missing feminisms’, including queer theory; critical race, intersectional and transnational feminisms; material-discursive feminism; and critical studies on men and masculinities. A more detailed discussion of the latter, as a relatively new, growing and politically contentious area, is further developed to highlight more specifically which feminist and gender theories are mainly in use in marketing and consumer research and which are little or not used. In the light of this, it is argued that marketing and related disciplines have thus far largely neglected several key contemporary gender and feminist theorisations, particularly those that centre on gender power relations. The potential impact of these theoretical frames on transdisciplinary studies in marketing and consumer research and research agenda(s) is discussed

Comprehensive analysis of epigenetic clocks reveals associations between disproportionate biological ageing and hippocampal volume

The concept of age acceleration, the difference between biological age and chronological age, is of growing interest, particularly with respect to age-related disorders, such as Alzheimer’s Disease (AD). Whilst studies have reported associations with AD risk and related phenotypes, there remains a lack of consensus on these associations. Here we aimed to comprehensively investigate the relationship between five recognised measures of age acceleration, based on DNA methylation patterns (DNAm age), and cross-sectional and longitudinal cognition and AD-related neuroimaging phenotypes (volumetric MRI and Amyloid-β PET) in the Australian Imaging, Biomarkers and Lifestyle (AIBL) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Significant associations were observed between age acceleration using the Hannum epigenetic clock and cross-sectional hippocampal volume in AIBL and replicated in ADNI. In AIBL, several other findings were observed cross-sectionally, including a significant association between hippocampal volume and the Hannum and Phenoage epigenetic clocks. Further, significant associations were also observed between hippocampal volume and the Zhang and Phenoage epigenetic clocks within Amyloid-β positive individuals. However, these were not validated within the ADNI cohort. No associations between age acceleration and other Alzheimer’s disease-related phenotypes, including measures of cognition or brain Amyloid-β burden, were observed, and there was no association with longitudinal change in any phenotype. This study presents a link between age acceleration, as determined using DNA methylation, and hippocampal volume that was statistically significant across two highly characterised cohorts. The results presented in this study contribute to a growing literature that supports the role of epigenetic modifications in ageing and AD-related phenotypes

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Relationships between emotional climate and the fluency of classroom interactions

This study examined emotional climate in relation to the teaching and learning of grade 7 science. A multi-method and multi-theoretic approach used sociocultural frameworks as a foundation for interpretive research, conversation analysis, prosody analysis, and studies of nonverbal conduct. Emotional climate varied continuously throughout a lesson. Dialogues occurred and afforded learning when interactions between the teacher and students were fluent and included humour and collective effervescence. Emotional climate was negatively valenced when the teacher and/or students endeavoured to establish and maintain power by restricting others’ participation to spectator roles. The teacher’s endeavours to maintain and establish control over students were potentially detrimental to teaching and learning, teachers and learners. This type of teaching gradually evolved into a form we referred to as cranky teaching, whereby the teacher and her students showed signs of frustration and the enacted teaching and learning roles lacked fluency. The methods we pioneered in the present study might be helpful for other teachers who wish to participate in research on their classes to ascertain what works and should be strengthened, and identify practices and rituals that are deleterious and in need of change