bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncommon Causes of Nontraumatic Intracerebral Hemorrhage
Authors: Tartarin Hugo , Morotti Andrea , Van Etten Ellis S. , Hausman-Kedem Moran , Charidimou Andreas , Jouvent Eric , Susen Sophie , Cordonnier Charlotte , Pasi Marco , Boulouis Grégoire
Published: April 2024

Nontraumatic intracerebral hemorrhage is an important health issue. Although common causes such as hypertension and cerebral amyloid angiopathy predominantly affect the elderly, there exists a spectrum of uncommon etiologies that contribute to the overall incidence of intracerebral hemorrhage. The identification of these rare causes is essential for targeted clinical management, informed prognostication, and strategic secondary prevention where relevant. This topical review explores the uncommon intracerebral hemorrhage causes and provides practical clues for their clinical and imaging identification. By expanding the clinician’s differential diagnosis, this review aims to bridge the gap between standard intracerebral hemorrhage classification systems and the nuanced reality of clinical practice.
LDL-c Lowering, Ischemic Stroke, and Small Vessel Disease Brain Imaging Biomarkers: A Mendelian Randomization Study
Authors: Dib Marie-Joe , Zagkos Loukas , Meena Devendra , Burgess Stephen , Chirinos Julio A. , Gill Dipender
Published: April 2024

BACKGROUND:

The effects of lipid-lowering drug targets on different ischemic stroke subtypes are not fully understood. We aimed to explore the mechanisms by which lipid-lowering drug targets differentially affect the risk of ischemic stroke subtypes and their underlying pathophysiology.

METHODS:

Using a 2-sample Mendelian randomization approach, we assessed the effects of genetically proxied low-density lipoprotein cholesterol (LDL-c) and 3 clinically approved LDL-lowering drugs (HMGCR [3-hydroxy-3-methylglutaryl-CoA reductase], PCSK9 [proprotein convertase subtilisin/kexin type 9], and NPC1L1 [Niemann-Pick C1-Like 1]) on stroke subtypes and brain imaging biomarkers associated with small vessel stroke (SVS), including white matter hyperintensity volume and perivascular spaces.

RESULTS:

In genome-wide Mendelian randomization analyses, lower genetically predicted LDL-c was significantly associated with a reduced risk of any stroke, ischemic stroke, and large artery stroke, supporting previous findings. Significant associations between genetically predicted LDL-c and cardioembolic stroke, SVS, and biomarkers, perivascular space and white matter hyperintensity volume, were not identified in this study. In drug-target Mendelian randomization analysis, genetically proxied reduced LDL-c through NPC1L1 inhibition was associated with lower odds of perivascular space (odds ratio per 1-mg/dL decrease, 0.79 [95% CI, 0.67–0.93]) and with lower odds of SVS (odds ratio, 0.29 [95% CI, 0.10–0.85]).

CONCLUSIONS:

This study provides supporting evidence of a potentially protective effect of LDL-c lowering through NPC1L1 inhibition on perivascular space and SVS risk, highlighting novel therapeutic targets for SVS.
Near-Infrared II Photobiomodulation Preconditioning Ameliorates Stroke Injury via Phosphorylation of eNOS
Authors: Yokomizo Shinya , Kopp Timo , Roessing Malte , Morita Atsuyo , Lee Seeun , Cho Suin , Ogawa Emiyu , Komai Eri , Inoue Kazumasa , Fukushi Masahiro , Feil Susanne , Kim Hyung-Hwan , Bragin Denis E. , Gerashchenko Dmitry , Huang Paul L. , Kashiwagi Satoshi , Atochin Dmitriy N.
Published: April 2024

BACKGROUND:

The current management of patients with stroke with intravenous thrombolysis and endovascular thrombectomy is effective only when it is timely performed on an appropriately selected but minor fraction of patients. The development of novel adjunctive therapy is highly desired to reduce morbidity and mortality with stroke. Since endothelial dysfunction is implicated in the pathogenesis of stroke and is featured with suppressed endothelial nitric oxide synthase (eNOS) with concomitant nitric oxide deficiency, restoring endothelial nitric oxide represents a promising approach to treating stroke injury.

METHODS:

This is a preclinical proof-of-concept study to determine the therapeutic effect of transcranial treatment with a low-power near-infrared laser in a mouse model of ischemic stroke. The laser treatment was performed before the middle cerebral artery occlusion with a filament. To determine the involvement of eNOS phosphorylation, unphosphorylatable eNOS S1176A knock-in mice were used. Each measurement was analyzed by a 2-way ANOVA to assess the effect of the treatment on cerebral blood flow with laser Doppler flowmetry, eNOS phosphorylation by immunoblot analysis, and stroke outcomes by infarct volumes and neurological deficits.

RESULTS:

Pretreatment with a 1064-nm laser at an irradiance of 50 mW/cm
2
improved cerebral blood flow, eNOS phosphorylation, and stroke outcomes.

CONCLUSIONS:

Near-infrared II photobiomodulation could offer a noninvasive and low-risk adjunctive therapy for stroke injury. This new modality using a physical parameter merits further consideration to develop innovative therapies to prevent and treat a wide array of cardiovascular diseases.
The Computational Turn in International Law
Authors: Lie Runar Hilleren , Langford Malcolm
Published: April 2024

The recent computational turn carries the potential to both enrich and destabilise international law research. Epistemologically, it offers a repertoire of data science methods, including network analysis, text processing and analysis, machine learning, and large language and agent-based models. Ontologically, with its inductive and macroscopic logic, it can inflect and challenge our established understandings of the nature and role of international law. In this article, we review the growing use of computational approaches in international law research, with a focus on their methodological particularity and potential contributions to doctrinal and non-doctrinal research questions. At the same time, we discuss the limitations of the computational turn, especially issues of suitability, quality, and feasibility.
The Chessboard Toghrās of Safavid Royal Decrees
Authors: Barati András
Published: April 2024

One of the most characteristic and resilient elements of state documents promulgated by the chancelleries of medieval and early modern Turkic Islamic empires is the toghrā, or calligraphic signature of rulers. In the administrative history of Iran, the chessboard toghrā constitutes a short and lesser-known variant. This royal emblem appeared during the Safavid period as the result of several administrative reforms. In this paper, I outline the development of the toghrā in medieval Iran on the basis of surviving documents and fragments and then offer a detailed portrait of the birth and brief life of the chessboard toghrā. Furthermore, the conspicuous similarity between this form and the toghrās of Mughal emperors precipitates a comparison and close analysis of their different elements and characteristics. Drawing on both published and unpublished royal decrees, this article explores the possible dimension of interrelation and provides insights into their similarities and differences in use and content.
Effect of interference installation method on interfacial properties and fatigue failure behavior of bolted composite joints
Authors: Wang Xiaohe , Cao Zengqiang , Guo Yingjiang
Published: April 2024

A novel dynamic installation (DI) method is proposed to improve the problems of severe installation damage, small installable interference size, and low installation efficiency of traditional static installation (SI) methods for installing interference bolts in composite bolted structures. The stress distribution and CFRP damage around the hole wall due to interference fitting and subsequent cyclic loading were predicted by finite element simulations. In addition, the fatigue life of DI and SI specimens was evaluated and the fatigue failure mechanisms were discussed. The results showed that the DI method provides a visible improvement in fatigue life, which is about 4 times that of the SI interference specimens and 38 times that of the non-interference specimen. In addition, DI introduces relatively higher average residual compressive stresses than SI, especially at the inlet of the laminate, which also results in a more uniform distribution along the axial direction of DI specimens. Micromorphological analysis of the specimens after fatigue failure indicated that the uniform stress distribution and low initial installation damage at the assembly interface introduced by the DI method during interference fit prevents severe delamination and crack propagation in joints subjected to external cyclic loading, such as the SI specimen. Severe extrusion deformation of the hole wall and matrix crushing are the main failure modes of DI specimens. Therefore, it is necessary to improve the interference installation method of composite materials.
A New Era for Ethnic Studies: Hearing From Early-Career Educators
Authors: Nguyen Alexander , Borrero Noah
Published: April 2024

In 2030 Ethnic Studies will be a required course for all high schoolers in California's public schools. This paper examines the opportunities and challenges of this milestone and how the future of Ethnic Studies can impact the U.S. education system as a whole. Through highlighting the history of Ethnic Studies and presenting the perspectives of eight early career Ethnic Studies teachers and counselors, this study showcases the importance of Ethnic Studies in providing spaces for students of Color to see themselves in school curricula, build community, and envision substantive change through their teaching.
Staying Close to Home: A Descriptive Analysis of the High School Graduates Who Return to Teach in Their Home District
Authors: Redding Christopher
Published: April 2024

Given urban school and district administrators’ historical challenges with recruiting and retaining a high-quality, racially diverse teacher workforce, there is a need to better understand the factors shaping why graduates return to teach in their home district. This descriptive study examines the high school students who returned to teach in their home district—a large urban district in the southeastern United States. White female, economically privileged, and higher achieving graduates returned to teach at the highest rates, although notable differences by race/ethnicity were observed. Implications for urban teacher recruitment are discussed.
Taking Stock and Looking Forward to the Future of Pathogen Politics in Light of New Insights and Recommendations: COVID-19 Threat Was Meaningfully Associated With Support for Liberal Policies in the United States
Authors: Fiagbenu Michael Edem
Published: April 2024

Infectious disease outbreaks are expected to predict support for conservative policies. However, earlier studies (January–June, 2020) reached conflicting findings regarding the association between COVID-19 threat and policy preferences in the United States. We revisit this issue by analyzing five nationally representative surveys conducted during the relatively severe periods of the pandemic (August 2020–December, 2020; total N = 82,753). Using Bayesian inference, we find strong evidence that subjective (e.g., fear of infection and pandemic outrage) but not objective (e.g., local cases and deaths) threat predicted support for liberal policies (e.g., immigration and universal health care). Meta-analyses revealed that the estimates depend on the type of subjective (.05 ≥ r ≤ .60) or objective (.00 ≥ r ≤ .14) COVID-19 threat. We propose an emotion-mediated dual-process model of pathogen management suggesting that infectious disease outbreaks activate both avoidance and caregiving motives that translate, respectively, into support for right-wing and left-wing policies.
Patterns and Characteristics of Amphetamine-type Stimulant Use in a North-eastern State of India: A Cross-sectional Study
Authors: Rao Ravindra , Ganesh Ragul , Kishore Kunal , Madan Ira , Khandpal Bhagwati , Sharma Charanjit
Published: April 2024

Background:

South Asia generally reports low levels of amphetamine-type stimulant (ATS) use, with few studies on the pattern of ATS use. We assessed the pattern of ATS use and associated high-risk behavior in Manipur, a north-eastern state of India.

Methods:

209 adult male ATS users (mean age 28.8 years) from three districts of Manipur were interviewed. Data were collected on the patterns of high-risk behavior with ATS use, health consequences, and help-seeking. The severity of use with various substances was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Depression and anxiety were assessed by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scale, respectively.

Results:

The mean duration of ATS use was 3.7 years (SD 2.3). The majority used ATS almost daily (88%) and depended on ATS (77%). Methamphetamine (99.5%) was the most used ATS orally. Around 87% also suffered from opioid dependence. About 76% injected drugs, most commonly heroin. Almost three-fourths (78%) used ATS before their sexual intercourse, 31% of whom did not use condoms. Most reported physical problems with ATS and had above-cut-off scores on PHQ-9 and GAD-7. The majority (95%) reported that they could procure ATS easily. Also, the majority (93%) had thought of quitting ATS use.

Discussion:

Most ATS users start using ATS at a young age and have comorbid other drug use, including heroin. ATS use is associated with various physical and psychological problems. Focusing on ATS use in India and developing strategies to address this problem is essential.
Pursuit of Equity: Women on a Low Income Navigating Access to Health and Social Services in Canada
Authors: Duhn Lenora , Sparringa Michaela , Waite Jennifer , Camargo-Plazas Pilar
Published: April 2024

Background

Existing research highlights the role of social determinants of health, such as education and housing, in predicting health outcomes and the challenges that arise from deficiencies in these areas, often linked to societal inequities. Gender and income are recognized as social determinants of health, yet the complexities of their interplay, particularly for women with low income seeking health and social services in Canada, need more exploration.

Objective

This study investigates how gender and income intersect to affect access to health and social services for Canadian women with low income.

Methods

Employing a participatory action approach with arts-based and interpretive methodologies, the study partnered with a non-profit organization to engage five women through photovoice, interviews, and a focus group, aiming to capture their experiences in accessing services.

Results

The analysis revealed three primary themes: the labyrinth-like complexity of navigating health and social service systems, the importance of mental health sanctuaries, and the value of supportive networks. Participants reported difficulties and frustrations in system navigation, often feeling ignored by service providers. Contrarily, community agencies provided essential non-judgmental support, including daily necessities and emotional care, with the companionship of pets also being a notable source of comfort.

Conclusion

The findings advocate for a shift towards more person-centred care in health and social service systems to better serve women in vulnerable positions, emphasizing the need to simplify the process of accessing services and ensuring that service providers recognize and address the unique challenges faced by equity-deserving groups.
Examining Sexual Health Organizational Networks in Urban African American Communities Using Social Network Theory
Authors: Taylor Nina , Dolcini M. Margaret , Catania Joseph A. , Harper Gary , Cristobal Audrey , Timmons Tyler April
Published: April 2024

Purpose

Collaboration among organizations offering sexual health and youth development services has the potential to provide youth with effective sexual health support. However, formally structured efforts (eg, coalition formation) may be impractical or unsuitable for low-income communities where resources are often already limited. Social network theories provide an alternative approach for building collaborative organizational networks.

Approach

Research aims to evaluate the barriers and facilitators to collaboration in sexual health organizational networks.

Setting

Organizations in low income, urban, communities in Chicago and San Francisco that serve African American adolescents.

Participants

Providers (n = 22) from organizations that offer sexual health services and youth development services.

Methods

Focus groups (n = 4) were conducted and analyzed utilizing a combination of coding strategies.

Results

Barriers to collaboration included resource limitations and competition, differences in organizational roles and deliverables, and prejudice and stigma. Identifying common ground among organizations was found to be a facilitator to collaboration. Social network concepts in conjunction with study findings lead to the development of a practice model that hypothesizes a pathway for organizations to improve collaboration without formally structured efforts.

Conclusion

Our findings offer ways to encourage collaboration among organizations that support youth sexual health in low-income, urban, African American communities without relying on formal structures. Such collaborations may be critical for improving the provision of comprehensive sexual health support.
The impacts of economic growth, foreign direct investment inflows, and energy usage on air pollution through globalization in China: A vector error correction model approach
Authors: Gurbuz Eren Can
Published: April 2024

During its economic globalization, China ranked first in the world regarding air pollution since 2005. China's massive carbon dioxide emission that causes global warming, directly or indirectly, can be stimulated by its economic globalization process, which needs to be observed. Hence, this article aims to observe the direct and indirect impacts among foreign direct investment (FDI) inward, energy usage, carbon dioxide emissions, economic globalization, the share of the industry sector in GDP, and economic growth from the exact starting point of globalization, in other words opening the gate of China (1979) to the intensive trade war between China and the USA, that began to change international policies (2013) of China. The vector error correction model (VECM) and the Granger causality tests are performed to obtain the causality directions and impacts among the variables. The empirical results reveal emerging FDI-led economic growth and the existence of cultivating air pollution owing to energy use, FDI inward (polluting-FDI), and economic globalization in China. Regarding the output of Granger causality tests, direct unidirectional causality from energy use to air pollution and indirect unidirectional causality from energy use to economic growth through inward FDI are observed. This study proposes crucial policies to encourage cleaner production and energy-saving technologies that reduce air pollution of China and stimulate China's economic growth during globalization.
Home monitoring of fetal heart rhythm: Lived experiences of women with anti-SSA/Ro52 autoantibodies and their co-parents
Authors: Tingström Joanna , Öst Elin , Bergman Gunnar , Burström Åsa
Published: April 2024

Objective

The aim of this study was to explore the parents’ experiences of home monitoring of the fetal heart rhythm. Women with anti-SSA/Ro52 autoantibodies carry a 2%–3% risk of giving birth to a child with congenital heart block (CHB), following transplacental transfer and antibody-mediated inflammation in the fetal conduction system during 18th to 24th gestational week. Early detection and subsequent treatment have been reported to decrease morbidity and mortality. Therefore, home monitoring of the fetal heart rhythm by Doppler has been offered at our fetal cardiology center. This study was undertaken to explore the lived experience of the routine.

Methods

Participants were recruited from a single fetal cardiology center. Consecutive sampling was used. The inclusion criteria were women with SSA/Ro52 antibodies who had undergone Doppler examinations within the last two and a half years at the hospital and had monitored the fetal heartbeat at home. A semi-structured questionnaire was created, and the participants were interviewed individually. The interviews were transcribed verbatim and analyzed according to qualitative content analysis.

Results

The overall theme was defined as “walking on thin ice,” with six underlying categories: reality, different strategies, gain and loss, healthcare providers, underlying tension, and conducting the examinations again, all with a focus on how to handle the home monitoring during the risk period.

Conclusion

Both the mother and the co-parent expressed confidence in their own abilities and that the monitoring provided them with the advantage of growing a bond with the expected child. However, all the participants described a feeling of underlying tension during the risk period. The results show that home monitoring is not experienced as complicated or a burden for the parents-to-be and should be considered a vital part of the chain of care for mothers at risk for giving birth to a child with CHB. However, explaining the teamwork between the different caregivers, for the patients involved, their areas of expertise, and how they collaborate with the patient continues to be a pedagogic challenge and should be developed further.
Managerial Compensation, R&D Investment, and Operating Efficiency in Taiwanese Listed Companies: The Moderating Effects of Firm Size and Corporate Risk
Authors: Lee Hui-Tzu , Luo Lieh-Ming , Chiu Chia-Chou
Published: April 2024

Our study explores how managerial compensations are associated with both R&D investment and operating efficiency, which are pillars of competitive advantage for Taiwanese listed companies. Additionally, it investigates how firm size and corporate risk moderate this relationship. Our study’s findings validate these two hypotheses, revealing a positive correlation between managerial compensation and both R&D investment and operating efficiency. Moreover, we observe that firm size enhances this connection, while corporate risk acts as a weakening factor. These results indicate that managerial compensation in Taiwanese companies is crafted with consideration for both immediate financial performance and enduring contributions to company development. The study contributes contemporary evidence on the interplay between factors fostering long-term competitive advantages and the structures of managerial compensation.

JEL Codes: G32, M12
Identities and the City: Socialities amongst Migrant Domestic Workers in Kolkata
Authors: Bhowmik Urbee
Published: April 2024

Migrant subjectivities, experiences and agency have not received the attention needed within development studies discussions on migration, and gender remains to be mainstreamed within understandings of migration. This article attempts to contribute towards bridging these gaps by outlining the findings of a study that explored sociality amongst migrant domestic workers in Kolkata. It outlines experiences of living the migrant identity amongst women migrating from rural West Bengal to Kolkata as well as forms of sociality they engage in at the level of the everyday. Socialities with their employers at the site of paid domestic work allow them to lay claims to the city by drawing on identities based in the Partition of India, 1947. Drawing on the concepts of ‘beings’ from Amartya Sen’s capability approach and of the ‘right to the city’, originally formulated by Henri Lefebvre, the article captures two significant questions emerging from these socialities: those of identity and self, and relationship with the city. It further shows the interrelation between these two frameworks that becomes apparent in the context of what the above socialities imply for the women in the study.
Playing Cricket: India’s Soft Power, Nation Branding and Future Prospects
Authors: Das Suman Kumar , Borah Akhil Chandra , Mallick Shovit
Published: April 2024

The growing interdependence among nations, the advancement of science and technology and the impact of globalisation have made it less useful for nations to rely predominantly on hard power to pursue their foreign policies’ goals. In the contemporary era, nations have shifted their attention to soft power as an alternative policy to maximise gains from other countries. Although the exercise of hard power is still relevant in international relations, soft power has become a less destructive option. For instance, sports has proved its power as a tool of diplomacy at different times. In India, cricket has moved from its status as a mere sport to a powerful instrument of diplomacy. In this article, the authors analyse the value of sports in general and cricket in particular as an instrument of public diplomacy, its capacity for nation branding, and the future prospects of cricket in pursuing India’s foreign policy goals.
Evaluation of Correlation between the Level of Vitamin D and Glycosylated Hemoglobin in Type 2 Diabetic Mellitus and Nondiabetic Mellitus
Authors: Shukla Jitendra , Singh Anand , Sachan Nidhi , Verma Radhey Shyam , Kumari Rinki , Dubey G. P. , Yadav Sanjeev Kumar
Published: April 2024

Background:

The pancreas contains Vitamin D (Vit.-D) and an enzyme that regulates insulin levels. Vitamin D deficiency is associated with several severe health conditions, such as cardiovascular disease, diabetes, various cancers, and multiple sclerosis (MS). Therefore, the objective of the current study is to investigate the correlation between Vitamin D levels and glycosylated hemoglobin (HbA1c) in both patients and controls.

Materials and Methods:

The study enrolled 163 T2DM (Group I) and 174 healthy (Group II) subjects to estimate the level of Vit.-D and HbA1c in the blood serum of all subjects, using radioimmunoassay and high-performance liquid chromatography, respectively.

Results:

The results revealed that Group I had a lower level of Vit.-D (17.82 ± 2.23 ng/mL) than Group II. Similarly, they have high HbA1c levels, showing significant ( P < 0.001; Student’s t-test). Further, in Group I, Vit.-D levels were negatively correlated with HbA1c levels ( P < 0.001; r2 = 0.07, linear regression). Group I and II combined analysis revealed an inverse relationship between Vit.-D levels and HbA1c ( P < 0.001; r2 = 0.021).

Conclusion:

The study concluded a negative correlation between Vit.-D levels and HbA1c levels in T2DM. However, Vit.-D therapy can recover this correlation, which helps control glycemic levels.
Who covers what? Analyzing audience perceptions of gender differences in news beat coverage
Authors: Santia Martina , Willnat Lars , Jastrzebski Stan
Published: April 2024

This study investigates differences in news beat coverage between female and male journalists and their potential effects on audiences. We employ data from a representative survey of 1,600 U.S. journalists to show that female journalists are more likely to cover feminine beats (i.e., culture and health) and less likely to cover masculine beats (i.e., politics and sports) than male journalists. We complement this data with an online experiment to examine whether audiences value feminine beats covered by female journalists less than masculine beats reported by male journalists. Our results show that female journalists are not necessarily rated more positively when reporting on feminine beats—and feminine beats are not seen as more important when delivered by a female journalist.
Enhancement of silk fabric knife-stabbing resistance for soft body armor
Authors: El Messiry Magdi , Eltahan Eman
Published: April 2024

Traditional silk, known for its strength, flexibility, and comfort, shows promise as a lightweight, comfortable material for stab-resistant armor. This study explores enhancing silk’s knife-stabbing resistance for soft body armor through surface treatments. This study aims to augment the knife-stabbing resistance of silk fabric for soft body armor. Designed a falling tower setup to investigate fabric responses under impact. Exploring the addition of layers with coatings like silicon dioxide deposition, rice ash deposition, and aluminum oxide particles, the investigation revealed significant enhancements. A solitary silk layer exclusively coated with resin exhibited improvements of approximately 37.07%, 29.21%, and 13.47% in stab resistance for rice ash, aluminum oxide, and silicon oxide particles, respectively. The specific knife penetration depth indicated that the coating is more effective in diminishing penetration depth. The research identified that 7 layers of pure silk and 3 layers coated with rice ash satisfy National Institute of Justice Standard–0115.00, S1 as 26 layers of silk fabric, demonstrating a reduction without compromising protective efficacy.
Impact of Lifestyle Medicine Interventions on the Management of Systemic Hypertension in Primary Care: A Canadian Randomized Controlled Trial
Authors: Marin-Couture Elisa , Moulin Julie-Alexandra , Thibault Anne-Sophie , Poirier Paul , Després Jean-Pierre , Gallant Anette , Lamarre Vincent , Alméras Natalie , Lemieux Isabelle , Chabot Christian , Gallani Maria-Cecilia , Piché Marie-Eve , Arsenault Benoit J. , Tremblay Angelo , Paquette Jean-Sébastien , Rhéaume Caroline
Published: April 2024

The study aimed to evaluate the feasibility of implementing lifestyle interventions in primary care settings with hypertensive patients and their effect on blood pressure, body composition, cardiometabolic markers, and antihypertensive drug use. Sixty participants diagnosed with stage 1 hypertension were randomly assigned to 4 groups: (1) Standard medical care (control), (2) Physical activity protocol, (3) Dietary Approach to Stop Hypertension (DASH) diet, and (4) Combination of physical activity protocol and DASH diet. Participants received counseling from family physicians, nurses, kinesiologists, and registered dietitians. Various assessments were conducted before (T0) and after (T6) the interventions, including 24-h ambulatory blood pressure monitoring, blood and urine tests, anthropometric measurements, computed tomography to measure adipose tissue, submaximal exercise test to estimate maximal oxygen consumption and health questionnaires. Fifty-one (51) participants (51/57, 89%) completed the program. All interventions reduced blood pressure indices between T0 and T6, except the combined interventions group. Body composition and cardiometabolic parameters were improved in all groups, except for the control group. In total, 28% of participants (7/23) reduced or stopped their antihypertensive medications at T6. The results suggest that structured lifestyle interventions are feasible in primary care and improve blood pressure and cardiometabolic parameters in patients with stage 1 hypertension.
Macleaya cordata Extract Inhibits LPS-Induced IPEC-J2 Inflammation Through TLR4-Mediated NF-κB and MAPK Signaling Pathways
Authors: Han Diangang , Yang Hongqing , Che Litao , Zhang Chong , Li Jing , Ye Lingling , Zhang Chunyong , Guo Rongfu , Xin Jige
Published: April 2024

Objectives: The Macleaya cordata has long been utilized as a traditional medicinal remedy for treating inflammation in certain countries, and it is also being considered as a potential alternative to antibiotic growth promoters in livestock breeding. However, the molecular mechanisms underlying its anti-inflammatory characteristics have not been thoroughly investigated. In this study, we assessed the anti-inflammatory effects of the Macleaya cordata extract (MCE) and elucidated the molecular mechanism in the porcine intestinal epithelial cell line J2 (IPEC-J2) stimulated by lipopolysaccharide (LPS). Methods: The IPEC-J2 cells were pretreated with various concentrations of MCE (50 ng/mL, 100 ng/mL, and 150 ng/mL) prior to stimulation with LPS to induce of inflammation. Subsequently, the secretion levels and mRNA expression of the inflammatory cytokines IL-6, TNF-α, IFN-γ, and IL-10 were assessed. The impact of MCE on the activation of nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways was investigated. Results: The results demonstrated that MCE significantly suppressed the production and mRNA expression levels of pro-inflammatory cytokines in LPS-induced IPEC-J2 cells, while promoting the expression of anti-inflammatory cytokines. Moreover, it down-regulated the phosphorylation of NF-κB (p65) and attenuated the expression of phosphorylated JNK, ERK, and p38 MAPKs in a concentration-dependent manner. Furthermore, MCE downregulated the expression of TLR4 and MyD88, which serve as crucial upstream signaling molecules. The findings of this study suggest that the anti-inflammatory effect of MCE is attributed to its ability to regulate inflammatory cytokines and mediators by inhibiting the TLR4-mediated NF-κB and MAPK signaling pathways. Conclusions: Therefore, MCE holds promise as a potential therapeutic and preventive agent for managing inflammatory reactions and diseases in livestock and poultry breeding, warranting further investigation.
“Just Because It’s a Conspiracy Theory Doesn’t Mean They’re Not Out to Get You”: Differentiating the Correlates of Judgments of Plausible Versus Implausible Conspiracy Theories
Authors: Frenken Marius , Reusch Annika , Imhoff Roland
Published: April 2024

Although conspiracy theories exhibit varying degrees of plausibility as explanations for societal events, they are typically considered epistemically problematic. Since normative ascriptions of plausibility are not essential to their definition, we sought to examine whether judgments of (im)plausible conspiracy theories have different psychological underpinnings. In two preregistered studies ( N = 563), the plausibility of fictitious conspiracy theories was operationalized by pretest ratings (Study 1) or by experimentally manipulating supporting information in a belief updating paradigm (Study 2). While the general suspicious mind-set of conspiracy mentality was associated with perceiving greater plausibility in consensually plausible conspiracy theories, this was markedly stronger for implausible conspiracy theories. Cognitive variables were only negatively associated with attributing greater plausibility to conspiracy theories deemed implausible. The results suggest that a general suspicious perspective, along with limited cognitive skills and rational thinking dispositions, is related to biased plausibility judgments of conspiracy theories and the underweighting of information disconfirming them.
Tricuspid regurgitation in pulmonary arterial hypertension: a right ventricular volumetric and functional analysis
Authors: Yoshida Keimei , van Wezenbeek Jessie , Wessels Jeroen N. , de Man Frances S. , Sunagawa Kenji , Vonk-Noordegraaf Anton , Bogaard Harm Jan
Published: April 2024

Background

The consequences of tricuspid regurgitation (TR) for right ventricular (RV) function and prognosis in pulmonary arterial hypertension (PAH) are poorly described and effects of tricuspid valve repair on the RV are difficult to predict.

Methods

In 92 PAH patients with available cardiac magnetic resonance (CMR) studies, TR volume was calculated as the difference between RV stroke volume and forward stroke volume,i.e.pulmonary artery (PA) stroke volume. Survival was estimated from the time of the CMR scan to cardiopulmonary death or lung transplantation. In a subgroup, pressure–volume loop analysis including two-parallel elastances was applied to evaluate effective elastances, including net afterload (effective arterial elastance (Ea)), forward afterload (effective pulmonary arterial elastance (Epa)) and backward afterload (effective tricuspid regurgitant elastance (ETR)). The effects of tricuspid valve repair were simulated using the online software package Harvi.

Results

26% of PAH patients had a TR volume ≥30 mL. Greater TR volume was associated with increased N-terminal pro-brain natriuretic peptide (p=0.018), mean right atrial pressure (p<0.001) and RV end-systolic and -diastolic volume (both p<0.001). TR volume ≥30 mL was associated with a poor event-free survival (p=0.008). In comparison toEa,Epacorrelated better with indices of RV dysfunction. Lower end-systolic elastance (Ees) (p=0.002) andETR(p=0.030), higherEpa(p=0.001) and reducedEes/Epa(p<0.001) were found in patients with a greater TR volume. Simulations predicted that tricuspid valve repair increases RV myocardial oxygen consumption in PAH patients with severe TR and lowEesunless aggressive volume reduction is accomplished.

Conclusions

In PAH, TR has prognostic significance and is associated with low RV contractility and RV–PA uncoupling. However, haemodynamic simulations showed detrimental consequences of tricuspid valve repair in PAH patients with low RV contractility.
CGRP-targeted medication in chronic migraine - systematic review
Authors: Oliveira Renato , Gil-Gouveia Raquel , Puledda Francesca
Published: April 2024

Background

Chronic migraine is a highly debilitating condition that is often difficult to manage, particularly in the presence of medication overuse headache. Drugs targeting the calcitonin gene-related peptide (CGRP), or its receptor have shown promising results in treating this disorder.

Methods

We searched Pubmed and Embase to identify randomized clinical trials and real-world studies reporting on the use of medication targeting the calcitonin gene-related peptide in patients with chronic migraine.

Results

A total of 270 records were identified. Nineteen studies qualified for the qualitative analysis. Most studies reported on monoclonal antibodies targeting CGRP (anti-CGRP mAbs), that overall prove to be effective in decreasing monthly migraine days by half in about 27.6–61.4% of the patients. Conversion from chronic to episodic migraine was seen in 40.88% of the cases, and 29–88% of the patients stopped medication overuse. Obesity seems to be the main negative predictor of response to anti-CGRP mAbs. There is no evidence to suggest the superiority of one anti-CGRP mAb. Despite the lack of strong evidence, the combination of anti-CGRP medication with onabotulinumtoxinA in chronic migraine is likely to bring benefits for resistant cases. Atogepant is the first gepant to demonstrate a significant decrease in monthly migraine days compared to placebo in a recent trial. Further, anti-CGRP mAb and gepants have a good safety profile.

Conclusion

There is strong evidence from randomized trials and real-world data to suggest that drugs targeting CGRP are a safe and effective treatment for chronic migraine.
Bibliometric analysis of ChatGPT in medicine
Authors: Gande Sharanya , Gould Murdoc , Ganti Latha
Published: April 2024

Introduction

The emergence of artificial intelligence (AI) chat programs has opened two distinct paths, one enhancing interaction and another potentially replacing personal understanding. Ethical and legal concerns arise due to the rapid development of these programs. This paper investigates academic discussions on AI in medicine, analyzing the context, frequency, and reasons behind these conversations.

Methods

The study collected data from the Web of Science database on articles containing the keyword “ChatGPT” published from January to September 2023, resulting in 786 medically related journal articles. The inclusion criteria were peer-reviewed articles in English related to medicine.

Results

The United States led in publications (38.1%), followed by India (15.5%) and China (7.0%). Keywords such as “patient” (16.7%), “research” (12%), and “performance” (10.6%) were prevalent. The Cureus Journal of Medical Science (11.8%) had the most publications, followed by the Annals of Biomedical Engineering (8.3%). August 2023 had the highest number of publications (29.3%), with significant growth between February to March and April to May. Medical General Internal (21.0%) was the most common category, followed by Surgery (15.4%) and Radiology (7.9%).

Discussion

The prominence of India in ChatGPT research, despite lower research funding, indicates the platform’s popularity and highlights the importance of monitoring its use for potential medical misinformation. China’s interest in ChatGPT research suggests a focus on Natural Language Processing (NLP) AI applications, despite public bans on the platform. Cureus’ success in publishing ChatGPT articles can be attributed to its open-access, rapid publication model. The study identifies research trends in plastic surgery, radiology, and obstetric gynecology, emphasizing the need for ethical considerations and reliability assessments in the application of ChatGPT in medical practice.

Conclusion

ChatGPT’s presence in medical literature is growing rapidly across various specialties, but concerns related to safety, privacy, and accuracy persist. More research is needed to assess its suitability for patient care and implications for non-medical use. Skepticism and thorough review of research are essential, as current studies may face retraction as more information emerges.
Low-value chronic prescription of acid reducing medication among Dutch general practitioners: impact of a patient education intervention
Authors: Müskens Joris L. J. M. , van Dulmen Simone A. , Hek Karin , Westert Gert P. , Kool Rudolf B.
Published: April 2024

Background

Dyspepsia is a commonly encountered clinical condition in Dutch general practice, which is often treated through the prescription of acid-reducing medication (ARM). However, recent studies indicate that the majority of chronic ARM users lack an indication for their use and that their long-term use is associated with adverse outcomes. We developed a patient-focussed educational intervention aiming to reduce low-value (chronic) use of ARM.

Methods

We conducted a randomized controlled study, and evaluated its effect on the low-value chronic prescription of ARM using data from a subset (n = 26) of practices from the Nivel Primary Care Database. The intervention involved distributing an educational waiting room posters and flyers informing both patients and general practitioners (GPs) regarding the appropriate indications for prescription of an ARM for dyspepsia, which also referred to an online decision aid. The interventions’ effect was evaluated through calculation of the odds ratio of a patient receiving a low-value chronic ARM prescription over the second half of 2021 and 2022 (i.e. pre-intervention vs. post-intervention).

Results

In both the control and intervention groups, the proportion of patients receiving chronic low-value ARM prescriptions slightly increased. In the control group, it decreased from 50.3% in 2021 to 49.7% in 2022, and in the intervention group it increased from 51.3% in 2021 to 53.1% in 2022. Subsequent statistical analysis revealed no significant difference in low-value chronic prescriptions between the control and intervention groups (Odds ratio: 1.11 [0.84–1.47], p > 0.05).

Conclusion

Our educational intervention did not result in a change in the low-value chronic prescription of ARM; approximately half of the patients of the intervention and control still received low-value chronic ARM prescriptions. The absence of effect might be explained by selection bias of participating practices, awareness on the topic of chronic AMR prescriptions and the relative low proportion of low-value chronic ARM prescribing in the intervention as well as the control group compared to an assessment conducted two years prior.

Trial registration

10/31/2023 NCT06108817.
Association between symptoms of depression and inflammatory parameters in people aged over 90 years
Authors: Zabielska Paulina , Szkup Małgorzata , Kotwas Artur , Skonieczna-Żydecka Karolina , Karakiewicz Beata
Published: April 2024

Background

Old age is a period of life that presents many health and social challenges, resulting in a greater vulnerability to the development of mental disorders, including depression. There has been a growing interest in the relationship between depression and inflammatory factors, because of its potential clinical and therapeutic implications. Inflammatory processes, which were originally understood as a response to infection and trauma, appear to play an important role in the pathogenesis of depression in the elderly. The aim of the study was to analyse the relationship between the severity of depressive disorders and inflammatory parameters in people over 90 years of age.

Methods

The study was conducted in Poland in 2017. The study population consisted of long-lived individuals, both living at home and staying in residential care homes. The participants were 90 people of both sexes (69 women and 21 men), aged between 90 and 103 years (mean = 92.36; SD = 2.98). The study was conducted using the diagnostic survey method with a questionnaire technique. The Geriatric Depression Scale (GDS) was used to carry out the analysis. The levels of selected inflammatory factors were determined using relevant laboratory tests.

Results

In the study group, the highest percentage of people had symptoms of moderate depression (n = 36;40%), followed by those without depression (n = 35;38.9%). There was a weak negative correlation between GDS scores and fibrinogen levels (p ≤ 0.05). The logistic regression model showed no significant relationship between inflammatory parameters and the development of depressive disorders.

Conclusions

Inflammatory parameters do not appear to predict the development of depressive disorders in people over 90 years of age.
Effect of play-based intervention on children’s mental status and caregiver involvement during hospitalization: findings from Pakistan
Authors: Bharuchi Vardah Noor Ahmed , Rasheed Muneera A.
Published: April 2024

Background

The nurturing care framework (NCF) encompasses responsive caregiving, health, nutrition, safety and security by parents and other caregivers. It improves health, development and wellbeing of children. A hospital environment can be detrimental to the developmental and emotional needs of children hence NCF can be applied to hospitalized children.

Objective

The objective was to determine if (i) play stimulation intervention mediated by non-specialist providers (caregivers) improves mental status of children who are hospitalized; (ii) to examine if difference varies between different providers and iii) if there is variation based on child age and criticalness of illness.

Method

A one-group pretest-posttest research was carried out using purposive sampling in a pediatric unit in Karachi, Pakistan, from November 2017 to December 2019. Children aged 3 months to 6 years were offered play stimulation by trainee psychologists. The outcome was measured through an observation tool, the Mental Status Examination Scale (MSE-S) developed for the study.

Results

A total of 524 sessions were delivered to 351 children. Significant mean difference was observed on MSE-S before and after the intervention when it was provided by trainees (9.95, CI = 8.11, 11.7), mothers (mean difference = 5.86, CI = 5.30, 6.42), fathers (mean difference = 5.86, CI = 4.48, 7.24) and non-specialist providers [caregivers (mean difference = 5.40, CI = 3.91, 6.89). Significant differences in mean was observed on MSE-S across different age groups and criticalness of illness.

Conclusion

It was concluded that play stimulation not only affects the behaviour of children but also varies when delivered by caregivers and trainees. Hence, interventions that involve parents are feasible.