bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Mesenchymal Stem Cells versus Minoxidil for Androgenic Alopecia Treatment: A Detailed Animal-Based Histological and Morphometric Study
Authors: Kamar Sherif A. , Naiem Hamdy Khaled , El-Nefiawy Nagwa Ebrahim , Mohammed Heba , Fetouh Marwa A.
Published: November 2024

Introduction: Androgenic alopecia (AGA), a hair loss condition caused by dihydrotestosterone binding to hair follicle receptors, negatively impacts quality of life for both men and women. Current treatments like minoxidil and finasteride have limitations, highlighting the need for alternative therapies, such as human umbilical cord blood-derived mesenchymal stem cells (HUCB-MSCs). Methods: In this study, forty-eight adult male Wistar albino rats (3 months old) were used. The control group (Group I) received no treatment, while the other rats underwent AGA induction via daily subcutaneous testosterone injections (100 mg/kg). These rats developed alopecia and were divided into three groups: AGA (Group II), AGA plus daily minoxidil spray (Group III), and AGA plus a single intradermal injection of HUCB-MSCs (1 mL containing 1 × 105 cells, Group IV). After 4 weeks, the rats were sacrificed, and skin specimens were prepared for histological analysis using H&E, Masson’s trichrome, and immunohistochemical staining for CK 19, vascular endothelial growth factor (VEGF), and TUNEL antibodies. Results: It was shown that HUCB-MSC treatment reversed structural damage to hair and follicles, normalizing conditions within 1-week post-injection. The treatment enhanced the anagen phase, suppressed telogen and catagen phases, reduced apoptosis, and increased VEGF and CK 19 immune reactions. Observational follow-up for Groups III and IV revealed that while the minoxidil group experienced significant hair loss after 37 days, the stem cell group exhibited dense and long hair covering the treated area. Conclusion: HUCB-MSC therapy demonstrated superior efficacy over minoxidil with no observed side effects, indicating its potential as a promising alternative for AGA treatment.
СИМУЛЯЦІЙНІ ТЕХНОЛОГІЇ НАВЧАННЯ ЯК НЕВІД’ЄМНА СКЛАДОВА КОМПЕТЕНТНІСНОГО ПІДХОДУ В СУЧАСНІЙ ВИЩІЙ МЕДИЧНІЙ ОСВІТІ
Authors: Бойчук Т. М. , Попова І. С.
Published: November 2024

Завдання сучасної вищої медичної освіти полягає у підготовці висококваліфікованих, конкурентоспроможних медичних працівників, які володіють знаннями, ставленням та вмінням надавати якісні медичні послуги й ефективно комунікувати з пацієнтом. У кризових умовах формат навчання як для студентів, так і для інтернів та лікарів вимушено змінюється на дистанційний чи змішаний, що унеможливлює процес оволодіння та відпрацювання практичних навичок за класичним підходом біля ліжка хворого чи в сучасних центрах симуляційних технологій. Тому метою даної роботи було проаналізувати існуючі підходи у медичній освіті для вирішення проблеми навчання практичних навичок за умов недоступності класичних підходів та провести пошук адаптованих методів навчання в сучасній вищій медичній освіті. У режимі змішаного чи дистанційного навчання рівень медичної освіти не повинен знижуватись, що забезпечується адаптивними підходами для здобуття, відпрацювання та вдосконалення практичних навичок на різних рівнях до- та післядипломної медичної освіти. Такою альтернативою є використання тренажерів для самостійного відпрацювання практичних навичок, які не передбачають перебування слухача в симуляційному центрі, застосування габаритних манекенів чи муляжів, та постійного наставництва викладачів: робота може виконуватися в домашніх умовах за умов самостійного придбання тренувального матеріалу або ж у приміщенні читального залу за умов надання в користування тренажерів ЗВО. Для повноцінного підвищення знань та вмінь лікарі й інструктори екстреної медичної допомоги повинні мати змогу проходити онлайн-курси з БПР на основі віртуальних сценаріїв та реалістичних, нестандартних клінічних завдань. У результаті роботи з симуляційними тренажерами вищих рівнів складності слухач отримує достатній досвід виконання та відтворення практичних навичок, зворотний зв’язок і доступність до практичної роботи у будь-який час, чого наразі не забезпечує класичний підхід у викладанні практичних навичок.
ДОСВІД ВПРОВАДЖЕННЯ НОВОЇ ДИСЦИПЛІНИ «МЕТОДОЛОГІЯ БІОАНАЛІТИЧНИХ ДОСЛІДЖЕНЬ» У ПІДГОТОВКУ МАЙБУТНІХ МАГIСТРIВ ФАРМАЦIЇ
Authors: Логойда Л. С. , Криськів Л. С. , Пелешок К. Є. , Горин М. М.
Published: November 2024

Одним із напрямів професійної діяльності для здобувачів вищої освіти ОПП «Фармація» у Тернопільському національному медичному університеті iменi I. Я. Горбачевського Міністерства охорони здоровʼя України після закінчення навчання є робота в лабораторіях із вивчення фармакокінетики та бiоеквiвалентностi ЛЗ. Нова вибіркова дисципліна «Методологія біоаналітичних досліджень» впроваджена в навчальний процес у 2022–2023 н. р. для здобувачів вищої освіти V курсу фармацевтичного факультету очної та заочної форм навчання.
Методологія біоаналітичних досліджень як наука базується на загальних закономірностях хімічних наук, вивчає методи аналізу аналітів різних фармакологічних груп у ході доклінічних та клінічних досліджень, включаючи дослідження біоеквівалентності та біодоступності, а також дослідження in vitro в категорії ADMET (всмоктування, розподіл, метаболізм, виділення і токсичність), які застосовуються в сучасній світовій фармацевтичній індустрії для розробки та вдосконалення нових лікарських засобів на ранній доклінічній стадії. Обсяг дисциплiни становить 90 год: лекції – 6 год, практичні заняття – 24 год та самостійна робота здобувачів вищої освіти – 60 год. Усі лекції супроводжуються мультимедійними даними для покращення сприйняття інформації при вивченні дисципліни. Під час проведення практичних занять використовуються інтерактивні технології колективно-групового навчання, технології ситуативного моделювання та технології опрацювання дискусійних питань, які допомагають здобувачам вищої освіти зрозуміти й засвоїти основні принципи біоаналітичної розробки та її валідації при вивченні фармакокінетики і біоеквівалентності ЛЗ. Також на практичних заняттях та під час самостійної роботи здобувачі вищої освіти опановують веб-аплети і програмні ресурси, серед яких: SwissADME, SwissTarget Prediction, SuperPred, ProTox 3.0, AutoDock 4.2, PyMOL та інші.
Знання, отримані здобувачами вищої освіти під час вивчення вибіркової дисципліни «Методологія біоаналітичних досліджень», стануть ключовим етапом у формуванні професійних компетентностей та впровадженні їх у майбутній професійній діяльності магістрів фармації.
Tragédia anunciada: Julien Benda e a (re)volta da traição dos Intelectuais
Authors: Costa Marta Nunes da
Published: November 2024

In this article, I will indirectly revisit Julien Benda's emblematic work entitled The Treason of the Intellectuals, from 1927, as a way of raising the question that will guide the text: are we witnessing a return of the treason of intellectuals today? If so, what form does it take? This article has three parts. In the first, I contextualize the work and show how the identification initially postulated by Benda between philosopher and intellectual generates an important dissociation and a subversion of the concept of intellectual. In the second part, I explore the implications of this subversion and point to Benda's defense of democracy in the post-war context. In the third part, I explore the signs of the treason of intellectuals today, based on specific examples of university practices, and I suggest that the current scenario represents the announcement of a tragedy that is already known.
Social Determinants of Health and Disparities in Guideline-Directed Medical Therapy Optimization for Heart Failure
Authors: Jacobs Joshua A. , Ayodele Iyanuoluwa , Bress Adam P. , Sterling Madeline R. , Pandey Ambarish , Derington Catherine G. , Zheutlin Alexander R. , Shah Kevin S. , Greene Stephen J. , Alhanti Brooke , Blanco Rosalia , Fonarow Gregg C.
Published: November 2024

BACKGROUND:

Fewer than 20% of eligible patients with heart failure with reduced ejection fraction receive all 4 pillars of guideline-directed medical therapy. Understanding disparities by race, ethnicity, sex, and adverse social determinants of health is necessary to equitably optimize quadruple therapy.

METHODS:

Utilizing the American Heart Association’s Get With The Guidelines-Heart Failure registry, we examined associations between race and ethnicity, sex, and adverse social determinants of health (insurance type and documented social need [any barrier to accessing health care]) with quadruple therapy optimization (QTO) in patients with heart failure with reduced ejection fraction hospitalized between July 1, 2021, and September 30, 2023, with complete medication data at discharge. We calculated adjusted mean differences (AMDs) in the discharge QTO score (range, 0%–100%) reflecting the proportion of eligible use of renin-angiotensin system inhibitors, β-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors and compared across demographic and adverse social determinants of health groups.

RESULTS:

Among 82 637 patients (median age, 66 years; 32.5% female; 57.0% non-Hispanic White; 76.4% prior heart failure with reduced ejection fraction), the overall mean QTO score was 56.2% (SD, 25.5). After adjustment, compared with non-Hispanic White individuals, Black (AMD, 2.56 percentage points [95% CI, 2.16–2.96]) and Hispanic individuals (AMD, 0.71 percentage points [95% CI, 0.11–1.31]) had higher QTO scores. Females had higher QTO scores than males (AMD, 1.94 percentage points [95% CI, 1.58–2.31]). Patients with no insurance (AMD, −4.90 percentage points [−5.62 to −4.17]), Medicaid (AMD, −0.45 percentage points [−0.89 to −0.01]), and Medicare (AMD, −1.64 percentage points [−2.10 to −1.18]) had lower QTO scores versus private insurance. Those with an identified social need (n=24 651) had lower QTO scores than those without (AMD, −3.40 percentage points [95% CI, −4.10 to −2.71]).

CONCLUSIONS:

Disparities in QTO were most evident for patients with no insurance, Medicaid, Medicare, or potentially an identified social need. Future efforts should focus on reducing gaps to improve equitable guideline-directed medical therapy use.
Comprehensive Proteomics Profiling Identifies Circulating Biomarkers to Distinguish Hypertrophic Cardiomyopathy From Other Cardiomyopathies With Left Ventricular Hypertrophy
Authors: Akita Keitaro , Maurer Mathew S. , Tower-Rader Albree , Fifer Michael A. , Shimada Yuichi J.
Published: November 2024

BACKGROUND:

Distinguishing hypertrophic cardiomyopathy (HCM) from other cardiomyopathies with left ventricular hypertrophy (LVH), such as hypertensive LVH, transthyretin amyloid cardiomyopathy, and aortic stenosis, is sometimes challenging. Using plasma proteomics profiling, we aimed to identify circulating biomarkers and dysregulated signaling pathways specific to HCM.

METHODS:

In this multicenter case-control study, plasma proteomics profiling was performed in cases with HCM and controls with hypertensive LVH, transthyretin amyloid cardiomyopathy, and aortic stenosis. Two-thirds of patients enrolled earlier in each disease group were defined as the training set and the remaining one-third as the test set. Protein concentrations in HCM were compared with those in hypertensive LVH (comparison 1), transthyretin amyloid cardiomyopathy (comparison 2), and aortic stenosis (comparison 3). Candidate proteins that meet the following 2 criteria were selected: (1) higher abundance in HCM throughout all 3 comparisons or lower abundance in HCM throughout all 3 comparisons with univariable
P
<0.05 and |log
2
(fold change)| >0.5 in both the training and test sets and (2) independently associated with HCM with multivariable
P
<0.05 after adjusting for clinical parameters significantly different between HCM and controls. Using the selected candidate proteins, a logistic regression model to distinguish HCM from controls was developed in the training set and applied to the test set. Finally, pathway analysis was performed in each comparison using proteins with different abundance.

RESULTS:

Overall, 4979 proteins in 1415 patients (HCM, n=879; hypertensive LVH, n=331; transthyretin amyloid cardiomyopathy, n=169; aortic stenosis, n=36) were analyzed. Of those, 5 proteins were selected as candidate proteins. The logistic regression model with these 5 proteins had an area under the receiver operating characteristic curve of 0.86 (95% CI, 0.82–0.89) in the test set. The MAPK (mitogen-activated protein kinase) and HIF-1 (hypoxia-inducible factor 1) pathways were dysregulated in HCM throughout the 3 comparisons.

CONCLUSIONS:

This study identified circulating biomarkers that distinguish HCM from other cardiomyopathies with LVH independently from confounders and revealed signaling pathways associated with HCM.
Mavacamten: Real-World Experience From 22 Months of the Risk Evaluation and Mitigation Strategy (REMS) Program
Authors: Desai Milind Y. , Seto Dewey , Cheung Michael , Afsari Sonia , Patel Niki , Bastien Arnaud , Lockman Jeffrey , Coiro Michele , Martinez Matthew W.
Published: November 2024

BACKGROUND:

Mavacamten is the only cardiac myosin inhibitor approved by the U.S. Food and Drug Administration for the treatment of patients with symptomatic New York Heart Association class II–III obstructive hypertrophic cardiomyopathy. Under the Risk Evaluation and Mitigation Strategy program for mavacamten, patients are required to be monitored for the development of systolic heart failure and reduction of left ventricular ejection fraction (LVEF) to <50%. We report results from the mavacamten Risk Evaluation and Mitigation Strategy database (April 28, 2022 to February 27, 2024).

METHODS:

Data on health care providers and pharmacy certification, patient monitoring (from Patient Status Forms, based partly on echocardiograms), and screening for drug interactions before each dispense were collected.

RESULTS:

Of the 6299 patients who received ≥1 dose of mavacamten, 60.0% were women; 64.6% were aged >60 years. Of the 5573 patients with submitted Patient Status Forms, 256 (4.6%) developed LVEF <50%, and 71 (1.3%) experienced heart failure requiring hospitalization. On the 29 111 status forms in these patients, each representing an assessment of an echocardiogram, LVEF <50% was reported on 276 (0.9%), and heart failure requiring hospitalization was reported on 86 (0.3%). Of the 1929 patients with ≥1 year of treatment, 78 (4.0%) had an LVEF reduction to <50%, and 4 (0.2%) experienced LVEF <50% and heart failure requiring hospitalization but later resumed treatment. Of the 3228 patients initiated on 5 mg/d mavacamten and were treated for at least 6 months, 2391 (74.1%) remained at 5 or 10 mg/d. At 3 and 6 months following mavacamten treatment initiation, 57.2% and 70.3%, respectively, demonstrated post-Valsalva left ventricular outflow tract gradient <30 mm Hg.

CONCLUSIONS:

We describe the feasibility and experience of the first 22 months of the Risk Evaluation and Mitigation Strategy program for prescribing mavacamten in >6000 patients with symptomatic obstructive hypertrophic cardiomyopathy. The need for temporary interruption for LVEF <50% was low, including for patients on therapy ≥1 year, with even fewer LVEF reductions associated with heart failure requiring hospitalization.
Associations of Circulating Platelet Endothelial Cell Adhesion Molecule‐1 Levels With Progression of Cerebral Small‐Vessel Disease, Cognitive Decline, and Incident Dementia
Authors: Sim Ming Ann , Tan Eugene S. J. , Chan Siew Pang , Cai Yuan , Chai Yuek Ling , Chong Joyce Ruifen , Chong Eddie Jun Yi , Robert Caroline , Venketasubramanian Narayanaswamy , Tan Boon Yeow , Lai Mitchell K. P. , Hilal Saima , Chen Christopher L. H.
Published: November 2024

Background

The association between platelet endothelial cell adhesion molecule‐1 (PECAM‐1) with cerebral small‐vessel disease and cognition in dementia‐free subjects remains uninvestigated.

Methods and Results

A prospective cohort of dementia‐free subjects was recruited from memory clinics and followed up for 5 years. Annual neurocognitive assessments and twice‐yearly brain magnetic resonance imaging scans were performed. Associations of baseline plasma PECAM‐1 levels with cerebral small‐vessel disease, cognitive decline (Montreal Cognitive Assessment scores and executive function
Z
scores), and incident dementia were evaluated. Of 213 subjects (aged 70.2±7.7 years, 51.2% men), median PECAM‐1 levels were 0.790 (interquartile range, 0.645–0.955 ng/mL). Compared with the highest tertile, subjects within the lowest PECAM‐1 tertile had greater cross‐sectional white matter hyperintensity volume (β=4.84 [95% CI, 0.67–9.01];
P
=0.023), age‐related white matter change scores (β=1.39 [95% CI, 0.12–2.67];
P
=0.033), and cerebral microbleeds (Adjusted risk ratio, 2.59 [95% CI, 1.19–5.62];
P
=0.016). Of the 204 participants with follow‐up data (median, 60.0 [interquartile range, 60.0–60.0] months), 24 (11.8%) developed incident dementia. Compared with the highest tertile, subjects within the lower tertiles of PECAM‐1 had a higher risk of incident dementia (first tertile: adjusted hazard ratio [AHR], 4.52 [95% CI, 1.35–15.13];
P
=0.024; second tertile: AHR, 3.28 [95% CI, 1.02–10.60];
P
=0.047). The lowest PECAM‐1 tertile was associated with greater progression of white matter hyperintensity volume (β=4.15 [95% CI, 0.06–8.24];
P
=0.047), cerebral microbleeds (incident relative risk [IRR], 2.21 [95% CI, 1.05–4.65];
P
=0.036), and decline in executive function (β=−0.45 [95% CI, −0.76 to −0.14];
P
=0.004), and Montreal Cognitive Assessment (β=−1.32 [95% CI, −2.30 to −0.35];
P
=0.008) scores.

Conclusions

In dementia‐free subjects, lower circulating PECAM‐1 levels are associated with greater cerebral small‐vessel disease progression and cognitive decline, thus warranting future study as a potential therapeutic target.
Burden of Hyperlipidemia, Cardiovascular Mortality, and COVID‐19: A Retrospective‐Cohort Analysis of US Data
Authors: Pham Hoang Nhat , Ibrahim Ramzi , Sainbayar Enkhtsogt , Olson April , Singh Amitoj , Khanji Mohammed Y. , Lee Justin , Somers Virend K. , Wenger Christopher , Chahal C. Anwar A. , Mamas Mamas A.
Published: November 2024

Background

Hyperlipidemia is a major cardiovascular disease (CVD) risk factor, but there are limited data on its mortality trends in CVD over time. We assessed annual hyperlipidemia‐related CVD mortality trends in the United States, including the COVID‐19 pandemic's impact.

Methods and Results

Mortality data were obtained from the Centers for Disease Control and Prevention repository between 1999 and 2020 among patients ≥15 years old, using
International Classification of Diseases, Tenth Revision
(
ICD‐10
) codes for hyperlipidemia (E78.0–E78.5) and CVD (I00–I99). Age‐adjusted mortality rates (AAMRs) per 1 000 000 population were standardized to the 2000 US population. Log‐linear regression models were used to evaluate mortality shifts. Average annual percentage change from 1999 to 2019 was used to project 2020 AAMRs, estimating pandemic‐attributed excess deaths. From 1999 to 2020, 483 155 hyperlipidemia‐related CVD deaths occurred. Despite a general CVD mortality decline, hyperlipidemia‐related CVD AAMRs rose from 36.33 in 1999 to 99.77 in 2019. Ischemic heart diseases (AAMR 49.39) were the leading cause, whereas hypertension had the highest mortality increase (average annual percentage change +10.23%). Mortality rates were higher in men (AAMR 104.87) and non‐Hispanic (AAMR 82.49), and rural populations (AAMR 89.98). Highest mortality was observed in Black populations (AAMR 84.35), those ≥75 years old (AAMR 646.45), and Western US regions (AAMR 96.88). During the first pandemic year, deaths exceeded projections by 10.55%, with notable increases among ages 35 to 75 (14.23%), Hispanic (17.96%), Black (14.82%), and urban (11.68%) groups.

Conclusions

Hyperlipidemia‐related CVD mortality has risen over the past 2 decades, further heightened by the COVID‐19 pandemic, with higher impact on men, Black Americans, the older population, and rural residents. Further study is needed to understand contributing factors and mitigate disparities.
Impact of Environmental Noise and Sleep Health on Pediatric Hypertension Incidence: ABCD Study
Authors: De Moraes Augusto César F. , Ma Martin Y. , Nascimento‐Ferreira Marcus V. , Hunt Ethan H. , Hoelscher Deanna M.
Published: November 2024

Background

Pediatric hypertension is linked to environmental factors like neighborhood noise disrupting sleep, which is crucial for health. The specific interaction between noise and sleep health in causing hypertension still needs to be explored.

Methods and Results

We analyzed data from 3320 participants of the ABCD (Adolescent Brain Cognitive Development) study, recruited across 21 US cities and monitored from 2018 to 2020 through 2020 to 2022. Participants with complete data on Fitbit‐tracked sleep, blood pressure, height, neighborhood noise, and covariates (biological sex, race and ethnicity, pubertal stage, waist circumference) were included. Hypertension was defined as average blood pressure ≥95th percentile for age, sex, and height. Sleep health was categorized on the basis of daily duration: healthy (9–12 hours), moderately healthy (±1 hour from optimal), and low (≥1 hour deviation). Noise exposure was measured as median nighttime anthropogenic noise levels by zip code. The incidence of hypertension increased from 1.7% (95% CI, 1.4–2.1) in 2018 to 2020 to 2.9% (95% CI, 2.4–3.6) in 2020 to 2022. Adolescents with healthier sleep had a lower risk of developing hypertension (relative risk, 0.63 [95% CI, 0.25–0.82]), while no significant effects were found for neighborhood noise alone or in combination with sleep health.

Conclusions

Adequate sleep significantly reduces the risk of hypertension in adolescents, independent of environmental noise exposure. These findings underscore the importance of promoting good sleep hygiene among youth to mitigate hypertension risk.
Racial and Ethnic and Sex Disparities in the Outcomes and Treatment of In‐Hospital Cardiac Arrest: A Nationwide Analysis From the United States
Authors: Mohamoud Abdilahi , Abdallah Nadhem , Ismayl Mahmoud , Linzer Mark , Karim Rehan M. , Wardhere Abdirahman , Johnson Dawn , Goldsweig Andrew
Published: November 2024

Background

In‐hospital cardiac arrest (IHCA) is associated with significant morbidity and mortality. The relationships between race and ethnicity and sex on outcomes and treatment patterns among patients with IHCA remain poorly understood.

Methods and Results

We conducted a retrospective study using the National (Nationwide) Inpatient Sample (NIS) database from 2016 to 2020 to identify adult patients with IHCA and examine the associations between in‐hospital outcomes and race and ethnicity (White, Black, Hispanic) and sex. The primary outcome was in‐hospital mortality. Secondary outcomes included rates of in‐hospital procedures. Multivariable logistic regression analysis was used to adjust for potential confounders. Among 207 770 patients with IHCA, 26.6% had ventricular tachycardia/ventricular fibrillation and 73.4% had pulseless electrical activity/asystole. For ventricular tachycardia/ventricular fibrillation arrest, Black men (adjusted odds ratio [aOR], 1.42 [95% CI, 1.21–1.66]), Black women (aOR, 1.25 [95% CI, 1.05–1.50]), and Hispanic women (aOR, 1.30 [95% CI, 1.01–1.66]) had higher odds of mortality compared with White men (corresponding adjusted risk ratios [aRRs], 1.10 [CI, 1.06–1.14], 1.06 [95% CI, 1.02–1.11], and 1.08 [95% CI, 1.01–1.14], respectively). In the pulseless electrical activity/asystole arrest subgroup, Black men (aOR, 1.25 [95% CI, 1.11–1.39]) and Hispanic men (aOR, 1.22 [95% CI, 1.07–1.40]) had higher odds of mortality (corresponding aRRs, 1.04 [95% CI, 1.02–1.06] and 1.04 [95% CI, 1.01–1.06], respectively). Black patients with IHCA were less likely to receive percutaneous coronary intervention, coronary artery bypass grafting, and mechanical circulatory support compared with White men.

Conclusions

Significant racial and ethnic and sex disparities exist in outcomes and treatment patterns among patients with IHCA. Targeted efforts and further studies are needed to better understand and address these disparities and improve outcomes.
Diastolic Dysfunction and the Risk of Stroke and Major Bleeding
Authors: Kundrick John , Saba Karina I. , Naniwadekar Aditi , Singla Virginia , Mulukutla Suresh , Thoma Floyd , Bhonsale Aditya , Kancharla Krishna , Voigt Andrew , Shalaby Alaa A. , Estes III N.A. Mark , Jain Sandeep , Saba Samir
Published: November 2024

BACKGROUND:

Left ventricular diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes including atrial fibrillation. Whether DD is independently associated with incident stroke and transient ischemic attack (TIA) and with bleeding events is not known. We performed this observational cohort analysis to examine the impact of DD on the risk of stroke/TIA and major bleeding.

METHODS:

Patients who underwent at least 1 cardiac echocardiogram and were followed for at least 3 months were included in this study. Patients with a prior history of stroke, TIA, or major bleeding, as determined by
International Classifications of Diseases
codes, were excluded. Smart key-phrase search was applied to echocardiographic reports to classify patients into 4 groups based on the most severe DD assessment. Patients in whom the presence of DD could not be determined were excluded. The final study cohort was followed to the end point of hospital admission for stroke/TIA and major bleeding, and independent predictors of these events were evaluated using the multivariable Cox proportional hazards method.

RESULTS:

The final study cohort (age, 56±18 years; 56% women) had 96 702 patients with no DD and 18 164, 5881, and 1340 patients with DD grades I, II, and III, respectively. Over a median follow-up of 3.4 years, 2938 (2.4%) patients were hospitalized for stroke/TIA and 5567 (4.6%) for major bleeding. After adjusting for age, the CHA
2
DS
2
-VASc score, chronic kidney disease, use of antiplatelet agents, use of anticoagulation agents, the year of echocardiographic testing, household income, and history of atrial fibrillation, DD remained a strong predictor of incident stroke/TIA (hazard ratio, 1.22 per grade increase in DD [95% CI, 1.16–1.29];
P
<0.001) and major bleeding (hazard ratio, 1.20 per grade increase in DD [95% CI, 1.16–1.25];
P
<0.001).

CONCLUSIONS:

DD is independently associated with a higher risk of cerebrovascular accidents and major bleeding. DD should be considered when counseling patients regarding their risk profile and management options.
A Comparison between Pope Francis and Leonardo Boff’s Views on the Ecological Crisis
Authors: Chen Jiji
Published: November 2024

This article sets out to compare the works of Pope Francis’ Laudato Si’ and Leonardo Boff’s Cry of the Earth, Cry of the Poor in the way in which they share a common theme to do with the environmental crisis facing our earth. The similarities include their focus on Latin America, the importance of cross-cultural dialogue, and their concern for the welfare of the poor and other created beings. Both authors argue that anthropocentrism is a misinterpretation of Scripture and that a new cross-cultural dialogue is necessary to address this issue. While Pope Francis advocates using the power of science and technology to create an ‘integral ecology’, Boff prefers to start with cosmology and develop ‘new paradigms’. A comparative study can contribute to a reflection on the relationship between Christian theology and ecology, politics, and human beings; an analysis of anthropocentrism can clarify how human beings deal with their relationship with other created beings.
10. רענ versus הרענ with Feminine Singular Referent
Authors: Hornkohl Aaron D.
Published: November 2024

The chapter focuses on the peculiarity of the Hebrew of the Tiberian Torah, the written component of which generally refers to both ‘young male’ and ‘young female’ by means of the form נער. The corresponding reading component, by contrast, distinguishes masculine נַעַר and feminine נַעֲרָה, like the combined Tiberian written-reading tradition of the rest of the Bible and ancient Hebrew sources more generally. The consonant-vocalic dissonance sets the CBH of the Masoretic Torah apart from that of the Prophets and Writings.

The potential explanations for this phenomenon centre around whether the differences in the Tiberian Torah are primarily orthographic or linguistic. An orthographic explanation posits that the spelling reflects anomalous archaic final-defective spelling conventions, with the Masoretic Torah retaining older forms. Conversely, a linguistic interpretation suggests that the written form נער functioned as an epicene term in ancient Hebrew, initially lacking distinct gender markers, but later developing into the more differentiated forms seen elsewhere. Ultimately, the chapter proposes that both ancient linguistic features and later developments influenced the Tiberian texts, indicating that the distinction between the written forms in the Torah and those in the Prophets and Writings may represent a combination of historical language preservation and subsequent standardisation practices during the Second Temple Period.
Conclusion
Authors: Hornkohl Aaron D.
Published: November 2024

The book investigates whether the linguistic and orthographic features that differentiate the Tiberian Torah from the non-LBH Prophets and Writings signify inner-CBH diachronic development. Scholars generally agree that the composition of the CBH corpus occurred over centuries, from approximately 1000 BCE to 600 BCE, but the effects of inner-CBH evolution have been obscured by various factors, including the transition from oral to written traditions, the complexities of the writing system, scribal practices, and the influence of oral reading traditions. Although the limited sample size of the Tiberian biblical corpus poses challenges, it is argued that these obstacles can be navigated through careful analysis of the evidence, considering alternative explanations, and recognising the implications of findings, ultimately asserting that such factors do not entirely hinder diachronic investigation.

The study addresses two major methodological issues: the potential for extant distinctions between CBH texts to represent secondary developments and the challenge of distinguishing between orthographic variation and linguistic significance. It recognises the need for a nuanced understanding of biblical literature’s periodisation, particularly regarding the Documentary Hypothesis and the CBH-LBH dichotomy. The author posits a schema of ABH-CBH1-CBH2-TBH-LBH, tentatively associating CBH with 1000–600 BCE and dividing it into CBH1 (representing 1000–800 BCE) and CBH2 (reflecting 800–600 BCE). Despite uncertainties inherent in the evidence, the author expresses optimism about the potential for understanding the development of ancient Hebrew and the composition and transmission of the Hebrew Bible through principled use of the data and their integration in plausible narratives that account for inner-CBH variation.
A New ENSO Statistical Prediction Model considering Extratropical Effects and Its Application to the Prediction of the 2015/16 El Niño Event
Authors: Tan Jing , Feng Licheng , Jiang Hua , Zhou Qian , Huang Yongyong
Published: November 2024

Understanding the evolution mechanisms and providing accurate predictions for ENSO continue to be a challenge for the research community. In recent years, some studies pointed out that the extratropical Pacific atmosphere and ocean variations may affect the evolution of ENSO, which is different from the classical theoretical framework of ENSO. In this study, by combining tropical atmosphere and ocean predictors with extratropical precursors, an ENSO statistical prediction model was constructed. It was found that including extratropical predictors can significantly enhance the prediction skills of the model. The Victoria mode index (VMI) can significantly improve the prediction skills in the 10–12-month lead model and can effectively help the model cross the spring predictability barrier (SPB). When predicting 6–8 months in advance, the South Pacific Oscillation index (SPOI) can improve the prediction skills, but the degree of the improvement is relatively small. The model was also applied to conduct prediction experiments on the 2015/16 El Niño event. It was found that the model can successfully predict the event nearly 1 year in advance, mainly due to the inclusion of the VMI. Due to the interdecadal variation in the relationship between predictors and ENSO, when constructing the 6-month lead model, using data since 2000 and replacing the 6-month lead VMI with a 10-month lead, one can effectively improve the model’s prediction skills, especially in predicting the intensity of 2015/16 El Niño events, which has shown significant improvement.
Sino-Japanese Reactive Diplomacy Through BRI and FOIP in Bangladesh: Economic Implications
Authors: Akon Md. Saifullah , Raj S. M. Rabby , Aktar Md. Nadim , Abdullah-Al-Mamun
Published: November 2024

This study delves into the realm of Sino-Japanese reactive diplomacy within the context of Bangladesh. It primarily examines their engagements through the Belt and Road Initiative (BRI) and the Free and Open Indo-Pacific (FOIP) vision. The study evaluates these diplomatic efforts’ economic upshots in a continuously changing regional context. The contest between China and Japan for influence in Bangladesh has grown in the last few years due to the country’s constant economic growth. This study investigates how both nations use reactive diplomacy, reacting to each other’s actions and changing tactics to support Bangladesh’s economic growth. The Chinese government has invested significantly in infrastructure-related projects in Bangladesh as a part of the BRI, and Japan’s FOIP strategy strongly emphasises connectedness and high-quality infrastructure. This dichotomy of approaches leads to an intricate web of interactions with local stakeholders, reflecting diverse economic implications. However, the study emphasises how crucial it is to examine Bangladesh’s strategy for navigating this diplomatic rivalry—that is, how to balance the economic gains from bilateral investments while avoiding undue reliance or political entanglements.
Justice & Joy: Transforming Healing Praxis in Counseling Psychology and Beyond
Authors: Neville Helen A.
Published: November 2024

Amid today's polycrisis—marked by global violence, chaos, and uncertainty—there is an urgent imperative for healing. In this reimagined presidential address, I advocate for centering justice and joy as powerful forces for healing, which is a core value of the Society of Counseling Psychology (SCP). I share SCP's yearlong activities exploring personal and collective healing. Drawing from interdisciplinary research, critical dialogue, and my experiences co-teaching a course on this topic, I introduce a framework outlining six healing ingredients of joy: deep connection, existential recognition, flow, shared beliefs and actions, radical hope, and self-determination/freedom/liberation. Before presenting this framework, I examine Black joy as a counter to the epistemic violence that often erases the contributions of Black scholars. The proposed new framework portrays joy not only as a personal emotion, but as a collective assertion of humanity. I conclude with recommendations to advance healing practices in research, training, and practice.
De jure powersharing 1975–2019: Updating the Inclusion, Dispersion, and Constraints Dataset
Authors: Ziff Alix , Barnum Miriam , Abadeer Ashley , Chu Jasmine , Jao Nicole , Zaragoza Marie , Graham Benjamin AT
Published: November 2024

Powersharing institutions are often prescribed to enhance civil peace, democratic survival, and the equitable provision of public services, and these institutions have become more prevalent over time. Nonetheless, the past decade has seen a rise in democratic backsliding and competitive authoritarianism, raising questions about how the relationship between powersharing, democracy, and civil peace may be evolving. This article introduces an update to the Inclusion, Dispersion, and Constraints (IDC) powersharing dataset that adds nine years of data, up through 2019. These new data include enhanced intercoder reliability checks, a significant reduction in missing values, and the documentation and correction of some coding errors in the original data. We also employ latent variable models to estimate each of three types of powersharing, allowing scholars to account for measurement uncertainty in analyses of the causes and consequences of powersharing. This dataset allows scholars to address urgent questions about whether previously observed relationships between powersharing and democracy and powersharing and civil peace still hold in this new era, and in what contexts powersharing institutions remain advisable.
Exploring Gender Disparities in Prosecutorial and Judicial Decision-Making in the Global South: Evidence from Argentina
Authors: Quintana-Navarrete Miguel , Fondevila Gustavo , Cafferata Fernando G.
Published: November 2024

Objectives

This study examines gender disparities in criminal cases from the earliest stages of prosecutorial decision-making in Argentina.

Methods

The data for this study are all alleged crimes reported to prosecutors in La Pampa, Argentina between January 2016 and July 2019 that had ended by August 2019. Logistic and multinomial regression models with judicial district-by-year fixed effects are used to estimate the probability of case-ending and other important decisions for counts with women as suspects vis-à-vis men.

Results

The results show that prosecutors are more likely to decline investigating crime reports with women as suspects. Once accepted for investigation, counts with women are also more likely to be dismissed and less likely to receive a conviction. Gender disparities also accumulate across decisions and are reflected in faster adjudications for women. The gender gap in disposition shrinks considerably for some women, most notably those with a prior conviction, providing some evidence of selective leniency.

Conclusions

This study shows that women are treated more leniently than men, from the earliest prosecutorial decisions and across major outcomes in a Global South country. The implications of these findings are discussed in terms of theoretical frameworks developed in the Global North.
Metatheoretical Distinctions in Theories of Functional Differentiation: Delineating Alternative Traditions
Authors: Taylor Mitchell J.
Published: November 2024

While the concept of functional differentiation is one of sociology’s oldest analytic tools, there is significant confusion about its meaning and purpose in the contemporary discipline. This article addresses one source of uncertainty: the conflicting array of ontological and methodological positions which are currently attached to the differentiation term. Drawing on Laudan’s philosophy of science, I argue that sociology does not house a unified program of differentiation theory, but is instead marked by at least two discrete traditions of differentiation thinking. Disentangling these traditions will, I contend, clarify our thinking, and help reduce the prevalence of internally contradictory conceptual models.
Theoretical Approaches to Communicative Practices in the Study of Intergenerational Communication and Aging
Authors: Giles Howard
Published: November 2024

Intergenerational communication and aging is a thriving interdisciplinary, methodologically diverse field having significant implications for understanding the aging process. This opening article to the special issue provides a brief overview of this research domain, with particular attention to theoretical practices within it. Communication accommodation theory (CAT) is introduced given it has provided a foundation for other well-cited models of communication and aging. In so doing, a couple of the CAT principles are elaborated, based on recent work on age meta-stereotyping and intergroup felt understanding. CAT is also a component of the influential “communication ecology model of successful aging” and, after exploring some of its tenets, its visually schematic representation is elaborated as well as connections speculated regarding its relationship with the communicative lives of SuperAgers. Thereafter, highlights emerging from the articles in this special issue that follow are drawn out.
“This Generation” from Mark to Judas: On the Hermeneutics of Intra-gospel Reception
Authors: Edsall Benjamin A.
Published: November 2024

Although the reception of Mark has a very long tradition within New Testament studies in discussions of the Synoptic problem or the relation of the Synoptics to John, nevertheless works on reception of the Gospel beyond the New Testament are few. Further, especially for the early period, these works focus primarily on the fact of Markan reception—who knew it and accepted it—rather than its hermeneutical potential. The present essay focuses on this hermeneutical question, tracing the Markan language of “this generation” through its reception, rejection, and adaptation in Gospel literature up to the Gospel of Judas. I argue that this intra-Gospel reception reflects back on Mark itself and illuminate aspects of its interpretive possibilities. Indeed, I aim to show here that Mark’s reception is intrinsic to its possibility for meaning at all and by attending to the ways in which early texts from Matthew to Judas interpret Mark enables one to appreciate the very different ways Mark’s potential meaning is actualized. This argument demonstrates the value of uniting exegetical and diachronic description with a dialogical hermeneutical framework, facilitating mutual interpretation without simple harmonization.
Influence of Injury Patterns and Management Strategies on Outcomes in Trauma Patients with Epistaxis
Authors: Alnemare Ahmad K.
Published: November 2024

Background: Epistaxis is a common emergency, particularly in the context of trauma. Understanding patterns and outcomes of epistaxis in a trauma setting can inform treatment strategies and improve patient care. Objectives: To evaluate the demographic characteristics, clinical features, and outcomes of patients treated for epistaxis following trauma. Methods: This retrospective case-control study included 1106 patients from the National Trauma Data Bank diagnosed with trauma-related epistaxis. The clinical outcomes assessed included hospital stay duration, complication rates, and mortality. Results: In comparison with younger patients, older patients were found to undergo operative intervention significantly more frequently (median age, 65 years vs 44 years; P < .001). The prevalence of cardiovascular and psychiatric comorbidities was higher in the operative group ( P = .004 and P = .041, respectively). Mortality risk was not found to be independently influenced by epistaxis management approach. Conclusions: In older individuals with comorbid conditions, trauma-related epistaxis is more likely to result in operative intervention and associated complications. Nonetheless, the management of epistaxis does not appear to have a significant impact on mortality risk.
Prophylactic 24 versus 48 h cephalosporins in cardiac surgery: A randomized trial
Authors: Koudieh Mohammed , Al Saif Shukri , Oueida Farouk , Baradai Abdulaziz , Alkhamees Khalid , Otabi Abdullah , Al Tahir Hatem , Younis Hesham , Al Qudaihi Ghada , Essa Mostafa , Maharem Tarek , Fadel Mostafa , Al Balwai Dina , Eskander Khalid
Published: November 2024

Background

Recommendations for cardiac surgery advocate for antibiotic prophylaxis for up to 48 hour after surgery. However, recent reports found a significant reduction in surgical site infection with extended duration. We evaluated the effect of the type of prophylactic antibiotics and administration durations on the postoperative surgical site infection rate following cardiac surgery in adults.

Methods

An investigator-initiated randomized controlled trial was conducted from 2018 to 2022 on adult patients undergoing cardiac surgery. Patients were randomized into four groups based on antibiotic treatment type and duration: 24 h cefazolin, 24 h cefuroxime, 48 h cefazolin, and 48 h cefuroxime. The primary outcome was the rate of surgical site infections within 90 days of surgery.

Results

A total of 568 patients were included in this study. The four groups had similar baseline characteristics, including age, sex, EuroSCORE II, and baseline HbA1c. A total of 75 patients developed infection within 90 days postoperative. The overall infection rate was not statistically different across the four groups ( p = 0.193). The efficacy of cefazolin and cefuroxime in reducing infection was comparable ( p = 0.901). Extended prophylaxis was associated with a significantly reduced overall infection rate within 90 days postoperatively compared to 24-h prophylaxis (10.2% vs. 16.3%; risk ratio = 0.62, 95% confidence interval: 0.40–0.96, p = 0.032).

Conclusion

Using cefazolin or cefuroxime for 48 h instead of 24 h was more effective in reducing the overall surgical site infections rate up to 90 days after surgery.
Reliability, validity and usability of the K-force® grip dynamometer to evaluate handgrip-strength in patients with intensive care unit-acquired weakness
Authors: van Iperen Ingrid D , Stegink Daphne , Tempert- de Haan Barbara L , Flim Marleen , van der Stoep Robert , Spronk Peter E
Published: November 2024

Objective

Handgrip dynamometry is recognised as a method for evaluating volitional muscle strength in the intensive care, but conventional handgrip dynamometers cannot accurately measure grip strength in very weak patients. The aim of this study was to determine the reliability, validity and usability of the K-force® grip in patients with intensive care unit-acquired weakness.

Design

Evaluation of measurement properties of the K-force® grip.

Setting

Two Intensive Care Units in The Netherlands.

Participants

Patients diagnosed with intensive care unit-acquired weakness according to a Medical Research Council sum score <48.

Intervention & Main measures

Intra- and inter-rater reliability of the K-force® grip were assessed using the intraclass correlation coefficient. Concurrent validity was examined using calibration weights. The usability was evaluated with the System Usability Scale.

Results

Intra-rater reliability showed an intraclass correlation coefficient of 0.987 for the dominant hand and 0.972 for the non-dominant hand. Inter-rater reliability showed coefficients of 0.944 for the dominant hand and 0.942 for the non-dominant hand. There was a perfect correlation ( r = 1) between the K-force® grip and the calibration weights. The usability of the K-force® grip was rated excellent by 11 healthcare professionals with a System Usability Scale score of 86.

Conclusions

The K-force® grip is a promising new tool for the evaluation of muscle strength in intensive care unit-acquired weakness patients who are too weak to use conventional hand dynamometers.
Do High-Level Visits Reflect Regional Priorities? A Study of U.S. News Media Data
Authors: Aras Bulent , Dagci Kenan
Published: November 2024

This study examines the representation of regional organization (RO) interests during high-level visits of their member states to the United States using a novel dataset of 1,040 news articles from 1991 to 2023. The data analysis focuses on ASEAN, BRICS, ECOWAS, and GCC and employs sentiment analysis and topic modeling to explore how member states leverage these visits and how U.S. news media frames these events. The analysis of data reveals that member states strategically utilize high-level visits to promote RO agendas and interests, with varying levels of success depending on the RO and the U. S. media’s reception. Furthermore, the analysis reveals a shifting focus from bilateral issues to regional and international concerns over time, underscoring the evolving priorities of RO member states in a globalized world. The findings offer valuable insights into the interplay of national and regional interests during high-level diplomatic visits and the influential role of U.S. news media in shaping public perception.