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Acute alterations in blood lactate in the setting of transient stress induced myocardial ischaemia
No full textAbstract
Background
An elevation in resting venous blood lactate levels ([La-]b) in conditions of myocardial hypoperfusion is associated with adverse prognosis and survival. This investigation aimed to assess changes in venous [La-]b levels induced by dobutamine stress in the presence and absence of myocardial ischaemia and adverse outcomes at 1-year.
Methods
404 consecutive patients (mean age 70±10 years, 243 male) reporting chest pain underwent dobutamine stress echocardiography and were categorised as ischaemic (IS) or non-ischaemic (NI) responders. Conventional and global longitudinal strain (GLS) echocardiographic measures were recorded at rest. Venous [La-]b samples were acquired at rest, peak stress and 1, 3, 5 and 10-minutes into recovery using a commercially available Lactate Pro 2 device.
Results
There were no significant differences in [La-]b concentrations between IS (1.75±0.76 mmol×L-1) and NI (1.73±0.60 mmol×L-1) responders at baseline (p=0.592). However, [La-]b concentrations were significantly greater at peak stress (1.83±0.57 vs. 1.68±0.60 mmol×L-1), 1 (1.90±0.56 vs. 1.73±0.71 mmol×L-1), 3 (1.97±0.56 vs. 1.73±0.71 mmol×L-1), 5 (1.98±0.60 vs. 1.74±0.70 mmol×L-1), and 10-minutes (2.01±0.63 vs. 1.76±0.71 mmol×L-1) into recovery between IS and NI responders (all p<0.001), respectfully. GLS was significantly lower in IS compared to NI responders (-15.5±2.9 vs -16.2±2.7%, p=0.02) at baseline. In patients who experienced an adverse cardiac event during 1-year of follow-up, GLS (-14.4±2.7 vs -16.1±2.8%, p<0.001) and [La-]b concentrations were significantly lower at baseline (1.54±0.55 mmol×L-1 vs. 1.78±0.70 mmol×L-1, p=0.02), as were [La-]b concentrations at 5 (1.68±0.55 mmol×L-1 vs. 1.88±0.68 mmol×L-1, p=0.04) and 10-minutes (1.70±0.56 mmol×L-1 vs. 1.93±0.71 mmol×L-1, p=0.02) into recovery compared to patients who did not experience an adverse event, respectively. GLS (HR 1.21; 95% CI 1.11 to 1.33, p<0.001) and [La-]b concentrations at 10-minutes into recovery (HR 0.54; 95% CI 0.33 to 0.85, p=0.01) were significant independent predictors of an adverse event.
Conclusions
Transient myocardial ischaemia is associated with a significant elevation in [La-]b concentrations, which extends into the recovery period, compared to NI responders. A blunted metabolic response to dobutamine stress and attenuated longitudinal myocardial mechanics are independently associated with short-term adverse events
Obsessive-compulsive disorder (OCD) help-seeking influences and the relationship between distress tolerance, mindfulness, self compassion and OCD
No full textBackground: Research and reviews have often overlooked the qualitative findings regarding potential influences on help-seeking for obsessive-compulsive disorder (OCD).
Method: A systematic literature search of seven databases was conducted, resulting in 1029 papers. Fourteen qualitative papers and one mixed methods paper focused on the perspectives and experiences of people living with OCD and their relatives were extracted for thematic synthesis. The quality of studies was assessed using the Critical Appraisal Skills Programme (CASP) framework.
Results: Thematic synthesis resulted in five themes, including ten subthemes: understanding and recognition of OCD, deciding if help is needed, stigma associated with disclosure, and searching for appropriate intervention and support outside professional networks. The findings give a lived experience voice to existing findings from quantitative reviews.
Conclusions: Whether people sought and engaged with help was influenced by individual,social, public health systems, and wider societal influences. The interconnected nature of these
influences needs to be considered in clinical and research implications. Limitations of the review include transferability due to the predominantly White-Eurocentric focus of participants contributing to included studies and limited explicit focus on the topics of seeking and engaging
with help
Intracellular and extracellular activities of V-domain Ig-containing suppressor of T cell activation (VISTA) modulated by immunosuppressive factors of tumour microenvironment.
No full textV-domain Ig-containing suppressor of T cell activation (VISTA) is a unique immune checkpoint protein, which was reported to display both receptor and ligand activities. However, the mechanisms of regulation of VISTA activity and functions by factors of tumour microenvironment (TME) remain unclear and understanding these processes is required in order to develop successful personalised cancer immunotherapeutic strategies and approaches. Here we report for the very first time that VISTA interacts with another immune checkpoint protein galectin-9 inside the cell most likely facilitating its interaction with TGF-β-activated kinase 1 (TAK1). This process is required for protection of lysosomes, which is crucial for many cell types and tissues. We found that VISTA expression can be differentially controlled by crucial factors present in TME, such as transforming growth factor beta type 1 (TGF-β) and hypoxia as well as other factors activating hypoxic signalling. We confirmed that involvement of these important pathways modulated by TME differentially influences VISTA expression in different cell types. These networks include: TGF-β-Smad3 pathway, TAK1 (TGF-β-activated kinase 1) or apoptosis signal-regulating kinase 1 (ASK1)-induced activation of activating transcription factor 2 (ATF-2) and hypoxic signalling pathway. Based on this work we determined the five critical functions of VISTA and the role of TME factors in controlling (modulating or downregulating) VISTA expression. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
Evaluating listening behaviours of nightclub goers: An international web-based study with resident advisor
No full textBackground: Nightclubs expose nearly 40% of young adults in high- and middle-income countries to damaging levels of noise with attendant risk of noise-damage hearing symptoms and sequelae of mood disorders, social isolation and dementia. This study evaluated clubbers hearing symptoms, visiting behaviours and safe listening habits.
Material and Methods: A web-based, population-specific data collection tool was shown to visitors of the dance music website Resident Advisor over a 7-hour period. It identified how often and for how long clubbers attend loud music venues (as this will influence their safe-noise dose) alongside their attitudes, use of safer listening practices and whether their visit frequency changed with the presence of hearing symptoms. For analysis, we used descriptive statistics, Chi-squared test, Fisher exact test and logistic regression analysis.
Results: We collected 1020 (29.0%) responses from 3516 data collection tool invites. Key findings are as follows: 73.4% (n = 749) of respondents had permanent ear symptoms (‘sometimes’, ‘often’ or ‘always’). Respondents attended loud music venues 1–5 times per month (78.5%, n = 801) for a duration of 5–6 hours a visit (41.1%, n = 419) on average. When in loud venues, 32.3% wore earplugs, 38.5% took regular listening breaks, 5.9% checked the noise level, 45.4% moved to a quieter spot and 13.2% had a hearing test in the last year. Two-thirds and one-half of those with no or temporary hearing symptoms, respectively, would attend music venues less often if they were to develop symptoms or if symptoms were to worsen.
Conclusions: Based on our visit data, the average music venue patron has some degree of permanent hearing-damage symptoms and should be aware that they are very likely to exceed their safe-noise dose (and risk irreversible hearing damage) even in venues adhering to the World Health Organization standard for safe listening loudness
Authentic leadership and well-being in sport: the mediating role of psychological safety and the moderating role of interpersonal violence
No full textSport leaders, such as coaches, are critical in promoting psychological safety with subsequent effects on athlete well-being. However, many athletes experience interpersonal violence (e.g., psychological abuse), which can negatively influence their well-being and may attenuate the beneficial effects of positive coaching styles such as authentic leadership in psychologically safe environments. Understanding the relationship between authentic leadership, psychological safety and athlete well-being after experiencing interpersonal violence in sport is important in designing effective safeguarding interventions and policy. In this study, we were the first to examine the indirect relationship between authentic leadership and well-being via psychological safety, and if the direct relationship between authentic leadership and well-being is moderated by interpersonal violence. Competitive athletes (N = 305; 52% female, 29.20 ± 12.62 years old) completed an anonymous questionnaire measuring authentic leadership of their current coach, psychological safety, interpersonal violence, and well-being. Authentic leadership was indirectly related to well-being via psychological safety (effect size = 0.13, 95% CI = 0.07 to 0.19), and the direct effect of authentic leadership on well-being was significant only when interpersonal violence scores were low or moderate. These findings suggest that when athletes perceive their coaches to be authentic leaders, they are more likely to feel psychologically safe, and in turn have a greater sense of well-being. However, authentic leaders are less likely to positively influence well-being when athletes have experienced interpersonal violence even when they feel psychologically safe. A need exists to prevent interpersonal violence so that coaches displaying authentic leadership qualities can positively influence their athletes’ well-being
Commuter students: What do you need to make a student city work?
No full textStudents’ experience is geographical: it happens in accommodation, on public transport, in their GP’s surgery, in work, and in the voting booth. Students and graduates bring economic and cultural benefits to their regions yet they are rarely considered as objects of policy. Susan Kenyon and Joel Dowson draw on research and practice to ask how universities can influence regional policymakers to attract and retain students and graduates
Harpsichord recital
No full textBaroque pieces played on a harpsichord, two recitals of 45 minutes of music
Exploring the factors for inequalities in attainment outcomes within foundation year business and law at CCCU – A student perspective
Full text linkThe main focus of the paper is on understanding the factors in attainment and outcome inequalities from a student perspective within foundation year in Business and Law at Canterbury Christ Church University (CCCU). We will explore and reflect on teaching and learning and critically evaluate the impact of interventions based on the sector bast practices, adapted and implemented during academic year 2023-2024. The research aims at understanding the BAME attainment gap within the foundation year programme through exploration of themes such as sense of belonging and the role of ethnicity.
Critical Race Theory (Rollock and Gillborn, 2011) will be used predominantly reflecting on teaching and learning and understanding student lived experiences and perceptions of the students of colour (BAME: Black, Asian and minority ethnic groups).
Structured interviews (qualitative) will be used to collect data to aid understanding of the individual learning experiences in wider societal context. Participants will be recruited through purposive sampling. The data will be analysed using thematic analysis (Braun and Clarke (2006). The results will help to assess the impact of undertaken interventions and inform further interventions to aid pedagogical transformation across our foundation level programmes. We hope to share some preliminary results, and we hope that the final project results will inform good practice across other schools/ faculties in different disciplines
The psychological impact of birth trauma on fathers: a narrative review
No full textBackground/Aims
There is a paucity of evidence on how birth trauma can affect the mental health of fathers. This review aimed to determine the common psychological effects of witnessing traumatic events during birth for fathers.
Methods
A narrative literature review of primary research and literature reviews was conducted using the British Nursing Index, CINAHL, Maternity and Infant Care, PubMed and EBSCO. A total of 6 research articles were included.
Results
Data analysis generated three themes: toxic masculinity: the role of fathers in the birthing environment; unpreparedness: expectation vs reality; and relationships with partner and others.
Conclusions
Traumatic events during labour and birth can have a profound impact on both mother and father. Fathers may experience poor mental health in the perinatal period, which can impact their relationship with their partner and the baby. It was noted that some healthcare professionals were more supportive than others. Effective communication is essential to quality care provision, which should help to manage poor paternal mental health in the perinatal period.
Implications for practice
Services are needed to identify and address poor mental health in the perinatal period for both mothers and fathers. Antenatal education should include information about all potential outcomes during labour and birth. More healthcare professionals are needed with expertise in mental health, including the ability to assess and refer to specialist services where necessary
On religion in R. G. Collingwood's Speculum Mentis
No full textThis paper contrasts R. G. Collingwood’s early discussion of religion in Religion and Philosophy (1916) with that in Speculum Mentis (1924). Whereas the former is recognisable as an expression of contemporary Anglican theological thought (as represented by William Temple and others), the latter shows Collingwood moving more clearly in the direction Hegelian philosophy. Anglican ideas of the relationship of faith and reason, transcendence and immanence, the meaning-bearing capacity of the material world, mysticism and the common good are used to engage, illumine, and contest Collingwood’s position in Speculum Mentis. Collingwood’s remarks on the ontological proof of the Absolute (in place of God) are analysed with reference to both Hegel and more recent work on ontological arguments. It is argued that theological thought survives Collingwood’s critique in Speculum Mentis, and that this is evident in his essay, “Reason is Faith Cultivating Itself” (1927)