26199 research outputs found
Sort by
Enhancing East Asian Security Coordination
No full textThe war in Ukraine has surpassed the predictions of countless analysts and armchair generals since it began in February 2022. The steadfastness and effectiveness of Ukrainian defense efforts have prompted political leaders and defense planners in East Asia to re-evaluate many assumptions that previously guided their regional policy, especially regarding tensions in the Taiwan Strait. While the threat of armed attack by the People's Republic of China (PRC) had long been seen as a vague possibility, many believed that in the postmodern era, territorial aggression between sovereign countries belonged to the past. Vladimir Putin's invasion of Ukraine exposed the fallacy of this belief. Consequently, plans and preparations for a potential attack on Taiwan by a similarly assertive leader like China's Xi Jinping have now been prioritized and addressed with renewed urgency.
Japan, second only to Taiwan in vulnerability, faces significant risks to the geopolitical stability of the region should such an event occur. Given the heightened stakes, analysts and planners in East Asia must take a sober look at the situation and develop innovative strategies to ensure an effective defense — recognized as the most potent deterrent against potential Taiwan contingencies. This book examines these issues from various angles, emphasizing the critical need for proactive measures.
In this compelling analysis, the authors of the chapters delve into the unexpected and prolonged conflict in Ukraine, a war that has reverberated through global geopolitical thought. The resilience of Ukraine's defense forces has necessitated a critical reassessment in East Asia, particularly concerning longstanding tensions in the Taiwan Strait. The stakes are higher than ever, making an effective defense the key to deterring future geopolitical challenges in the region. This book scrutinizes the situation from diverse perspectives, emphasizing the imperative for East Asian analysts and planners to develop innovative solutions to safeguard against potential Taiwan contingencies
Attitude & Practices of Higher Education Teachers about “Teaching for Sustainable Development” in the UK
Get PDFThis research paper explores the views and perceptions of academics towards embedding Education for Sustainable Development (ESD) into their academic practices and presents study findings on academics’ views on ESD. This study utilized anonymous questionnaires to obtain participant opinions. Participants were encouraged to share personal practices around ESD. This study observed that academics have a diverse perception of the ESD concept, and most academics are aware of ESD to some extent. The results indicate the presence of a statistical relationship between academics’ years of experience in higher education (HE) and their awareness of ESD. Also, early career academics are more likely to be open to incorporating ESD into their teaching practices. In addition to these, this paper discussed that while academics may or may not already be incorporating ESD into their teaching practices, institutional commitment to embedding ESD into policies, staff training, curriculum development, and assessment is critical in ensuring effective integration of ESD into HE
Understanding Islamic Law (Shari’ia): Third Edition Authored by Raj Bhala
No full textScholars have often found studying the subject Islamic law to be complex and intricate. This may be attributed to various reasons. Firstly, there is no uniform definition of what Islamic law refers to today. Secondly, there is no single source codifying Islamic laws that is universally acknowledged and implemented. Thirdly, due to various Islamic sects adopting varying degrees of interpretations and theological beliefs within Islam, achieving a uniform definition and interpretation is extremely difficult across all Muslim states, if not impossible
Midwives’ readiness for midwife-led care: a mixed-methods study
Get PDFBackground/Problem
To integrate midwife-led care in Belgian maternity services, understanding whether midwives are primed of executing the change is needed.
Aim
To explore Belgian midwives’ readiness for midwife-led care and understand the underlying processes.
Methods
A mixed-methods sequential study: 1) A survey including 414 practising midwives and 2) individual interviews with 12 (student) midwives. General linear model analysis was used to examine the trend between knowledge, self-efficacy and performance mean scores - indicators of midwife-led care readiness - proposed in a 27-item questionnaire. The Readiness Assessment Framework served as a template for qualitative thematic analysis.
Findings
Template analysis illustrated the underlying mechanisms of midwifery-led care readiness: Governmental and institutional steering and rule-making functions, regulation and reimbursement, awareness of midwife-led care among stakeholders, capacity to extend primary care postpartum services to antenatal and intrapartum care and healthcare professionals’ lack of awareness of available data of women’s experiences and midwife-led care efficacy in Belgium. These qualitative findings contribute to the understanding of the significant trend with decreasing function for knowledge, self-efficacy and performance mean scores of 25 midwife-led care readiness indicators, and the two non-significant indicators referring to a physiological postpartum period.
Discussion/Conclusion
In determining midwife readiness for midwife-led care, we observed adequate knowledge mean scores, associated with low self-efficacy and even lower midwife-led care performance mean scores. Our findings suggest limited readiness for MLC in antenatal and intrapartum care. Belgian midwives are the domain experts of postpartum services but face challenges in extending midwife-led care to antenatal and intrapartum services
TCT-765 Lipid-Lowering Therapy in Contemporary PCI Practice
No full textBackground
Patients with coronary artery disease (CAD) face high risks for recurrent events, especially within the first year after myocardial infarction or coronary revascularization. Historically, achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets is challenging.
Methods
In this prospective observational cohort study from 2 ongoing PCI trials (NCT04923191 and NCT04390672), we investigated lipid-lowering therapy (LLT) use during the first year after contemporary percutaneous coronary intervention (PCI). Machine learning facilitated logistic regression identified predictors of LLT intensification.
Results
LLT regimens were intensified in about one-third of patients, primarily by adding ezetimibe to statin therapy (Table 1). Of concern, 7.2%-8.8% of patients received no LLT, and only 2% were on PCSK9 inhibitors. Preprocedural country of treatment, age, and LDL-C levels were significant predictors of LLT intensification, with baseline LDL-C being the strongest predictor (Figure 1; OR: 6.36; P < 0.001; C-index = 0.711).
Lipid-Lowering Regimen at Baseline Lipid-Lowering Regimen at 12 Months
No Lipid-Lowering Therapy Statin Monotherapy Statin Plus Ezetimibe Total
No lipid-lowering therapy 36 (2.9) 139 (11.4) 57 (4.7) 232 (19)
Statin monotherapy 39 (3.2) 627 (51.2) 202 (16.5) 868 (70.9)
Statin plus ezetimibe 2 (0.2) 9 (0.7) 112 (9.2) 124 (10.1)
Total 77 (6.3) 775 (63.3) 372 (30.4) 1,224 (100)
Values are n (%). 32% (398/1,224) patients hadintensification in LLT in the first year. 4% (50/1,224) patients had deintensification in LLT in the first year. 63% (776/1,224) patients had no change in LLT in the first year, with the majority (81%) staying on statin monotherapy.
Conclusions
Preprocedural LDL-C levels strongly predict LLT intensification within the first year after PCI. With approximately 8% of patients receiving no LLT, directly prescribing high-intensity statins plus ezetimibe after PCI could bridge the gap and mitigate early residual risk
A multifaceted approach to investigate interactions of thifluzamide with haemoglobin
No full textThis study explores the interaction between the pesticide thifluzamide (TF) and haemoglobin (Hb) to understand potential structural changes that might affect Hb's function. Using a combination of UV–visible and fluorescence spectroscopy, circular dichroism (CD), molecular docking, molecular dynamics (MD) simulations, and electrochemical methods, we investigated these interactions in detail. Spectroscopy results indicated the formation of a stable TF-Hb complex, with a binding constant of 6.64 × 105 M−1 at 298 K and a 1:1 binding ratio. The stability of this complex was confirmed by a free energy change (∆G) of −34.491 kJ mol−1. CD spectroscopy was employed to confirm structural changes in Hb due to thifluzamide binding. Molecular docking studies revealed that TF interacts with specific amino acids in Hb, such as ALA, HIS, VAL, LYS, and LEU, with a binding energy of −25.10 kJ mol−1. MD simulations supported these findings by showing conformational changes in Hb upon TF binding, as indicated by RMSD and RMSF analyses. Electrochemical experiments further confirmed the interaction, evidenced by a consistent decrease in the TF peak in the presence of Hb. Overall, our findings shed light on how TF binds to Hb, causing structural changes that could potentially impact its normal function. This research enhances our understanding of the biochemical effects of TF on Hb, which could have significant implications for biological systems
Correction to: sMILES SSPs: a library of semi-empirical MILES stellar population models with variable [α/Fe] abundances
Get PDFPhage Therapy: A Targeted Approach to Overcoming Antibiotic Resistance
Get PDFThe rise of antibiotic-resistant bacterial infections has become a significant global health threat, necessitating the need for alternative therapeutic strategies. The use of bacteriophages—viruses that particularly infect and lyse bacteria—in phage therapy has resurfaced as a potentially effective substitute for conventional antibiotics. This narrative review aims to explore the mechanisms, applications, challenges, and prospects of phage therapy in combating antibiotic-resistant infections. A thorough analysis of the literature was carried out by exploring online databases, such as Google Scholar, PubMed, Scopus, and Web of Science. The search focused on peer-reviewed articles, clinical trials, and authoritative reports published in the last 10 years. The review synthesized findings from studies on phage mechanisms, therapeutic applications, regulatory challenges, and advances in phage engineering. Phage therapy demonstrates several advantages over antibiotics, including high specificity for target bacteria, the ability to penetrate biofilms, and a lower propensity for resistance development. However, significant challenges remain, such as regulatory and production hurdles, the potential for phage resistance, and interactions with the host immune system. Advances in genetic engineering have enhanced the therapeutic potential of phages, and personalized phage therapy is emerging as a viable approach for tailored treatments. Phage therapy holds significant promise as an alternative to antibiotics, particularly in the fight against antibiotic-resistant bacteria. While challenges persist, ongoing research, technological advancements, and collaborative efforts are crucial for integrating phage therapy into mainstream clinical practice, potentially revolutionizing the treatment of bacterial infections and addressing the global antibiotic resistance crisis
TCT-676 Incidence of Coronary Microvascular Dysfunction in ANOCA Patients With and Without a History of Severe Covid-19 Infection: The COMET-19 Study
No full textBackground
Post-acute sequelae of SARS-CoV-2 infection can manifest as anginal chest pain. However, the underlying mechanisms, including the role of coronary microvascular dysfunction (CMD), remain elusive. We investigated the CMD incidence and endotypes in angina without obstructive coronary artery disease (ANOCA) patients with a history of severe Covid-19 infection.
Methods
COMET-19 (NCT05841485) is a multicentre, prospective cross-sectional study including 117 consecutive ANOCA patients: 59 with a history of severe Covid-19 infection (Covid group) and 58 without (control group). All patients underwent coronary physiology assessment for fractional flow reserve (FFR), coronary flow reserve (CFR), and index of microvascular resistance (IMR). CMD was defined as CFR <2.0 or IMR ≥25, with functional CMD defined as CFR <2.0 and IMR <25 and structural CMD defined as CFR <2.0 and IMR ≥25.
Results
The incidence of CMD was 47.5% (n = 28) in the Covid group and 24.1% (n = 14) in the control group (P = 0.015), predominantly driven by the higher incidence of structural CMD in the Covid group (28.8% vs 5.8%; P < 0.001), whereas functional CMD was more common in the control group (19.0% vs 6.8%; P < 0.001). (FigA,B) Compared with the control group, Covid patients had significantly higher IMR (20.0 [15.0-42.0] vs 17.0 [12.0, 21.0]; P = 0.002) but similar FFR (0.89 vs 0.9; P = 0.327) and CFR (2.68 vs 2.74; P = 0.540).
Conclusions
ANOCA patients with a history of severe Covid-19 infection had a higher incidence of CMD, particularly structural CMD, suggesting a link between Covid-19 and microvascular impairment
TCT-515 Myocardial Blood Flow Distribution Derived From CCTA, Myocardium at Risk, and Revascularization Completeness in FASTTRACK CABG
No full textBackground
There is no objective, quantitative, and universal definition of complete revascularization with invasive or noninvasive angiography.
Methods
Patients in the FASTTRACK CABG trial (n = 114), CABG guided solely by coronary computed tomography angiography (CCTA), and fractional flow reserve derived from CCTA (FFRCT) were included. Left ventricular percentage myocardial blood flow distribution (LV%MYO) was computed in the 16 SYNTAX coronary segments. Given each point of the fixed myocardial weighing factor represents 16.7% (1/6) of blood flow, the myocardial weighing factor of each coronary segment = 6 × LV%MYO. Graft patency and topographic adequacy were assessed at 30-day follow-up CCTA (n = 96). By subtracting the LV%MYO of segments anastomosed to a nonstenotic graft from the pre-CABG global LV%MYO, the post-CABG residual LV%MYO was obtained.
Results
FFRCT and LV%MYO were analyzed in 106 patients, with 53 having at least 1 total occlusion. The fixed myocardial weighing factors differ significantly from the weighing factors derived from LV%MYO. (Figure 1) The pre-CABG global LV%MYO and post-CABG residual LV%MYO were 70.1 ± 18.8% and 14.0 ± 15.3%, respectively. Residual LV%MYO ≤10% was achieved in 42 patients (43.8%). Among the 106 coronary segments not revascularized, the main reason was the operator’s decision not to graft, whereas graft occlusion accounted for 22.6% (24/106).
Conclusions
LV%MYO enables clinicians to objectively quantify the myocardium at risk of each coronary segment and to prospectively predict and retrospectively assess the revascularization completeness