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Aspirin-Free Prasugrel Monotherapy After Percutaneous Coronary Intervention in Patients With Non-ST Elevation Acute Coronary Syndrome
Get PDFBackground: In the presence of a potent P2Y12inhibitor such as prasugrel, the additional clinical antithrombotic benefit of aspirin is unclear. The feasibility of prasugrel monotherapy without aspirin after percutaneous coronary intervention (PCI) has been demonstrated in chronic coronary syndrome, but is yet to be assessed in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and low anatomical complexity.
Methods and Results: ASET-Japan is a single-arm study investigating the safety of prasugrel 12-month monotherapy with a locally approved dose (loading 20 mg; maintenance 3.75 mg), started immediately after successful PCI using platinum-chromium everolimus-eluting SYNERGY stents. The primary ischemic endpoint is a composite of cardiac death, spontaneous target vessel myocardial infarction, or definite stent thrombosis; the primary bleeding endpoint is Bleeding Academic Research Consortium (BARC) Type 3 and 5 bleeding. ASET-Japan recruited 101 NSTE-ACS patients from 11 Japanese sites. The mean (±SD) age was 69.1±12.3 years and 36.6% had a PRECISE-DAPT score >25. The mean anatomical SYNTAX score was 7.9±4.7. At 1 year, the primary ischemic endpoint occurred in 1 patient (1.0%; cardiac death). Two BARC Type 3a bleeding events occurred (2.0%): 1 due to a gastric ulcer and 1 to a descending colon malignancy.
Conclusions: Low-dose (3.75 mg/day) prasugrel monotherapy started immediately after SYNERGY stent deployment was feasible and safe in selected NSTE-ACS patients
Defining three principles for credible evidence synthesis and reviews in health professions education
Get PDFAs reviews become increasingly central to informing educational practice and guiding research in health professions education, the need for methodological clarity and quality has grown. This Commentary highlights three foundational principles – alignment, rigor, and transparency – that underpin high-quality reviews, regardless of type. We illustrate how these principles apply across commonly used review types, including systematic, scoping, realist, and narrative reviews. By aligning the research question with the appropriate review methodology, employing rigorous processes for evidence collection and synthesis, and maintaining transparency in methodological reporting, review teams can produce credible, transferable, and dependable findings. Embracing these principles not only enhances the trustworthiness of reviews but also supports stakeholders in applying synthesized knowledge effectively, ultimately advancing evidence-informed decision-making in health professions education
Impact of flunitrazepam on Calliphora vicina (Diptera: Calliphoridae) microbiome dynamics
No full textThis study explored the effects of flunitrazepam, a benzodiazepine, on the microbiome diversity of Calliphora vicina Robineau‐Desvoidy, 1830 (Diptera: Calliphoridae). By examining the microbial shifts throughout developmental stages, the research contributes valuable data to the field of forensic entomotoxicology. Two colonies of 500 adults were fed minced beef liver, spiked and non‐spiked with 25 mg of flunitrazepam, and reared under controlled conditions (24°C, relative humidity of 45%, 12:12 light–dark cycle). Following oviposition, egg clusters were transferred, and the experiment was carried out in triplicate under the same experimental conditions. A total of 54 specimens, including all developmental stages, were collected for microbiome investigation via Illumina MiSeq. Both colonies had a 19‐day development cycle from eggs to teneral. However, flunitrazepam‐fed specimens were heavier, particularly during the pupa and teneral stages. Microbiome analysis revealed significant differences in diversity and composition between the colonies and across developmental stages. Pseudomonadota (Proteobacteria) dominated the control adults, while Bacteroidota and Bacillota (Firmicutes) were more prevalent in flunitrazepam‐fed adults. Additionally, Enterobacterales, Lactobacillales, and Morganellaceae showed notable variations across different stages. This study highlights the significant impact of flunitrazepam on the microbiome dynamics of C. vicina , revealing notable morphological changes related to the specimens' weight toward the end of the development cycle and alterations in microbiome composition. These findings have important implications for forensic entomotoxicology, particularly in the accurate estimation of the minimum postmortem interval (mPMI)
Ritual returns
No full textThis chapter examines the intersection of commemoration and commodification in UK Halloween festivals, tracing their evolution from the ancient Celtic festival of Samhain to modern-day events shaped by commercial imperatives and cultural memory. Drawing on two case studies – Derry Halloween in Northern Ireland and Paisley Halloween Festival in Scotland – it explores how death, folklore and the supernatural are repackaged as public spectacle and tourist economy. While these events invoke authentic heritage symbols, they simultaneously participate in global consumer culture, blurring the lines between sacred ritual and market-driven entertainment. Situating these developments within the broader frameworks of dark event tourism, occulture and heritage commodification, this chapter offers a critical lens on how seasonal festivals function as both acts of remembrance and engines of economic growth
Psychological violence in intimate relationships: stressor interactions and psychological outcomes
No full textThis study aimed to develop the Psychological Abuse in Intimate Relationships Scale (PAIRS), a psychometrically sound measure capturing the multifaceted nature of psychological abuse, and to examine its dimensions and associations with trauma-related psychological outcomes. An initial item pool was created by reviewing 16 existing scales in the psychological abuse literature. Seventy-one items were generated and tested in a pilot study (n = 337). In the second phase, data were collected online from 1,012 ever-partnered women. Exploratory factor analysis (EFA) with Promax rotation examined the dimensional structure of PAIRS. ANOVAs compared women exposed to psychological abuse alone versus those also exposed to physical and/or sexual violence. Hierarchical regressions examined the associations between psychological abuse and peri-trauma distress and PTSD. The PAIRS demonstrated excellent internal consistency (Cronbach’s α = 0.98), and its subscales showed high reliability (Cronbach’s α = 0.80–0.95). EFA revealed a dominant unrotated factor, indicating a coherent psychological abuse construct. The rotated solution yielded eight interrelated factors, reflecting its multifaceted structure. Psychological abuse explained the largest proportion of variance in peri-trauma distress and PTSD. While psychological abuse alone was significantly associated with peri- and post-trauma outcomes, the severity of impairment was substantially amplified when it co-occurred with physical and/or sexual violence, consistent with cumulative and multiplicative effects. The PAIRS is a reliable and valid tool for capturing the multidimensional nature of psychological abuse. It offers important clinical and research utility by identifying specific abusive behavior patterns. Future research should validate the PAIRS in more diverse populations
Industrial Symbiosis and Circular Economy in Zero-Waste Management Approaches
No full textIndustry-based solid waste is a huge burden to the environment. Dumping or the burning industrial waste is considered outdated which flitters away resources and demanding virgin materials from the ecosystems to continue the production. A circular economy (CE) seeks to keep resources in use for as long as possible, minimizing waste and dependency on raw materials which is the key factor in growing global emphasis on achieving sustainability. In achieving CE targets in industrial level, integration with Industrial Symbiosis (IS) is considered a critical solution to address waste management challenges. CE focuses on reducing waste, reusing resources, and promoting sustainable production and consumption patterns, while IS emphasizes collaboration between industries to optimize resource use and minimize environmental impact. This book chapter aims to examine how circular economy principles and industrial symbiosis can be jointly applied to improve industrial waste management, highlighting the potential for creating closed-loop processes that enhance resource efficiency. It highlights the importance of technological innovation, supportive policy frameworks, and cultural transformation in realizing this vision. Key challenges include outdated policies, insufficient infrastructure, and public resistance to behavioral change. Howver, the incorporation of advanced technologies, such as AI-powered sorting systems and pneumatic waste pipes, exemplifies the significant strides that can be made toward a waste-free industrial future. Ultimately, this book chapter advocates for the synergistic implementation of CE and IS, proposing a collaborative, integrated approach to waste management that could lead to significant environmental, economic, and social benefits
Micro Human Efforts in Disaster Resiliency: Introduction
No full textIn 2021, a thought-provoking special issue of the I nternational Journal of Mass Emergencies and Disasters (IJMED) ignited an important conversation about Micro Human Efforts (MHE). Titled “Multidisciplinary Perspectives of Micro Human Efforts in Post-Disaster Recovery”, this issue opened the door to exploring the vital, yet often overlooked, role of small-scale human efforts during extreme climatic events. Recognizing the emerging significance of MHE, the special issue's editors teamed up with IJMED to establish some preliminary definitions. As the official dissemination platform of the International Sociological Association's (ISA) Research Committee on Sociology of Disasters (RC39), IJMED stood out as a credible platform for addressing these multifaceted themes tied to climate-induced disasters
Sustainability tactics in consumer finance: Exploring moderation of behavior, desire and service
No full textThis study examines how consumer buying behavior (CBB) shapes desire to buy (DB) and whether service impact on purchase (SIP) conditionally moderates these relationships, with implications for sustainable consumer finance. Using survey data from consumers across Asia, Africa, Europe, the Middle East, and the Americas, the study applies a rigorous sequential analytical approach, including reliability assessment, exploratory and confirmatory factor analyses, and interaction-based moderation modeling. The findings show that unconventional price preferences, promotional sensitivity, and value-oriented buying significantly influence both impulsive and borrowing-driven purchase desires, while financial consciousness alone does not exert a direct effect. SIP emerges as a selective moderator: it strengthens the relationship between financial consciousness and impulsive buying and attenuates impulsive tendencies among value-oriented consumers. Most other moderation effects are context-specific rather than universal, indicating that service conditions amplify or constrain consumer desires only under particular behavioral configurations. Overall, the study demonstrates that sustainable consumer finance outcomes arise from the joint alignment of behavioral traits and service environments rather than from isolated consumer characteristics, offering theoretically grounded insights for sustainability-oriented financial strategies
First systematic evaluation of anthropogenic debris dynamics in Sri Lankan fishery harbors: Spatial and temporal trends of macroplastic accumulation in the Western Province
No full textDespite being identified as key pollution hot spots, debris dynamics in fishery harbors (FH) are poorly characterized. This study provides a comprehensive evaluation of macroplastic accumulation patterns in five FH of the Western Province of Sri Lanka through one complete annual cycle. Plastic was the major pollutant type (~85%), with single-use plastics (60.92%), considerably exceeding fishery-related plastic debris (9.67%), even though the study was conducted in fishery-specific settings. Spatial variation was substantial across FH with infrastructure design proving to be the key controlling factor in debris retention rather than environmental factors such as rainfall and tide level. Breakwater-enclosed FH designs recorded considerably higher dynamics compared to open designs and localized zones of high accumulation of the plastic debris were recognized in particular infrastructure geometries. Seasonal patterns were present at some FH, with peak accumulation during the second inter-monsoon and northeast monsoon period, which was driven by intensity variation in the operations and not directly by environmental forcing. Debris originated mainly from local sources with negligible contribution of transboundary debris. The accumulation is governed by hierarchical controls, with infrastructure design as the primary, operation intensity as the secondary, and environmental setting as the tertiary determinant. These findings provide evidence that effective management requires infrastructure-based solutions and local waste management interventions, rather than strategies suggested for environmentally driven coastal systems. The infrastructure-based classification framework and evidence-based prioritization methodology are replicable tools to support policy development and an increase in the optimization of limited available resources for sustainable FH operations worldwide