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Psychedelic Experiences and Long-Term Spiritual Growth: A Systematic Review
No full textPsychedelic substances, which can occasion mystical experiences, are sometimes used for religious and spiritual reasons. Despite strong links between psychedelics and spirituality, no previous systematic review has investigated connections between psychedelics and indicators of long-term spiritual growth. Thus, 34 empirical studies were analyzed with 19,724 total participants from 32 independent samples. A variety of methodologies were used among the reviewed studies, and some studies included international samples. Results showed that psychedelics—especially classic psychedelics (e.g., psilocybin, LSD, and DMT)—have been studied more often in this context than other substances. Findings indicate that psychedelic use is linked with a variety of subjective indicators of spiritual growth, including stronger perceived connections with the divine, a greater sense of meaning, increased spiritual faith, increased engagement in religious and spiritual practices, an increase in feelings of unity and self-transcendence, positive changes in worldview, increased connectedness with others, and reduced fear of death. Many studies that reported on one of these indicators also reported on others, implying a co-occurrence of these facets during and after psychedelic experiences. Spiritual growth was often related to mystical experiences, with higher mystical experience ratings associating positively with perceived spiritual growth
Association Between Spinal Manipulation, Butalbital Prescription, and Medication Overuse Headache in Adults with Tension-Type Headache: Retrospective Cohort Study
No full textBackground and Aims: Butalbital is an acute headache medication commonly prescribed for tension-type headache (TTH), although discouraged by guidelines due to a risk of medication overuse headache (MOH). Considering spinal manipulative therapy (SMT) may reduce TTH frequency and intensity, we hypothesized adults with TTH receiving chiropractic SMT would be less likely to receive a butalbital prescription over 2 years versus matched controls not receiving SMT. We secondarily compared likelihood of MOH between cohorts. Methods: We searched a United States medical records database of patients attending academic medical centers for adults with TTH, from 2013 to 2024, excluding those diagnosed with other headaches and seen in inpatient/emergency settings. We divided patients into two cohorts: (1) SMT and (2) non-SMT, using propensity matching to control for demographics and other variables associated with likelihood of butalbital prescription and MOH. Results: Three thousand one hundred and sixteen patients remained per cohort after matching. The incidence of butalbital prescription was lower in the SMT cohort compared to the non-SMT cohort (SMT: 1.7%; non-SMT: 3.8%), yielding an RR (95% CI) of 0.46 (0.33–0.63; p \u3c 0.001). The incidence of MOH was lower in the SMT cohort versus non-SMT cohort (SMT: 0.5%; non-SMT: 1.2%), yielding an RR (95% CI) of 0.44 (0.25–0.80; p \u3c 0.001). Conclusion: Adults receiving chiropractic SMT had a significantly lower likelihood of butalbital prescription and, tentatively, MOH compared to matched controls not receiving SMT. These findings support current guideline recommendations favoring SMT in TTH care, though future studies should replicate and compare these findings with other nonpharmacologic clinicians and interventions
A Preliminary Review of the Utility of Artificial Intelligence to Detect Eosinophilic Chronic Rhinosinusitis
No full textKey points: While typically diagnosed with biopsy, ECRS may be predicted preoperatively with the use of AI. Various AI models have been used, with pooled sensitivity of 0.857 and specificity of 0.850. We found no statistically significant difference between the accuracy of various AI models
Experimental Investigation of Heat Transfer and Pressure Drop in Copper Manifold Microchannel Heat Sinks
No full textOver the past decade, various two-phase cooling solutions have been implemented to dissipate power in high heat flux electronic components. The manifold microchannel heat sink is an efficient thermal management solution that reduces heat resistance while also limiting the pumping power. However, there is limited work available on small form factor manifold microchannels with traditional heat sinking materials like copper. In this study, an experimental investigation is conducted to evaluate the heat transfer and pressure drop performance of copper manifold microchannel heat sinks using an environmentally friendly refrigerant, R1233zd(E), as the working fluid. A microchannel plate and a manifold plate, both made of oxygen-free copper, are sandwiched together to form the manifold microchannel test sample assembly. To compare the effects of geometric parameters, a total of six manifold microchannel test samples are investigated, including two types of manifold plates and three types of microchannel plates. The experiments are performed with refrigerant mass flow rates ranging from 5 to 15 g/s and inlet subcooling temperatures ranging from 3 to 10 K. The heat transfer coefficient increases with a decreasing number of manifolds and with an increase in the number and width of the microchannels. The pressure drop decreases in configurations with more microchannels, more manifolds, and larger microchannel widths. Compared to traditional microchannels, manifold microchannels significantly reduce the total pressure drop. However, their heat transfer performance at higher heat flux conditions is limited by the trapped bubbles phenomena. In comparison to traditional microchannels, manifold microchannels demonstrate much higher performance in dissipating the same amount of heat flux while limiting pumping power, as indicated by the COP
Changes in Lean Body Mass With Glucagon-Like Peptide-1-Based Therapies and Mitigation Strategies
No full textWeight loss induced by glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual glucagon-like peptide-1 receptor (GLP-1R)/glucose-dependent insulinotropic polypeptide receptor agonists is coming closer to the magnitudes achieved with surgery. However, with greater weight loss there is concern about potential side effects on muscle quantity (mass), health and function. There is heterogeneity in the reported effects of GLP-1-based therapies on lean mass changes in clinical trials: in some studies, reductions in lean mass range between 40% and 60% as a proportion of total weight lost, while other studies show lean mass reductions of approximately 15% or less of total weight lost. There are several potential reasons underlying this heterogeneity, including population, drug-specific/molecular, and comorbidity effects. Furthermore, changes in lean mass may not always reflect changes in muscle mass as the former measure includes not only muscle but also organs, bone, fluids, and water in fat tissue. Based on contemporary evidence with the addition of magnetic resonance imaging-based studies, skeletal muscle changes with GLP-1RA treatments appear to be adaptive: reductions in muscle volume seem to be commensurate with what is expected given ageing, disease status, and weight loss achieved, and the improvement in insulin sensitivity and muscle fat infiltration likely contributes to an adaptive process with improved muscle quality, lowering the probability for loss in strength and function. Nevertheless, factors such as older age and severity of disease may influence the selection of appropriate candidates for these therapies due to risk of sarcopenia. To further improve muscle health during weight loss, several pharmacological treatments to maintain or improve muscle mass designed in combination with GLP-1-based therapies are under development. Future research on GLP-1-based and other therapies designed for weight loss should focus on more accurate and meaningful assessments of muscle mass, composition, as well as function, mobility or strength, to better define their impact on muscle health for the substantial number of patients who will likely be taking these medications well into the future
Don’t Rain on My Protest: The Effect of Anti- Racism Protests on Democratic Vote Shares in Midwestern Suburbs
Get PDFAfter George Floyd was murdered in May of 2020, a massive wave of anti-racism and antipolice brutality protests erupted across the United States. In addition to matters such as racial prejudice and awareness of racial discrimination, some studies have measured the effect of those protests on the 2020 presidential election. Previous research has shown that higher protest attendance in specific geographic areas causes increased vote shares in those areas for candidates aligned with the protests. We expand on this research, employing an instrumental variable (IV) model with rainfall as an exogenous source of variation in protest attendance to assess the effect of anti-racism protests in the summer of 2020 on vote shares in the 2020 presidential election in Midwest metropolitan areas. We use town and city level election results and protests within each city’s metropolitan statistical area (MSA). Furthermore, we group towns and cities by the proportion of white residents to compare the effect of protest attendance on vote share across different racial demographic groups. Contrary to previous literature, we find that greater protest attendance decreased the Democratic vote share in suburbs surrounding six midsize Midwestern cities at a statistically significant level. However, the effect is not significantly different across the demographic groups
Studying the History of Histopathology in Preclinical Medical Education as a Guide for the Uniform Integration of Radiology in Medical Education
Get PDFRadiology and pathology, though distinct fields within medical education, share a common foundation in their essential roles for accurate diagnosis and understanding of diseases. While pathology, particularly histopathology, has long been integrated into preclinical medical education in the United States, radiology education has traditionally been less emphasized. This paper examines the historical development of histopathology training in medical education and its central role, contrasting it with the comparatively peripheral position of radiology education. We explore the historical context of medical education in the United States, tracing the integration of histopathology following the Flexner Report of 1910. In contrast, radiology, emerging later as a specialized field, has faced challenges in achieving comparable integration into medical curricula. Despite the increasing importance of medical imaging in diagnosis and treatment, radiology education remains variable and often lacking in standardization across medical schools. We highlight the need for greater emphasis on radiology education to better prepare medical students for modern clinical practice, where medical imaging plays an increasingly pivotal role. A call for a comprehensive assessment of radiology education and advocacy for its integration into preclinical curricula is made, emphasizing the importance of collaboration between the radiology profession and accrediting bodies to ensure competence in imaging across medical specialties. As medical imaging continues to advance and become more integral to healthcare, it is imperative that medical education reflects this evolution by establishing radiology as a fundamental component of preclinical training
Approach to Simple Kidney Cysts in Children
Get PDFThe finding of a simple kidney cyst in a child can pose a diagnostic and management challenge for pediatric nephrologists, urologists, and primary care providers. The reported prevalence varies from 0.22 to 1% in large ultrasonography-based series of more than 10,000 children each. The true prevalence, however, may be higher or lower, as factors such as variations in referral patterns, indications for ultrasonography, or technical considerations could impact prevalence rates. For many patients, simple kidney cysts may be found incidentally when imaging is performed for another indication. Although simple cysts can occur in children, they may also represent the first sign of autosomal dominant polycystic kidney disease (ADPKD) or other less common cystic kidney diseases. Definitive guidelines regarding the evaluation and monitoring of children with simple kidney cysts have not been established. The desire on the part of the practitioner and/or parents to establish a definitive diagnosis should be balanced with the cost and inconvenience of repeated imaging and visits with specialists. The goals of this review are to (1) outline the definition, epidemiology, clinical presentation, and natural history of simple kidney cysts in childhood; (2) describe clinical features that could suggest a diagnosis other than a simple kidney cyst; and (3) present a suggested framework for evaluating and monitoring of children with one or more simple kidney cysts
Appropriateness of Care: Deep Venous Procedures
Get PDFIn the past decade, technologies to treat venous pathologies have increased dramatically, to the benefit of an often underserved and overlooked population of patients with venous disease. However, given the rapid release of various technologies, including venous-dedicated stents and thrombectomy devices across varied venous pathologies, evidence-based guidelines have been slow to develop. When discussing appropriateness of care, one needs to consider optimal patient selection, technical approach, medical management, and surveillance protocols, to name a few. All of which, in the venous space, are currently widely varied in practice. The future of deep venous work is limitless, but multicenter, randomized controlled trials are needed to optimally treat patients with venous disease
Emergency Department Imaging Utilization Post-Transcatheter Aortic Valve Replacement: Single Institution 7-Year Experience
Get PDFPurpose: This study aims to highlight presentations, acute findings and imaging phenotypes of patients presenting to the emergency department (ED) within 30 days of a transcatheter aortic valve replacement (TAVR). Methods: A retrospective review of patients diagnosed with aortic valve disease who underwent a TAVR between Jan 2015 and Nov 2021 at a large academic medical center was completed. From an initial 1271 patients, 146 were included based on their presentation to the ED within 30 days post-TAVR procedure. Patient data, including ED presentation details and imaging results, were recorded and de-identified. Results: Of the 146 post-TAVR patients, there were 168 ED visits within 30 days. The median time to ED after TAVR was 12 days. Respiratory symptoms were the most common complaint (27%). Neurological (23%) and cardiovascular symptoms (18%) followed. Cross-sectional imaging was conducted 250 times across visits, with an average of 1.7 scans per patient. CTs were most frequently used, followed by ultrasounds, especially echocardiograms and duplex extremity vasculature ultrasounds. 30.1% of patients had acute findings from imaging. Specific findings included heart failure (5.5%), access site complications (5.5%), pneumonia (5.5%), intracranial pathologies (3.4% for strokes and 0.7% for hematoma), and pleural effusion (3.4%). Echocardiograms and CTA chest were most associated with significant acute findings. Conclusion: Our study highlights the vital role of early and accurate imaging in post-TAVR patients within 30 days post-procedure. As transcatheter approaches rise in popularity, emergency radiologists become instrumental in diagnosing common post-procedural presentations. Continued research is essential to devise post-discharge strategies to curtail readmissions and related costs. Proper imaging ensures prompt, effective care, enhancing overall patient outcomes
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