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Thrombocytopenia in Sepsis
Full text linkPlatelets, traditionally known for their role in hemostasis, have emerged as key players in immune response and inflammation. Sepsis, a life-threatening condition characterized by systemic inflammation, often presents with thrombocytopenia, which at times, can be significant. Platelets contribute to the inflammatory response by interacting with leukocytes, endothelial cells, and the innate immune system. However, excessive platelet activation and consumption can lead to thrombocytopenia and exacerbate the severity of sepsis. Understanding the multifaceted roles of platelets in sepsis is crucial for developing effective therapeutic strategies. Targeting platelet-mediated inflammatory responses and promoting platelet production may offer potential avenues for improving outcomes in septic patients with thrombocytopenia. Future research should focus on elucidating the mechanisms underlying platelet dysfunction in sepsis and exploring novel therapeutic approaches to optimize platelet function and mitigate inflammation. This review explores the intricate relationship between platelets, inflammation, and thrombosis in the context of sepsis
The Association Between County-Level Social Determinants of Health and Cardio-Kidney-Metabolic Disease Attributed All-Cause Mortality in the US: A Cross Sectional Analysis
No full textBackground: The American Heart Association recently defined cardio-kidney-metabolic (CKM) syndrome as the intersection between metabolic, renal, and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality in the US is essential for developing targeted public interventions. Methods: We analyzed state-level and county-level CKM-associated all-cause mortality data (2010-2019) from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER). Median and interquartile (IQR) age-adjusted mortality rates (aaMR) per 100,000 were reported and linked with a multi-component metric for social deprivation: the Social Deprivation Index (SDI: range 0 - 100) grouped as: I: 0 – 25, II: 26 – 50, III: 51 – 75, and IV: 75 – 100. We fit pairwise comparisons between SDI groups and evaluated aaMR stratified by sex, race, and location. Results: In 3101 counties, pooled aaMR was 505 (441-579). Oklahoma (643) and Massachusetts (364) had the highest and lowest values. aaMR increased across SDI groups [I: 454(404, 505), IV: 572(IQR: 495.9, 654.7); p \u3c 0.001]. Men had higher rates [602 (526, 687)] than women [427 (368, 491)]. Metropolitan [476 (419, 542)] had lower rates than non-metropolitan counties [521 (454, 596)]. Non-Hispanic Black [637 (545, 731)] had higher rates than non-Hispanic White residents [497 (437, 570]. CKM associated aaMR remained reasonably constant between 2010 and 2019 (Mann Kendall test for trend p-value = 0.99). Conclusions: In the US, CKM mortality disproportionately affects more socially deprived counties. Inability to reduce CKM mortality rates over the study period highlights the need for targeted policy interventions to curb the ongoing high burden
Computational Model Predicts Function of Rho-Gtpase Binding for Plexin Receptor Gap Activity on Rap1B Via Dynamic Allosteric Changes
No full textPlexin-semaphorin signaling regulates key processes such as cell migration, neuronal development, angiogenesis, and immune responses. Plexins stand out because they can directly bind with both Rho- and Ras-family small GTPases through their intracellular domains when these GTPases are in their active, GTP-bound states. This binding occurs via intracellular regions, which include a Rho-GTPase binding domain and a GTPase-activating protein (GAP) segment. Studies have shown that Rho and Ras GTPases play vital roles in plexin signaling and activation. However, the structural dynamics of plexins and GTPases and how these conformational changes affect interactions when plexin is bound with both Ras and Rho-GTPases or bound to only one specific GTPase have remained unclear. In this study, we conducted molecular dynamics simulations on six distinct plexin-GTPase bound systems to investigate the differences in conformations and dynamics between plexin-B1 and three GTPases: Rap1b, Rnd1, and Rac1. Our analysis revealed that dynamics with Rac1 are more altered compared to Rnd1, depending on whether plexin\u27s GAP domain is bound or unbound to Rap1b. In addition, we further investigated alterations in network centralities and compared the network dynamics of the plexin-GTPase complexes, focusing on the differences when plexin is bound to both Ras (Rap1b) and Rho-GTPases (Rnd1/Rac1) versus when it is bound to only one GTPase. Our study revealed that Rnd1 exhibits stronger and more stable interactions with plexin-B1 in the absence of Rap1b, while Rac1 shows fewer and less stable connections in comparison. These computational models have features that broadly agree with experimental results from hydrogen-deuterium exchange detected by mass spectrometry. Such insights provide a better understanding of the molecular mechanisms underlying plexin-GTPase interactions and the complexities of signaling mechanisms involving GTPases in general
When Logics Collide: How Private Firms In Ghana Can Manage The Relationship Between Commercial And Employee Logics To Help Drive Organizational Excellence
Full text linkThis study investigates the dynamic relationship between commercial and employee logics in the context of Ghanaian private sector organizations striving for excellence. The research acknowledges the unique geographical context’s influence on institutional logics and aims to contribute an additional dimension to the institutional logics perspective. Ghanaian organizations, like many across Africa, struggle to effectively manage the divergent and potentially conflicting demands between the firm’s commercial goals (commercial logic) and employee interests (employee logic) in pursuit of organizational excellence. However, when they are addressed together (as complementary logics), these logics serve as key drivers of organizational excellence. This study employs a qualitative multi-case study methodology involving executive and non-executive staff from Ghanaian private sector organizations. The findings detail what constitutes organizational excellence, commercial logic, and employee logic in a Ghanaian context. The findings further propose a dual approach, consisting of engaged and situational approaches, to effectively manage the interplay between these logics. Balancing mechanisms, such as segmenting, bridging, and demarcating, play pivotal roles in navigating both approaches to ensure an organization doesn’t overamplify one logic for an extended period. Ultimately, this research provides valuable insights for Ghanaian organizational leaders on navigating multiple logics while pursuing organizational excellence, offering practical recommendations for achieving sustained success
Women\u27s Empowerment in APCNF: A Critical Examination of Feminist Goals in Agroecology
No full textThis paper delves into the critical issues surrounding agroecology, with a specific focus on the intersection of ecology, polity, society, and economy. In the context of the Anthropocene era, the global threat of climate change poses significant challenges such as rising sea levels, extreme weather events, and disruptions in food production. The paper highlights the predicted impacts of climate change on food security, particularly in the tropics, emphasizing the need for social and environmental justice in mitigation and adaptation efforts. Furthermore, it discusses the concept of political agroecology as a lens to address sociological and political aspects within the realm of agroecology. Through an exploration of feminist goals in agroecology, the paper also examines the role of women empowerment in advancing sustainable agricultural practices. Overall, this paper aims to contribute to the discourse on agroecology by shedding light on key themes and challenges at the nexus of ecology, society, and politics
Associations between Retinopathy of Prematurity and the Risks of Hearing Loss: A Propensity Matched Analysis
No full textPurpose: While retinopathy of prematurity (ROP) and hearing loss (HL) share many risk factors, whether patients with ROP have a higher risk of HL remains largely unknown. Therefore, this study aimed to explore the association between ROP and the risk of having HL. Methods: The electronic medical records contained in a United States national database were retrospectively reviewed. Patients younger than 18 years old with a record of receiving hearing screening were included. Eligible patients with a history of ROP were assigned to the ROP cohort, while those without ROP diagnosis after vision screening served as controls. After adjusting for covariates via propensity score matching, the two cohorts were compared to evaluate the odds ratios (OR) of having hearing loss. To assess the impact of ROP severity and treatment on the OR, secondary analyses were additionally performed by further stratifying the ROP cohort based on the severity and treatment status. Results: The primary analysis revealed that, compared to controls (n = 2,978, mean age: 2.34 ± 2.77 years; 51.1 % female) the ROP cohort (n = 2,978, mean age: 2.40 ± 3.13 years; 50.9 % female) had higher odds of having HL (OR = 1.42, CI = 1.25–1.61). However, among patients with ROP, the odds of HL did not differ between the mild and severe cohorts (OR = 0.99, CI = 0.73–1.34) or between the treated and untreated cohorts (OR = 0.79, CI = 0.50–1.24). Conclusion: HL was more common among children with ROP after adjusting for other risk factors of HL. Confirmation of this association in future controlled research settings could provide a rationale for increasing the frequency of hearing screening in children with ROP
Predicting Emotions across Schizotypy Levels
No full textSuccessfully navigating the social world requires making accurate predictions about others. Individual differences in emotion prediction–the ability to predict someone\u27s subsequent emotion given their current emotional state–can lead to variability in social success. In this study (N = 1024) we found evidence that individuals with heightened schizotypy displayed worse emotion prediction accuracy. This difficulty with emotion prediction was associated with increased loneliness, diminished social support, and smaller social networks, partially mediating some of the social difficulties in individuals with heightened schizotypy. Individuals with heightened schizotypy showed disruptions to key sources of affective information, meaning they had less reliable information about how emotions work when making emotion predictions. Specifically, their own emotion experiences were less typical, and their perception of others’ emotions was less accurate. These findings highlight emotion prediction as a key social cognitive construct that should be considered in future research for individuals across the schizophrenia spectrum
Exploring the Effect of LED-to-Photodetector Spacing on Subcutaneous Photoplethysmography for Continuous Blood Pressure Measurement
Full text linkPhotoplethysmography (PPG) is widely used to measure heart rate, blood oxygenation, and more recently, blood pressure. Implanted PPG systems offer the possibility to measure similar real-time measures of cardiovascular health, however, the detection method may vary due to a lack of capillary vessels for PPG sensors to observe in muscle tissue. To improve volumetric blood detection in large muscles, without relying on the capillary density of skin, a flexible PPG sensor was developed. The sensor included multiple spacing of illuminating infrared (IR) light emitting diodes (LEDs) and a single IR photodetector. This arrangement was expected to enable detection of blood volume changes at variable distances from the sensor face, potentially at much longer depths then feasible with skin-mounted PPG devices. IR bench phantoms simulating a large blood vessel embedded in IR absorbing, tissue-mimicking rubber were developed and used to determine the sensor performance in vitro. A preliminary in vivo test used an adult rabbit to provide additional performance validation. Test results reveal an observed trend of increased SNR for deeper vessel depths for the farthest LED to detector spacing which is aligned with our initial prediction. However, ANOVA and post-hoc tests reveal that these trends did not reach statistical significance. The in vivo test showed a relationship consistent with relevant literature. Future experiments are required to improve the phantom’s representation of the biological setting and to confirm a reduced SNR variation for the farthest spacing
Rightsizing Regulations to Foster Innovation and a Healthy Business Environment: Insights from Elite Executives
Full text linkThis study examines insights from business executives on how TRAILS—that is, taxes, regulations, assessments, interventions, litigation, and subsidies—influence entrepreneurial behavior and firm performance. Using an applied constructivist grounded theory design, we conducted 17 in-depth interviews to identify how top business executives view the effects of regulations on business performance. We adopt the premise that the right level and set of regulations lead to a healthier business environment. We find that right-sized TRAILS catalyze entrepreneurial dynamism, whereas wrong-sized TRAILS impose hidden opportunity costs, stifle innovation, and erode institutional trust. Crucially, the study reveals the vital role of the government as the Umpire—an impartial enforcer and calibrator of TRAILS that safeguards public welfare and sustains the feedback loops essential for market innovation and civic resilience. Building on Bastiat’s broken-window insight and foundational theories, we propose a role for executives in which they serve in an advisory capacity and inform policy design without expanding the state’s remit. We further urge policymakers to support sustainable innovation and societal vitality by fostering systemic conditions, such as knowledge creation, polycentric feedback, discovery processes, and aligned incentives, while also preserving institutional accountability and market discipline
Complex Factors Impacting Smoking Behavior in Cancer Survivors with Food Insecurity
Full text linkObjectives: Tobacco use remains prevalent among people with social needs, such as food insecurity. In this study, we aimed to understand the complex experiences of low-income cancer survivors with food insecurity who smoke tobacco, to identify the unique smoking cessation needs for this group. Methods: We conducted in-depth, semi-structured qualitative interviews with 40 adults experiencing food insecurity who continued smoking after a cancer diagnosis. Interviews focused on smoking behaviors, cessation interest, cancer experiences, and financial circumstances. We analyzed the data using reflexive thematic analysis. Results: In this sample of cancer survivors (50% female, mean age 42 years, 60% black/African American, 32% with lung cancer), experiences of food insecurity were interwoven with financial hardship exacerbated by cancer treatment. Three themes illustrated a complexity of intersecting factors in this group: (1) smoking and cancer-related stress; (2) cancer and smoking‐related emotions and beliefs; and (3) cancer treatment and self‐efficacy to quit. Conclusions: Low-income cancer survivors face unique challenges and stressors that impact smoking and smoking cessation. Research towards developing tailored, coordinated, and ongoing smoking cessation efforts may involve attention to individual-level, healthcare-level, and structural-level barriers to cessation
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