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Contemporary outcomes for medical management of symptomatic patients with moderate to severe carotid stenosis
No full textINTRODUCTION
Medical therapy for secondary prevention of stroke has evolved markedly since the
landmark NASCET and ECST-1 carotid surgery trials. The aim of this study was to
perform a systematic review of stroke outcomes in adults with recent stroke or TIA with
50-99% carotid stenosis, treated with modern medical therapy over the last decade.
EVIDENCE ACQUISITION
A systematic review according to PRISMA guidelines, using a predefined search strategy
on MEDLINE, EMBASE, Google Scholar, The Cochrane Database and clinicaltrials.gov.
Inclusion criteria were studies of symptomatic patients with 50-99% carotid
atherosclerotic stenosis published since 2015.
EVIDENCE SYNTHESIS
6 completed studies gave original data on stroke and TIA outcomes. In general the risk of
bias was moderate to high. One month stroke outcomes were reported as 1%, at 3
months 2%, at 1 year 10% and at 2 years 13%.
CONCLUSIONS
Modern medical therapy, along with improvements in hyperacute stroke care, may have
reduced the early risks associated with carotid plaque rupture. This in turn has
implications for the role of carotid endarterectomy</p
Digital technologies for traceability and transparency in the global fish supply chains: a systematic review and future directions
No full textEnsuring sustainability and ethical practices in global fish supply chains requires robust implementation of digital technologies that conform to traceability and transparency policies in the fisheries industry. This paper provides an in-depth review of 27 impactful studies published from 2008 to 2024, examining how digital technologies enhance fish supply chain traceability to inform effective global fisheries policies. The review identifies three key research streams: (1) enabling technologies such as blockchain and Internet of Things; (2) critical traceability parameters for transparency, including fraud prevention and consumer trust; and (3) sustainability benefits, such as enhanced regulatory compliance and cold-chain efficiency. By mapping gaps in current research, this study establishes a future research and policy agenda and underscores the transformative potential of digital innovations in sustainable fish supply chain governance. Policymakers are encouraged to utilise these technologies to create strong frameworks that ensure transparent data sharing and compliance verification among all supply chain participants in order to address illegal, unreported, and unregulated fishing, promote sustainability, and safeguard human rights in fisheries. Although the focus of this paper is on fish supply chains, findings and recommendations may apply to traceability and transparency in other supply chains aiming for sustainable operations.</p
Investigating the soluble suppressor of tumorigenicity 2 biomarker in addition to natriuretic peptides in managing patients with heart failure and a reduced ejection fraction
No full textIntroduction: Soluble suppressor of tumorigenicity 2 (sST2) is a member of the interleukin-1 receptor family that has been suggested as a biomarker for prognostication and risk stratification in heart failure (HF). Although prognostic capability and threshold levels are established in chronic HF, the utility of sST2 as repeated measurements linked to HF statuses during acute HF is currently unknown. This study aimed to investigate sST2 in addition to natriuretic peptides in patients with heart failure with reduced ejection fraction.Methods: Between December 2019 and January 2022, consecutive patients admitted to Basildon University Hospital for acute decompensated HF with reduced ejection fraction (LVEFResults: In the 168 patients with paired sST2 samples, a median reduction of 32.3% (95% CI 9.6 - 53.6) in sST2 level was detected between HF decompensation and recompensation (pConclusion: The present study demonstrated that there is a significant reduction in sST2 levels between HF decompensation and recompensation, which has significant prognostic capability independent of NT-proBNP and therefore provides additive value in management of HF patients. Future research should explore the practical clinical utility of sST2 changes in monitoring and guiding treatment of HF.</p
An integration of physical and psychological health through the Hero’s Journey in Guided Imagery & Music: A cross-case analysis
No full textThe Hero’s Journey narrative is prevalent in literature and the cinema and is also often utilized as a framework within which to explore and understand the circuitous nature of a client’s therapeutic process. The Hero’s Journey is conceptualized and discussed predominantly as a psychological process occurring within the mythological and imagery world of the client in psychotherapy, which is also applied to music psychotherapy approaches such as Guided Imagery and Music (Bonny Method). A cross case analysis of case studies conducted by researcher-clinicians from four different countries have revealed unexpected affordances of the Hero’s Journey for both physical and psychological domains via narrative and thematic analyses of clients’ GIM experiences. This cross-case analysis compares four GIM clients’ narratives from four different countries of origin within four applied clinical contexts: substance use disorder, a single musician, cancer care, and cardiac rehabilitation. A brief client history and summarized therapeutic case material from each case study (research or clinical) is presented in terms of methodology, emergence, and significance of the Hero’s Journey. The cross-case analysis explores and reviews these GIM case studies, where clients have undergone literal physical and psychological transformation and/or engaged with both physical and psychological aspects of their health conditions as integral components of their therapeutic and recovery processes. Further, links are made to manifestations of mental and physical health with the Hero’s Journey in the GIM process.</p
Cognitive impairment, depressive symptoms, and demographic characteristics of care home residents living with dementia in six countries
No full textOBJECTIVES: As the prevalence of dementia and depression continues to increase globally, understanding the interplay between these conditions becomes important for effective diagnosis, treatment, and tailoring of interventions. We investigate the relationship between depressive symptoms and cognitive impairment and the potential role of sociodemographic characteristics, among care home residents in Australia, Germany, the Netherlands, Norway, Türkiye, and the United Kingdom. METHOD: The study used baseline data from an international cluster-randomised controlled trial comprising 1021 residents with dementia and depressive symptoms in 86 care home units. The relationship between cognitive impairment and depressive symptoms was investigated using linear mixed effects models, with country, age, sex, marital status, and education level as possible predictors. RESULTS: Higher severity of cognitive impairment was related to more severe depressive symptoms in all countries. The association was especially strong in Türkiye. Marital status was a significant predictor for depressive symptoms and education level predicted cognitive ability. CONCLUSION: Findings confirm that lower cognitive ability is associated with more depressive symptoms across different contexts in a large international sample. As thresholds to long-term care are likely to be set even higher in the future, interventions to alleviate depressive symptoms among older adults with dementia become even more important.</p
From Biomechanics to Welfare: Integrative Advances in Equine Sports Medicine and Rehabilitation
No full textEquine sports medicine continues to advance at pace, driven by innovations in technology, AI, biomechanics, exercise physiology, and clinical diagnostics [...]</p
Preserving fossilized soft tissues: advancing proteomics and unveiling the evolutionary history of cancer in dinosaurs
No full textUnderstanding how life-history strategies influence cancer susceptibility in dinosaurs requires a molecular-level analysis of preserved soft tissues. While previous research has largely focused on skeletal remains, the discovery of soft tissue structures in fossils, such as Telmatosaurus transsylvanicus, highlights the need for a new approach. Paleoproteomics offers a transformative opportunity to analyze ancient proteins, revealing the evolutionary trade-offs between growth, reproduction, and cancer suppression. This study argues that prioritizing fossil collection and soft tissue preservation is crucial, as future advances in molecular techniques will allow deeper insights into disease evolution. By integrating life-history theory with paleopathology, we can better understand the selective pressures that shaped cancer susceptibility in extinct species and identify potential mechanisms of tumor resistance. This commentary highlights the necessity of long-term fossil conservation efforts to support future breakthroughs in evolutionary biology and comparative oncology.</p
Trends in Higher Education (Eritrea)
No full textUp to 2003/04, Eritrea had only one higher education institution (HEI), the University of Asmara (UoA) -- a renowned university established in 1958. By the academic year 2002/2003, the UoA had 5934 students, 254 academic staff, and 39 departments offering various undergraduate programs (Leonida, 2004). Moreover, in 2004, the UoA established the School of Graduate Studies and started graduate programs in six fields of study (Rena, 2008). It is also worth noting that the UoA had started evening classes for students who could not attend their university studies during the daytime due to work, family, and other responsibilities. However, from 2004 to 2005, the Government of Eritrea (GoE) restructured the only university in the country into seven new HEIs (Tsegay, 2021). Six of the University of Asmara colleges became autonomous HEIs in different parts of the country and three colleges were merged to form one HEI, the Eritrea Institute of Technology (EIT)…</p
Towards more efficient synthetic immunomodulators: biological characterization and mechanism of action of monosaccharide-derived TLR4 agonists
No full textToll-like receptors (TLRs), including TLR4, play a crucial role in innate immunity activation, and small molecular TLR4 activators (agonists) are in the preclinical and clinical phases of development as vaccine adjuvants or tumor immunotherapeutics. Recently, we generated novel glucosamine-derived compounds, FP molecules, that are active as TLR4 agonists. Despite their chemical structure differing from LPS, some of these compounds, including compound FP18, mimicked the biological activity of LPS and its capacity to activate TLR4 and its downstream pathways. In contrast to FP18, compound FP20 showed immunostimulant activity that was only partially due to TLR4 agonism. This activity was mainly associated with NLRP3 inflammasome activation. We generated a panel of glycosylated FP20 derivatives (glyco-FP20) bearing different monosaccharides linked to C6 of the glucosamine. The biological activity of glyco-FP20 was related to TLR4 activation, as assessed from preliminary experiments in HEK-Blue cells. We presented a comprehensive study of the mechanism of action of glyco-FP20 derivatives and their effect on TLR4 signalling, leading to macrophage M1 polarisation and pyroptosis in THP-1 derived macrophages. Results revealed that, similarly to LPS and differently from FP20, glyco-FP20 derivatives were potent TLR4 agonists inducing TLR4/MyD88 signalling pathways that led to M1 macrophage polarisation, associated with NF-kB activation/translocation and release of a number of proinflammatory mediators in THP-1-derived macrophages. In particular, compound FP20 Rha activated TLR4/TRIF signalling, associated with phosphorylation of STAT1/IRF3, leading to the production of IFN-β in THP-1-derived macrophages. Furthermore, using a specific GSD inhibitor (U73), we demonstrated the ability of FP20 and glyco-FP20 to induce GSD-dependent pyroptosis, which was associated with IL-1β/IL-18 and LDH release in THP-1-derived macrophages. These results show that the optimization of FP20 glycosylation can increase the biological potency of the parent molecule and can be used in preclinical development as vaccine adjuvants or macrophage-based cancer immunotherapy.</p
Towards the ‘care-full’ university: A national study of staff who are caregivers in the UK Higher Education sector
No full textThis research report presents the key findings of the Towards the ‘care-full’ university: A national study of staff who are caregivers in the UK Higher Education sector project. It builds on a smaller, separate project, conducted in our own institution (Moreau and Wheeler, 2022). The key ambitions of the new, scaled-up project presented in this report are to generate an understanding of the experiences of staff who are caregivers at a time of considerable transformation for the HE workforce and to identify a pathway to impact, so as to foster the development of a more inclusive culture for carers across the HE sector. This endeavour also coincides with the development of a range of policies across the sector, aiming to support staff’s wellbeing and recognising the new modes of doing paid and care work associated with the Covid-19 pandemic.</p
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