340880 research outputs found
Sort by
Safety, Feasibility, and Diagnostic Yield of Invasive Coronary Function TestingNetherlands Registry of Invasive Coronary Vasomotor Function Testing
No full textImportance Patients with angina and no obstructive coronary artery disease frequently have coronary vasomotor dysfunction as underlying pathophysiological mechanism, comprising epicardial spasm, microvascular spasm, and/or microcirculatory dysfunction. These endotypes can be diagnosed by invasive coronary function testing which has previously shown to be safe in tertiary and expert centers. Objective To determine the prevalence of vasomotor dysfunction in patients with angina and no obstructive coronary artery disease who were clinically referred for a coronary function test (CFT); and assess safety and feasibility of a CFT. Design, Setting, and Participants This quality improvement study was performed using the Netherlands Registry of Invasive Coronary Vasomotor Function Testing (NL-CFT), a prospective, observational registry, in 15 participating hospitals (2 tertiary and 13 nontertiary). Patients with angina and no obstructive coronary artery disease who were referred for a clinically indicated CFT between December 2020 and January 2024 were included. Main Outcomes and Measures A complete CFT consisted of acetylcholine spasm provocation testing and assessment of microcirculatory function. Prevalence of different endotypes based on test results and overall safety were assessed. Results Among a total of 1207 patients included, 978 (81%) were female; and the mean (SD) age was 60 (10) years. The prevalence of coronary vasomotor dysfunction was very high (78%). There were 11 (0.9%) major and 10 (0.8%) minor complications reported. Of them, 3 major and all minor were definitely related to the coronary function test. No procedural death, myocardial infarction, or stroke was observed. No differences were found in the occurrence of complications between tertiary and nontertiary centers. Conclusions and Relevance This study found that a CFT was feasible and safe to perform in both tertiary and nontertiary centers with a high diagnostic yield
Ethical collection of animal cadavers for veterinary education
No full textThe use of animal cadavers in initial and continuing veterinary education is widely accepted, but ethical considerations regarding how to obtain and use them are often lacking. It can be argued that the use of animal cadavers should be guided by principles similar to those regulating the collection of human cadavers for scientific purposes. In humans, the use of unclaimed cadavers from unknown provenance, cadavers from criminals or homeless people, or cadavers robbed from their grave no longer happens in most countries. Accordingly, body donation programs have been emphasized to be the sole acceptable source of cadavers for medical education. The purpose of this article is to argue that this should also be the case for domestic animals, contrary to the current practices of using unwanted animals or animals bred for this purpose. But having a body donation program is not enough to make it ethical: care should also be taken in order to include principles such as informed consent from the owners, the absence of commercial uses of the bodily remains and the respect for all parties involved in the process. Overall, the importance of maintaining respect towards the reception and use of a donated cadaver in all circumstances should be the ethical priority for students and practitioners. By applying such principles, we can better ensure that the use of animal cadavers in education and training is transparent, respectful and responsible
Electoral Rules and the Provision of Early Childhood Education and Care:Evidence from Brazil
No full textThis paper investigates whether electoral rules impact the expansion of public early childhood education and care (ECEC) services using Brazil as a case study. These services are provided mainly by Brazilian municipalities, and although enrolment for children aged 0 to 3 is not mandatory, it has increased continuously over the last two decades, with large heterogeneity between municipalities. Furthermore, electoral rules in Brazil establish a dual ballot system only for municipalities with more than 200,000 registered voters, enabling us to evaluate its impact on the ECEC provision through a regression discontinuity design. We find that public creche net enrolment rates are around five to six percentage points larger in municipalities under the dual ballot system. ECEC expenditure levels are around BRL 425 to 461 per child higher in these municipalities
What Is "Zone 2 Training"?:Experts' Viewpoint on Definition, Training Methods, and Expected Adaptations
No full textBackground: The role of high-volume low-intensity training for enhancing endurance performance has gained growing interest in recent years. Specifically, so-called "zone 2 training" is currently receiving much attention, and many propose that this is the target intensity at which a large proportion of total endurance training should be performed. However, despite the popularity of this concept, there is no clear consensus among coaches, athletes, and scientists regarding the definition of zone 2 training. Purpose: This commentary summarizes the perspectives, experience, and knowledge of an expert panel of 14 applied sport scientists and professional coaches with the aim of providing insight and a basis for definitional consensus on zone 2 training. Moreover, potential training strategies at this intensity are proposed, and the expected physiological adaptations when exercising at this intensity and related research gaps are also discussed. Results: Experts reached consensus that zone 2 training should preferably be performed at intensities located immediately below the first lactate or ventilatory threshold through continuous, variable, or interval-type sessions. Furthermore, experts expected a broad range of central and peripheral adaptations from zone 2 training. These expected adaptations might not be unique to zone 2 and could also be induced with sessions performed at slightly higher and lower intensities. Conclusions: This commentary provides practical insight and unified criteria regarding the preferred intensity, duration, and session type for the optimization of zone 2 training based on the perspectives of acknowledged sport scientists and professional coaches
A case report of a sigmoid perforation within an inguinoscrotal hernia sac caused by ingestion of a chicken wishbone
No full textIntroduction and importance: Ingestion of foreign bodies is common and often harmless. However sharp objects like bones can cause intestinal perforations, particularly at anatomical narrowing points. Diagnosis is challenging due to patients' lack of recollection of ingestion and subtle imaging findings. We present a rare case of a sigmoid perforation within an inguinoscrotal hernia sac caused by a chicken wishbone, discovered during elective hernia repair surgery. Case presentation: A 66-year-old male presented with a left inguinoscrotal hernia causing mild discomfort, but without signs of local infection or an acute abdomen. Preoperative imaging showed sigmoid colon within the hernia sac without complications. During elective surgery, pus and fecal material were drained from the hernia sac, revealing a perforated sigmoid colon with a chicken wishbone protruding. Eight centimeters of inflamed sigmoid colon were resected, and primary anastomosis was performed given the contained perforation and the patient's stable condition. Postoperative complications included anastomotic dehiscence, necessitating further surgeries, however the patient recovered well and remains in good health at 12-month follow-up. Clinical discussion: This case highlights the diagnostic challenge of intestinal perforation by foreign bodies, especially without acute symptoms. Omental adhesion likely sealed the perforation, preventing peritonitis. Conclusion: A sigmoid perforation within an inguinoscrotal hernia sac caused by a chicken wishbone is rare. Effective management requires careful postoperative care. This case contributes to the understanding of intestinal perforations caused by foreign bodies and their unique challenges
The Efficacy of Honey for the Treatment of Perineal Wounds Following Vaginal Birth:A Narrative Review
No full textBackground/Objectives: During vaginal delivery, the perineum can be damaged either by episiotomy or by a spontaneous perineal tear, leading to several complications. The wound healing process should proceed as quickly and properly as possible without an infection. Medical grade honey (MGH) may be a potent treatment option due to its antimicrobial and pro-healing activities. This literature study investigated the role of honey in the treatment of vaginal wounds after delivery. Methods: Studies published before 17 July 2024 in the PubMed, Web of Science, Embase, Scopus, EBSCO host/CINAHL, Cochrane Library, and Google Scholar databases about honey, episiotomy wounds, and perineal tears, as well as those investigating wound healing and/or pain, were assessed. Results: Ten studies were included (six RCTs, of which three were double-blind, one was quasi-experimental with a posttest only, and three were observational studies without a control group), with 723 participants in total. Six of the seven controlled studies showed honey significantly improved various outcome measures, such as improved wound healing, and reduced need for pain medication. The three non-controlled studies also had a positive outcome, improving wound healing and decreasing pain intensity and prickling sensation. However, the overall quality of available evidence is limited. Different types of honey concentrations, origins, and additives were used in the included studies. Using a standardized MGH formulation may help to maintain consistent and potent effects. Therefore, additional research is needed to determine the efficacy of MGH in perineal trauma and to establish guidelines for clinical use. Conclusions: Honey potentially has a great effect on wound healing of perineal trauma; however, more research is necessary to substantiate the findings in the current literature
A Perspective on Home-Based Sexual Health Care:Evidence, Access, and Future Directions
No full textPurposeThis perspective explores the impact of home-based sexual health services on accessibility to STI and HIV testing for priority populations. This study evaluates home-based services as independent care options and as complementary components of traditional clinic-based care.Recent FindingsChallenges for persons to attend clinic-based sexual health care can be overcome by offering lower threshold home-based sexual health care. Implementing home-based services has successfully reached priority populations, including previously untested men who have sex with men (MSM) and individuals with a high exposure risk for sexually transmitted infections (STI) including human immunodeficiency virus (HIV), attending location-based sexual health care. A challenge in home-based services is to ensure equitable care, such as for individuals with limited access to digital resources or low health literacy.SummaryWhile home-based sexual health services enhance the accessibility of sexual healthcare, to ensure equitable care, research into the needs of still underserved populations and subsequent tailoring of the care offered, is needed. Continuous monitoring and evaluation of the implementation of home-based services may maximize the advantages of this promising type of care
Not So Bioorthogonal Chemistry
No full textThe advent of bioorthogonal chemistry has transformed scientific research, offering a powerful tool for selective and noninvasive labeling of (bio)molecules within complex biological environments. This innovative approach has facilitated the study of intricate cellular processes, protein dynamics, and interactions. Nevertheless, a number of challenges remain to be addressed, including the need for improved reaction kinetics, enhanced biocompatibility, and the development of a more diverse and orthogonal set of reactions. While scientists continue to search for veritable solutions, bioorthogonal chemistry remains a transformative tool with a vast potential for advancing our understanding of biology and medicine. This Perspective offers insights into reactions commonly classified as "bioorthogonal", which, however, may not always demonstrate the desired selectivity regarding the interactions between their components and the additives or catalysts used under the reaction conditions
Roadmap for alleviating the manifestations of ageing in the cardiovascular system
Get PDFAgeing of the cardiovascular system is associated with frailty and various life-threatening diseases. As global populations grow older, age-related conditions increasingly determine healthspan and lifespan. The circulatory system not only supplies nutrients and oxygen to all tissues of the human body and removes by-products but also builds the largest interorgan communication network, thereby serving as a gatekeeper for healthy ageing. Therefore, elucidating organ-specific and cell-specific ageing mechanisms that compromise circulatory system functions could have the potential to prevent or ameliorate age-related cardiovascular diseases. In support of this concept, emerging evidence suggests that targeting the circulatory system might restore organ function. In this Roadmap, we delve into the organ-specific and cell-specific mechanisms that underlie ageing-related changes in the cardiovascular system. We raise unanswered questions regarding the optimal design of clinical trials, in which markers of biological ageing in humans could be assessed. We provide guidance for the development of gerotherapeutics, which will rely on the technological progress of the diagnostic toolbox to measure residual risk in elderly individuals. A major challenge in the quest to discover interventions that delay age-related conditions in humans is to identify molecular switches that can delay the onset of ageing changes. To overcome this roadblock, future clinical trials need to provide evidence that gerotherapeutics directly affect one or several hallmarks of ageing in such a manner as to delay, prevent, alleviate or treat age-associated dysfunction and diseases
Innovative Capacity in Triple Helix Partnerships:an Assessment of Conditions for Social Learning
No full textThe Triple Helix (3H) model has attracted considerable attention in both developed and emerging economies as a tool to enhance innovation for economic development (Etzkowitz and Leydesdorff, 2000). This article examines the assumption underlying the triple helix that the exchange of diverse knowledge between academia, industry, and government stimulates innovativeness. The research underlying this article investigates whether and how learning is facilitated by triple helix based on a case study of three partnerships established by the Bright Future in Agriculture project in Ethiopia. Data was gathered from 57 respondents through in-depth interviews and surveys. The findings show that participant's learning has taken place due to a more diverse and relevant network, but that 3H partnerships are not by default catalysts for innovation. The authors argue that this would need purposeful orchestration. This study further supports the plea in literature for quadruple or even quintuple helix models, being more apt as inclusive networks for learning and innovation