Exploring the Intersection of Dementia and Myocardial Infarction: Vascular Perspectives.

Emerging evidence underscores the relationship between myocardial infarction and dementia, implicating a profound influence on patient health. The bidirectional relationship between myocardial infarction and dementia is highlighted by pathophysiological changes in vasculature function, lifestyle factors, and environmental influences. Our literature review aims to explore the complex relationship between these 2 pathologies and highlight the pathways by which they mutually influence each other.

Comparative assessment of chondral defect repair using migratory chondroprogenitors suspended in either gelled or freeze-dried platelet-rich plasma: An in vitro and ex vivo human osteochondral unit model study.

BACKGROUND: Chondroprogenitors, with enhanced chondrogenic potential, have emerged to be a promising alternative for cell-based therapy in cartilage repair. Platelet-rich plasma (PRP), widely used for intra-articular treatment, has a short half-life. Freeze-dried PRP (FD-PRP), with an extended half-life and retained growth factors, is gaining attention. This study compares the efficacy of Migratory Chondroprogenitors (MCPs) in gelled PRP and FD-PRP using in-vitro and ex-vivo models, assessing FD-PRP as a potential off-the-shelf option for effective cartilage repair. METHODOLOGY: MCPs were isolated from osteoarthritic cartilage samples (n = 3), characterized through FACS and RT-PCR. For in-vitro analysis, cells were loaded into gelled PRP and FD-PRP scaffolds at a density of 1x106 cells per scaffold. Trilineage differentiation studies and live-dead assays were conducted on MCPs using Calcein AM/Propidium Homodimer-1. In ex-vivo analysis, MCPs of the same density were added to Osteochondral Units (OCU) with chondral defects containing PRP gel and FD-PRP scaffolds, harvested on the 15th and 35th days for histological examination. Controls included cell-free scaffolds. RESULTS: Our in-vitro analysis demonstrates the robust viability of MCPs in both scaffolds, with no discernible impact on their differentiation capacity. Ex-vivo analysis of the OCU for cartilage repair showed that the chondrogenic potential characterized by the accumulation of extracellular matrix containing glycosaminoglycans and collagen type II production (with no alteration in collagen type X), was observed to be better with the gel PRP and the gel PRP containing MCP groups. CONCLUSIONS: These findings support the preference for gel PRP as a superior synergistic scaffold for chondroprogenitor delivery.

Survey of NCI-Designated Cancer Centers on the Utilization of Palliative Care in Pancreatic Cancer Patients.

Recognized as one of the deadliest cancers, pancreatic cancer underscores an urgent need for palliative care. We surveyed palliative care directors at all 65 National Cancer Institute (NCI) cancer centers to assess the utilization and timing of palliative care involvement in pancreatic cancer patients. 1) Does your palliative care team have a policy to get involved with every pancreatic cancer patient? a. Yes b. No 2) When palliative care is involved with pancreatic cancer patients, in what setting are you typically/primarily first asked to be involved? a. Early in the patient's treatment journey (focusing on symptom management) b. Later in the patient's treatment journey (focusing on end-of-life discussions and explaining hospice) All 65 NCI-designated centers responded, achieving 100% of the targeted sample. Among these centers, 64 lacked a policy for palliative care involvement with every pancreatic cancer patient. Additionally, 38 centers initiated intervention early, focusing on symptom management, while 15 centers started palliative care late in the treatment journey, emphasizing end-of-life discussions. Furthermore, 12 centers initiated intervention both early and late when treating pancreatic cancer. There is an increasing recognition among medical centers of palliative care's necessity for pancreatic cancer, with a rising trend toward early integration. Variation in the timing and emphasis of palliative care involvement remains. Future research should explore barriers to accessing palliative care and compare outcomes of early versus late intervention. By addressing these areas, healthcare providers can potentially improve outcomes for pancreatic cancer patients.

Striding Toward Cardiovascular Health: The Impact of Step Counts on Heart Wellness.

In an era characterized by sedentary lifestyles, cardiovascular diseases pose a significant global health challenge. As preventive healthcare strategies evolve, this article explores the tangible and accessible metric of step counts and their implications for cardiovascular health. The review provides insights into potential benefits, challenges, and future directions in promoting physical activity for heart wellness.

Mapping geographic disparities in treatment and clinical outcomes of high-grade aneurysmal subarachnoid hemorrhage in the United States.

BACKGROUND AND OBJECTIVE: Although high-grade (Hunt and Hess 4 and 5) aneurysmal subarachnoid hemorrhage (aSAH) typically portends a poor prognosis, early and aggressive treatment has previously been demonstrated to confer a significant survival advantage. This study aims to evaluate geographic, demographic, and socioeconomic determinants of high-grade aSAH treatment in the United States. METHODS: The National Inpatient Sample (NIS) was queried to identify adult high-grade aSAH hospitalizations during the period of 2015 to 2019 using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD) codes. The primary clinical endpoint of this analysis was aneurysm treatment by surgical or endovascular intervention (SEI), while the exposure of interest was geographic region by census division. Favorable functional outcome (assessed by the dichotomous NIS-SAH Outcome Measure, or NIS-SOM) and in-hospital mortality were evaluated as secondary endpoints in treated and conservatively managed groups. RESULTS: Among 99 460 aSAH patients identified, 36 795 (37.0%) were high-grade, and 9210 (25.0%) of these were treated by SEI. Following multivariable logistic regression analysis, determinants of treatment by SEI included female sex (adjusted OR (aOR) 1.42, 95% CI 1.35 to 1.51), transfer admission (aOR 1.18, 95% CI 1.12 to 1.25), private insurance (ref: government-sponsored insurance) (aOR 1.21, 95% CI 1.14 to 1.28), and government hospital ownership (ref: private ownership) (aOR 1.17, 95% CI 1.09 to 1.25), while increasing age (by decade) (aOR 0.93, 95% CI 0.91 to 0.95), increasing mortality risk (aOR 0.60, 95% CI 0.57 to 0.63), urban non-teaching hospital status (aOR 0.66, 95% CI 0.59 to 0.73), rural hospital location (aOR 0.13, 95% CI 0.7 to 0.25), small hospital bedsize (aOR 0.68, 95% CI 0.60 to 0.76), and geographic region (South Atlantic (aOR 0.72, 95% CI 0.63 to 0.83), East South Central (aOR 0.75, 95% CI 0.64 to 0.88), and Mountain (aOR 0.72, 95% CI 0.61 to 0.85)) were associated with a lower likelihood of treatment. High-grade aSAH patients treated by SEI experienced significantly greater rates of favorable functional outcomes (20.1% vs 17.3%; OR 1.20, 95% CI 1.13 to 1.28, P<0.001) and lower rates of mortality (25.8% vs 49.1%; OR 0.36, 95% CI 0.34 to 0.38, P<0.001) in comparison to those conservatively managed. CONCLUSION: A complex interplay of demographic, socioeconomic, and geographic factors influence treatment patterns of high-grade aSAH in the United States.

Ultra-brief training in cognitive reappraisal or mindfulness reduces anxiety and improves motor performance efficiency under stress.

BACKGROUND AND OBJECTIVES: We examined the effects of ultra-brief training in mindfulness and cognitive reappraisal on affective response and performance under stress. We hypothesized that one or both types of training would decrease affective responding and improve performance, and that these effects might be moderated by acute stress induction. DESIGN: We manipulated training (mindfulness, cognitive reappraisal, control) between subjects and level of stress (low, high) within subjects in a 3 × 2 mixed factorial design. Method: Participants (N = 112, ages 18-35) completed two sessions on different days. In each session, they received mindfulness or cognitive reappraisal training or listened to a control script prior to a low- or high-stress simulated hostage situation. We measured motor performance efficiency (proportion of shots that hit hostile and hostage targets), affective responding (self-reported anxiety, salivary cortisol and alpha amylase, and autonomic physiology), and physical activity. RESULTS: Compared to control instructions, ultra-brief training in cognitive reappraisal or mindfulness reduced subjective anxiety and increased performance efficiency. There were few effects of training on other measures. CONCLUSION: Ultra-brief training in cognitive reappraisal or mindfulness prior to a stressful task may be both helpful and harmful; effects are preliminary and subject to boundary conditions.

Giloy: a potential anti-COVID-19 herb with propitious pharmacological attributes: a short review.

Plant-based medicine actually restores the balance in the body instead of treating the source of the disease. The strain of coronavirus (SAR-CoV-2) going to be more serious due to the lack of a reliable treatment option. Holistic treatment for this disease is in the form of Ayurveda as traditional medicine. As the infection of coronavirus is spreading like a wildfire, so the one way to fight is 'immunity'. Building immunity is the only way to stay safe and healthy and prepared themselves for the ongoing pandemic. In the current scenario, good immunity safeguard us from disease progression and prevention from this deadly virus. Giloy herb came into the limelight after the start of the COVID-19 pandemic due to its immunomodulatory and antiviral activity. The genome sequencing of Giloy is proved to be a breakthrough for controlling the COVID-19.Communicated by Ramaswamy H. Sarma.

Biobased Castor Oil-Based Polyurethane Foams Grafted with Octadecylsilane-Modified Diatomite for Use as Eco-Friendly and Low-Cost Sorbents for Crude Oil Clean-Up Applications.

Herein we report the synthesis and characterization of novel castor oil-based polyurethane (PU) foam functionalized with octadecyltrichlorosilane (C18)-modified diatomaceous earth (DE) particles, exhibiting superior hydrophobicity and oil adsorption, and poor water absorption, for use in effective clean-up of crude oil spillage in water bodies. High-performance and low-cost sorbents have a tremendous attraction in oil spill clean-up applications. Recent studies have focused on the use of castor oil as a significant polyol that can be used as a biodegradable and eco-friendly raw material for the synthesis of PU. However, biobased in-house synthesis of foam modified with C18-DE particles has not yet been reported. This study involves the synthesis of PU using castor oil, further modification of castor oil-based PU using C18 silane, characterization studies and elucidation of oil adsorption capacity. The FTIR analysis confirmed the fusion of C18 silane particles inside the PU skeleton by adding the new functional group, and the XRD study signified the inclusion of crystalline peaks in amorphous pristine PU foam owing to the silane cross-link structure. Thermogravimetric analysis indicated improvement in thermal stability and high residual content after chemical modification with alkyl chain moieties. The SEM and EDX analyses showed the surface's roughness and the incorporation of inorganic and organic elements into pristine PU foam. The contact angle analysis showed increased hydrophobicity of the modified PU foams treated with C18-DE particles. The oil absorption studies showed that the C18-DE-modified PU foam, in comparison with the unmodified one, exhibited a 2.91-fold increase in the oil adsorption capacity and a 3.44-fold decrease in the water absorbing nature. From these studies, it is understood that this novel foam can be considered as a potential candidate for cleaning up oil spillage on water bodies.

Surface properties of alkylsilane treated date palm fiber.

The present work focuses on investigating the effect of non-fluoro short-chain alkylsilane treatment on the surface characteristic of date palm (Phoenix dactylifera) fiber. Raw date palm fiber (DPF) was treated with octylsilane and the surface properties of treated fiber was investigated using thermogravimetric analysis (TGA), fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), contact angle analysis and X-ray diffraction (XRD) on configuring the thermal stability, chemical structures and surface properties (morphology, hydrophobicity and crystallinity). The decomposition temperature of 75% mass loss raw and treated DPF, the onset of temperatures were increased from 464 to 560 °C with the introduction of alkylsilane. Hydrophobicity and crystallinity index of the DPF fibers were increased from 66.8° to 116° and 31 to 41, introducing octylsilane to raw DPF. The SEM and XRD experimental results showed that the octylsilane treatment could effectively increase the pore size and crystallinity index as an indication of the removal of non-crystalline cellulosic materials from DPFs. Thermal stability, hydrophobicity and crystallinity of the fibers increased on DFP after alkylsilane treatment. The results indicated that alkylsilane-treated DPFs were a suitable reinforcing substitute for hydrophobic polymer composite.

Articular chondroprogenitors in platelet rich plasma for treatment of osteoarthritis and osteochondral defects in a rabbit knee model.

BACKGROUND: Articular chondroprogenitors are a promising contender for cartilage repair due to their inherent nature which stands primed for chondrogenesis and minimal hypertrophic preponderance. Platelet rich plasma (PRP) has been extensively used for treating cartilage defects and osteoarthritis (OA), due to its chondro-inductive properties and abundant pool of growth factors. The aim of this study was to assess the efficacy of chondroprogenitors injected with PRP versus PRP alone in the healing of experimentally created early OA and osteochondral defects (OCD) in a rabbit model. METHODS: Adult New Zealand White male rabbits were used for cell and PRP isolation. Chondroprogenitors were isolated by fibronectin adhesion assay, labelled with iron oxide, characterized for surface markers, differential potential and expanded. PRP was isolated by double spin centrifugation using a TriCell kit. Study groups included (a) Monosodium iodoacetate induced early OA and (b) critical OCD. Following intervention (test arm: PRP+ chondroprogenitors and control arm: PRP), assessment was performed at 6- and 12-weeks which included histopathological examination and scoring (OARSI and Modified Wakitani score), immunohistochemistry analysis (Collagen type II and X) and synovial fluid S100A12 levels. RESULTS AND CONCLUSION: Comparable, evident healing was noticed in both test and control arms when the OA group samples were assessed at both time points. In the OCD group, PRP alone exhibited significantly better results than the test arm, although repair was notable in both interventions. Further evaluation of chondroprogenitors is required to assess their role as a standalone therapy and in combination with PRP to further cartilage regeneration.

Herbal Medicine: Clinical Perspective and Regulatory Status.

Herbal medicines play an important role in treating various ailments due to their potentially high therapeutic values and acceptability by patients with different health complications. The practice of herbal medicine involves the use of a part of a plant, the entire plant, or a selective isolated phytoconstituent. The search for new drugs during the scientific era revived the interest in the discovery of herbal drugs from different natural resources. The present modern healthcare system involves the utilization of drugs and 50% of them are of natural origin. In recent years, there had been an upsurge in the interest for search of novel herbal drugs by the pharmaceutical industry. However, the discovery of such new novel phytomedicines involves various challenges in the identification of active constituents; their characterization, pharmacological activity, toxicity/adverse effects, drug interactions, and, most importantly, their regulatory requirements. The present review is mainly focused on the history of herbal medicine, current clinical perspective, and pharmaceutical and regulatory challenges facing herbal drugs. Moreover, problems encountered in drug discovery from herbal resources and their possible solutions have been delineated.

Joint Preservation Surgery for Medial Compartment Osteoarthritis.

Single compartment osteoarthritis is a commonly encountered condition in the middle-aged population, with the medial compartment being the most commonly involved compartment. Medial compartment osteoarthritis becomes seriously disabling for these active patients, with a very few definitive solutions. These patients quickly stop responding to the conservative methods such as lifestyle modification, drugs, physiotherapy, and rehab programs. Less invasive procedures such as intra-articular injections or joint debridement also do not give a long-lasting relief. On the other hand, this population is too young to undergo a knee replacement surgery because the failure rate of a knee replacement surgery is too high in the middle-aged patients as compared with the elderly population. A combination of biological stimulation of the damaged single compartment cartilage and biomechanical correction surgery can give a long-lasting relief in the middle-aged population. Because the medial compartment osteoarthritis is increasingly being treated with joint preservation surgeries, it is important to lay out the step-by-step surgical technique of a joint preservation surgery. This Technical Note presents the detailed technique, patient selection flow chart, tips, pearls, and surgical decision making, along with a surgical video of a joint preservation surgery.

Evidence-based status of osteochondral cylinder transfer techniques: a systematic review of level I and II studies.

PURPOSE: Our purpose was to examine the Level I and II evidence for the use of osteochondral cylinder transfer technique (OCT) for cartilage repair. METHODS: A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that involved OCT were identified. Only Level I and II studies that compared OCT to other modalities of treatment such as microfracture (MF) and autologous chondrocyte implantation (ACI) were selected. RESULTS: A total of 8 studies matched the selection criteria with 2 Level I and 6 Level II studies. Four studies compared OCT with MF, 3 compared OCT with ACI, and one compared all 3 techniques. Of 3 studies, 4 came from a single center. Mean age of patients ranged from 24 to 33 years, and mean follow-up ranged from 9 to 124 months. The studies from the single center showed superior results from OCT over MF, especially in younger patients, with one study having long-term follow-up of 10 years. They also showed an earlier return to sports. The size of the lesions were small (average < 3 cm(2)). The 4 other independent studies did not show any difference between OCT and ACI, with one study showing inferior outcome in the OCT group. Magnetic resonance imaging (MRI) showed good osseous integration of the osteochondral plugs to the subchondral bone. Histologic examination showed that there was hyaline cartilage in the transplanted osteochondral plugs but no hyaline cartilage between the plugs. CONCLUSIONS: From the studies of a single center, OCT had an advantage over MF in younger patients with small chondral lesions. Comparison of outcomes between OCT and ACI showed no significant difference in 2 studies and contrasting results in another 2 studies. There was insufficient evidence for long-term results for OCT. LEVEL OF EVIDENCE: Level II, systematic review of Level I and II studies.

Evidence-based status of second- and third-generation autologous chondrocyte implantation over first generation: a systematic review of level I and II studies.

PURPOSE: The purpose of this study was to examine the Level I and II evidence for newer generations of autologous chondrocyte implantation (ACI) versus first-generation ACI and to establish whether the newer generations have overcome the limitations associated with first-generation ACI. METHODS: A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that dealt with ACI were identified. Only Level I and II studies that compared newer generations against earlier generations were selected, whereas studies that compared ACI against other methods of cartilage repair were excluded. RESULTS: A total of 7 studies matched the selection criteria. Two studies compared periosteum-based autologous chondrocyte implantation (P-ACI) against collagen membrane-based autologous chondrocyte implantation (C-ACI), whereas one study each compared membrane-associated autologous chondrocyte implantation (MACI) against P-ACI and C-ACI. One study on C-ACI compared results related to age, whereas 2 studies evaluated postoperative rehabilitation after MACI. There was weak evidence showing that C-ACI is better than P-ACI and that MACI is comparable with both P-ACI and C-ACI. The weak evidence is because of studies with short durations of follow-up, small numbers of patients, medium-sized defects, and younger age groups. There is good evidence favoring an accelerated weight-bearing regimen after MACI. There is currently no evidence that supports scaffold-based ACI or arthroscopic implantation over first-generation ACI. CONCLUSIONS: The hypothesis is thus partly proved in favor of C-ACI/MACI against P-ACI with weak evidence, in favor of accelerated weight bearing after MACI with strong evidence, and not in favor of arthroscopic and scaffold-based implantations because of unavailable evidence. LEVEL OF EVIDENCE: Level II, systematic review of Level I and II studies.

2,5,6-trisubstituted imidazo[2,1-b][1,3,4]thiadiazoles: search for antihyperlipidemic agents.

A novel series of 2,5,6-trisubstituted imidazo[2,1-b][1,3,4]thiadiazoles 4(a-d) and 7(a-i) were rationally designed through QSAR based pharmacophore approach and synthesized from 5-(1,3-benzodioxol-5-yl)-[1,3,4]thiadiazol-2-amine (1). The structures of these compounds were established by IR, (1)H NMR, (13)C NMR, HRMS technique. All the compounds were evaluated for their in vitro antihyperlipidemic activity using trition induced hyperlipidemic model. The newly synthesized title compound 7d, 7e and 7h showed a significant decrease in the serum, TCH, TG LDL and VLDL values along with an increase in serum HDL levels as compared to standard drug Fenofibrate. The treated groups also showed significant decrease in the atherogenic index, LDL:HDL risk ratios and the level of SGOT, SGPT and ALP activities compared to cholesterol induced hyperlipidemic control group.

Consideration of religious sentiments while selecting a biological product for knee arthroscopy.

PURPOSE: There is an increasing use of various synthetic and biological products in orthopaedics. The use of a biological product can be a major area of concern for patients of various cultures/religions. The purpose of this work is to study various restrictions in different faiths and their compatibility with available products focused on cartilage repair. METHODS: A systematic search in several databases, CINAHL, EMBASE, Global health, PubMed, MEDLINE and the Cochrane collaboration, was performed to find out various religious beliefs of some major religions regarding the use of animal products. Hindu, Muslim, Christian, Jewish and Buddhist faiths were studied to find out whether animal-derived surgical implants are permitted. Major religious scholars were asked about their opinions, and guidelines related to human/religious ethics were evaluated. A market survey was carried out to find out biological contents of various products and their compatibility. RESULTS: Jews and Muslims have religious restrictions for porcine products, while Hindus reject bovine products. Vegetarian Hindus reject usage of any animal product. Most Christians do not have any restrictions except those who follow vegetarian dietary regulations. Though there is no prohibition for the use of animal products in Buddhism, a code of non-violence to animals is being followed. However, difference of opinion exists about interpretation of these dietary guidelines for surgical usage amongst various scholars. CONCLUSION: Products of biological origin have a definite restriction for various religions, with few exceptions. Surgeons should know the source of the product and should be aware of the basic requirements of the patient's faith. Patient should be informed about the source of the product and alternative if available, and an informed consent may be considered. LEVEL OF EVIDENCE: Type of study, Level V.