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BACKGROUND: One of the main illnesses in the globe that causes impairment and death in people is stroke. In the globe today, it ranks as the second leading cause of death and the leading cause of death in China. OBJECTIVE: This paper analyses into the critical role of risk perception in developing individual awareness of stroke risk and encouraging proactive preventive health behaviors, essential for effective primary stroke prevention strategies and reduced stroke incidence. It discusses the concept of risk perception, the content and dimensions of global stroke assessment tools, and their application status, aiming to provide insights for their development and intervention research. METHODS: Risk perception encompasses subjective assessments of stroke likelihood and severity, influenced by personal experiences, knowledge of risk factors, beliefs about prevention effectiveness, and emotional responses. Global stroke assessment tools, like the Framingham Stroke Risk Score and CHA2DS2-VASc Score, evaluate stroke risk based on factors such as age, gender, blood pressure, and cholesterol levels. In order to improve risk perception and proactive health management and lower the burden of strokes, the paper assesses the advantages and disadvantages of these tools and makes recommendations for improving accessibility, customizing interventions, running educational campaigns, promoting multidisciplinary collaboration, and integrating technology. RESULTS: By combining the research tools of stroke risk perception, it is found that the evaluation tools are mostly single-dimensional evaluation tools centered on the two dimensions of onset possibility and susceptibility. CONCLUSION: Some scholars have developed multi-dimensional evaluation tools, but the evaluation population is relatively limited, and the evaluation system lacks comprehensiveness and systematization.
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Background: Knee replacement surgery can significantly improve the quality of life of patients with severe knee osteoarthritis. Equitable access to knee replacement surgery is important to ensure that everyone, regardless of their socioeconomic status or geographical location, have fair and timely access. Objectives: The aim of our study was to (1) describe the health equity profile and quality of life of patients awaiting knee replacement at a single academic hospital in South Africa and to (2) describe the association between these health equity factors and the waiting time. Method: A cross-sectional survey and retrospective record review of patients awaiting knee replacement was conducted using the PROGRESS-Plus health equity framework. Chi-square statistics were used to calculate association between health equity factors and the waiting time. Results: Three-hundred and two (N = 302) patients (77% female; mean age 67 years) participated, of whom one in three patients waited 5 years or longer for surgery. Elderly patients (> 70 years) and patients from lower socio-economic background were less likely to have equitable access to surgery. Conclusion: The current screening protocol for knee replacement surgery in the public health care sector does not provide equitable access to surgery. A more holistic screening approach alongside selective surgical prioritisation and rehabilitation could reduce the waiting list and facilitate equitable access to care. Clinical implications: Health equity factors such as socioeconomic status, age, and other patient characteristics such as life roles and employability should be taken into consideration when screening patients for elective knee replacement waiting lists.
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Heart failure (HF) has a severe impact on public health development due to high morbidity and mortality and is associated with imbalances in cardiac immunoregulation. Macrophages, a major cell population involved in cardiac immune response and inflammation, are highly heterogeneous and polarized into M1 and M2 types depending on the microenvironment. M1 macrophage releases inflammatory factors and chemokines to activate the immune response and remove harmful substances, while M2 macrophage releases anti-inflammatory factors to inhibit the overactive immune response and promote tissue repair. M1 and M2 restrict each other to maintain cardiac homeostasis. The dynamic balance of M1 and M2 is closely related to the Traditional Chinese Medicine (TCM) yin-yang theory, and the imbalance of yin and yang will result in a pathological state of the organism. Studies have confirmed that TCM produces positive effects on HF by regulating macrophage polarization. This review describes the critical role of macrophage polarization in inflammation, fibrosis, angiogenesis and electrophysiology in the course of HF, as well as the potential mechanism of TCM regulation of macrophage polarization in preventing and treating HF, thereby providing new ideas for clinical treatment and scientific research design of HF.
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Plant-parasitic nematode research in the Middle East and North Africa (MENA) region faces significant challenges rooted in a need for proper assembly, diversity, and a unified and purpose-driven framework. This led to exacerbating their detrimental effects on crop production. This systematic review addresses the current situation and challenges that require targeted interventions to sustainably manage plant-parasitic nematodes and reduce their detrimental impact on agriculture production in the MENA region. We analyzed the nematode-related research conducted within the region over the past three decades to assess available resources and promote diverse research approaches beyond basic morphology-focused surveys. We show that crops are attacked by a diverse spectrum of plant-parasitic nematodes that exceed the global economic threshold limits. In particular, Meloidogyne species exceed the threshold limit by 8 - 14-fold, with a 100% frequency of occurrence in the collected soil samples, posing a catastrophic threat to crop production and the economy. We highlight detrimental agriculture practices in the MENA region, such as transferring soil from established fields to barren land, which enhances the dissemination of plant-parasitic nematodes, disrupting soil ecology and causing significant agricultural challenges in newly cultivated areas. Looking into the behavior of farmers, raising awareness must be accompanied by available solutions, as more practical alternatives are needed to gain the confidence of the farmers. We propose integrating microbial-based products and soil development practices in hygienic farming as resilient and sustainable solutions for nematode management. Increased emphasis is required to diversify the nematode-related research areas to bridge the gaps and facilitate the transition from fundamental knowledge to practical solutions. A cohesive network of nematologists and collaboration with national and international entities is crucial for exchanging knowledge related to legislation against invasive species.
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Sharing research data has great potential to benefit science and society. However, data sharing is still not common practice. Since public research funding agencies have a particular impact on research and researchers, the question arises: Are public funding agencies morally obligated to promote data sharing? We argue from a research ethics perspective that public funding agencies have several pro tanto obligations requiring them to promote data sharing. However, there are also pro tanto obligations that speak against promoting data sharing in general as well as with regard to particular instruments of such promotion. We examine and weigh these obligations and conclude that all things considered funders ought to promote the sharing of data. Even the instrument of mandatory data sharing policies can be justified under certain conditions.
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Ética em Pesquisa , Disseminação de Informação , Obrigações Morais , Disseminação de Informação/ética , Humanos , Apoio à Pesquisa como Assunto/ética , Comportamento CooperativoRESUMO
This paper analyzes the relationship between Foreign Direct Investment (FDI), economic growth, and institutional quality to maintain sustainable energy efficiency in BRICS. The objective of our study is to decompose which elements collectively impact the uptake of sustainable energy practices. A comprehensive dataset and an advanced econometric model Data Envelopment Analysis (DEA) are employed to investigate the dynamics at play. It has been done through comprehensive research to understand these FDI mechanisms driving the sustainable energy transition, bringing forth the fundamental role of strong institutions and sustained growth. In contrast to existing models, the analysis incorporates institutional quality, providing a fresh perspective on the impact of this factor on FDI and economic development in the BRICS economies. Findings show the crucial position FDI holds in developing sustainable energy and the institutional structure's effectiveness in accomplishing the current objectives. We have kept the position of economic growth, which serves as the essential driver for environmentally friendly use of energy resources. Our results have shown that FDI in sustainable energy is a requisite for economic growth improvement and the need for such progress to be supported by effective institutions to facilitate intra-regional investments.
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MicroRNAs (miRNAs) are 18-25 nucleotides long, single-stranded, non-coding RNA molecules that regulate gene expression. They play a crucial role in maintaining normal cellular functions and homeostasis in organisms. Studies have shown that miR-124-3p is highly expressed in brain tissue and plays a significant role in nervous system development. It is also described as a tumor suppressor, regulating biological processes like cancer cell proliferation, apoptosis, migration, and invasion by controlling multiple downstream target genes. miR-124-3p has been found to be involved in the progression of various kidney diseases, including diabetic kidney disease, calcium oxalate kidney stones, acute kidney injury, lupus nephritis, and renal interstitial fibrosis. It mediates these processes through mechanisms like oxidative stress, inflammation, autophagy, and ferroptosis. To lay the foundation for future therapeutic strategies, this research group reviewed recent studies on the functional roles of miR-124-3p in renal diseases and the regulation of its downstream target genes. Additionally, the feasibility, limitations, and potential application of miR-124-3p as a diagnostic biomarker and therapeutic target were thoroughly investigated.
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Nefropatias , MicroRNAs , MicroRNAs/metabolismo , MicroRNAs/genética , Humanos , Nefropatias/genética , Nefropatias/metabolismo , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/genética , Injúria Renal Aguda/genética , Injúria Renal Aguda/metabolismo , Animais , Estresse Oxidativo , Nefrite Lúpica/genética , Nefrite Lúpica/metabolismo , Cálculos Renais/genética , Cálculos Renais/metabolismoRESUMO
Changes in hematological parameters due to diabetes are reflected in changes in whole blood viscosity (WBV). Understanding the impact of diabetes and its cardiovascular disease (CVD) complications can provide substantiation of how laboratory tests for WBV are useful to monitor the progression and treatment. The review examines research work done in the past 20 years to provide a framework for the present agenda. This was a narrative review that followed the standard Scale for the Assessment of Narrative Review Articles (SANRA) approach. It includes both conceptual and empirical reviews. WBV was appraised in the context of bibliographic research on diabetes and other related factors such as metabolic syndrome (MetS) and oxidative stress. The association of abnormal erythrocytes as well as the relationship between WBV and MetS is established. Changes in diabetes that contribute to the development of diabetic cardiovascular complications occur through the pathway of WBV physiology. However, longitudinal analysis is very limited. There is a dearth of longitudinal study data on WBV in diabetes management. This lack of data justifies a need for further studies, especially prospective and retrospective analysis, to investigate the prevalence of diabetes mellitus about the prevalence of cardiovascular complications indices, especially estimated WBV (eWBV) between periods and within cohorts.
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Monitoring treatment progress through progress feedback is recognized for its efficacy and demonstrated value. However, its integration and utilization within treatments still need to be improved. Insufficient understanding exists regarding the factors within geriatric mental healthcare influencing the adoption of progress feedback. This study aimed to explore the determinants impacting the utilization of progress feedback within outpatient geriatric mental healthcare, specifically focusing on age-related perspectives and patient group characteristics. This qualitative investigation employed semi-structured interviews involving clinicians (N = 14) selected from four outpatient geriatric teams. The findings revealed both inhibiting and facilitating perspectives concerning progress feedback. Clinicians preferred user-friendly, specific, and tailored measures. Challenges included organizational support, integration in work processes, training, and the digital progress feedback system. Age-related perspectives such as older adults' diverse issues, limited digital skills, and cognitive problems hindered implementation, particularly in the oldest generation of older patients. In outpatient geriatric mental healthcare, many factors and attitudes influencing progress feedback align with those observed in adult psychiatry literature. Moreover, this study highlights specific age-related factors that impede the adoption and implementation of progress feedback, shedding light on the specific barriers within this context.
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An important question about moral progress is what causes it. One of the most popular proposed mechanisms is moral reasoning: moral progress often happens because lots of people reason their way to improved moral beliefs. Authors who defend moral reasoning as a cause of moral progress have relied on two broad lines of argument: the general and the specific line. The general line presents evidence that moral reasoning is in general a powerful mechanism of moral belief change, while the specific line tries to establish that moral reasoning can explain specific historical examples of moral progress. In this paper, we examine these lines in detail, using Kumar and Campbell's (2022, A Better Ape: The Evolution of the Moral Mind and How It Made Us Human. Oxford University Press) model of rational moral progress to sharpen our focus. For each line, we explain the empirical assumptions it makes; we then argue that the available evidence supports none of these assumptions. We conclude that at this point, we have no idea if moral reasoning causes moral progress.
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Hepatitis B virus (HBV)-related liver disease poses a major threat to human health worldwide. Although interferon and nucleoside analogues are commonly administered for treating chronic HBV infection, their use is limited by considerable side effects, drug resistance and incapacity for HBV elimination. Hence, novel HBV therapeutics are urgently required. For numerous years, traditional Chinese botanical drugs have been widely used to treat HBV-related diseases. The natural metabolites derived from these traditional drugs exhibit significant anti-HBV effects and serve as potential novel drugs for treating HBV. For overall understanding the therapeutic potential of these metabolites, the anti-HBV effects and mechanisms of action of 107 natural metabolites are summarized in this article. Mechanistically, these natural metabolites exert their anti-HBV effects by influencing the expression and function of host and/or viral genes, which differs from the mechanism of action of nucleoside analogues. Indeed, combining natural metabolites with nucleoside analogues can exert synergistic effects. Accordingly, natural metabolites or their chemically modified derivatives represent potential novel drugs and adjuvants for anti-HBV treatment.
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BACKGROUND: Evidence-based practice is the principle governing a range of healthcare practices and beyond. However, it has suffered from a lack of philosophical rigour. This paper sets out to analyse the epistemological basis of evidence-based practice. METHOD: The paper uses a conceptual analysis. First, it describes the implicit epistemology at work in evidence-based practice. Second, it evaluates the implicit epistemological basis. RESULTS: The analysis indicates that evidence-based practice lacks an explicit epistemological basis. It shows, moreover, that the implicit epistemological basis is untenable. CONCLUSION: There is a need to re-think the epistemological basis for evidence-based practice. Evidence-based practice is out of touch with developments within philosophy of science.
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Prática Clínica Baseada em Evidências , Conhecimento , Humanos , Filosofia , Filosofia Médica , Medicina Baseada em Evidências/métodosRESUMO
Objective: Prolonged labor is the commonest indication for intrapartum cesarean section, but definitions are inconsistent and some common definitions were recently found to overestimate the speed of physiological labor. The objective of this review is to establish an overview of synonyms and definitions used in the literature for prolonged labor, separated into first and second stages, and establish types of definitions used. Data sources: A systematic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, Emcare, and Academic Search Premier. Study eligibility criteria: All articles in English that (1) attempted to define prolonged labor, (2) included a definition of prolonged labor, or (3) included any synonym for prolonged labor, were included. Methods: Data on study design, year of publication, country or region of origin, synonyms used, definition of prolonged first and/or second stage, and origin of provided definition (if not primarily established by the study) were collected into a database. Results: In total, 3402 abstracts and 536 full-text papers were screened, and 232 papers were included. Our search established 53 synonyms for prolonged labor. Forty-three studies defined prolonged labor and 189 studies adopted a definition of prolonged labor. Definitions for prolonged first stage of labor were categorized into: time-based (n=14), progress-based (n=12), clinician-based (n=5), or outcome-based (n=4). For the 33 studies defining prolonged second stage, the majority of definitions (n=25) were time-based, either based on total duration or duration of no descent of the presenting part. Conclusions: Despite efforts to arrive at uniform labor curves, there is still little uniformity in definitions of prolonged labor. Consensus on which definition to use is called for, in order to safely and respectfully allow physiological labor progress, ensure timely management, and assess and compare incidence of prolonged labor between settings.
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The performance of natural rubber (NR), a naturally occurring and sustainable material, can be greatly enhanced by adding different fillers to the NR matrix. The homogeneous dispersion of fillers in the NR matrix is a key factor in their ability to reinforce. As a novel method, wet mixing technology may effectively provide good filler dispersion in the NR matrix while overcoming the drawbacks of conventional dry mixing. This study examines the literature on wet mixing fillers, such as graphene, carbon nanotubes, silica, carbon black, and others, to prepare natural rubber composites. It also focuses on the wet preparation techniques and key characteristics of these fillers. Furthermore, the mechanism of filler reinforcement is also examined. To give guidance for the future development of wet mixing technology, this study also highlights the shortcomings of the current system and the urgent need to address them.
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PURPOSE: To identify potential clinical diagnostic and prognostic markers for allergic rhinitis (AR) by analyzing a range of inflammatory and clinical markers in a cohort of patients. METHODS: We conducted a retrospective analysis of clinical data from 493 AR patients treated at Qianjiang Central Hospital from January to March 2023. Patients were categorized based on their outcome. Inclusion and exclusion criteria were strictly applied to select the study population. Various clinical and inflammatory markers were assessed, and statistical analyses were performed to evaluate their diagnostic and prognostic utility. RESULTS: No significant differences in traditional demographic factors were found between the good and poor prognosis groups (all P > 0.05). However, significant differences were observed in several inflammatory and clinical markers: Interleukin-4 (IL-4) levels were 17.32 ± 4.21 pg/mL in the good prognosis group versus 18.56 ± 5.89 pg/mL in the poor prognosis group (t=2.562, P=0.011). Interleukin-5 (IL-5) levels were 15.65 ± 3.78 pg/mL versus 16.52 ± 4.56 pg/mL, respectively (t=2.221, P=0.027). Transforming growth factor-ß1 (TGF-ß1) levels were 39.16 ± 8.92 pg/mL versus 41.32 ± 9.67 pg/mL (t=2.513, P=0.012), and histamine levels were 11.87 ± 3.21 ng/mL versus 12.56 ± 4.03 ng/mL (t=1.991, P=0.047). Interleukin-13 (IL-13) levels were 16.32 ± 3.56 pg/mL versus 17.09 ± 4.21 pg/mL (t=2.108, P=0.036). Serum immunoglobulin E (IgE) levels were significantly different, with 164.87 ± 45.32 IU/mL in the good prognosis group compared to 198.56 ± 58.21 IU/mL in the poor prognosis group (t=6.866, P < 0.001). The composite biomarker model demonstrated high predictive value for AR prognosis with an Area Under Curve of 0.906. Individual markers such as TGF-ß1, IL-13, and serum IgE levels showed strong diagnostic potential. CONCLUSION: Our findings underscore the clinical utility of various inflammatory and clinical markers as diagnostic and prognostic indicators for AR. TGF-ß1, IL-13, and serum IgE levels, in particular, demonstrated significant diagnostic and prognostic value. An integrated approach combining multiple biomarkers could enhance the accuracy of AR diagnosis and prognosis. Further validation through prospective clinical studies and consideration of treatment interventions are recommended to clarify the clinical implications of these markers.
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INTRODUCTION: ChatGPT has attracted a lot of interest worldwide for its versatility in a range of natural language tasks, including in the education and evaluation industry. It can automate time- and labor-intensive tasks with clear economic and efficiency gains. METHODS: This study evaluated the potential of ChatGPT to automate psychometric analysis of test questions from the 2020 Portuguese National Residency Selection Exam (PNA). ChatGPT was queried 100 times with the 150 MCQ from the exam. Using ChatGPT's responses, difficulty indices were calculated for each question based on the proportion of correct answers. The predicted difficulty levels were compared to the actual difficulty levels of the 2020 exam MCQ's using methods from classical test theory. RESULTS: ChatGPT's predicted item difficulty indices positively correlated with the actual item difficulties (r (148) = -0.372, p < .001), suggesting a general consistency between the real and the predicted values. There was also a moderate significant negative correlation between the difficulty index predicted by ChatGPT and the number of challenges (r (148) = -0.302, p < .001), highlighting ChatGPT's potential for identifying less problematic questions. CONCLUSION: These findings unveiled ChatGPT's potential as a tool for assessment development, proving its capability to predict the psychometric characteristics of high-stakes test items in automated item calibration without pre-testing in real-life scenarios.
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Cinnamomum camphora chvar. borneol, a rare camphor tree variant recently identified in China, is distinguished by its high concentration of D-borneol, also known as " plant gold" due to its significant value. The essential oil extracted from this variant,rich in monoterpenes and sesquiterpenes, demonstrates a broad spectrum of pharmacological activities, including analgesic, antiinflammatory, antioxidant, cognition-enhancing, anti-bacterial, and insecticidal effects. These properties, underscored by extensive research, highlight the oil's potential in the biomedical, chemical, and food sectors as a valuable commodity. Nonetheless, the safety profile of this valuable oil remains poorly characterized, with its chemical composition and therapeutic efficacy subject to variations in the factors like geographic origin, harvesting timing, part used for extraction, and processing techniques. Such variability poses challenges to its clinical application and hampers the efficient exploitation of this resource. This review synthesizes current studies on C. camphora chvar. borneol essential oil and provides a detailed examination of its chemical and pharmacological profiles. In this study, we discuss existing research gaps and propose strategies for advancing its clinical use and industrial application, aiming to provide a foundational reference for future investigations and the resolution of its commercial and therapeutic challenges.
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Canfanos , Cinnamomum camphora , Óleos Voláteis , Cinnamomum camphora/química , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Humanos , Animais , Antioxidantes/química , Antioxidantes/farmacologia , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologiaRESUMO
The discipline development is the pillar for the development of traditional Chinese medicine( TCM). The academic progress in TCM is the commanding height of the discipline development of TCM. To lead and promote the development and academic progress of TCM, the China Association of Chinese Medicine has summarized the Top Ten Academic Achievements in Traditional Chinese Medicine during 2020-2022, the Major Scientific Problems, Engineering Technical Problems, and Industrial Technical Problems in Traditional Chinese Medicine during 2019-2023, and the Remarkable Research Achievements of Traditional Chinese Medicine during 2012-2022. Based on the above research reports and the research achievements awarded the national science and technology prizes in TCM in the last 20 years and according to the current situation and layout of TCM discipline development, this paper reviews the major research achievements of TCM in the last two decades and the latest research progress in TCM during 2020-2023. The major scientific, engineering technical, and industrial technical problems in TCM are analyzed and the emerging trends of TCM are prospected in accordance with the development laws and characteristics of TCM. This review provides new ideas and reference for the high-quality development of TCM in the new era.
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Medicina Tradicional Chinesa , Medicina Tradicional Chinesa/tendências , China , Humanos , Medicamentos de Ervas ChinesasRESUMO
Excess agricultural biomass waste is increasing rapidly, leading to many environmental and governance issues. Therefore, increased attention has been paid to the recycling and value-added application of agricultural biomass waste. In recent years, the research of agricultural biomass waste utilization and derived functional materials has mainly included the following two aspectsï¼ â the extraction of natural polymers and value-added applications and â¡ the direct preparation of new carbon-based materials, including adsorption, catalysis, energy storage electrode, and composite functional materials. The conversion of agricultural biomass waste into functional materials has been gradually realized and widely used. To enable industrial-scale production and the quality and safety of agricultural biomass waste derivatives and to develop highly feasible and cost-effective biomass waste conversion methods should be the focus of future studies.
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The prevention and control requirements for HIV/AIDS vary significantly among different populations, posing substantial challenges to the formulation and implementation of intervention strategies. Dynamically assessing the heterogeneity and disease progression trajectories of various groups is crucial. Latent class growth model (LCGM) serves as a statistical approach that fits a longitudinal data into N subgroups of individual development trajectories, identifying and analyzing the progression paths of different subgroups, thereby offering a novel perspective for disease control strategies. LCGM has shown significant advantages in the application of HIV/AIDS prevention and control, especially in gaining a deeper understanding and analysis of epidemiological characteristics, risk behaviors, psychological research, heterogeneity in testing, and dynamic changes. Summarizing the advantages and limitations of applying LCGM can provide a reliable basis for precise prevention and control of HIV/AIDS.