Changes In System Research Articles

Effect of Personalized Prebiotic and Probiotic Supplements on the Symptoms of Irritable Bowel Syndrome: An Open-Label, Single-Arm, Multicenter Clinical Trial

Background/Objectives: Prebiotics and probiotics have been reported to improve symptoms of irritable bowel syndrome (IBS). Nevertheless, the effects of prebiotics/probiotics can vary depending on the IBS subtypes. The purpose of this study was to investigate the effects of personalized prebiotic and probiotic supplements based on intestinal microbiota and IBS subtypes in patients. Methods: Patients with diarrhea-type IBS (IBS-D), constipation-type IBS (IBS-C), and mixed-type IBS (IBS-M) were enrolled (n = 40 per group; total: n = 120). Personalized prebiotic and probiotic supplements were determined according to the IBS subtypes and intestinal microbiota. The patients received supplements for 4 weeks. The primary outcome was the change in the IBS-severity scoring system from baseline to week 4. Results:The IBS-severity scoring system significantly decreased in all patients (−38.0 [95% confidence interval (CI): −53.6, −22.4]; p < 0.001), in patients with IBS-D (−44.5 [95% CI: −70.6, −18.5]; p = 0.004) and IBS-C (−51.2 [95% CI: −79.4, −22.9]; p = 0.002), but not in those with IBS-M (−20.0 [95% CI: −48.0, 8.1]; p = 0.47). In this study, no serious adverse events were observed that had a causal relationship with the intervention. Conclusions: In conclusion, personalized prebiotic and probiotic supplements selected according to individual intestinal microbiota and IBS subtype may alleviate the severity of IBS symptoms, particularly in patients with IBS-C and IBS-D.

Alternative protein sources in the European diets – integrating health risk‐benefit and sustainability ‘ALTERNATIVA’

Abstract The pressure global food systems exert on the environment has amplified over time, following the growth of the human population, changes in the food consumption patterns and intensification of the production systems. Without changes in food systems, an overpressure on agriculture and food production will be unavoidable, with inevitable consequences for the environment and human health. Animal‐derived protein production like meat and milk is among the most important drivers of this impact. Under this context, the evaluation of the health and sustainability impacts of alternatives for animal‐based food proteins are central aspects of this discussion. Health risk‐benefit assessment (RBA) of foods estimates the overall human health impact following exposure to a particular food or food component, integrating risks and benefits in comparable measures. Methods that simultaneously consider the environmental impact of the food production systems were needed to perform a sustainable holistic assessment. “ALTERNATIVA | Alternative protein sources in the European diets – integrating health risk‐benefit and sustainability” aimed to develop a holistic approach to assess the impact of alternative protein sources, integrating health and sustainability assessment. This project, considering five complementary work packages, developed activities to enhance the capacity‐building among members of the consortium in applying methodologies related to the health RBA and sustainability impact assessment; to develop, in collaboration with different stakeholders, a protocol to integrate the assessment of the impact of foods/diets on health and on sustainability; to apply the derived framework to a case study, to validate it with a real case scenario, estimating the health and sustainability impacts of replacing red meat consumption by pulses in two different countries; and to disseminate and promote the established method of integrated health and sustainability assessment to other potential EU users. This external scientific report summarizes the main outputs and results obtained in the context of the ALTERNATIVA project.

Interaction between three key species in the sea ice-reduced Arctic Barents Sea system.

Population dynamics depend on trophic interactions that are affected by climate change. The rise in sea temperature is associated with the disappearance of sea ice in the Arctic. In the Arctic part of the Barents Sea, Atlantic cod, capelin and polar cod are three fish populations that interact and are confronted with climate-induced sea ice reductions. The first is a major predator in the system, while the last two are key species in Arctic and sub-Arctic ecosystems, respectively. There are still many unknowns regarding how predicted environmental change may influence the joint dynamics of these populations. Using time series from a 32 year long survey, we developed a state-space model that jointly modelled the dynamics of cod, capelin and polar cod. Using a hindcast scenario approach, we projected the effect of reduced sea ice on these populations. We show that the impact of sea ice reduction and concomitant sea temperature increase may lead to a decrease of polar cod abundance at the benefit of capelin but not of cod which may decrease, resulting in strong changes in the food web. Our analyses show that climate change in the Arcto-boreal system can generate different species assemblages and new trophic interactions, which is the knowledge needed for effective management measures.

Extended Learning beyond Physical Schools in Rural Contexts in Uganda; a Case of Kyotera District

The period of Covid -19 pandemic unlocked many lessons and opened up the need to benchmark various interventions in the social setup, more so, the means to manage social services like education. Education is a right enshrined in article 26 (1) of the 1948 United Nations Human rights Declaration, and the Constitution of the Republic of Uganda (1995), particularly articles 30, 34(2) and objective XVIII. Uganda’s Vision 2040 asserts that, the education curriculum, examination and instruction methods should always be revised to suit the proposed changes in the education system as well as being responsive to the global demands. The COVID-19 lockdown which took almost two years, introduced non-formal learning through use of internet, radios and televisions but these did not favor rural settings. In Uganda, 55.2 percent of households have radios, 7.2 percent own televisions while 19 percent can access internet with ease. Basing on participatory action design laid on the social learning framework the assumption is that data becomes information only when filtered through a theory of reality that common data is set on the policy environment, yielding diverse political strategies and holding distinct practical programs for implementation if interpreted through different value filters. This intriguing reality led us to visit 25 out of 30 Local Council (LC) one (1) Chairpersons in Kyotera and Kasaali Town Councils and found that each received one copy of learning materials which could be accessed through photocopying yet 10 percent of the beneficiaries could comply. To address the challenge and using these materials, we organized a total of 168 audio lessons for primary one to six; and senior one to three classes which we recorded and saved on memory sticks. We drew a timetable of three hours a day throughout a week and louder speakers were mounted in 11 most rural villages in Kyotera District to deliver lessons. Through interviews conducted on visit of at least one home from a village and from political leaders, testimonies showed that learning took place. Head teachers interviewed [4] also confirmed the same We concluded that through recorded audio lessons, content can well be delivered at any time. We recommend that; Governments, institutions, teachers and other facilitators, should adopt the model to extend learning to beyond classrooms with audio lessons for future use in learning and revisions. This can be through transmission of lessons on simple memory sticks and discs. Stakeholders at all levels of education should be encouraged to appreciate existence of pre- developed lessons and lectures which Amy not require internet connection by teachers -Government Organizations should use the model and fund extension of learning in rural villages in order to affirmatively have all learners supplement on learning obtained from classrooms

Revisiting the musical reminiscence bump: insights from neurocognitive and social brain development in adolescence

Music listening is enjoyed across the lifespan and around the world. This has spurred many theories on the evolutionary purpose of music. The Music for Social Bonding hypothesis posits that the human capacity to make music evolved for the purpose of creating and preserving relationships between one another. Considering different time periods of music use across the lifespan, adolescence is especially a period of social reorientation away from family towards peers, characterized by new social bonds and increased prosocial behavior. This shift is accompanied by notable structural and functional changes in brain networks supporting reward processing and prosocial behavior. Reviewing the extant literature on developmental cognitive neuroscience and adolescent music use, we propose that neurocognitive changes in the reward system make adolescence an ideal developmental time window for investigating interactions between prosocial behavior and reward processing, as adolescence constitutes a time of relative increase in music reward valuation. Testing this hypothesis may clarify our understanding of developmental trajectories in music reward valuation, and offer insights into why music from adults’ adolescence holds a great deal of personal significance.

Analysis of Thyroid Disorders in the Occurrence of Paroxysmal Atrial Fibrillation

Thyroid disorders can directly affect the cardiovascular system, especially atrial fibrillation arrhythmia. Atrial fibrillation can be triggered by hormonal changes in the human body system. This can be dangerous and can increase the risk of stroke in sufferers. For this reason, researchers conducted this study to be able to analyze the risk of atrial fibrillation due to thyroid disorders. This study used a retrospective analytical design, with a chi square test to determine the risk of increased atrial fibrillation due to thyroid disorders. This study was conducted at Budhi Asih Hospital with Holter monitoring patient samples. The results of this study showed that in patients with thyroid disorders, the results of Holter monitoring showed paroxysmal atrial fibrillation as much as 9.9%, with a p-value: 0.000; OR: 39.346. The conclusion is that there are significant results between thyroid disorders and the incidence of paroxysmal atrial fibrillation

Intersectional Analysis of Social Risk and Need Among a Large Representative Sample of Adults from an Integrated Health System in the United States

IntroductionSocial health is increasingly a focus of healthcare systems. Representative and intersectional analyses of individuals’ social risks such as food, housing, transportation, and financial insecurity, and their interest in receiving assistance from the healthcare system (social needs), can provide healthcare organizations with more nuanced estimates that can lead to more effective interventions. MethodsWe conducted cross-sectional survey of a representative sample of 43,936 Kaiser Permanente members in December 2019-September 2020. Study inclusion was based on membership, age, address, and absence of dementia. Modified Poisson regression models estimated respondents' social risks and needs overall and within domain (food, housing, finances, or transportation). and by intersectional strata based on a combination of age, income, gender, and race and ethnicity. ResultsOf 10,274 who completed the survey, 52% reported any social risk and 32% had any social need. Financial strain was the most prevalent risk (44%), followed by food insecurity (31%), housing instability (17%), and transportation (7%). Our intersectional analyses generated 74 intersectional groups. Across the intersectional groups, higher income (>$50,000/year) or older age (>60) adults consistently had lower risk and need. However, this pattern varied by race and ethnicity. In particular, older and lower-income, Pacific Islander, African-American/Black and Multiracial adults had the highest estimates of social risk and need. ConclusionsHigher risk and need among particular intersectional groups suggest the importance of tailored interventions for social needs. The high aggregate prevalence of social risks and needs suggests that system and policy changes must compliment universal and population-based social health screening and assistance interventions in healthcare organizations.

An interview with Pennsylvania State representative Tarik Khan, PhD, FNP-BC.

Nurse practitioners (NPs) take on diverse and essential roles. In an exclusive interview, Representative Tarik Khan, PhD, FNP-BC, highlights the impact NPs can have in the political arena. Transitioning from an NP to a legislator in Pennsylvania, Dr. Khan's journey reflects his commitment to health care reform, driven by hospital closures, lack of patient care access, and the COVID-19 pandemic. Elected in 2022, Dr. Khan leverages his health care background to address a wide range of legislative issues, passing significant bills. He advocates for NPs to engage politically, emphasizing their unique perspective and problem-solving skills. Dr. Khan's story underscores the transformative potential of NPs in shaping public policy and advancing systemic change.

Towards a comprehensive analysis of agricultural land systems in the EU and US: A critical view on publicly available datasets

Understanding agricultural land systems is paramount to preparing for future transitions under climate change. Systematic quantitative, multi-context analyses of agricultural land systems are a promising way of increasing our understanding but rely on the availability of large-scale and commensurable data. The available data, however, are outcomes of political priorities and processes and thus not neutral windows into agricultural realities. We map, describe, and compare publicly available and publicly curated data describing agricultural land systems—those devoted to the production of food, fuel, and fiber—in the United States (US) and European Union (EU) to identify underlying data collection norms and political priorities. We discuss how these priorities shape what we can(not) see in each region and articulate future data needs to support an in-depth understanding of agricultural land systems dynamics. This comprehensive understanding of how and why agricultural land systems change is imperative to promoting sustainable, resilient, and just agriculture futures.

The ultrasound characteristics of the cardiovascular system in systemic lupus erythematosus in children

Background. Systemic lupus erythematosus (SLE) is one of the most typical diffuse connective tissue diseases characterized by the involvement of many organs and systems in the pathological process. Cardiac involvement in SLE is one of the most common manifestations of visceritis in both adults and children. According to various authors, the frequency of heart involvement ranges widely from 40% to 90–95%, with changes being detected in 100% of patients during autopsy. Establishing an accurate diagnosis of cardiovascular system changes in SLE is challenging yet crucial for assessing disease activity and prognosis. This has become possible with the clinical application of modern objective functional methods of examination such as echocardiography and Doppler, which have significantly increased the detection rate of even subclinical forms of heart involvement. Purpose – of the study is to examine the structural and functional state of the heart in children with systemic lupus erythematosus using echocardiography. Materials and Methods. We analyzed echocardiography and Doppler data of 32 children aged from 11 to 18 years old with systemic lupus erythematosus who were examined and treated at the Institute for the Protection of Children’s and Adolescents’ Health of the National Academy of Medical Sciences of Ukraine. There were 7 boys (21.87%) and 25 girls (78.13%) among the patients. The diagnosis was confirmed through comprehensive clinical, laboratory, and instrumental examinations. Ultrasound scanning of the heart and major vessels was performed using «Siemens SL-1» and «Logic-400» General Electric pulse-wave devices with color mapping. Results. The study revealed that the most frequent signs of systemic connective tissue dysplasia diagnosed by echocardiography were the presence of abnormal chords in the left ventricle (in 24 patients – 75%) and mitral valve prolapse (in 12 patients – 37.50%). A typical sign of the disease was lupus carditis manifested by the reduction in the left ventricular diameter systolic contraction (22 patients – 68.75%) and thickening of the left ventricular myocardium and the thickness of the interventricular membrane in 15 patients (46.88%). Left ventricular contractile function was reduced (EF < 60%) in 15 patients (46.88%). In cases with a disease duration of up to two years and grade I activity of the pathological process, an increase in contractile function was observed in 3 patients (9.38%). Grade I/II mitral insufficiency was present in 2 patients (6.25%). Grade I aortic insufficiency was found in 1 patient (3.13%). Characteristic changes in the right ventricle were also observed in patients with systemic lupus erythematosus. The most common findings included enlargement of the right ventricular cavity and the outlet tract of the right ventricle (in 15 patients – 46.88%), hyperkinesia (in 3 patients – 9,38%) and myocardial thickening. Accumulation of fluid in the pericardial cavity during echocardiography was observed in 9 patients (28.13%) as a sign of polyserositis. The amount of liquid was small. Conclusions. The study established the polymorphism of pathological changes in the cardiovascular system of patients with systemic lupus erythematosus, which dictates the necessity of conducting echocardiography and Doppler both at the initial examination and during monitoring of the pathological process and treatment quality. The high frequency of diagnosed abnormal chords may indicate a congenital predisposition of connective tissue in patients with systemic lupus erythematosus to dysplasia. Echocardiography is especially valuable for identifying valve and pericardial lesions.

Traumatic brain injury outcomes at the “epicenter of the epicenter” of the united states COVID-19 pandemic amidst ongoing socio-demographic challenges

Abstract Introduction Traumatic brain injury (TBI) poses a significant public health challenge with profound impacts at individual, family, community, and societal levels. Early during the COVID-19 pandemic, the neighborhood of Elmhurst, Queens in New York City was a hotspot dubbed the “epicenter of the epicenter” of the crisis in the United States, requiring major changes in healthcare resource allocation. This study investigates how different phases of the COVID-19 pandemic affected the incidence, severity, and clinical outcomes of TBI in this geographical area. Methods TBI admissions to NYC Health + Hospitals/Elmhurst, a Level 1 Trauma Center, during the first six months of 2019, 2020, and 2021 were retrospectively analyzed. Data were grouped into three periods: pre-pandemic (1/1/19–6/30/19 and 1/1/20–2/29/20) [Group 1], first COVID-19 wave (3/1/20–6/30/20) [Group 2], and second COVID-19 wave (1/1/21–6/30/21) [Group 3]. Univariate analyses were conducted to explore factors potentially associated with TBI outcomes; variables that reached statistical significance (p < 0.05) were included in a binary logistic regression analysis dichotomized into good outcome (discharge to home or acute rehabilitation disposition) and poor outcome (discharge to skilled nursing facility/subacute rehabilitation, hospice, or in-hospital mortality). Results Analysis of 443 TBI patients (median age 56 [range 38, 73]; mean admissions/week 5.6 ± 2.7) demonstrated no significant variance in age (H = 0.92; p = 0.63), sex (χ2 = 1.4, p = 0.51), or ethnicity (χ2 = 17.1; p = 0.07) across groups. Group 2 had significantly fewer weekly admissions (3.9 ± 2.6) compared to Groups 1 (5.9 ± 2.2; p = 0.02) and 3 (6.1 ± 2.9; p = 0.01). Over the course of the pandemic, the proportion of uninsured patients decreased from 15 to 4%, while Medicaid and Medicare coverage rates rose from 25 to 41% and 20% to 28%, respectively (p < 0.001). A binary logistic regression model dichotomized by discharge outcome for all 443 TBI patients confirmed that increasing age (OR = 0.95; 95% CI 0.93–0.97; p < 0.001) and Injury Severity Score (OR = 0.88; 95% CI 0.83–0.93; p < 0.001) were inversely correlated with good outcome, while higher Glasgow Coma Scale (OR = 1.26; 95% CI 1.17–1.36; p < 0.001) was positively correlated. Of particular interest, Black/Hispanic ethnicity (OR = 0.36; 95% CI 0.19–0.66; p = 0.002) and public health insurance (Medicaid/Medicare) coverage (OR = 0.83; 95% CI 0.68–1.00; p = 0.05) were both associated with less favorable outcomes. Neither group designation, patient sex, COVID-19 status, or need for neurosurgical intervention was correlated with outcome (p > 0.05). Conclusion Despite the changes in TBI admission patterns throughout New York City during the COVID-19 pandemic, the quality of patient outcomes at our institution remained relatively consistent across the pandemic’s different phases, as assessed by discharge disposition. However, two important socioeconomic factors—ethnicity and health insurance status—were significantly associated with outcome, underscoring the need for systemic changes to address ongoing disparities in neurotrauma care.

Mobilizing strategic inflection points for sustainment of an effective intervention in an integrated learning health system: an interpretive description

BackgroundInnovative models of care have the potential to improve the sustainability of health systems by improving patient and provider experiences and population outcomes while simultaneously reducing costs. Yet, it is challenging to recognize the distinctive points during research and quality improvement processes that contribute to sustainment of effective interventions. The business concept of an inflection point—the position on the curve of a trajectory where the progress in implementation of an intervention is accelerated or decelerated—may be useful to understand implementation and improve sustainability and ultimately sustainment of effective interventions. The purpose of this study was to retrospectively identify and describe strategic inflection points that accelerated the sustainability process and led to the sustainment of Alberta Family Integrated Care.MethodsThis qualitative study was conducted in Alberta, Canada and employed an interpretive description design. Purposively sampled documents (proposals, project management plans, reports to funders and sponsors, meeting minutes, and fidelity audit and feedback checklists) from the Alberta Family Integrated Care cluster randomized controlled trial and quality improvement project constituted data for this study.ResultsTo accelerate sustainability in the research context, we identified (1) alignment with strategic priorities, (2) iterative, user-centered co-design, and (3) contextualization of implementation as strategic inflection points. To accelerate sustainability in the health system context, we identified (1) the learning health system, (2) enduring partnerships, (3) responsivity to societal and system change, (4) embedded governance, and (5) intentional integration into the health system as strategic inflection points. Capitalizing on these strategic inflection points led to sustainment of Alberta Family Integrated Care in the provincial health system.ConclusionsWe identified key inflection points in the research and health system contexts that led to sustainment of Alberta Family Integrated Care. By anticipating, recognizing, and leveraging inflection points in the sustainability process, researchers may be able to accelerate implementation and achieve sustainment of multi-component interventions in complex systems.Trial registrationClinicalTrials.gov: NCT02879799. Registration date: May 27, 2016. Protocol version: June 9, 2016; version 2. Protocol publication: https://doi.org/10.1186/s13063-017-2181-3.

Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians.

This research investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration. Qualitative interviews were conducted with both Rongoā practitioners and Western surgeons. The data collected were subjected to thematic analysis to extract key themes related to the integration process, challenges faced, and the potential for mutual recognition and respect between the two healing paradigms. The study reveals a deep respect for Rongoā Māori among Western surgeons but identifies significant systemic barriers that impede its integration. These include bureaucratic challenges and the absence of clear referral pathways. Rongoā practitioners express concerns over being overlooked within the healthcare system and highlight a lack of awareness among healthcare professionals about their practices. Despite these challenges, there is a shared interest in collaborative approaches to healthcare that respect and incorporate Rongoā Māori. The findings underscore the need for systemic changes to facilitate the integration of Rongoā Māori into mainstream healthcare, including the development of clear referral pathways and initiatives to raise awareness among healthcare professionals. The study highlights the need for a more collaborative healthcare approach that values the contributions of Rongoā Māori, aiming to improve patient care through holistic practices.

Elephant in the Room: How to Assess the Vote-weighting System in the Council of the EU

The article emphasises the complementarity of research based on voting power theory with the analysis of the structure of blocking. Combining both methods enables a more comprehensive assessment of the vote weighting system in the Council of the EU, in particular the impact of changes in the voting system on the position of individual Member States and the power balance in this institution. I make two contributions to the existing literature. Firstly, the study develops a non-random voting model, dedicated to QMV in the Council, which abandons the assumption that each coalition of players is equally likely and takes into account the role of the European Commission as an agenda-setter. This not only allows us to exclude many coalitions that are only theoretically possible, but also to analyse the blocking structure from the perspective of different states or coalitions in the Council. Secondly, it shows that the application of blocking structure analysis provides novel insights into the Council’s voting system. Unlike the a priori voting power approach, such analysis does not focus on distribution of winning power in the Council, but on the Member States’ ability to build minimal blocking coalitions. Hence, it complements the application of mathematical indices of voting power in the assessment of the voting system in this institution.

Praktik Dagang di Pakan Serikat Koto VII Basambilan Koto, Sijunjung (1980-1998)

Abstract: This research aims to analyze how traditional markets shape local capitalist practices in Pakan Serikat Koto VII Basambilan Koto, Sijunjung, from 1980 to 1998. The research employs a historical method with four stages: heuristics, criticism, interpretation, and historiography. The research findings demonstrate that traditional markets have shaped local capitalist practices in Pakan Serikat Koto VII Basambilan Koto. These practices manifest in various forms, including trading systems, social relations, cultural exchange, and social change. The establishment of Pakan Serikat VII Koto has driven social change in the community, such as changes in livelihood systems and lifestyles. The research concludes that traditional markets play a crucial role in shaping local capitalist practices in Pakan Serikat Koto VII Basambilan Koto. Traditional markets serve not only as places for exchanging goods and services but also as venues for social interaction, cultural exchange, and social change. Keywords: Traditional market, Local capitalism, Pakan Serikat Koto VII Basambilan Koto, Sijunjung, 1980-1998

Elucidating the Fundamental Process of Methyl-(5hydroxymethyl) Furan-2-Carboxylate Toxin Biosynthesis in Curvularia lunata Causing Maize Leaf Spot

Maize leaf spot, which is caused by Curvularia lunata (Wakkre) Boedijn, was epidemic in the maize-growing regions of northeastern and northern China in the mid-1990s, where it led to large yield losses. Since then, the epidemic has evolved into a kind of common disease. In recent years, however, a tendency of becoming an epidemic disease again has been observed in some areas in China due to significant changes in climate, farming, systems and crop varieties. The significance of methyl-(5hydroxymethyl) furan-2-carboxylate (M5HF2C) as a nonspecific host toxin in causing maize leaf spot disease has been demonstrated in previous research. However, the key enzymes involved in M5HF2C toxin synthesis remain unclear. In our study, we demonstrate that the synthesis of M5HF2C toxin starts from a precursor substrate in the pathogen, furfural, which is then catalytically dehydrogenated into furoic acid via an alcohol dehydrogenase (CLADH6). The furoic acid was further confirmed as one of the raw materials for the biosynthesis of M5HF2C toxin based on deletion mutants of the alcohol dehydrogenase gene (Cladh6) in C. lunata, which had reduced M5HF2C toxin-producing ability; however, this ability could be restored in all deletion mutants through complementation with furoic acid, thereby confirming that furoic acid is an intermediate in the biosynthesis of M5HF2C toxin. In summary, the biosynthesis process of M5HF2C toxin in C. lunata involves three transformation steps: (1) from xylose to furfural; (2) then from furfural to furoic acid; and (3) eventually from furoic acid to M5HF2C toxin. Our research findings provide new clues in elucidating the major steps in the process of M5HF2C toxin biosynthesis in C. lunata.

Теория эндогенного роста: исследование исторических предпосылок и ретроспективных особенностей эволюции в рамках отдельных макроэкономических парадигм и моделей экономического роста

To date, the main research on macroeconomic theory identifies five main factors of economic growth that will be decisive in the coming decades: population and human capital; capital and capital markets; globalization and trade; technology and innovation, as well as new frontiers for productivity growth. It remains an undeniable fact that innovations stimulate modern economic growth. At the same time, in the process of its evolution, any macroeconomic paradigm faces certain limitations associated with changes in the socio-economic system of society, and as a result, there is a need to rethink what are the historical prerequisites and retrospective features of the evolution of the endogenous macroeconomic theory of economic growth. The purpose of the article is to study the nature of similarities and contradictions, and the nature of the mutual influence of various macroeconomic paradigms within the framework of the evolution of the endogenous macroeconomic theory of economic growth; the roles of generalizing and separating factors that cause the emergence and development of individual elements of this macroeconomic paradigm. The scientific novelty of the article is presented by the author’s new critical view of the study of historical prerequisites and retrospective features of the evolution of individual macroeconomic theories and models of economic growth, especially the endogenous growth model, in order to show that the nature of innovation itself has an ambiguous assessment from the side of macroeconomic science.

Correlating stroke risk with non-invasive cerebrovascular perfusion dynamics using a portable speckle contrast optical spectroscopy laser device

Stroke poses a significant global health threat, with millions affected annually, leading to substantial morbidity and mortality. Current stroke risk assessment for the general population relies on markers such as demographics, blood tests, and comorbidities. A minimally invasive, clinically scalable, and cost-effective way to directly measure cerebral blood flow presents an opportunity. This opportunity has the potential to positively impact effective stroke risk assessment prevention and intervention. Physiological changes in the cerebrovascular system, particularly in response to hypercapnia and hypoxia during voluntary breath-holding can offer insights into stroke risk assessment. However, existing methods for measuring cerebral perfusion reserves, such as blood flow and blood volume changes, are limited by either invasiveness or impracticality. Herein we propose a non-invasive transcranial approach using speckle contrast optical spectroscopy (SCOS) to non-invasively monitor regional changes in brain blood flow and volume during breath-holding. Our study, conducted on 50 individuals classified into two groups (low-risk and higher-risk for stroke), shows significant differences in blood dynamic changes during breath-holding between the two groups, providing physiological insights for stroke risk assessment using a non-invasive quantification paradigm. Given its cost-effectiveness, scalability, portability, and simplicity, this laser-centric tool has significant potential for early diagnosis and treatment of stroke in the general population.

Addressing Systemic Racism in Mental Health Care

Systemic racism is a public health crisis that needs to be urgently and effectively addressed. Historical racism, contemporary biases, and prejudicial attitudes have persistently affected and damaged the mental health of people of color (POC) throughout the world. Although the 2021 apology from American Psychological Association (APA) acknowledged the profession’s contribution to racism, much more work needs to be done to rectify and address past and current harm. A comprehensive, actionable, and concrete plan is needed to catalyze change. Adopting a socioecological approach can help tackle the multiple levels in which discrimination and unequal treatment take place. This necessitates more than just addressing the social determinants of illness, but also transforming the cultural competence of providers, organizations, and the mental health delivery system. Key to improving outcomes for POC domestically and abroad is increasing the affordability and access to care, diversifying and improving the cultural competence of the mental health workforce, and developing culturally adapted and effective care tailored to meet the culture-specific needs of diverse communities. Progress can only happen through proactive action and utilization of an anti-racist stance that commits significant financial and scientific resources to promote institutional, structural, systemic, and policy changes.

How does being a twin premature infant affect systemic inflammatory indices?

Purpose: Systemic inflammatory indices are newly defined parameters in diseases in the field of neonatology. However, it is not known whether the levels of systemic inflammatory indices change in twin preterms. Materials and Methods: Premature infants