Biochemical aspirin resistance in stroke patients - a cross-sectional single centre study

Aspirin use is known to reduce the recurrence of stroke. However, the clinical response to aspirin has been mixed. The rate of stroke recurrence whilst on aspirin treatment is still unacceptably high. A plausible explanation for this may be resistance to the effects of aspirin. The causes of aspirin resistance are manifold and multi-factorial. We conducted a study to investigate the prevalence rate of biochemical aspirin resistance in a cohort of aspirin-naïve stroke patients. We also sought to determine the inherent factors that may predispose towards the development of aspirin resistance. Method: This was a cross-sectional, observational study conducted on patients admitted to our centre with an acute stroke who were aspirin-naïve. The diagnosis of an acute stroke was confirmed by clinical history and brain imaging. Fifty consecutive patients were prospectively enrolled. Socio-demographic data were collected and baseline blood investigations were performed. Patients were tested for biochemical aspirin resistance using Multiplate® platelet analyser (Dynabyte, Munich, Germany) after 5 doses of aspirin, corresponding to a total dose of 900 mg. Results: The median age of patients was 65.5 years and 54 % of patients were female. There were 11 smokers; of these 10 were male. Twenty-six (52 %) patients were Chinese, 21 (41 %) were Malay and 3 (6.0 %) were Indian. Aspirin resistance was present in 14 % of our patients. There was an inverse relationship between the presence of aspirin resistance and plasma HDL levels (r = -0.394; p = 0.005). There was no relationship observed between aspirin resistance and total cholesterol, triglycerides, LDL, HbA1c, ALT, ALP, urea and creatinine levels. There were no significant differences in demographic profiles or smoking status between the aspirin resistant and non-aspirin resistant groups. We did not find any link between ethnicity and aspirin resistance. Conclusions: Our results indicate that a lower HDL level is associated with biochemical aspirin resistance. This may increase platelet aggregation and consequently increase the risk of a recurrent stroke. The clinical implications for aspirin resistance are far reaching. Any evidence that correctable factors may negatively influence the action of aspirin warrants further investigation. The prevalence rate of biochemical aspirin resistance in our study is comparable to the findings in other studies performed in an Asian population. Further research is required to determine how our findings translate into clinical aspirin resistance and stroke recurrence

Implementasi Keadilan Gender di Pondok Pesantren Sabilurrosyad Kota Malang

Gender equality still becomes a sensitive issue in Islamic educational institutions, especially in pesantren, a traditional Islamic educational institution. There is a strong assumption that in the socio-religious tradition of pesantren, women's subordination still practices widely. However, some pesatren take serious attention to overcome this issue through their daily activities within pesantren. One of which is Pesantren Sabilurrosyad in Malang, East Java. This article aims to elaborate on the realization of gender justice in the pesantren. This research uses a qualitative approach through observation and in-depth interviews with the board members of pesantren, as well as its male and female students. The results showed that the Pesantren Sabilurrosyad had implemented the values of gender justice in their socio-religious activities. The implementation forms include providing opportunities for female students to become head of student association; female students are given freedom to recite the Koran directly to the kyai; and female teachers (ustadzah) are given the opportunity to share in one forum with male students.Kesetaraan gender masih menjadi isu sensitive di lembaga pendidikan Islam, khususnya di pondok pesantren. Terdapat anggapan bahwa dalam tradisi sosial-keagamaan di pesantren subordinasi perempuan masih terjadi. Hal ini menjadi perhatian bagi beberapa pesantren yang ingin menjadikan isu ini sebagai bagian dari aktivitas pesantren, salah satunya adalah Pondok Pesantren Sabilurrosyad di Malang. Artikel ini bertujuan untuk mengelaborasi perwujudan keadilan gender di pondok tersebut. Penelitian ini menggunakan pendekatan kualitatif melalui observasi dan wawancara mendalam terhadap para pengurus ponpes dan santri putra dan santri putri. Hasil penelitian menunjukkan bahwa pondok pesantren Sabilurrosyad telah mengimplementasikan nilai-nilai keadilan gender dalam tradisi sosial-keagamaan pesantren. Wujud implementasi tersebut diantaranya adalah memberikan kesempatan kepada santri putri untuk menjadi ketua pondok, santri putri diberikan kebebasan untuk mengaji langsung kepada kyai, serta pengajar putri (ustadzah) diberikan peluang untuk bersama 1 (satu) forum dengan santri putra

Galactic cosmic ray simulation at the NASA space radiation laboratory – Progress, challenges and recommendations on mixed-field effects

For missions beyond low Earth orbit to the moon or Mars, space explorers will encounter a complex radiation field composed of various ion species with a broad range of energies. Such missions pose significant radiation protection challenges that need to be solved in order to minimize exposures and associated health risks. An innovative galactic cosmic ray simulator (GCRsim) was recently developed at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL). The GCRsim technology is intended to represent major components of the space radiation environment in a ground analog laboratory setting where it can be used to improve understanding of biological risks and serve as a testbed for countermeasure development and validation. The current GCRsim consists of 33 energetic ion beams that collectively simulate the primary and secondary GCR field encountered by humans in space over the broad range of particle types, energies, and linear energy transfer (LET) of interest to health effects. A virtual workshop was held in December 2020 to assess the status of the NASA baseline GCRsim. Workshop attendees examined various aspects of simulator design, with a particular emphasis on beam selection strategies. Experimental results, modeling approaches, areas of consensus, and questions of concern were also discussed in detail. This report includes a summary of the GCRsim workshop and a description of the current status of the GCRsim. This information is important for future advancements and applications in space radiobiology

A cross-sectional survey of public knowledge of the monkeypox disease in Nigeria

The Monkeypox Disease (MPXD) gained attention due to its widened geographical distribution outside of Africa, Hence, a it was declared a global health emergency. The index case in Europe was from a Nigerian traveller. This study assessed public awareness and knowledge of the MPXD by conducting an online, cross-sectional survey of educated Nigerians. A total of 822 respondents were recruited using the snowball sampling method between the 16th to 29th of August 2022. More responses were retrieved from the Northeastern geopolitical region (30.1%, n=220) than other regions. Descriptive statistics revealed that 89% (n=731/822) of the study participants were aware of the MPXD but only 58.7% (n=429/731) of them had good knowledge of the disease with a mean knowledge score of 5.31 +/- 2.09. The main knowledge gaps were in the incubation period of the disease, the signs and symptoms, its mode of transmission, and preventive practices needed to curb the spread of the monkeypox virus (MPXV). Specifically, only 24.5% (n=179) of them knew that MPXV can be transmitted via sexual contact. Most of the study participants (79.2%, n=651) opined that we can prevent the occurrence of public health emergencies in the future. The multivariable logistic regression analysis revealed that of the socio-demographic variables, the male gender (OR: 1.69; 95% CI: 1.22,2.33); Ph.D. level education (1.44; 95% CI: 1.048,4.23); and being homosexual (OR:1.65; 95% CI: 1.07,3.78) were significantly associated with good knowledge of MPXD. Despite the varying prevalence across the country, the region of residence within Nigeria did not influence the knowledge of MPXD among the respondents. The knowledge gaps necessitate intensified public health risk communication with a focus on modes of transmission and the preventive measures needed to curb the spread of the MPXV.Peer reviewe