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The mitral valve is a complex anatomical structure whose physiological functioning relies on the biomechanical properties and structural integrity of its components. Their compromise can lead to mitral valve dysfunction, associated with morbidity and mortality. Therefore, a review on the morphometry of the mitral valve is crucial, more specifically on the importance of valve dimensions and shape for its function. This review initially provides a brief background on the anatomy and physiology of the mitral valve, followed by an analysis of the morphological information available. A characterisation of mathematical descriptions of several parts of the valve is performed and the impact of different dimensions and shape changes in disease is then outlined. Finally, a section regarding future directions and recommendations for the use of morphometric information in clinical analysis of the mitral valve is presented. [ABSTRACT FROM AUTHOR]

We identify and examine the assumption of information determinism that is commonplace in policy arenas: that mere access to the “right information” will precipitate desired actions. Our analysis focuses on implications of information determinism in three cases: California disaster response plans in the 1980s, an Indian development project in the 1990s, and an education project directed at the Global South in the 2000s. Our analyses shows that planning based on information deterministic assumptions tends to overlook the sociomaterial circumstances of information production and circulation, including how social structures and materiality shape information in practice. Further, they imbue what we call “information” with the agency to bring about change. While we do not deny that “information” can be useful, we argue that policy needs to move away from information deterministic thinking and its singular focus on information access to address the needs of marginalized and vulnerable populations. [ABSTRACT FROM PUBLISHER]

The article discusses a study on the specific processes through which women negotiate gender dynamics and power structures within their families and their villages around information and communication technology (ICT) use by drawing on female ICT intermediaries in rural China and India. It cites findings that women are constantly engaged in negotiating their roles in a family and community in their role as ICT intermediaries.

Open Government Data (OGD) initiatives promise to make governments transparent, enabling citizens to participate actively in governance. Yet, empirical evidence suggests that OGD doesn't have the democratic impact that its advocates expect. Based on a 14-month ethnography of India's livelihood program, we argue that the assumptions underlying the design of OGD initiatives vary with citizens' social context. We show how OGD initiatives are state-centric in their design to make the functioning of the everyday state legible towards controlling corruption. However, citizens and social activists do not always share such an "anti-corruption" view in their engagement with the everyday state. Instead, they prioritise "getting things done", i.e. accessing the state's services. The state-centric OGD is of limited value to them due to its techno-official language and its emphasis on aggregate datasets. We suggest complementing state-centric OGD with citizen-centric OGD to enable the citizens to "see the state". [ABSTRACT FROM AUTHOR]

Objective: Patient attitudes toward mental illness are an important determinant of treatment compliance and treatment outcome. A patient's age, sex, style of thinking, lifestyle, and beliefs all may influence perceptions. This study aimed to determine patient attitudes.Method: Patients with a depressive disorder (n = 102) who were referred for psychiatric consultation and treatment to a community general hospitial psychiatric outpatient clinic completed a 9-item self-report questionnaire to determine their perceptions of the biological, psychological, cognitive, and spiritual causes of their depressive disorder.Results: Women were more likely to endorse their depressive disorder as related to a biological abnormality. With respect to age, older individuals were less likely to identify cognitive factors and loss of spirituality as causal factors in their depression.Conclusions: A relation exists between demographic variables, including sex and age, and beliefs about causes of depression and related disorders. These findings have implications for refining patient psychoeducation. [ABSTRACT FROM AUTHOR]

Accessible summary [ABSTRACT FROM AUTHOR]

Over the past few years, an increasing convergence can be observed between international and Indian initiatives towards cashlessness, often involving a broad range of actors and influences. Despite this convergence, it is also clear that the conceptualization and implementation, or goals and outcomes of cashlessness can vary considerably, which indicates the need for a closer look at the Indian case. In this introductory note to the special issue on cashlessness in India, we outline the variety of institutions, stakeholders (regulatory, financial and technological actors), technologies and policies involved. As we have observed, digital payments and financial inclusion are two significant planks of cashlessness in India. Perhaps as a result, digital payments have been intentionally defined in a broad manner in India – ranging from anti-cash to less-cash and now contactless payments in the aftermath of Covid-19. Considering the variety of legal, economic, social and technological concerns involved, this special issue adopts 2 complementary foci to study cashlessness in India: technological visions and the systems undergirding it, and practices of end users. The special issue includes four papers. The first paper argues that the Digital India programme may lead to the commercialization of bias. The second paper historicizes the Indian demonetization of 2016 and examines its stated and unstated goals. The next paper provides a conceptual model on technology adoption in the context of digital payments. The final paper argues that users strategically switch between multiple payments media based on the context in which the transaction is taking place. [ABSTRACT FROM AUTHOR]

Background: Acute stress-induced (takotsubo) cardiomyopathy can result in a heart failure phenotype with a prognosis comparable with that of myocardial infarction. In this study, we hypothesized that inflammation is central to the pathophysiology and natural history of takotsubo cardiomyopathy.Methods: In a multicenter study, we prospectively recruited 55 patients with takotsubo cardiomyopathy and 51 age-, sex-, and comorbidity-matched control subjects. During the index event and at the 5-month follow-up, patients with takotsubo cardiomyopathy underwent multiparametric cardiac magnetic resonance imaging, including ultrasmall superparamagnetic particles of iron oxide (USPIO) enhancement for detection of inflammatory macrophages in the myocardium. Blood monocyte subpopulations and serum cytokines were assessed as measures of systemic inflammation. Matched control subjects underwent investigation at a single time point.Results: Subjects were predominantly middle-aged (64±14 years) women (90%). Compared with control subjects, patients with takotsubo cardiomyopathy had greater USPIO enhancement (expressed as the difference between pre-USPIO and post-USPIO T2*) in both ballooning (14.3±0.6 milliseconds versus 10.5±0.9 milliseconds; P<0.001) and nonballooning (12.9±0.6 milliseconds versus 10.5±0.9 milliseconds; P=0.02) left ventricular myocardial segments. Serum interleukin-6 (23.1±4.5 pg/mL versus 6.5±5.8 pg/mL; P<0.001) and chemokine (C-X-C motif) ligand 1 (1903±168 pg/mL versus 1272±177 pg/mL; P=0.01) concentrations and classic CD14++CD16- monocytes (90±0.5% versus 87±0.9%; P=0.01) were also increased whereas intermediate CD14++CD16+ (5.4±0.3% versus 6.9±0.6%; P=0.01) and nonclassic CD14+CD16++ (2.7±0.3% versus 4.2±0.5%; P=0.006) monocytes were reduced in patients with takotsubo cardiomyopathy. At 5 months, USPIO enhancement was no longer detectable in the left ventricular myocardium, although persistent elevations in serum interleukin-6 concentrations ( P=0.009) and reductions in intermediate CD14++CD16+ monocytes (5.6±0.4% versus 6.9±0.6%; P=0.01) remained.Conclusions: We demonstrate for the first time that takotsubo cardiomyopathy is characterized by a myocardial macrophage inflammatory infiltrate, changes in the distribution of monocyte subsets, and an increase in systemic proinflammatory cytokines. Many of these changes persisted for at least 5 months, suggesting a low-grade chronic inflammatory state.Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02897739. [ABSTRACT FROM AUTHOR]

Background: Acute stress induced (takotsubo) cardiomyopathy can result in a heart failure phenotype with a prognosis comparable to myocardial infarction. In this study, we hypothesized that inflammation is central to the pathophysiology and natural history of takotsubo cardiomyopathy. Methods: We prospectively recruited 53 patients with takotsubo cardiomyopathy and 50 age, sex and co-morbidity matched control subjects. During the index event and at 5 months follow-up, takotsubo patients underwent multiparametric cardiac magnetic resonance imaging including ultrasmall superparamagnetic particles of iron oxide (USPIO) enhancement. Blood monocyte subpopulations and serum cytokines were assessed as measures of systemic inflammation. Matched controls underwent investigation at a single time point. Results: Subjects were predominantly middle aged (65±13years) women (90%). When compared to control subjects, patients with takotsubo cardiomyopathy had greater USPIO enhancement (expressed as the difference between pre-USPIO and post-USPIO T2*) in both ballooning (14.5±0.6 vs 10.5±0.9 ms, p≤0.001) and non-ballooning (12.7±0.6 vs 10.5±0.9 ms, p=0.05) left ventricular myocardial segments. Serum interleukin-6 (23.1±4.5 vs 6.5±5.8 pg/mL, p< 0.001) and growth-regulated protein (1903±168 vs 1272±177 pg/mL, p=0.01) concentrations, and classical CD14++CD16- monocytes (90±0.5 vs 87±0.9%, p=0.006) were also increased whilst intermediate CD14++CD16+ (5.3±0.3 vs 6.9±0.6%, p=0.01) and non-classical CD14+CD16++ (2.7±0.3% vs 4.2±0.5%, p=0.004) monocytes were reduced in patients with takotsubo cardiomyopathy. At 5 months, USPIO enhancement was no longer detectable in the left ventricular myocardium although there remained persistent elevations in serum interleukin-6 concentrations (p=0.009) and reductions in intermediate CD14++CD16+ monocytes (5.6±0.4 vs 6.9±0.6%, p=0.02). Conclusions: We demonstrate for the first time that takotsubo cardiomyopathy is characterized by myocardial cellular inflammation, and systemic cellular and cytokine activation. Many of these changes persisted for up to 5 months suggesting a low-grade chronic inflammatory state. [ABSTRACT FROM AUTHOR]

Background: Persons with bipolar disorder are often overweight and cluster risk factors for cardiovascular disease. Some antibipolar agents adversely impact upon weight and the lipid milieu. Recent data suggest that valproic acid, a commonly prescribed mood stabilizer, may be associated with polycystic ovarian syndrome (PCOS). This adverse event has not been systematically studied in bipolar disorder. Method: Thirty-eight female subjects, aged 18–50 years, meeting DSM-IV criteria for bipolar I or II disorder, in any phase of illness were evaluated. Eighteen females received valproate (sodium valproate and valproic acid) and 20 females received lithium. Patients completed questions regarding their menstrual, reproductive and medical histories. During the follicular phase they were assessed for weight, body mass index (BMI kg/m2 ), and changes in the reproductive endocrine milieu that included morning estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex-hormone binding globulin (SHBG), androstenedione, dehydroepiandrosterone-sulfate (DHEAS), testosterone, free testosterone, prolactin and thyroid-stimulating hormone (TSH). The blood was also analyzed for fasting metabolic parameters which included total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), insulin, glycosylated hemoglobin (HbA1C), insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding-protein 1 (IGFBP-1), fasting blood glucose and morning leptin. Results: Nine (50%) of the valproate-treated females had menstrual abnormalities versus three (15%) of the lithium-treated females (p < 0.05). Valproate-treated females had significantly higher levels of follicular phase androgen concentrations than lithium-treated females (p < 0.05). Nine (50%) of females who were overweight (BMI ≥ 25 kg/m2 ) and with a history of menstrual irregularities also exhibited laboratory evidence of... [ABSTRACT FROM AUTHOR]

Background: Depressive disorders are common, and result in high individual and societal costs. The majority of research assessing depression has occurred in urban areas. There is a paucity of research examining the prevalence of and risk factors for depression in rural general practice. Aim: The aim of this study was to examine the prevalence of and risk factors for depression in a rural area of North Wales in the context of a large multi-centre European study. Method: One thousand nine hundred and ninety-nine people randomly selected from a health authority database underwent a two-phase screening method to identify depression. The first phase involved patients completing a self-rating postal questionnaire (the Beck Depression Inventory or BDI). In the second phase, those scoring above cut-off underwent detailed diagnostic interview (Schedules of Clinical Assessment in Neuropsychiatry or SCAN). The SCAN diagnostic interview can generate either DSM-IV or ICD-10 diagnoses; the DSM-IV classification system was used here. Results: One thousand two hundred and thirty-nine (63 %) people responded to the initial screening questionnaire. The prevalence rate for all DSM-IV depressive disorders was calculated to be 6.1 % (95 % CI 4.1, 9.0) whereas the prevalence rate for DSM-IV major depressive disorder was 5.1 % (CI 3.37, 7.66). Multivariate analysis indicated that several variables were related to BDI caseness, including gender, employment status, social support and negative life events. Conclusion: Levels of reported depression are relatively low in North Wales compared to those observed in a neighbouring urban area using comparable data collection methods. A number of factors traditionally associated with increased risk from depression were predictive of scoring above cut-off on the BDI in a rural North Wales sample. [ABSTRACT FROM AUTHOR]

Objective: Antiepileptic drugs (AEDs) are commonly employed in the treatment of bipolar disorder. The efficacy and tolerability of topiramate, a novel anticonvulsant, and bupropion SR when added to mood stabilizer therapy were compared under single-blind conditions (rater-blinded) in patients meeting DSM-IV criteria for bipolar I/II depression. Methods: A total of 36 out-patients with Hamilton Depression Rating Scale (HDRS-17) scores ≥16 were randomized to receive escalating doses of either topiramate (50–300 mg/day) or bupropion SR (100–400 mg/day) for 8 weeks. Data were analyzed on an intent-to-treat basis using the last observation carried forward method. Results: The percentage of patients meeting a priori response criteria (≥50% decrease from baseline in mean HDRS-17 total score) was significant for both topiramate (56%) and bupropion SR (59%) [t (17)=2.542, p=0.04 and t (17)=2.661, p=0.03, respectively]. Baseline demographic and clinical parameters were comparable between the two treatment groups. The mean doses of study medication were 176 mg/day (SD=102 mg/day) for the topiramate-treated group and 250 mg/day (SD=133 mg/day) for the bupropion SR-treated group. A significant and comparable reduction in depressive symptoms was observed from baseline to endpoint following topiramate and bupropion SR treatment, according to a ≥ 50% reduction in the HDRS-17. Total mean HDRS-17 scores significantly decreased from baseline to endpoint in both groups (p=0.001), however, differences between the topiramate-treated group and the bupropion SR-treated group were not significant [t (36)=1.754, p=0.097]. Both topiramate and bupropion SR were generally well tolerated. Thirteen patients discontinued the study: 2 because of lack of efficacy, 1 due to withdrawal of consent and 10 following side-effects (six in the topiramate and four in the bupropion SR-treated group). There were no cases of affective switch in either arm. Weight loss... [ABSTRACT FROM AUTHOR]