Search Results (201)

Background: Jehovah’s Witness (JW) patients pose a unique challenge to cardiac surgery due to their refusal of blood products, typically precluding them from becoming candidates for orthotopic heart transplantation (OHT). While “bloodless” cardiac surgery has been described in ideal candidates, anemic or other hematologic-risk patients are typically excluded. We describe a successful “bloodless” OHT in a non-ideal JW patient with anemia and cardiogenic shock, with ventricular assist through a transvalvular pump to bridge and optimize hematologic status prior to operation. Case Presentation: A 58-year-old male JW with end-stage non-ischemic cardiomyopathy (NICM) and an ejection fraction of 15–20% experienced repeated decompensation despite maximal medical therapy and implantable cardioverter–defibrillator (ICD) implantation. Two years since first presentation, he developed cardiogenic shock and required intra-aortic balloon pump (IABP) support. Iatrogenic anemia occurred during IABP placement and required femoral re-access and upgrade to Impella^® 5.5 support. During mechanical support, he was given a total blood conservation plan that included intravenous iron, darbepoetin alfa, restricted phlebotomy, and nutritional supplementation. Hemoglobin was increased from 7.8 to 10.4 g/dL. Successful “bloodless” OHT was subsequently performed on him with an estimated blood loss of 200 mL, 72 min cardiopulmonary bypass duration, and no transfusion. He was discharged on the nineth day after surgery with a hemoglobin level of 9.9 g/dL and returned to full activity. Discussion: Despite inherent risks, bloodless OHT may safely be performed in selected JW patients by means of multidisciplinary coordination, modern mechanical circulatory support, and hematopoietic stimulation. Our case highlights the utility of Impella^® 5.5 as a bridge-to-transplant strategy for anemic, hemodynamically unstable JW patients. This is in harmony with evidence from previous studies indicating similar results for JW and non-JW transplant recipients under strict optimization protocols. It also supports the expansion of candidacy criteria if appropriate planning and modern blood conservation strategies are employed. Conclusions: Transfusion religious objection ought not preclude JW patients from lifesaving OHT. With judicious perioperative planning, third-generation transvalvular pumps, and hematologic optimization, “bloodless” heart transplantation is possible—potentially even in non-ideal candidates. Full article

On 18 September 2023, the Spanish State recognised the Notorio Arraigo (firmly established, or literally, notorious deep rootedness) of the Bahá’í Community of Spain through a Ministerial Order, integrating it into the group of recognised religious denominations, albeit without any signed cooperation agreements. This milestone reflects the evolving legal–political frameworks of religious freedom since the arrival of the Bahá’í Faith in Spain in the mid-20th century, as well as the strategies employed to consolidate and institutionalise itself as a religious denomination, influenced by Bahá’í principles. This paper examines how these principles have inspired the Community’s secular strategies throughout different historical phases: from a restrictive Catholic confessional framework to the current non-confessional state, which guarantees religious freedom. It also analyses the actions undertaken to obtain recognition of Notorio Arraigo and considers the challenges and needs faced by the Bahá’í Community at this new level of recognition. Full article

Fish-derived collagen can reduce the risk of disease transmission and has no religious or cultural restrictions. However, it has limited applications due to its poor thermal stability. In this study, black carp swim bladder collagen (BBC), classified as a type I collagen, was extracted. Amino acid composition analysis revealed that BBC had a higher proline hydroxylation rate of 39.57%. Fourier transform infrared spectroscopy revealed that BBC exhibited a complete triple-helix structure. The fractional viscosity curve and differential scanning calorimetry curves revealed that the thermal denaturation temperature (Td) and the melting temperature (Tm) were 30.85 °C and 107.19 °C, respectively. The dynamic rheological analysis showed that as the concentration increased from 5 mg/mL to 20 mg/mL at 0.01 Hz, the storage modulus increased from 0.979 Pa to 84.2 Pa. When the temperature exceeded the Td, the BBC solution exhibited viscous behaviour as the frequency increased. The steady-shear analysis showed that the BBC was a shear-thinning fluid. Functional properties analysis revealed that BBC exhibited better emulsification properties, foaming properties, water absorption capacity and oil absorption capacity than land-derived collagen, making it suitable for emulsifiers, bubbling beverages, and frozen meat preservation. Additionally, BBC promoted the growth of MT3C3-E1 cells and maintained the normal morphology of the cells. These results showed that BBC is a promising substitute for terrestrial collagen in functional foods, cosmetics, and biofunctional materials. Full article

Continuous decrease in inertia and sensitivity to load/generation fluctuation are significant challenges for present-day power networks. The primary reason for these issues is the increased penetration capabilities of renewable energy sources. An imbalanced load with significant power output has a substantial impact on the frequency and voltage characteristics of electrical networks. Various load frequency control (LFC) technologies are widely used to address these issues. Existing LFC approaches in the literature are inadequate in addressing system uncertainty, parameter fluctuation, structural changes, and disturbance rejection. As a result, the purpose of this work is to suggest a better LFC approach that makes use of a combination of a one plus tilt fractional filtered derivative (1+TDF^λ) cascaded controller and a fractional order proportional–integral–derivative (PI^λD^μ) controller, which is referred to as the recommended 1+TDF^λ/PI^λD^μ controller. Drawing inspiration from the dynamics of religious societies, including the roles of followers, missionaries, and leaders, and the organization into religious and political schools, this paper proposes a new application of the efficient divine religions algorithm (DRA) to improve the design of the 1+TDF^λ/PI^λD^μ controller. A triple-area test system is constructed to analyze a realistic power system, taking into account certain physical restrictions such as nonlinearities as well as the impact of PV and wind energy integration. The effectiveness of the presented 1+TDF^λ/PI^λD^μ controller is evaluated by comparing their frequency responses to those of other current controllers like PID, FOPID, 2DOF-PID, and 2DOF-TID^μ. The integral time absolute error (ITAE) criterion was employed as the objective function in the optimization process. Comparative simulation studies were conducted using the proposed controller, which was fine-tuned by three recent metaheuristic algorithms: the divine religions algorithm (DRA), the artificial rabbits optimizer (ARO), and the wild horse optimizer (WHO). Among these, the DRA demonstrated superior performance, yielding an ITAE value nearly twice as optimal as those obtained by the ARO and WHO. Notably, the implementation of the advanced 1+TDF^λ/PI^λD^μ controller, optimized via the DRA, significantly minimized the objective function to $0.4704\times {10}^{-4}$. This reflects an approximate enhancement of $99.5\%$ over conventional PID, FOPID, and 2DOF-TID^μ controllers, and a $99\%$ improvement relative to the 2DOF-PID controller. The suggested case study takes into account performance comparisons, system modifications, parameter uncertainties, and variations in load/generation profiles. Through the combination of the suggested 1+TDF^λ/PI^λD^μ controller and DRA optimization capabilities, outcomes demonstrated that frequency stability has been significantly improved. Full article

This paper examines the sexual and reproductive health (SRH) knowledge, experiences, service access, and unmet needs of Rohingya adolescent refugee girls living in the camps of Cox’s Bazar, Bangladesh. The refugee population in these camps is approximately 1.3 million, with more than half under the age of 18 and girls representing over one quarter of the total. Given the growing proportion of adolescent girls, SRH knowledge and service provision are critical both for the refugee community and for Bangladesh’s broader sustainable development goals. Drawing on direct accounts from adolescent girls and insights from community-based key informants, this research explores levels of SRH awareness, willingness to seek care, encounters with sexual violence, understanding of sexually transmitted diseases, and reproductive health priorities. It also identifies barriers to service delivery faced by healthcare and humanitarian providers. The findings highlight how cultural norms, social constraints, and religious beliefs intersect with structural barriers—including lack of education, financial dependence, gender-based violence, and the need for parental or spousal consent—to restrict access to SRH services. Despite these challenges, some participants reported successfully receiving reproductive health care. This paper calls for coordinated action from the government, humanitarian agencies, and social service organisations to improve both the availability and accessibility of SRH services for adolescent refugee girls. Strategies should include enhanced outreach, culturally responsive engagement, and sustained follow-up care to promote safety, dignity, and well-being within the camps. Full article

Cultural and religious norms significantly influence reproductive decisions, including prenatal testing and pregnancy termination. We conducted a cross-sectional study among Muslim women living in mixed Jewish-Arab cities compared to those in predominantly Arab cities in Israel. Data for all co-variates were obtained through participants’ self-reports by an online questionnaire of 36 items for adequate content validity between July 2022 and June 2023. In total, 1081 Israeli Muslim women aged 18–49 years were enrolled. Religious affiliation has been shown to influence individuals’ attitudes toward abortion, with members of religious communities often holding more restrictive or negative views on the subject. Muslim women residing in mixed Jewish-Arab cities demonstrate significantly higher uptake of both non-invasive and invasive prenatal testing, as well as pregnancy terminations following abnormal diagnoses, compared to those in predominantly Arab cities (p < 0.001), which indicates that proximity to Jewish communities, greater availability of health services, and exposure to more permissive social norms in mixed cities may reduce religious and cultural barriers, thereby facilitating more informed reproductive decisions. Older women (≥35) in mixed cities had a higher tendency to birth a child with abnormalities in the past than Arab cities (80.9% vs. 70.0%, respectively), However, women who lived in mixed cities underwent more non-invasive (87.2% vs. 64.8%, respectively), invasive prenatal tests (85.1% vs. 69.7%, respectively), and pregnancy termination (88.3% vs. 64.1%, respectively) than those in Arab cities, p < 0.001. Our findings indicate the importance of gaining a deeper understanding of the relations between religious convictions, cultural standards, and medical practices that should contribute to reducing the prevalence of genetic disorders with their associated adverse impact on families, communities, and healthcare systems. Full article

This article challenges historiographical interpretations that emphasize tsarist sponsorship of Muslim religious institutions on the nineteenth-century Kazakh steppe. Drawing on both tsarist archival records and local Muslim sources, it highlights the crucial role of Muslim patrons in fostering an Islamic transformation—or revival—marked by the rapid expansion of mosques, madrasas, and networks of Islamic scholars that connected the steppe to other centers of Islamic learning in the region. These patrons included influential political leaders, Muslim tsarist administrators, and merchants such as Qunanbay Oskenbay-ughli, Tinibay Kauken-ughli, and Jolaman Jandarbek-ughli, who financed Islamic institutions while navigating increasingly restrictive tsarist religious policies. Paradoxically, while the tsarist regime imposed legal constraints on Islam, its broader policies inadvertently contributed to the rise of these Muslim benefactors by enabling their accumulation of wealth, status, and political leverage. Full article

Background/Objectives: Despite legal frameworks acknowledging the need to protect the rights of female prisoners, penitentiary systems often neglect gender-specific needs, particularly for foreign women. Among them, Muslim women face distinct challenges linked to cultural and religious practices, which are frequently unmet in prison contexts. This review aims to explore the academic literature on the experiences of Muslim women in detention. Methods: A systematic review was conducted using three major bibliographic databases—Scopus, PubMed, and Web of Science—covering the period from 2010 to 2024. Inclusion criteria focused on peer-reviewed studies examining the condition of Muslim women in prison. Of the initial pool, only four articles met the criteria and were included in the final analysis. Results: The review reveals a marked scarcity of research on Muslim women in prison at both national and international levels. This gap may be due to their limited representation or cultural factors that hinder open discourse. The selected studies highlight key issues, including restricted access to services, limited ability to practice religion, and language and cultural barriers. These challenges contribute to increased psychological vulnerability, which is often underestimated in prison settings. Conclusions: There is an urgent need for targeted research and culturally competent training for prison staff to adequately support Muslim women in detention. Greater academic and institutional attention is essential to develop inclusive policies that consider the intersection of gender, religion, and migration, particularly in the post-release reintegration process. Full article

Fish gelatin (FG) has garnered significant attention as an alternative to mammalian gelatin, primarily attributed to its distinct advantages. These include the absence of epidemic transmission risks and the lack of religious restrictions, making it a more universally acceptable and safer option. However, its application is limited due to shortcomings such as insufficient gel properties (such as rheological properties, gel strength, etc.). In this study, flaxseed gum (FFG) of 0–1.2% w/v was used to modify FG. The rheological properties, structural characteristics, and chemical bond changes of FG before and after modification were systematically analyzed using instruments such as a rheometer, infrared spectrometer, and Zeta potential analyzer. The results revealed that an appropriate amount of FFG could increase the gel strength of FG, but excessive FFG (>0.4%) reduced its gel strength. Moreover, FFG could increase the gelation transition temperature and apparent viscosity of the composite gel. FTIR confirmed that FFG and FG were bound through hydrogen bonding, β-sheet structure formation, and multi-electrolyte complexation. The ESEM showed that FFG promoted the formation of a denser network structure of FG. This study laid a theoretical foundation for the application and development of FG in the field of high-gel foods. Full article

Women disproportionately encounter negative affordances in urban environments—defined as features that severely restrict movement and impose harm. City venues are, thus, selectively permeable to women, though men face their own challenges, especially in intersectional contexts. The data in this study suggest that gender combines with ethnicity, socioeconomic status, and visible religious markers, making obstruction a shifting but nonetheless real phenomenon, much like a staircase genuinely impedes wheelchair access. Cultural context also matters: a Black woman may face one set of barriers in Paris, another in Seoul, with a Latin American woman encountering different ones in both. Building on these observations, the article argues that urban landscapes manifest gender-based political affordances—material configurations that reflect and reinforce social inequalities. As an affordance-based framework, the selective permeability model (1) draws on a well-supported theory of perception, where settings objectively present both favorable and hostile values relative to agents. The outlook (2) thereby challenges the stereotype that women’s spatial concerns are merely subjective. The position also (3) affirms that despite differences, people share bodily constraints and, hence, have largely overlapping values and experiences. The perspective accordingly avoids exaggerating divisions to the point of denying the mutual understanding that underlies empathetic norms. Full article

The COVID-19 pandemic exposed critical deficiencies in the United States’ legal system’s handling of emergency injunctions, particularly concerning religious freedom. This article examines the challenges courts faced in balancing public health measures with constitutional rights, focusing on the use of shadow dockets and the frequent dismissal of cases due to mootness. Analyzing key Supreme Court decisions and lower court rulings, we highlight the inconsistencies and delays that arose when addressing First Amendment challenges to pandemic-related restrictions. Arguments for procedural reforms, including expedited hearings and avoiding mootness dismissals in cases of national importance, are provided to protect fundamental rights during future public health crises. Full article

Background: PP-007 (SANGUINATE^®, PEGylated carboxyhemoglobin, bovine) is under development to treat conditions of ischemia/hypoxia. Hemorrhagic/hypovolemic shock (H/HVS) becomes a life-threatening comorbidity due in part to hypotension and hypoxia. Blood transfusions are indicated, but supply and compatibility issues may limit subject access or when blood is not an option due to religious restriction or concern for clinical complications. PP-007 is universally compatible with an effective hydrodynamic radius and colloidal osmotic pressure facilitating perfusion without promoting extravasation. Methods: A review of previous clinical trials was performed and revealed an Open-Label Phase 1 safety study of acute severe anemia (hemoglobin ≤ 5 g/dL) in adult (≥18 y) patients unable to receive red blood cell transfusion (NCT02754999). Primary outcomes included safety events with secondary efficacy measures of organ function and survival at 1, 14, and 28 days. Additionally, a retrospective review of published, peer-reviewed case reports was performed, evaluating the administration of Sanguinate for Expanded Access in those patient populations where blood was not an option over the past 12 years. Results: A total of 103 subjects were enrolled in the Phase I safety study with significant co-morbidities that most commonly included hypertension (n = 43), acute and chronic kidney disease (n = 38), diabetes mellitus (n = 29), gastrointestinal bleeds (n = 18), and sickle cell disease (n = 13). Enrollment characteristics included decreased hemoglobin and severe anemia (mean baseline hemoglobin of 4.2 g/dL). Treatments included an average of three infusions [range 1–17]. Secondary efficacy measures were mean Hb levels, respiratory support, and vasopressor requirements, all demonstrating clinically relevant improvements. Fourteen additional cases were identified in the literature. Though one patient died due to pre-treatment conditions, all patients but one were discharged home in stable condition. Conclusion: Collectively, these observations are encouraging and provide support for the continued evaluation of PP-007 in advanced clinical trials in severe anemia including H/HVS. The review of published case reports underscored the potential of Sanguinate to reduce early mortality. Adverse effects included transient hypertension, lethargy, dizziness, and troponin elevation. These findings highlight the need for continued research and funding of blood alternatives to improve outcomes when standard blood transfusions are unavailable or contraindicated. Full article

The article seeks to read the contribution of religious practices in prison education within the broader framework of spirituality as a search for meaning in life. It argues that religious engagement can foster cognitive and emotional development, providing inmates with a sense of purpose, community, and resilience that supports their reintegration into society. In light of an exceptional and extremely significant experience with APAC in Brazil’s police-free prison model, the authors aim to highlight the nexus between spirituality and re-education in contexts of deprivation and restriction of personal liberty. Indeed, the APAC (Association for the Protection and Assistance of the Convicted) model, central to this study, emphasizes nonviolent coexistence, responsibility, and spiritual care as part of its rehabilitative framework, with a significant reduction in recidivism rates and costs compared to traditional prisons. The model’s approach, grounded in a collective sense of responsibility and spirituality, aligns with Viktor Frankl’s and Paulo Freire’s theories on meaning and liberation, illustrating how spirituality can transform prison environments and promote social justice. The study concludes that spirituality in prisons not only aids individual redemption but also calls for structural changes to support reintegration, marking a shift towards a more human-centered penitentiary system. Full article

Background: Vitamin D plays a key role in bone metabolism and immune regulation. Populations with restricted sun exposure or limited dietary intake are particularly vulnerable to vitamin D deficiency. Orthodox Christian nuns represent a unique group in this regard, due to traditional clothing, limited outdoor activity, and prolonged religious fasting. However, few studies have compared them with lay individuals following similar dietary practices. Objective: This study aimed to investigate predictors of serum 25-hydroxyvitamin D [25(OH)D] concentrations in two female populations: Orthodox Christian nuns and women from the general population practicing intermittent (religious or non-religious) fasting. We also aimed to develop predictive models of vitamin D status for each group based on lifestyle and biochemical parameters. Methods: A total of 85 women (40 Orthodox nuns and 45 laywomen), aged 30–50 years, were enrolled. Serum 25(OH)D, parathyroid hormone (PTH), calcium levels, and anthropometric indices, including body mass index (BMI), total body fat, and visceral fat, were measured. Dietary calcium and vitamin D intake, as well as sun exposure, were assessed using validated questionnaires. Separate stepwise multiple regression models were constructed for each group to identify independent predictors of 25(OH)D concentrations. An additional combined model, including all participants, was also explored. Results: PTH was the most significant predictor, negatively correlating with 25(OH)D concentrations in both groups (p = 0.038), highlighting its regulatory role in vitamin D metabolism. When analyzed separately, the model for Orthodox nuns showed stronger explanatory power (adjusted R² = 0.718; p = 0.013) compared with the control group (adjusted R² = 0.362; p = 0.038), with PTH emerging as a key predictor in both. Conclusions: Distinct predictors of vitamin D status were identified in each group, reflecting the complex interplay between lifestyle and physiological factors. These findings suggest that targeted interventions, such as addressing PTH regulation in fasting populations or enhancing sun exposure in the general population, may be more effective in preventing vitamin D deficiency depending on the context. Full article

In the present study, we aim to review a series of constitutional provisions related to the status of religious freedom in Romania since the first Constitution to the present-day Law no. 489/2006 regarding religious freedom and the general status of denominations in Romania, the law that regulates the relationship of the state with all acknowledged denominations. We thus seek to achieve an analysis and evaluation of the Romanian legal framework that is relevant to the topic. In the second part of the study, we shall raise some cross-cutting issues related to derogations and limitations of the freedom of religion and belief as we briefly analyse two instances related to the recent COVID-19 pandemic, namely officiating religious services without public access and the restrictions regarding the pilgrimage in Iaşi, held every year on the 14th October, during the feast of Saint Pious Parascheva. Full article