bluuebunny/crossref_metadata_2025 huggingface dataset:
Equity issues in gender-affirming medical care in Kerala: a reflective commentary
Authors: Nayar K. Rajasekharan , Vinu S.
Published: September 2023

Gender-affirming medical care is the provision of transition-related medical services that support a transgender person’s own gender identity. Gender transitioning is a process that requires not only social support but also psychological and medical support, This paper attempts to document the challenges faced by transgender individuals (TG) especially in the context of gender affirming medical care in the Kerala context. The transition process is extremely complex as the preference for such process is varied. Some transgender individuals preferred social transition and/or medical transition to align their gender expression with their gender identity, while others chose to have a gender expression or identity outside the traditional gender binary. In Kerala, despite proactive policy and positive legal support, transgender individuals face many challenges in gender-affirming medical care which include lack of family support and equity-related issues with respect to a number of social support institutions including health services. A few possible interventions are suggested such as changes in medical curriculum, more active State support and sensitization of the society including health workers.
Correlation of the tumor escape phenotype with loss of PRELP expression in melanoma
Authors: Schäfer Helene , Subbarayan Karthikeyan , Massa Chiara , Vaxevanis Christoforos , Mueller Anja , Seliger Barbara
Published: September 2023

Background

Despite immunotherapies having revolutionized the treatment of advanced cutaneous melanoma, effective and durable responses were only reported in a few patients. A better understanding of the interaction of melanoma cells with the microenvironment, including extracellular matrix (ECM) components, might provide novel therapeutic options. Although the ECM has been linked to several hallmarks of cancer, little information is available regarding the expression and function of the ECM protein purine-arginine-rich and leucine-rich protein (PRELP) in cancer, including melanoma.

Methods

The structural integrity, expression and function of PRELP, its correlation with the expression of immune modulatory molecules, immune cell infiltration and clinical parameters were determined using standard methods and/or bioinformatics.

Results

Bioinformatics analysis revealed a heterogeneous, but statistically significant reduced PRELP expression in available datasets of skin cutaneous melanoma when compared to adjacent normal tissues, which was associated with reduced patients’ survival, low expression levels of components of the MHC class I antigen processing machinery (APM) and interferon (IFN)-γ signal transduction pathway, but increased expression of the transforming growth factor (TGF)-β isoform 1 (TFGB1) and TGF-β receptor 1 (TGFBR1). In addition, a high frequency of intra-tumoral T cells directly correlated with the expression of MHC class I and PRELP as well as the T cell attractant CCL5 in melanoma lesions. Marginal to low PRELP expression levels were found in the 47/49 human melanoma cell lines analysis. Transfection of PRELP into melanoma cell lines restored MHC class I surface expression due to transcriptional upregulation of major MHC class I APM and IFN-γ pathway components. In addition, PRELP overexpression is accompanied by high CCL5 secretion levels in cell supernatant, an impaired TGF-β signaling as well as a reduced cell proliferation, migration and invasion of melanoma cells.

Conclusions

Our findings suggest that PRELP induces the expression of MHC class I and CCL5 in melanoma, which might be involved in an enhanced T cell recruitment and immunogenicity associated with an improved patients’ outcome. Therefore, PRELP might serve as a marker for predicting disease progression and its recovery could revert the tumorigenic phenotype, which represents a novel therapeutic option for melanoma.
Perampanel’s forgiveness factor in a variable medication adherence paradigm in a rat model of chronic epilepsy
Authors: Guignet Michelle , Campbell Amanda , Vuong Jonathan , Whittington Dale , White H. Steve
Published: September 2023

Background

Poor medication adherence contributes to increased morbidity and mortality in patients with epilepsy and may be under-addressed in clinical practice. Ethical concerns make it impossible to study the impact of medication nonadherence in clinical trials, but our previous work emphasizes the importance of using preclinical approaches to address these questions. With over 30 clinically available antiseizure medicines (ASM’s), it remains an important question to understand the relationship between poor adherence and seizure incidence across mechanistically distinct ASM’s, including the broad-spectrum ASM, perampanel (PER).

Methods

We formulated PER into chow pellets to deliver to rats in a 100% fully adherent or 50% variable nonadherent paradigm via our novel automated medication-in-food delivery system. Chronic oral dosing was initiated in male rats with chronic epilepsy while monitoring 24/7 for videoEEG evidence of seizures during a 4-week placebo baseline and 4-week treatment phase. PER concentrations were monitored in plasma at 1-week intervals and correlated with degree of seizure control. The relationship between missed doses and extended patterns of nonadherence were correlated with breakthrough seizures.

Results

Fully adherent rats demonstrated a median reduction in seizure frequency of 50%, whereas nonadherent rats had a median increase of 54%. Plasma concentrations of PER were stable over the 4-week treatment period in both fully adherent and nonadherent groups, with levels being twice as high in fully adherent animals. There was no correlation between a single missed dose or series of missed doses and the incidence of breakthrough seizures. However, those animals in the nonadherent group that received PER for every meal during a 24-h period had a reduced likelihood of seizure incidence.

Conclusions

If our preclinical data is supported in the clinic, PER’s favorable pharmacokinetic profile in humans, combined with a lowered risk of breakthrough seizures suggests that it may provide a certain forgiveness factor if a dose is missed within a 24-h window.
Clinical and dosimetric outcomes of image-guided, dose-painted radiotherapy in muscle invasive bladder cancer
Authors: Navarro-Domenech Inmaculada , Arulanantham Shinthujah , Liu Zhihui Amy , Tjong Michael , Kong Vickie , Malkov Victor , Tadic Tony , Fleshner Neil , Kulkarni Girish , Zlotta Alexandre R , Catton Charles , Berlin Alejandro , Sridhar Srikala , Jiang Di , Chung Peter , Raman Srinivas
Published: September 2023

Purpose/Objective

Definitive radiotherapy (RT) is an alternative to radical cystectomy for select patients with muscle invasive bladder cancer (MIBC); however, there is limited data on dose-painted RT approaches. We report the clinical and dosimetric outcomes of a cohort of MIBC patients treated with dose-painted RT.

Material/Methods

This was a single institution retrospective study of cT2-4N0M0 MIBC patients treated with external beam radiotherapy (EBRT) to the bladder, and sequential or concomitant boost to the tumor bed. The target delineation was guided by either intravesical injection of Lipiodol or through fusion of the pre-treatment imaging. The majority were treated with daily image-guidance. Kaplan-Meier was used to characterize overall survival (OS) and progression-free survival (PFS). Cumulative incidence function (CIF) was used to estimate local (intravesical) recurrence (LR), regional recurrence (RR) and distant metastasis (DM). Univariable and multivariable cause-specific hazard model was used to assess factors associated with LR and OS.

Results

117 patients were analyzed. The median age was 73 years (range 43, 95). The median EQD2 to the boost volume was 66 Gy (range 52.1, 70). Lipiodol injection was used in 64 patients (55%), all treated with IMRT/VMAT. 95 (81%) received concurrent chemotherapy, of whom, 44 (38%) received neoadjuvant chemotherapy. The median follow-up was 37 months (IQR 16.2, 83.3). At 5-year, OS and PFS were 79% (95% CI 70.5–89.2) and 46% (95% CI 36.5–57.5). Forty-five patients had bladder relapse, of which 30 patients (67%) were at site of the tumor bed. Nine patients underwent salvage-cystectomy. Late high-grade (G3-G4) genitourinary and gastrointestinal toxicity were 3% and 1%.

Conclusion

Partial boost RT in MIBC is associated with good local disease control and high rates of cystectomy free survival. We observed a pattern of predominantly LR in the tumor bed, supporting the use of a dose-painted approach/de-escalation strategy to the uninvolved bladder. Prospective trials are required to compare oncological and toxicity outcomes between dose-painted and homogeneous bladder RT techniques.
Type III NRG-1 plays a regulatory role in the regeneration process of nerves from the beginning of transplantation
Authors: Wang Jun-Ning , He Sai , Yang Wei-xia , Lu Yao , Li Kun , Zhang Yu-Min , Wang Ya-Kang
Published: September 2023

The present study investigated the effect of type III Neuregulin-1 (NRG-1) on changes in the myelin sheath and the recovery of nerve function during the regeneration process following autologous nerve transplantation. Seventy-two Sprague–Dawley rats were divided into a Blank, Model and (antisense oligonucleotide, ASON) group. The Model and ASON groups of SD rats were subjected to autologous nerve transplantation, and the Blank group only had the sciatic nerve exposed. The Model and ASON groups were given local injections of 2 ml PBS buffer solution and 2 ml ASON of Type III NRG-1, respectively, the NRG-1 type III was inhibited by ASON. Changes in the sciatic nerve functional index (SFI) and conduction velocities were observed at different 6 time points. Regeneration of the myelin sheath was observed using transmission electron microscopy. Type III NRG-1 protein was detected using Western blotting and immunohistochemistry, and NRG-1 mRNA was detected using PCR. The SFI of the ASON group was lower than the Model group after transplantation. The conduction velocities of the ASON group on the 14th and 21st days after autologous nerve transplantation were lower than the Model group (P < 0.01). The protein and mRNA expression of type III NRG-1 in the ASON group was lower than the Model group at all 6 time points. The area of medullated nerve fibres was significantly different between the ASON group and the Model group on the 3rd day (P < 0.05), as was the number of medullated nerve fibres per unit area (P < 0.01). The diameter of axons was obviously different between the two groups (P < 0.01). Type III NRG-1 played an important regulatory role in the regeneration process of the nerve from the beginning of transplantation to the 28th day.
Shuangshen Ningxin capsule alleviates myocardial ischemia–reperfusion injury in miniature pigs by modulating mitophagy: network pharmacology and experiments in vivo
Authors: Jia Feifan , Chen Yuanyuan , Xin Gaojie , Li Lingmei , Liu Zixin , Xu Sujuan , Gao Jiaming , Meng Hongxu , Shi Yue , Ma Yanlei , Li Lei , Fu Jianhua
Published: September 2023

Background

Myocardial ischemia/reperfusion injury (MI/RI) is involved in a variety of pathological states for which there is no effective treatment exists. Shuangshen Ningxin (SSNX) capsule which is developed by Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine has been demonstrated to alleviate MI/RI, but its mechanism remains to be further elucidated.

Methods

The MI/RI miniature pigs model was constructed to assess the pharmacodynamics of SSNX by blocking the proximal blood flow of the left anterior descending branch of the cardiac coronary artery through an interventional balloon. The principal chemical compounds and potential targets of SSNX were screened by HPLC–MS and SwissTargetPrediction. The targets of MI/RI were identified based on Online Mendelian Inheritance in Man (OMIM) and GeneCards. Cytoscape 3.9.0 was applied to construct a protein–protein interaction (PPI) network, and Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed using metascape. To further validate the mechanism of SSNX, Molecular docking, Transmission electron microscopy, and Western blot analysis were used to test the effectiveness of targets in related pathways.

Results

Our results indicated that SSNX significantly improved cardiac function, attenuated myocardial I/R injury. Through network analysis, a total of 15 active components and 201 targets were obtained from SSNX, 75 of which are potential targets for the treatment of MI/RI. KEGG and MCODE analysis showed that SSNX is involved in the mitophagy signaling pathway, and ginsenoside Rg1, ginsenoside Rb1 and ginsenoside Rb2 are key components associated with the mitophagy. Further experimental results proved that SSNX protected mitochondrial structure and function, and significantly reduced the expression of mitophagy-related proteins PTEN-induced putative kinase 1 (PINK1), Parkin, FUN14 domain containing 1 (FUNDC1) and Bcl-2/E1B-19 kDa interacting protein 3 (BNIP3) in MI/RI miniature pigs.

Conclusion

In our study, the integration of network pharmacology and experiments in vivo demonstrated that SSNX interfered with MI/RI by inhibiting mitophagy.
Age-related hearing loss and its potential drug candidates: a systematic review
Authors: Hu Shiyu , Sun Qingru , Xu Fei , Jiang Ninghua , Gao Jianli
Published: September 2023

Background

Age-related hearing loss (ARHL) is one of the main illnesses afflicting the aged population and has a significant negative impact on society, economy, and health. However, there is presently no appropriate therapeutic treatment of ARHL due to the absence of comprehensive trials.

Objectives

The goal of this review is to systematically evaluate and analyze recent statistics on the pathologic classifications, risk factors, treatment strategies, and drug candidates of ARHL, including that from traditional Chinese medicine (TCM), to provide potential new approaches for preventing and treating ARHL.

Methods

Literature related to ARHL was conducted in databases such as PubMed, WOS, China National Knowledge Infrastructure (CNKI), and Wanfang from the establishment of the database to Jan, 2023. The pathology, causal factor, pathophysiological mechanism, treatment strategy, and the drug candidate of ARHL were extracted and pooled for synthesis.

Results

Many hypotheses about the etiology of ARHL are based on genetic and environmental elements. Most of the current research on the pathology of ARHL focuses on oxidative damage, mitochondrial dysfunction, inflammation, cochlear blood flow, ion homeostasis, etc. In TCM, herbs belonging to the kidney, lung, and liver meridians exhibit good hearing protection. Seven herbs belonging to the kidney meridian, 9 belonging to the lung meridian, and 4 belonging to the liver meridian were ultimately retrieved in this review, such as Polygonum multiflorum Thunb., Panax ginseng C.A. Mey, and Pueraria lobata (Willd.) Ohwi. Their active compounds, 2,3,4',5-Tetrahydroxystilbene-2-O-D-glucoside, ginsenoside Rb1, and puerarin, may act as the molecular substance for their anti-ARHL efficacy, and show anti-oxidative, neuroprotective, anti-inflammatory, anti-apoptotic, or mitochondrial protective effects.

Conclusion

Anti-oxidants, modulators of mitochondrial function, anti-inflammation agents, vasodilators, K+ channel openers, Ca2+ channel blockers, JNK inhibitors, and nerve growth factors/neurotrophic factors all contribute to hearing protection, and herbs are an important source of potential anti-ARHL drugs.
CRISPR/Cas9-mediated activation of NR5A1 steers female human embryonic stem cell-derived bipotential gonadal-like cells towards a steroidogenic cell fate
Authors: Danti Laura , Lundin Karolina , Sepponen Kirsi , Yohannes Dawit A. , Kere Juha , Tuuri Timo , Tapanainen Juha S.
Published: September 2023

The nuclear receptor subfamily 5 group A member 1 (NR5A1), encoding steroidogenic factor 1 (SF-1), has been identified as a critical factor in gonadal development in animal studies. A previous study of ours suggested that upregulation of NR5A1 during early gonadal differentiation in male (46,XY) human pluripotent stem cells steers the cells into a more mature gonadal cell type. However, the detailed role of NR5A1 in female gonadal differentiation has yet to be determined. In this study, by combining the processes of gonadal differentiation and conditional gene activation, we show that NR5A1 induction predominantly upregulates the female gonadal marker inhibin subunit α (INHA) and steroidogenic markers steroidogenic acute regulatory protein (STAR), cytochrome P450 family 11 subfamily A member 1 (CYP11A1), cytochrome P450 family 17 subfamily A member 1 (CYP17A1), hydroxy-delta-5-steroid dehydrogenase (HSD3B2) and hydroxysteroid 17-beta dehydrogenase 1 (HSD17B1). In contrast, NR5A1 induction did not seem to affect the bipotential gonadal markers gata binding protein 4 (GATA4) and Wilms’ tumour suppressor 1 (WT1) nor the female gonadal markers r-spondin 1 (RSPO1) and wnt family member 4 (WNT4). Differentially expressed genes were highly associated with adrenal and ovarian steroidogenesis pathways. Moreover, time-series analysis revealed different dynamic changes between male and female induced samples, where continuously upregulated genes in female gonadal differentiation were mostly associated with adrenal steroidogenesis. Thus, in contrast to male gonadal differentiation, NR5A1 is necessary but not sufficient to steer human embryonic stem cell (hESC)-derived bipotential gonadal-like cells towards a more mature somatic, female cell fate. Instead, it seems to direct bipotential gonadal-like cells more towards a steroidogenic-like cell population. The information obtained in this study helps in elucidating the role of NR5A1 in gonadal differentiation of a female stem cell line.
Whole-genome characterization of common rotavirus strains circulating in Vellore, India from 2002 to 2017: emergence of non-classical genomic constellations
Authors: Khakha Shainey Alokit , Varghese Tintu , Giri Sidhartha , Durbin Alan , Tan Gene S. , Kalaivanan Maheswari , Prasad Jasmin Helan , Kang Gagandeep
Published: September 2023

Rotaviruses (RVs) are the most common etiological agent of acute gastroenteritis among young children, even after vaccine introduction in low-income countries. A whole-genome classification representing the 11 RV genes, was introduced for surveillance and characterization of RVs. This study characterized the common circulating strains in Vellore, India from 2002 to 2017 to understand rotavirus strain diversity and evolution using Whole genome sequencing (WGS) carried out on Illumina MiSeq. The 89% (92% of Wa-like, 86% of DS-1-like) of strains had classical constellations, while reassortant constellations were seen in 11% (8% of Wa-like, 14% of DS-1-like) of the strains. The rare E6-NSP4 in combination with DS-1 like G1P[8] and the emergence of the OP-354 subtype of P[8] were identified. Phylogenetics of RV strains revealed multiple subtypes circulating in the past 15 years, with strong evidence of animal to human gene transmission among several strains.
Splenic sarcoid reaction mimicking metastases in patients after uterine cancer surgery: a report of two cases
Authors: Kitamura Kei , Ogura Toshiro , Miyamoto Ryoichi , Ishida Hiroyuki , Matsudaira Shinichi , Takahashi Amane , Kanda Hiroaki , Fukuda Takashi
Published: September 2023

Background

Tumor-associated sarcoid reactions have been observed with various tumors; however, they have not been reported with uterine cancer. We present two cases of splenic sarcoid reactions that mimicked metastases a few years after uterine cancer surgery.

Case presentation

Case 1 involved a 67-year-old female patient diagnosed with endometrial cancer (pT1aN0M0, pStage Ia, grade 1). The patient underwent open total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Three years after the initial surgery, computed tomography (CT) and positron emission tomography CT showed multiple splenic masses with increasing numbers and sizes. Splenic metastases were diagnosed, and laparoscopic splenectomy was performed. The histopathological analysis revealed sarcoid reactions in the spleen. Case 2 involved a 47-year-old female patient diagnosed with endometrial cancer (pT1aN0M0, pStage Ia, grade 1). The patient underwent laparoscopic total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Two years after the initial surgery, multiple splenic masses were observed. We performed laparoscopic splenectomy for the splenic metastases. Granuloma formations were identified in the splenic specimen and perisplenic lymph nodes that were removed simultaneously, resulting in a final diagnosis of sarcoid reaction. A review of the lymph nodes at the time of the previous uterine surgery revealed granuloma formation. Other than the presence of splenic masses, no findings suggestive of recurrence were observed in these cases. Uterine cancer and sarcoid reactions progressed without recurrence after splenectomy.

Conclusions

To the best of our knowledge, this is the first report of the late development of splenic sarcoid reactions after uterine cancer surgery. Sarcoid reactions and metastases are difficult to diagnose based on preoperative imaging results. However, reviewing the specimen at the time of the initial resection, the number of lesions, and the clinical findings (other than imaging findings) may aid in the determination of the correct diagnosis.
Thiothrix and Sulfurovum genera dominate bacterial mats in Slovak cold sulfur springs
Authors: Nosalova Lea , Mekadim Chahrazed , Mrazek Jakub , Pristas Peter
Published: September 2023

Microbiota of sulfur-rich environments has been extensively studied due to the biotechnological potential of sulfur bacteria, or as a model of ancient life. Cold terrestrial sulfur springs are less studied compared to sulfur-oxidizing microbiota of hydrothermal vents, volcanic environments, or soda lakes. Despite that, several studies suggested that sulfur springs harbor diverse microbial communities because of the unique geochemical conditions of upwelling waters. In this study, the microbiota of five terrestrial sulfur springs was examined using a 16 S rRNA gene sequencing. The clear dominance of the Proteobacteria and Campylobacterota phyla of cold sulfur springs microbiota was observed. Contrary to that, the microbiota of the hot sulfur spring was dominated by the Aquificota and Firmicutes phylum respectively. Sulfur-oxidizing genera constituted a dominant part of the microbial populations with the Thiothrix and Sulfurovum genera identified as the core microbiota of cold sulfur terrestrial springs in Slovakia. Additionally, the study emphasizes that sulfur springs in Slovakia support unique, poorly characterized bacterial communities of sulfur-oxidizing bacteria.
Scholastic Literary Theory: Intentionalism and the Desire for Stable Sense
Authors: Minnis Alastair
Published: September 2023

Scholastic intentionalism was a complicated and hardly consistent affair. Theologians sought security of meaning in the principle that a biblical author's intention could be found in the literal sense of his text. But the ultimate author of scripture, God, could have inscribed truths that transcended the intentions of inspired but merely human authors. Perhaps a text's intention was not curtailed by the temporal and historical circumstances of its composition? Further, scholastic debate rested on the assumption that truth emerges through vigorous confrontation. In practice, quotations were plucked from the full contexts that secured their meaning and conveyed authorial intention; those isolated excerpts were themselves treated as having sufficient authority to advance arguments. This history is related to present-day controversy about how the American Constitution (that modern authoritative text par excellence) should be implemented. There are striking parallels and intersections between scholastic literary theory and the “originalist” theory of constitutional interpretation; they share a common language of intentionalism, along with difficulties of interpretation.
The “World Migration Congress” of 1926 and the Limits of Socialist Internationalism
Authors: Poy Lucas
Published: September 2023

In recent years, scholars doing research on the anticommunist and social democratic tradition developed an interpretation in which socialist internationalism is portrayed not as opposed to nationalism but instead as complementary. This allowed them to move away from older perspectives and to examine the main features of international cooperation among socialists in a more positive light. Its substantial and convincing contributions notwithstanding, this literature also displays important shortcomings. Not only does it minimize the challenge that nationalism did pose to transnational solidarities; it is also too focused on Europe and therefore overlooks a more serious limit to internationalism, namely a perspective that proclaimed a principle of color-blind solidarity among all peoples of the world but in practice built a much more limited transnational community of workers either born in Europe or of European descent. This article engages with these historiographical trends and complicates our knowledge of socialist internationalism in the 1920s by exploring a unique and underresearched event, the “World Migration Congress,” held in London in 1926 and jointly organized by the International Federation of Trade Unions and the Labour and Socialist International, the main transnational networks of trade unionists and political parties of the social democratic tradition. Drawing on the idea that international organizations and meetings can be used as “observation points” for studying global history, the article uses the prolegomena to, the preparations for, and the discussions of this congress as a lens to understand the stances of socialist parties and reformist trade unions regarding the question of migration in the 1920s, explaining to what extent, and for what reason, they have changed in comparison with the prewar period. Moreover, it shows that the stances on migration were intertwined in many ways with socialist and labor perspectives on colonialism and condescending views of the “colored peoples” of the world.
Changes in Desk-Based Workers’ Sitting, Standing, and Stepping Time: Short- and Longer-Term Effects on Musculoskeletal Pain
Authors: DZAKPASU FRANCIS Q. S. , OWEN NEVILLE , CARVER ALISON , BRAKENRIDGE CHRISTIAN J. , EAKIN ELIZABETH G. , HEALY GENEVIEVE N. , LAMONTAGNE ANTHONY D. , MOODIE MARJ , COENEN PIETER , STRAKER LEON , DUNSTAN DAVID W.
Published: September 2023

Purpose

Sitting at work can be associated with musculoskeletal pain, but the effect of reductions in sitting is not well understood. We examined relationships with musculoskeletal pain of changes in sitting, standing, stepping, and short and long bouts of these behaviors.

Methods

Analyses pooled data from 224 desk workers (68.4% women; mean ± SD age = 45.5 ± 9.4 yr; body mass index = 28.1 ± 6.1 kg⋅m−2) in intervention trial. Device-assessed (activPAL3) sitting, standing, and stepping time and multisite musculoskeletal pain (Nordic Questionnaire; 12 body areas) were assessed at baseline, 3 months, and 12 months. Compositional data analyses in linear mixed-effects regressions examined relationships within 16 waking hours of the behaviors and their short and long bouts, with changes from baseline in acute and chronic multisite musculoskeletal pain at 3 and 12 months. Analyses were adjusted for initial group randomization and relevant covariates.

Results

At 3 months, increased standing relative to changes in other compositions was significantly associated with increased multisite musculoskeletal pain (acute: β = 1.54, 95% confidence interval [CI] = 0.10 to 2.98; chronic: β = 1.49, 95% CI = 0.12 to 2.83). By contrast, increased stepping relative to changes in other compositions was significantly associated with reduced multisite musculoskeletal pain (acute: β = −1.49, 95% CI = −2.97 to −0.02; chronic: β = −1.87, 95% CI = −3.75 to −0.01). Neither sitting reduction relative to changes in other compositions nor changes in short bouts relative to long bouts of the behaviors were significantly associated with multisite musculoskeletal pain changes. At 12 months, there were no significant associations for any of the compositional changes.

Conclusions

In the short term, while increasing standing with reduced sitting time can be unfavorable, concurrently increasing stepping could potentially reduce musculoskeletal pain. In the longer term, musculoskeletal pain may not be increased by moderate reductions in sitting time through spending more time standing or stepping.
Η διαχειριση και η προστασία των δασικών εκτάσεων κατά το ιδιωτικό δίκαιο
Authors: Χριστοδούλου Σοφία
Published: September 2023

Τα δάση διαδραματίζουν ένα σημαντικό και πολυλειτουργικό ρόλο στην ανάπτυξη της κοινωνίας και στην επίτευξη της οικολογικής ισορροπίας. Είναι απαραίτητα στην αντιμετώπιση της κλιματικής αλλαγής, συμβάλλουν στην προστασία της βιοποικιλότητας, ενώ προσφέρουν και άλλες περιβαλλοντικές υπηρεσίες. Τα δάση ωστόσο υφίστανται αυξανόμενη πίεση λόγω της αυξημένης ανθρώπινης δραστηριότητας. Η φύση τους ως ευπαθών και εύκολα αποσταθεροποιούμενων οικοσυστημάτων υπαγορεύει την ανάγκη για αποτελεσματική νομοθεσία στοχεύοντας σε μια αειφορική διαχείριση. Αντικείμενο της διατριβής είναι η ανάλυση της προστασίας των δασών στο αστικό δίκαιο που παρέχει ικανοποιητικές λύσεις για την προληπτική προστασία των δασών και την αποκατάσταση των ζημιών που προκαλούνται σε αυτά. Στο πρώτο μέρος εξετάζονται ο ορισμός των δασικών οικοσυστημάτων, η συνταγματική προστασία των δασών και η ευρωπαϊκή δασική στρατηγική η οποία στοχεύει στην αειφορική διαχείριση των δασών στην Ευρώπη και στη μείωση της αποδάσωσης. Ως αειφορική διαχείριση των δασών νοείται η διαχείριση και χρήση των δασών και των δασικών εκτάσεων κατά τρόπο, και σε βαθμό, ώστε να διατηρείται η βιολογική τους ποικιλότητα, η παραγωγικότητά τους, η ικανότητα αναγέννησης και η ζωτικότητά τους, καθώς και η ικανότητά τους να επιτελούν, τόσο στο παρόν, όσο και στο μέλλον, τις εύλογες οικολογικές, οικονομικές και κοινωνικές λειτουργίες, σε τοπικό, εθνικό και παγκόσμιο επίπεδο, χωρίς να βλάπτονται άλλα οικοσυστήματα.Το δεύτερο μέρος επικεντρώνεται στις διατάξεις του αστικού δικαίου που παρέχουν μια αποτελεσματική προστασία των δασικών οικοσυστημάτων όπως το δικαίωμα στην προσωπικότητα, οι διατάξεις του γειτονικού δικαίου, η διοίκηση των αλλοτρίων, η αδικοπρακτική ευθύνη και ο αδικαιολόγητος πλουτισμός. Στο τρίτο μέρος εξετάζονται οι περιορισμοί της κυριότητας επί των δασών. Ακολουθούν στο τέλος της διατριβής τα συμπεράσματα.
Οι εκπαιδευτικές αξίες των εκθεμάτων ως γέφυρες για τη σύνδεσή τους με τις φυσικές επιστήμες και το σχεδιασμό εκπαιδευτικών προγραμμάτων
Authors: Κορνελάκη Αθηνά - Χριστίνα
Published: September 2023

Η παρούσα εργασία διερευνά τρόπους γεφύρωσης των συλλογών μη επιστημονικών μουσείων με επιστημονικές έννοιες, αναλύοντας τις εκπαιδευτικές αξίες των εκθεμάτων τους και εντοπίζοντας έκδηλες ή άδηλες γέφυρες μεταξύ των εκθεμάτων και των θεμάτων φυσικών επιστημών των πρώτων βαθμίδων εκπαίδευσης. Στο πλαίσιο αυτό παρουσιάζονται πρόσφατες διεθνείς έρευνες καθώς και αποτελέσματα προγενέστερων ερευνών των συγγραφέων, τόσο για τον εντοπισμό των γεφυρών όσο και για την αξιοποίησή τους στο σχεδιασμό εκπαιδευτικών προγραμμάτων φυσικών επιστημών για μαθητές προσχολικής και πρωτο-σχολικής ηλικίας. Πιο συγκεκριμένα, περιγράφεται η περίπτωση του Αρχαιολογικού Μουσείου Ιωαννίνων και η ανάλυση των εκθεμάτων του καθώς και ένα παράδειγμα προγράμματος εκπαίδευσης φυσικών επιστημών που υλοποιήθηκε σε αυτό. Οι γέφυρες που εντοπίστηκαν, αφορούν τις τρεις από τις τέσσερις θεματικές του Αναλυτικού Προγράμματος Σπουδών για τις φυσικές επιστήμες της προσχολικής εκπαίδευσης, ζωντανοί οργανισμοί, αντικείμενα και υλικά, έννοιες και φαινόμενα από τον φυσικό κόσμο.
Effect of Active Release Technique and Cyriax approach on pain, grip strength and functional performance in individuals with lateral epicondylitis: a randomized clinical trial protocol
Authors: Nagore Aditi N. , Samal Subrat
Published: September 2023

Background: Tennis elbow, also known as lateral epicondylitis, is a painful condition characterized by irritation of the tendons that link the forearm muscles on the outside of the elbow, which can result from using the elbow too much. Active Release Technique (ART) is defined as a hands-on approach that manages cases to enable the identification and treatment of soft tissue injuries. Through the removal of fibrosis and adhesions that can develop in tissues as a result of overload from frequent use, the aim of ART, a soft tissue treatment, is to lessen tissue stress. Deep transverse friction (DTF) and Mill's manipulation, which are used shortly after DTF, have been used by Cyriax and Cyriax to successfully treat tennis elbow. ART and Cyriax techniques have shown promise for lateral epicondylitis sufferers. There hasn't yet been any research comparing these two approaches for participants with lateral epicondylitis. The aim is to examine the efficiency of ART with the Cyriax technique on lateral epicondylitis pain, strength, and function.

Methods: A total number of 60 participants will be included as per the inclusion criteria and then they will be further divided into 30 in each group. The physiotherapy intervention will be given to Groups A (ART) and Group B (Cyriax technique) along with conventional 12 sessions spread across four weeks, three times per week. Each patient will be evaluated during and after treatment on the baseline and after four weeks using the Visual Analogue Scale (VAS), hand grip strength dynamometer, and Patient-rated Tennis Elbow Evaluation (PRTEE) scale.

Conclusions: This physiotherapy intervention could be used in the treatment of lateral epicondylitis if our study's hypothesis is found to be accurate.

Registration: CTRI (CTRI/2023/06/053660; 08/06/2023).
Is East-West Life Expectancy Gap Narrowing in the Enlarged European Union?
Authors: Jasilionis Domantas , Meslé France , Vallin Jacques
Published: September 2023

The fall of the Berlin Wall in 1990 and EU enlargement in 2004 are two major political events in the recent history of the Central and Eastern European region. By systematically comparing the changes and differences in life expectancy at birth between the seven new member countries from Central and Eastern Europe and more advanced countries of the EU-15, this article attempts to identify the vanguards and laggards in the health convergence process before and after the 2004 EU enlargement. The results of decomposition analysis highlight the changing patterns of age- and cause-specific contributions to the differences in life expectancy. Finally, we focus on the variations in the progress in reducing the burden of cardiovascular diseases and external causes of death, which were known to be responsible for the long-term mortality crisis during the period of communist rule. Our findings suggest that the collapse of the communist regimes led to immediate positive changes in the Central European countries. At the same time, health disadvantages persisted and even worsened in the Baltic countries. Later on, joining the EU in 2004 was not accompanied by immediate systematic convergence of life expectancy. However, very rapid progress in the initially worst performing Baltic countries after 2007 and especially during the 2010s, may suggest a delayed positive impact of EU enlargement leading to decreasing longevity disadvantage. The convergence process after 2004 was generally slower in the initially better-performing four Central European countries. Despite these country-specific variations, Czechia, Poland, and, especially, Estonia remain clear health vanguards in the region. Further progress requires much more systematic efforts to combat cardiovascular diseases and the persisting burden of excess male mortality at adult working ages.

* This article belongs to a special issue on “Demographic Developments in Eastern and Western Europe Before and After the Transformation of Socialist Countries”.
The Performative Production of Trace Data in Knowledge Work
Authors: Aaltonen Aleksi , Stelmaszak Marta
Published: September 2023

Firms increasingly harness data that are created as by-products of information systems usage to evaluate and manage employees. However, such “trace data” can be a double-edged sword. The data can provide a whole new visibility into work practices but also, make work less transparent if the employees start to change their behavior to shape the data. We study this dilemma in the context of knowledge work that has traditionally eluded behavioral measurement. We show that when knowledge workers become aware of data collection and have an interest in how their work may be represented by the data, they start to actively perform the data. We identify different patterns by which employees shape work practices to produce trace data. The changes affect not only the actions and data of the focal employee but also, the actions and data of their colleagues and subordinates. Therefore, to fully realize the potential of trace data, managers may need to get involved in designing the data and to set a trace data policy that states how the data will be used in the organization.
Does Help Help? An Empirical Analysis of Social Desirability Bias in Ratings
Authors: Zheng Jinyang , Yin Guopeng , Tan Yong , Ding Jianing
Published: September 2023

Review-in-review (RIR) is a feature that allows viewers to generate positive or negative evaluations for primary quality evaluations of a product (e.g., ratings and reviews). This study reveals that it can cause social desirability bias in primary ratings: Reviewers who desire social recognition are driven to adjust their ratings (about 7.4% likelihood) to elicit more helpful responses and avoid unhelpful ones. This bias can be shown as distorted conformity to the prior rating distribution or extremity, depending on the RIR types. The model identifies how bias magnitude correlates with users’ social characteristics, thereby identifying vulnerable individuals. Platforms can incentivize less vulnerable users and remind susceptible ones to decrease the bias and can supplement rating conditional on the identified vulnerability extent (e.g., the distribution by the “independent” raters) to mitigate the bias’s impact on rating viewers. The simulation analysis compares the bias under different counterfactual RIR system designs, finding a composite RIR system (e.g., helpful and unhelpful RIRs) partially neutralizes the bias, obviating the need to remove all RIR features. The model further adapts to evaluate underexplored RIRs forms and can provide a “de-biased” metric while preserving individual ratings.
Fair Allocation of Vaccines, Ventilators and Antiviral Treatments: Leaving No Ethical Value Behind in Healthcare Rationing
Authors: Pathak Parag A. , Sönmez Tayfun , Ünver M. Utku , Yenmez M. Bumin
Published: September 2023

A priority system has traditionally been the protocol of choice for the allocation of scarce life-saving resources during public health emergencies. COVID-19 revealed the limitations of this allocation rule. Many argue that priority systems abandon ethical values, such as equity, by discriminating against disadvantaged communities. We show that a restrictive feature of the traditional priority system largely drives these limitations. Following minimalist market design, an institution design paradigm that integrates research and policy efforts, we formulate pandemic allocation of scarce life-saving resources as a new application of market design. Interfering only with the restrictive feature of the priority system to address its shortcomings, we formulate a reserve system as an alternative allocation rule. Our theoretical analysis develops a general theory of reserve design. We relate our analysis to debates during COVID-19 and describe the impact of our paper on policy and practice.

This paper was accepted by Axel Ockenfels, behavioral economics and decision analysis.
Drug breakdown: Bempedoic Acid
Authors: Rees Sharon
Published: September 2023

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #bempedoic acid
What's in a name? The complex conundrum of prescribing nomenclature in practice
Authors: Pryor Claire , Gilborson Sally , Henshaw Phill Morgan , Maddock Stuart
Published: September 2023

Health professionals who can legally prescribe medication and medical devices, but who are not doctors or dentists, come from a wide range of backgrounds, including the Nursing and Midwifery Council, General Pharmaceutical Council, and some Health and Care Professions Council registrants. The professionals are often grouped together and defined as ‘non-medical prescribers’. This may or may not be a useful collective term as, depending on professional registration, these professionals may be afforded differing prescribing rights, which may include a combination of independent/supplementary prescribing, independent prescribing (only), supplementary prescribing (only), or community nurse practitioner prescribing activity. This article explores the confusing nomenclature around prescribing, and the impact the names and terms used in practice have on professions. The naming and identification of role should be facilitative, to allow others to understand the legal context of prescribing activity, boundaries, and role expectations.
Non-medical prescribing in mental health services
Authors: Fernandez Jeff
Published: September 2023

This article examines the role of non-medical prescribing in mental health services through presentation of two case studies. In this sector, non-medical prescribing has been slow to start and is often not developed as fully as other areas of the NHS. There are many benefits to be gained from an expansion of non-medical prescribing, including wider patient choice and more accessible treatment for patients that is regarded as quick and responsive. This article promotes an area of mental health where non-medical prescribing has been embraced, and the value it has for the patient cohort it treats, by looking at the work of an inner-London hospital in the area of alcohol dependency. It is suggested that the role of the non-medical prescriber and their lead on prescribing can provide accessible treatment and good outcomes. Patient feedback shows this modern approach to healthcare is also well received. Therefore, these cases and patient outcomes should be shared to promote further expansion of prescribing in the mental health sector.
Cytotoxicity of leaves, stems, and flowers of Kecubung (Datura metel) extracts using the Brine Shrimp Lethality Test (BSLT) method
Authors: Humairani Rindhira , Purnama Nanda Rizki , Herpandi Herpandi , Syaifudin Mochamad , Zulfahmi Ilham , Akmal Yusrizal , Muliari Muliari , AS Agus Putra , Batubara Agung Setia
Published: September 2023

Brine shrimp (Artemia salina) cytotoxicity assays (BSLT) are one of the commonly used cytotoxic test methods to assess a plant extract's pharmacological activity and toxicity. Thus, this study aimed to examine the toxic levels of Kecubung (Datura metel) leaves extracted using different solvents, namely ethanol and ethyl acetate. The results showed that the LC50 value of flower ethanol, flower ethyl acetate, leaf ethanol, and stem ethyl acetate extracts had an LC50 value 1000, which was included in the toxic category. The LC50 value of flower ethanol is 121.044 ppm, flower ethyl acetate 105.89 ppm, leaf ethanol 639.589 ppm, and stem ethyl acetate 635.276 ppm. Ethanol leaf extract at a concentration of 1000 ppm showed the highest mortality with a percentage of 60% of the total number of A. salina. The flower ethanol extract showed the highest mortality at a concentration of 250 ppm with a percentage of 67% and at a concentration of 1000 ppm with a percentage of 70% of the total number of A. salina. Meanwhile, flower ethyl acetate and stem ethyl acetate extract at a concentration of 1000 ppm obtained 100% mortality of A. salina in the first 6 hours. The result shows that the flower ethyl acetate and stem ethyl acetate extract at a concentration of 1000 ppm is very toxic compared to other concentrations.Keywords:ToxicityArtemia salinaLC50Ethyl acetateEthanol
Important value index (IVI) and diversity of mangrove vegetation in Aceh Tamiang, Aceh Province
Authors: Dewiyanti Irma , Rifki Muhammad , Octavina Chitra , Ulfa Maria , Damora Adrian , Nurfadillah Nurfadillah
Published: September 2023

Mangrove ecosystem is one of the unique ecosystems that has high productivity and it grows along the coast of Aceh Province, Indonesia. The mangrove vegetation in Aceh Tamiang District was decreasing due to human exploitation i.e. stems of mangrove vegetation utilized by local communities become charcoal and firewood. These activities have a negative impact on live and growth of mangrove vegetation. Therefore, the purposes of the study are to analyses the important value index (IVI), mangrove species diversity, and to analyses the correlation between substrate characteristics with mangrove density. The research stations determined using the purposive sampling method and each station has three plots as replication. There were 4 research stations located in Seruway, Bandahara, Banda Mulia, and Manyak Paye sub districts. The study reported 12 species of mangrove in the tree’s category, 9 species of saplings, and 8 species of seedlings. The 12 species of mangroves found were Avicennia lanata, A. marina, A. officinalis, Brugeira parviflora, B. sexangula, Ceriops decandra, C. tegal, Lumnitzera recomosa, Nypa fruticans, Rhizopora apiculata, R. stylosa, and Sonneratia alba. The R. apiculata was species commonly found in each sampling location and it had highest IVI for the tree, sapling and seedling categories with the value of 207.24, 300, and 200, respectively. The average of diversity index was 1.56 categorized in the medium category. The moment Pearson correlation showed there was no significant correlation between the physical-chemical water parameters and substrate with the density of mangrove where Psig0.05.Keywords:Mangrove vegetationImportant value indexDensityDiversityAceh Tamiang