bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterisation of food governance for alternative and sustainable food systems: a systematic review
Authors: Oñederra-Aramendi Aintzira , Begiristain-Zubillaga Mirene , Cuellar-Padilla Mamen
Published: June 2023

Despite the various studies on food governance structured around alternative food systems (AFS), analysis of the essential characteristics of it which facilitate the sustainability of the food system (FS) is still incipient. This study aims to clarify the debate on the role of governance in sustainability of the FS by way of the following two objectives: (i) to characterise the analytical approach of the literature in the processes of structuring of food governance related to AFS, and (ii) to reflect qualitatively on the essential factors to be considered which ensure sustainable processes and trajectories of the AFS. The research methodology is based on a systematic review of the literature in order to define the approaches identified in the relevant studies in their analysis of the food governance process. From the results, a conceptual framework is proposed that determines the strategies related to food governance which can help meet the challenges of the AFS. A multi-actor and multilevel governance is identified that takes into account both structural and variable aspects linked to the interdependent relationships that are involved in the construction processes of the alternative food networks (AFN). We conclude our study by identifying certain gaps in the knowledge as well as new lines of study that we deem necessary in order to consolidate the AFS from a vision of sustainability.
What are the pathways between poverty and malaria in sub-Saharan Africa? A systematic review of mediation studies
Authors: Wafula Solomon T. , Habermann Theresa , Franke Mara Anna , May Jürgen , Puradiredja Dewi Ismajani , Lorenz Eva , Brinkel Johanna
Published: June 2023

Background

Malaria remains a major burden in sub-Saharan Africa (SSA). While an association between poverty and malaria has been demonstrated, a clearer understanding of explicit mechanisms through which socioeconomic position (SEP) influences malaria risk is needed to guide the design of more comprehensive interventions for malaria risk mitigation. This systematic review provides an overview of the current evidence on the mediators of socioeconomic disparities in malaria in SSA.

Methods

We searched PubMed and Web of Science for randomised controlled trials, cohort, case-control and cross-sectional studies published in English between January 1, 2000 to May 31, 2022. Further studies were identified following reviews of reference lists of the studies included. We included studies that either (1) conducted a formal mediation analysis of risk factors on the causal pathway between SEP and malaria infections or (2) adjusted for these potential mediators as confounders on the association between SEP and malaria using standard regression models. At least two independent reviewers appraised the studies, conducted data extraction, and assessed risk of bias. A systematic overview is presented for the included studies.

Results

We identified 41 articles from 20 countries in SSA for inclusion in the final review. Of these, 30 studies used cross-sectional design, and 26 found socioeconomic inequalities in malaria risk. Three formal mediation analyses showed limited evidence of mediation of food security, housing quality, and previous antimalarial use. Housing, education, insecticide-treated nets, and nutrition were highlighted in the remaining studies as being protective against malaria independent of SEP, suggesting potential for mediation. However, methodological limitations included the use of cross-sectional data, insufficient confounder adjustment, heterogeneity in measuring both SEP and malaria, and generally low or moderate-quality studies. No studies considered exposure mediator interactions or considered identifiability assumptions.

Conclusions

Few studies have conducted formal mediation analyses to elucidate pathways between SEP and malaria. Findings indicate that food security and housing could be more feasible (structural) intervention targets. Further research using well-designed longitudinal studies and improved analysis would illuminate the current sparse evidence into the pathways between SEP and malaria and adduce evidence for more potential targets for effective intervention.

Graphical Abstract
Earthquake preparedness in an urban area: the case of Dhaka city, Bangladesh
Authors: Rahman Md Mostafizur , Asikunnaby  , Chaity Nawshin Jahan , Abdo Hazem Ghassan , Almohamad Hussein , Al Dughairi Ahmed Abdullah , Al-Mutiry Motrih
Published: June 2023

This study aims to assess people’s preparedness for a potential earthquake in Dhaka, the capital of Bangladesh. We have employed a model with six dimensions of holistic individual preparedness. A self-reported online survey included 677 total participants. The multiple linear regression model and the Spearman rank correlation were used as needed. The majority of the participants (> 65%) did not have experience with any earthquake preparedness program, despite the fact that 92% of the population surveyed claimed to have experienced an earthquake in their region. More than 50% of those who experienced earthquakes acquired knowledge. 30% of people do not have access to immediate financial support in the event of a crisis. It was estimated that almost 50% of the population did not have earthquake insurance. Females lack the adaptability of males. A person’s level of earthquake preparedness was significantly associated with their level of education, household head occupation and monthly income, type of residential unit, and experience of earthquake preparedness program. Therefore, these factors should be considered while figuring out how to better prepare for earthquakes. A combination of holistic earthquake preparedness programs and effective education is generally required for competent holistic earthquake preparedness.
In an endotoxaemic model, antibiotic clearance can be affected by different central venous catheter positions, during renal replacement therapy
Authors: Bandert Anna , Lipcsey Miklós , Frithiof Robert , Larsson Anders , Smekal David
Published: June 2023

Background

In intensive care, different central venous catheters (CVC) are often used for infusion of drugs. If a patient is treated with continuous renal replacement therapy (CRRT) a second catheter, a central venous dialysis catheter (CVDC), is needed. Placing the catheters close together might pose a risk that a drug infused in a CVC could be directly aspirated into a CRRT machine and cleared from the blood without giving the effect intended. The purpose of this study was to elucidate if drug clearance is affected by different catheter placement, during CRRT. In this endotoxaemic animal model, an infusion of antibiotics was administered in a CVC placed in the external jugular vein (EJV). Antibiotic clearance was compared, whether CRRT was through a CVDC placed in the same EJV, or in a femoral vein (FV). To reach a target mean arterial pressure (MAP), noradrenaline was infused through the CVC and the dose was compared between the CDVDs.

Results

The main finding in this study was that clearance of antibiotics was higher when both catheter tips were in the EJV, close together, compared to in different vessels, during CRRT. The clearance of gentamicin was 21.0 ± 7.3 vs 15.5 ± 4.2 mL/min (p 0.006) and vancomycin 19.3 ± 4.9 vs 15.8 ± 7.1 mL/min (p 0.021). The noradrenaline dose to maintain a target MAP also showed greater variance with both catheters in the EJV, compared to when catheters were placed in different vessels.

Conclusion

The results in this study indicate that close placement of central venous catheter tips could lead to unreliable drug concentration, due to direct aspiration, during CRRT.
Cognitive Impairment and Self-Reported Dementia in UK Retired Professional Soccer Players: A Cross Sectional Comparative Study
Authors: Macnab Tara-Mei Povall , Espahbodi Shima , Hogervorst Eef , Thanoon Ahmed , Fernandes Gwen Sascha , Millar Bonnie , Duncan Ashley , Goodwin Maria , Batt Mark , Fuller Colin W. , Fuller Gordon , Ferguson Eamonn , Bast Tobias , Doherty Michael , Zhang Weiya
Published: June 2023

Background

Previous studies based on death certificates have found professional soccer players were more likely to die with neurodegenerative diseases, including dementia. Therefore, this study aimed to investigate whether retired professional male soccer players would perform worse on cognitive tests and be more likely to self-report dementia diagnosis than general population control men.

Methods

A cross-sectional comparative study was conducted between August 2020 and October 2021 in the United Kingdom (UK). Professional soccer players were recruited through different soccer clubs in England, and general population control men were recruited from the East Midlands in the UK. We obtained self-reported postal questionnaire data on dementia and other neurodegenerative diseases, comorbidities and risk factors from 468 soccer players and 619 general population controls. Of these, 326 soccer players and 395 general population controls underwent telephone assessment for cognitive function.

Results

Retired soccer players were approximately twice as likely to score below established dementia screening cut-off scores on the Hopkins Verbal Learning Test (OR 2.06, 95%CI 1.11–3.83) and Verbal Fluency (OR 1.78, 95% CI 1.18–2.68), but not the Test Your Memory, modified Telephone Interview for Cognitive Status, and Instrumental Activities of Daily Living. Analyses were adjusted for age, education, hearing loss, body mass index, stroke, circulatory problems in the legs and concussion. While retired soccer players were younger, had fewer cardiovascular diseases and other morbidities and reported healthier lifestyles, 2.8% of retired soccer players reported medically diagnosed dementia and other neurodegenerative disease compared to 0.9% of controls (OR = 3.46, 95% CI 1.25–9.63) after adjustment for age and possible confounders.

Conclusions

UK male retired soccer players had a higher risk of performing below established cut-off scores of dementia screening tests and were more likely to self-report medically diagnosed dementia and neurodegenerative diseases, despite having better overall physical health and fewer dementia risk factors. Further study is needed to determine specific soccer-related risk factors.
Protocol for the formative phase of a trial (SHE-CAN) to test co-designed implementation strategies for HPV-based cervical screening among vulnerable women in two diverse settings in India
Authors: Oommen Anu Mary , Basu Partha , Cherian Anne George , Zomawia Eric , Manoharan Ravikumar , Pricilla Ruby Angeline , Viswanathan Vidhya , Oldenburg Brian , Subramanian Sujha , Hawkes David , Saville Marion , Brotherton Julia M. L. ,   on behalf of the SHE-CAN collaborators, Peedicayil Abraham , Pautu Jeremy L. , Sangzuala  , Vanremmawii  , Hmangaihzuali Evelyn V. L. , Lalropuii  , Singarayar Pravin , George Kuryan , Grace Rebekah J. , George Tarun , Prasad Jasmine , Marcus Tobey , Thomas Anitha , Thomas Vinotha , Thomas Dhanya S. , Daniel Sherin , Varghese Kripa M. , Abraham Vinod J. , Muliyil Divya E. , Kannangai Rajesh , Abraham Priya , Rose Anuradha , Jeyapaul Shalini , Malini Tabeetha , Ram Thomas S. , John Neenu O. , Priya Ranjani D. , Kavitha K. , Meenatchi G. , Paul John , Mukherjee Pavan K. , Umesh Sasikala , John K. R. , Nightingale Claire , Kane Sumit , Ashfaq Maleeha , Chandran Arunah , Mosquera Isabel , Muwonge Richard , Carvahlo Andre
Published: June 2023

Background

In view of the WHO’s call for the elimination of cervical cancer as a public health problem, and current low screening coverage, Indian policy makers need evidence on how to effectively implement cervical screening programmes, ensuring equity in access.

Our study will follow the INSPIRE implementation framework to co-design and test HPV-based screening approaches in two states of India with different health system organisation, based on understanding the status of screening as currently implemented, readiness and challenges to transition to HPV-based screening, and preferences of key stakeholders. Here, we describe our protocol for the formative phase of the study (SHE-CAN).

Methods

The study population includes women from vulnerable populations, defined as residents of tribal areas, rural villages, and urban slums, in the states of Mizoram and Tamil Nadu. The baseline assessment will use mixed methods research, with desktop reviews, qualitative studies, and surveys. A capacity assessment survey of screening and treatment facilities will be done, followed by interviews with healthcare providers, programme managers, and community health workers. Interviews will be conducted with previously screened women and focus group discussions with under and never-screened women and community members. Stakeholder workshops will be held in each state to co-design the approaches to delivering HPV-based screening among 30–49-year-old women.

Discussion

The quality and outcomes of existing screening services, readiness to transition to HPV-based screening, challenges in providing and participating in the cervical cancer care continuum, and acceptability of screening and treatment approaches will be examined. The knowledge gained about the current system, as well as recognition of actions to be taken, will inform a stakeholder workshop to co-design and evaluate implementation approaches for HPV-based screening through a cluster randomised implementation trial.
Low prevalence of colistin-resistant Escherichia coli from companion animals, China, 2018–2021
Authors: Jiang Junyao , Ma Shizhen , Chen Siyu , Schwarz Stefan , Cao Yingqi , Dang Xukun , Zhai Weishuai , Zou Zhiyu , Shen Jianzhong , Lyu Yanli , Xia Zhaofei , Wang Yang
Published: June 2023

China banned colistin as growth promoter for animals in the year of 2017. A decrease of colistin-resistant Escherichia coli (COREC) and mcr-1-positive Escherichia coli (MCRPEC) were observed in livestock (pigs and chickens) and humans after the ban policy. However, the prevalence of COREC among Chinese companion animals after the ban policy has not been investigated. Here, we recovered 771 E. coli isolates from the China Antimicrobial Resistance Surveillance Network for Pets (CARPet) surveillance system (19 provinces/municipalities) from 2018 to 2021. We identified 12 COREC from eight dogs and four cats, among which one feline and three canine isolates were MCRPEC. The prevalence of COREC and MCRPEC in pets from 2018–2021 (1.1%–2.2% and 0.8%–1.1%) were lower than those from 2012–2016 (7.1%–17.8% and 6.1%–14.3%). The phylogenetic analysis revealed that the four MCRPEC isolates displayed genetic diversity, while one canine isolate exhibited only 26 SNPs difference with one human MCRPEC isolate in the same city, suggesting the exchange of MCRPEC isolates between companion animals and humans. In three MCRPEC isolates, mcr-1 was located on an IncI2 plasmid, which exhibited 99.5%–99.9% nucleotide sequence identity with plasmid pHNSD133-MCR from E. coli of chicken origin. In the remaining MCRPEC, mcr-1 was chromosomally located flanked by intact ISApl1 elements forming a unit of ISApl1-mcr-1-pap2-ISApl1. Despite the low prevalence of COREC and MCRPEC observed in companion animals after the ban policy, the association of pet-derived MCRPEC and mcr-carrying plasmids with those from humans and farm animals suggest that annual surveillance of colistin resistance in bacteria of pet origin is essential.
Care pathways for longstanding eating disorders must offer paths to recovery, not managed decline
Authors: Downs James
Published: June 2023

Eating disorders are historically underserved in healthcare, but are increasingly prevalent and recognised for their high costs regarding mortality, quality of life and the economy. Those with longstanding eating disorders are commonly labelled ‘severe and enduring’ (SEED), which has been challenged for its conceptual vagueness and potential to discourage patients. Attempts to define individuals from this cohort as having ‘terminal’ illness have also gained traction in recent years. This paper is grounded in lived/living experience and relevant research. It challenges the logical coherence and utility of SEED, arguing that the word ‘enduring’ unhelpfully situates intractability of longstanding illness within patients themselves and the nature of their illness. This risks a sense of inevitability and overlooks the important role of contextual factors such as lacking resources and insufficient evidence for withholding active treatment. Recommendations suggest approaches to dismantling unhelpful binaries between early intervention and intensive support, recovery and decline.
The Fake IQ Test: a novel measure of self-reflection in major depressive disorder
Authors: Marwood Lindsey , Kerr-Gaffney Jess , Wise Toby , Strawbridge Rebecca , Perkins Adam M. , Cleare Anthony J.
Published: June 2023

Background

Excessive negative self-referential processing plays an important role in the development and maintenance of major depressive disorder (MDD). Current measures of self-reflection are limited to self-report questionnaires and invoking imagined states, which may not be suitable for all populations.

Aims

The current study aimed to pilot a new measure of self-reflection, the Fake IQ Test (FIQT).

Method

Participants with MDD and unaffected controls completed a behavioural (experiment 1,n= 50) and functional magnetic resonance imaging version (experiment 2,n= 35) of the FIQT.

Results

Behaviourally, those with MDD showed elevated negative self-comparison with others, higher self-dissatisfaction and lower perceived success on the task, compared with controls; however, FIQT scores were not related to existing self-report measures of self-reflection. In the functional magnetic resonance imaging version, greater activation in self-reflection versus control conditions was found bilaterally in the inferior frontal cortex, insula, dorsolateral prefrontal cortex, motor cortex and dorsal anterior cingulate cortex. No differences in neural activation were found between participants with MDD and controls, nor were there any associations between neural activity, FIQT scores or self-report measures of self-reflection.

Conclusions

Our results suggest the FIQT is sensitive to affective psychopathology, but a lack of association with other measures of self-reflection may indicate that the task is measuring a different construct. Alternatively, the FIQT may measure aspects of self-reflection inaccessible to current questionnaires. Future work should explore relationships with alternative measures of self-reflection likely to be involved in perception of task performance, such as perfectionism.
Analysis of Cancer Research Projects in Sub-Saharan Africa: A Quantitative Perspective on Unmet Needs and Opportunities
Authors: Davies Lynne , Milner Danny A. , Shulman Lawrence N. , Kyokunda Lynnette , Bedada Alemayehu , Vuylsteke Peter , Masalu Nestory , Jackson Paul , Jennings Natanya , Odunlami Adesumbo , Mtshali Phangisile , Dugan Ute
Published: June 2023

PURPOSE

To evaluate the scope and types of cancer research projects in sub-Saharan Africa (SSA) to identify research gaps and inform future efforts.

METHODS

This retrospective observational study summarized information on cancer research projects in SSA from the International Cancer Research Partnership (ICRP) between 2015 and 2020, alongside 2020 cancer incidence and mortality data from the Global Cancer Observatory. SSA cancer research projects were identified as led by investigators in SSA countries, or by investigators in non-SSA countries with collaborators in SSA, or in database keyword searches. Projects from the Coalition for Implementation Research in Global Oncology (CIRGO) were also summarized.

RESULTS

A total of 1,846 projects were identified from the ICRP database, funded by 34 organizations in seven countries (only one, Cancer Association of South Africa, based in SSA); only 156 (8%) were led by SSA-based investigators. Most projects focused on virally induced cancers (57%). Across all cancer types, projects were most frequently related to cervical cancer (24%), Kaposi sarcoma (15%), breast cancer (10%), or non-Hodgkin lymphoma (10%). Gaps were observed for several cancers with higher incidence/mortality burden in SSA; for example, prostate cancer accounted for only 4% of projects but 8% of cancer-related deaths and 10% of new cases. Approximately 26% were dedicated to etiology. Treatment-related research declined over the study period (14%-7% of all projects), while projects related to prevention (15%-20%) and diagnosis/prognosis (15%-29%) increased. Fifteen CIRGO projects were identified; seven were relevant across multiple cancer types, and 12 focused either wholly or partially on cancer control (representing 50% of the total research effort).

CONCLUSION

This analysis shows notable discrepancies between cancer burden and research projects and identifies opportunities for future strategic investments in cancer care in SSA.
Barriers and Facilitators to Implementing Cost-Effective Evidence-Based Childhood Cancer Treatment in a Resource-Limited Setting in Egypt: A Qualitative Interview Study
Authors: Soliman Ranin , Heneghan Carl , Boylan Anne-Marie , Oke Jason , Eweida Wael , Elhaddad Alaa
Published: June 2023

PURPOSE

Childhood cancer treatment is complex, resource-intensive, and expensive, and resource-limited settings would benefit from providing cost-effective treatment approaches on the basis of evidence. Effective implementation of cost-effective evidence-based treatment requires knowledge about factors influencing its use. In this study, we determined the clinicians' perceptions of the barriers and facilitators to implementing cost-effective evidence-based treatment for children with cancer in a resource-limited pediatric oncology setting in Egypt.

METHODS

We conducted a qualitative study on the basis of semistructured interviews with senior clinicians who make high-level decisions on treatment protocols and tailored decisions for the atypically complicated group of patients. Purposive sampling was used to recruit the participants. Thematic analysis was conducted semantically to develop themes of barriers and facilitators.

RESULTS

Fourteen participants agreed to participate in the study: nine pediatric oncologists; three surgeons; and two radiation oncologists. We identified four main themes of barriers and facilitators: awareness and orientation; knowledge, skills, and attitudes; system, resources, and context; and clinical practice. The main barriers included absence of easily available costs/cost-effectiveness data, limited resources and inability to pay for expensive novel (cost-effective) drugs, and gap between evidence and practice. The main facilitators included adopting standard treatment protocols on the basis of clinical effectiveness, leadership support, availability of patients' clinical and cost data from local context, and existing knowledge and skills in clinical research and health economic evaluation. The interview participants also provided suggestions to promote the implementation of cost-effective evidence-based treatment in priority areas.

CONCLUSION

Our study findings provide an understanding of the barriers and facilitators affecting the implementation of cost-effective evidence-based treatment for childhood cancers in Egypt. We provide practical recommendations to address the implementation gaps with implications on practice, policy, and research.
Somatic EPAS1 Variants in Pheochromocytoma and Paraganglioma in Patients With Sickle Cell Disease
Authors: White Gemma , Nonaka Daisuke , Chung Teng-Teng , Oakey Rebecca J , Izatt Louise
Published: June 2023

Context

Somatic EPAS1 variants account for 5% to 8% of all pheochromocytoma and paragangliomas (PPGL) but are detected in over 90% of PPGL in patients with congenital cyanotic heart disease, where hypoxemia may select for EPAS1 gain-of-function variants. Sickle cell disease (SCD) is an inherited hemoglobinopathy associated with chronic hypoxia and there are isolated reports of PPGL in patients with SCD, but a genetic link between the conditions has yet to be established.

Objective

To determine the phenotype and EPAS1 variant status of patients with PPGL and SCD.

Methods

Records of 128 patients with PPGL under follow-up at our center from January 2017 to December 2022 were screened for SCD diagnosis. For identified patients, clinical data and biological specimens were obtained, including tumor, adjacent non-tumor tissue and peripheral blood. Sanger sequencing of exons 9 and 12 of EPAS1, followed by amplicon next-generation sequencing of identified variants was performed on all samples.

Results

Four patients with both PPGL and SCD were identified. Median age at PPGL diagnosis was 28 years. Three tumors were abdominal paragangliomas and 1 was a pheochromocytoma. No germline pathogenic variants in PPGL-susceptibility genes were identified in the cohort. Genetic testing of tumor tissue detected unique EPAS1 variants in all 4 patients. Variants were not detected in the germline, and 1 variant was detected in lymph node tissue of a patient with metastatic disease.

Conclusion

We propose that somatic EPAS1 variants may be acquired through exposure to chronic hypoxia in SCD and drive PPGL development. Future work is needed to further characterize this association.
Approach to the Patient With Bone Fracture: Making the First Fracture the Last
Authors: Wang Mawson , Seibel Markus J
Published: June 2023

The global burden of osteoporosis and osteoporotic fractures will increase significantly as we enter a rapidly aging population. Osteoporotic fractures lead to increased morbidity, mortality, and risk of subsequent fractures if left untreated. However, studies have shown that the majority of patients who suffer an osteoporotic fracture are not investigated or treated for osteoporosis, leading to an inexcusable “osteoporosis care gap.” Systematic and coordinated models of care in secondary fracture prevention known as fracture liaison services (FLS) have been established to streamline and improve the care of patients with osteoporotic fractures, and employ core principles of identification, investigation, and initiation of treatment. Our approach to the multifaceted care of secondary fracture prevention at a hospital-based FLS is illustrated through several case vignettes.
Postoperative Serum Cortisol and Cushing Disease Recurrence in Patients With Corticotroph Adenomas
Authors: Catalino Michael P , Moore Dominic T , Ironside Natasha , Munoz Alexander R , Coley Justin , Jonas Rachel , Kearns Kathryn , Min Le , Vance Mary Lee , Jane John A , Laws Edward R
Published: June 2023

Context

In Cushing disease, the association between the rate of serum cortisol decline and recurrent disease after corticotroph adenoma removal has not been adequately characterized.

Objective

To analyze postoperative serum cortisol and recurrence rates in Cushing disease.

Methods

Patients with Cushing disease and pathology-confirmed corticotroph adenoma were retrospectively studied. Cortisol halving time was estimated using exponential decay modeling. Halving time, first postoperative cortisol, and nadir cortisol values were collected using immediate postoperative inpatient laboratory data. Recurrence and time-to-recurrence were estimated and compared among cortisol variables.

Results

A total of 320 patients met inclusion/exclusion criteria for final analysis, and 26 of those patients developed recurrent disease. Median follow-up time was 25 months (95% CI, 19-28 months), and 62 patients had ≥ 5 years follow-up time. Higher first postoperative cortisol and higher nadir were associated with increased risk of recurrence. Patients who had a first postoperative cortisol ≥ 50 µg/dL were 4.1 times more likely to recur than those with a first postoperative cortisol < 50 µg/dL (HR 4.1, 1.8-9.2; P = .0003). Halving time was not associated with recurrence (HR 1.7, 0.8-3.8, P = .18). Patients with a nadir cortisol ≥2 µg/dL were 6.6 times more likely to recur than those with a nadir cortisol of < 2 µg/dL (HR 6.6, 2.6-16.6, P < .0001).

Conclusion

Postoperative nadir serum cortisol is the most important cortisol variable associated with recurrence and time-to-recurrence. Compared to first postoperative cortisol and cortisol halving time, a nadir < 2 µg/dL showed the strongest association with long-term remission and typically occurs within the first 24 to 48 hours after surgery.
Organophosphate Esters Disrupt Steroidogenesis in KGN Human Ovarian Granulosa Cells
Authors: Wang Xiaotong , Lee Elaine , Hales Barbara F , Robaire Bernard
Published: June 2023

Organophosphate esters (OPEs) are used extensively as flame retardants and plasticizers and are found ubiquitously in the environment and human matrices. Previous studies suggested that exposure to some of these chemicals may disrupt the homeostasis of female sex hormones and have detrimental effects on female fertility. Here, we determined the effects of OPEs on the function of KGN ovarian granulosa cells. We hypothesized that OPEs alter the steroidogenic ability of these cells by dysregulating the expression of transcripts involved in steroid and cholesterol biosynthesis. KGN cells were exposed for 48 h to one of five OPEs (1–50 μM): triphenyl phosphate (TPHP), tris(methylphenyl) phosphate (TMPP), isopropylated triphenyl phosphate (IPPP), tert-butylphenyl diphenyl phosphate (BPDP), and tributoxyethyl phosphate (TBOEP), or to a polybrominated diphenyl ether flame retardant, 2,2’,4,4’ tetrabromodiphenyl ether (BDE-47), in the presence or absence of Bu2cAMP. OPEs increased the basal production of progesterone (P4) and 17β-estradiol (E2) and had either no effect or inhibited Bu2cAMP-stimulated P4 and E2 synthesis; exposure to BDE-47 had no effect. qRT-PCR analyses revealed that OPEs (≥5 μM) increased the basal expression of critical genes (STAR, CYP11A1, CYP19A1, HSD3B2, and NR5A1) involved in steroidogenesis; upon stimulation, the expression of all genes tested was downregulated. An overall inhibition in cholesterol biosynthesis was induced by OPEs, characterized by a downregulation in HMGCR and SREBF2 expression. TBOEP consistently showed the least effect. Therefore, OPEs perturbed steroidogenesis in KGN granulosa cells by targeting the expression of steroidogenic enzymes and cholesterol transporters; these effects may have an adverse impact on female reproduction.
Thalidomide-Induced Primary Amenorrhea in a Patient With HbE/Beta-Thalassemia
Authors: Singha Arijit , Mukhopadhyay Pradip , Ghosh Sujoy
Published: June 2023

An 18-year-old girl was evaluated for primary amenorrhea. She was diagnosed with hemoglobin E (HbE)/beta-thalassemia during childhood and needed blood transfusions every month to maintain adequate hemoglobin levels. She was started on thalidomide to reduce her transfusion requirements at 12 years of age and became transfusion independent after 6 months. She had normal stature and Tanner stage 4 sexual maturation, but she failed to attain menarche. Investigations revealed that she had elevated serum gonadotropin levels, indicating primary ovarian dysfunction. Her karyotype was 46,XX. Ultrasonographic examination demonstrated the absence of follicles in both ovaries. There was no evidence of abnormalities of the urogenital tract. Thalidomide was stopped, and she attained menarche spontaneously 3 months thereafter. Subsequently, her menstrual cycles were regular. Repeat ultrasound scans demonstrated the presence of ovarian follicles as well as an increase in ovarian volume. Mechanistic links between ovarian dysfunction and thalidomide remain to be found. One possibility is impaired blood flow and follicular development.
Chronic Semaglutide Treatment in Rats Leads to Daily Excessive Concentration-Dependent Sucrose Intake
Authors: Cawthon Carolina R , Blonde Ginger D , Nisi A Valentina , Bloomston Haley M , Krubitski Belle , le Roux Carel W , Spector Alan C
Published: June 2023

Context

The glucagon-like peptide-1 receptor (GLP-1R) agonist semaglutide (SEMA) produces 15% weight loss when chronically administered to humans with obesity.

Methods

In 2 separate experiments, rats received daily injections of either vehicle (VEH) or SEMA starting at 7 µg/kg body weight (BW) and increasing over 10 days to the maintenance dose (70 µg/kg-BW), emulating clinical dose escalation strategies.

Results

During dose escalation and maintenance, SEMA rats reduced chow intake and bodyweight. Experiment 2 meal pattern analysis revealed that meal size, not number, mediated these SEMA-induced changes in chow intake. This suggests SEMA affects neural processes controlling meal termination and not meal initiation. Two-bottle preference tests (vs water) began after 10 to 16 days of maintenance dosing. Rats received either an ascending sucrose concentration series (0.03-1.0 M) and 1 fat solution (Experiment 1) or a 4% and 24% sucrose solution in a crossover design (Experiment 2). At lower sucrose concentrations, SEMA-treated rats in both experiments drank sometimes >2× the volume consumed by VEH controls; at higher sucrose concentrations (and 10% fat), intake was similar between treatment groups. Energy intake of SEMA rats became similar to VEH rats. This was unexpected because GLP-1R agonism is thought to decrease the reward and/or increase the satiating potency of palatable foods. Despite sucrose-driven increases in both groups, a significant bodyweight difference between SEMA- and VEH-treated rats remained.

Conclusion

The basis of the SEMA-induced overconsumption of sucrose at lower concentrations relative to VEH controls remains unclear, but the effects of chronic SEMA treatment on energy intake and BW appear to depend on the caloric sources available.
How to Capture Birds of Freedom: Picturing Tamil Women at War
Authors: Buthpitiya Vindhya
Published: June 2023

This article examines the uses of images of women fighters of the Liberation Tigers of Tamil Eelam during and after the Sri Lankan civil war (1983–2009) to explore the contrasting mobilizations of visual representations of Tamil women cadres, focusing on the cultivation and framing of contradictory nationalist imaginaries by competing ethnic and state actors. In northern Sri Lanka, portraits of gun-bearing women fighters were wielded to signal revolutionary possibilities for the future of the Tamil nation-state as well as to inform the political socialization of its hopeful citizens. Meanwhile, images of Tamil women cadres were cast as gendered and ethnicized threats by the Sri Lankan state in what constituted a calculated form of visual ethno-political othering and weaponization. This article reflects on the ways in which such appropriations exacerbated the political precarity of and the denial of victimhood to Tamil women.
Who Is Missing? Albums and Archives
Authors: Matthew Annu Palakunnathu
Published: June 2023

While collecting family photographs of some of the 2.5 million Indians who fought in World War II on behalf of their British colonizer, this article's author, an artist, found that the idea of photographic “ubiquity” was turned on its head. She became increasingly aware of how socioeconomic privilege, caste, and class played a role in who was never photographed and thus who is not represented in the history of photography, in photo albums, and in military archives. Three different installations titled The UNREMEMBERED: Indian Soldiers of World War II include the use family photographs and archival footage. In this article, the artist explores questions about who is not represented in photo albums and archives and approaches to remedying their absence.
Implanted Electrodes for Functional Electrical Stimulation to Restore Upper and Lower Extremity Function: History and Future Directions
Authors: Pellot-Cestero Joel E. , Herring Eric Z. , Graczyk Emily L. , Memberg William D. , Kirsch Robert F. , Ajiboye A. Bolu , Miller Jonathan P.
Published: June 2023

Functional electrical stimulation (FES) to activate nerves and muscles in paralyzed extremities has considerable promise to improve outcome after neurological disease or injury, especially in individuals who have upper motor nerve dysfunction due to central nervous system pathology. Because technology has improved, a wide variety of methods for providing electrical stimulation to create functional movements have been developed, including muscle stimulating electrodes, nerve stimulating electrodes, and hybrid constructs. However, in spite of decades of success in experimental settings with clear functional improvements for individuals with paralysis, the technology has not yet reached widespread clinical translation. In this review, we outline the history of FES techniques and approaches and describe future directions in evolution of the technology.
On the structure of the foot of the fly
Authors: Hepworth John
Published: June 2023

Having paid some attention to the structure of insects, I have carefully examined the fly’s foot (Musca domestica, &c.), and finding much misapprehension on the subject still existing (in a recent popular publication), I thought a few remarks might not be uninteresting to some of the readers of this Journal, and lead to a further investigation by some one more experienced in these matters than- myself. Some months after I had arrived at my conclusions I met with the following remarks, some of which come nearer my own ideas than anything I have yet met with :—
Should Patients with Renal Cell Carcinoma and Pathological Nodal Invasion Be Classified As Having Stage IV Disease?
Authors: Yu Kai-Jie , Chen Sy-Yuan , Lin Po-Hung , Liu Chung-Yi , Joon Aron Y. , Yang Yu-Kuan , Shao I.-Hung , Kan Hung-Chen , Chu Yuan-Cheng , Huang Liang-Kang , Chang Ying-Hsu , Chuang Cheng-Keng , Weng Wen-Hui , Pang See-Tong
Published: June 2023

Background

Lymph node invasion is associated with poor outcome in patients with renal cell carcinoma (RCC).

Patients and Methods

Patients with RCC within a single center from 2001 to 2018 were retrospectively obtained from the Chang Gung Research Database. Patient gender, physical status, Charlson Comorbidity Index, tumor side, histology, age at diagnosis, and body mass index (BMI) were compared. The overall survival (OS) and cancer-specific survival (CSS) of each group were estimated using the Kaplan–Meier method. Log-rank tests were used to compare between the subgroups.

Results and Conclusions

A total of 335 patients were enrolled, of whom 76 had pT3N0M0, 29 had pT1–3N1M0, 104 had T1–4N0M1, and 126 had T1–4N1M1 disease. Significant OS difference was noted between pT3N0M0 and pT1–3N1M0 groups with 12.08 years [95% confidence interval (CI), 8.33–15.84] versus 2.58 years (95% CI, 1.32–3.85), respectively (P < 0.005). No significant difference was observed in OS between pT1–3N1M0 and T1–4N0M1 groups with 2.58 years (95% CI, 1.32–3.85) versus 2.50 years (95% CI, 1.85–3.15, P = 0.72). The OS of N1M1 group was worse than that of N0M1 group with 1.00 year (95% CI, 0.74–1.26) versus 2.50 years (95% CI, 1.85–3.15, P < 0.05). Similar results were also observed in CSS. In summary, we claim that RCC with lymph node (LN) invasion should be reclassified as stage IV disease in terms of survival outcome.
IoT in Education: Implementation Scenarios through the Lens of Data Privacy Law
Authors: Kouroupis Konstantinos , Vagianos Dimitrios
Published: June 2023

The Internet of Things (IoT) is today one of the most rapidly developing digital technologies and has managed to establish a solid presence in the academic realm.  This article highlights the promising implications of IoT in Education including efficient school management, real-time data collection and analysis, resource management and global interconnectedness.  Implementation scenarios are many and incorporate billions of devices that collect huge amounts of data that can be exploited for a wide range of educational purposes.  In the post Covid19 era, the IoT as the so-called 3rd revolution of Information technology appeared to be able to support distance learning as well as to protect students in terms of virus spreading, guaranteeing a safe learning environment in their coming back to the classrooms. At the same time, all implementations scenarios raise concerns related to data privacy rights and data security. This article highlights the need for a legal context that protects privacy as well as fundamental rights and freedoms. Since the Internet of Things encompasses new technologies, such as Artificial Intelligence and Blockchain, the study of its regulatory framework is of primary interest. In addition, serious legal and ethical concerns arise which demand a relative critical approach. Therefore, it is pursued the proposal of fruitful guidelines which would lead to a powerful, productive and human-centric educational environment.
Predistorter for Nonlinear Distortion Mitigation in GFDM Systems
Authors: E. Jayati Ari , Margiantono Agus
Published: June 2023

Next-generation wireless systems use the non-orthogonal modulation technique known as generalized frequency division multiplexing (GFDM). The nonlinearity of the high-power amplifier (HPA) greatly affects the performance of the wireless system. Without phase distortion and only amplitude distortion in the GFDM system using HPA Model Rapp. The effects of nonlinear distortion that occur involve distortion of the amplitude, signal constellation distribution, and spectral distribution. There are two contributions to this paper. First, the impact of HPA Model Rapp's nonlinear distortion on the GFDM system in the AWGN (additive white Gaussian noise) and Rayleigh channels was investigated. The simplicity of this model is the reason it was picked and has an AM/AM (amplitude modulation/amplitude modulation) curve. Second, the linearization of HPA with the use of a predistorter method in GFDM systems has been proposed. The nonlinear distortion impact of HPA can be mitigated by this predistorter. This technique is implemented in the transmitter section. The system performance investigated is determined by a bit error rate (BER) analysis, a constellation diagram, and a spectrum analysis. HPA generates a 55 dB rise in out-of-band (OOB) in the signal spectrum. The HPA effect was successfully compensated for by a 55 dB decrease in the OOB value of the predistorter system.
The features of reactions to acute stress of neuro-endocrine-immune complex, metabolome, ECG and gastric mucosa in rats with various state of innate muscular endurance and resistance to hypoxia
Authors: Melnyk Oksana , Chendey Ivanna , Zukow Walery , Plyska Oleksandr , Popovych Igor
Published: June 2023

Background. It is known about wide variety of individual reactions to stress explained by genetics factors. On the other hand, it is also known about aerobic fitness variability between individuals. From the above it follows the hypothesis that inter-individual differences in normal conditions determine the characteristics of the body's response to acute stress. The purpose of this study is to test the hypothesis. Material and methods. The experiment is at 58 rats (28 males) Wistar line. Animals were tested for resistance to hypoxic hypoxia and aerobic muscular performance by swimming test. On the basis of the received data two qualitatively equivalent groups in a ratio 10/48 were formed. After a week of recovery over the next 10 days, one animal remained intact and 5 other rats were exposed to water-immersion and restraint stress. The next day after stress, the ECG recorded and some endocrine, metabolic and immune parameters determined as well as erosive-ulcerative lesions of the gastric mucosa evaluated. Results. Four clusters by hypoxic and swimming tests were created retrospectively: normal resistance to hypoxia and muscular endurance (n=11); moderately reduced resistance to hypoxia and normal swimming test (n=25); drastic increased swimming test and normal hypoxic test (n=3); significantly increased resistance to hypoxia and normal swimming test (n=9). Each cluster is characterized by specific (correctness of classification 100%) post-stress changes in 6 neuro-endocrine, 12 immune, 10 metabolic and 2 ECGs parameters, as well as the index of damage to the gastric mucosa. The swimming test determines the post-stress state of the registered parameters by 63,8%, the hypoxic test - by 57,5%, and taken together - by 79,1%. Conclusion. The post-stress neuro-endocrine, immune and metabolic parameters as well as injuries of myocardium and gastric mucosa in rats are determined significantly by innate muscular endurance and resistance to hypoxia.
Dynamic Routing and Wavelength Assignment with Reinforcement Learning
Authors: Kafaei Peyman , Cappart Quentin , Chapados Nicolas , Pouya Hamed , Rousseau Louis-Martin
Published: June 2023

With the rapid developments in communication systems, and considering their dynamic nature, all-optical networks are becoming increasingly complex. This study proposes a novel method based on deep reinforcement learning for the routing and wavelength assignment problem in all-optical wavelength-decision-multiplexing networks. We consider dynamic incoming requests, in which their arrival and holding times are not known in advance. The objective is to devise a strategy that minimizes the number of rejected packages due to the lack of resources in the long term. We use graph neural networks to capture crucial latent information from the graph-structured input to develop the optimal strategy. The proposed deep reinforcement learning algorithm selects a route and a wavelength simultaneously for each incoming traffic connection as they arrive. The results demonstrate that the learned agent outperforms the methods used in practice and can be generalized on network topologies that did not participate in training.
Build Students' Research Skills Through Collaborative Real-World Analysis-Based Learning
Authors: Sinensis Arini Rosa , Firdaus Thoha , Saulon Butch O
Published: June 2023

Research skills are one of the skills that need to be built for students to face the challenges of the 21st Century. Therefore, this study aims to build research skills through the Collaborative Real-World Analysis (CReW-A) learning model. This study uses the One-Shot Case Study design. Respondents came from 21 Physics Education students who were grouped into seven research groups. Research skills were observed using a 5-point Likert rating scale observation sheet. Students research skills were analyzed using Rasch modeling, the Wright map technique combined with the Logit Value of Person (LVP). After applying the Collaborative Real World Analysis (CReW-A) learning model for four weeks, students' research skills were well-developed in most research groups. So, the Collaborative Real World Analysis (CReW-A) learning model that has been implemented has been able to build the research skills of physical education students. Therefore, in the future, students can use these skills to innovate to face the challenges of the 21st Century.
Patient safety and clinical negligence: the importance of looking back
Authors: Tingle John
Published: June 2023

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some reports on patient safety and clinical negligence
Olivera Serrano, César (dir.), El Libro de los bienhechores del monasterio de san Benito el Real de Valladolid. Estudio y edición, Madrid, Dykinson, 2021
Authors: Arribas Ramos Lara
Published: June 2023

Reseña del libro: Olivera Serrano, César (dir.), El Libro de los bienhechores del monasterio de san Benito el Real de Valladolid. Estudio y edición, Madrid, Dykinson, 2021.