bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Tool for Safety Evaluation and a Combination of Measures for Efficacy Assessment of Cotransplanting Human Allogenic Neuronal Stem Cells and Mesenchymal Stem Cells for the Treatment of Parkinson Disease: Protocol for an Interventional Study
Authors: Jamali Fatima , Aldughmi Mayis , Khasawneh Mohammad W , Dahbour Said , Salameh Alaa A , Awidi Abdalla 
Published: October 2021

Background
Parkinson disease (PD) is a neurodegenerative disorder associated with a broad spectrum of motor and nonmotor symptoms. Any proposed cure needs to address the many aspects of the disease. Stem cell therapy may have potential in this regard as indicated in recent preclinical and clinical studies.

Objective
This protocol aims to examine the safety and therapeutic benefit of human Wharton jelly-derived mesenchymal stem cells (WJ-MScs) and their derivatives, neuronal stem cells (NSCs) in PD.

Methods
This clinical trial is a double-arm, single-blinded, phase I-II interventional study. Participants have been allocated to 1 of 2 groups: one receiving allogeneic WJ-MSCs alone, the other receiving NSCs and WJ-MScs. Participants are being followed-up and assessed over a period of 6 months. To assess safety, an incidence of treatment-emergent adverse events (TEAEs) tool tailored for PD is being used immediately and up to 6 months after treatment. For efficacy assessment, a number of factors are being used, including the gold standard severity test and the Unified Parkinson Disease Rating Scale. In addition, the following standardized assessments for different common symptoms in PD are being included: motor (both subjectively and objectively assessed with wearable sensors), sensory, quality of life and psychological well-being, cognition, and sleep quality. Furthermore, immune-modulatory cytokines and neuronal damage versus regeneration markers in PD, including the neuronal protein linked to PD, α-synuclein, are being monitored.

Results
Ten patients have been enrolled in this study and thus participant recruitment has been completed. The study status is active and beyond the recruiting stage. Study chart implementation, data collection, and analysis are ongoing.

Conclusions
The combination of NSCs and MSCs in PD may be useful for harnessing the best of the immunomodulation and neural repair characteristics of these cell types. The tailored comprehensive and scaled TEAEs and the variety of evaluation tools used enables a comprehensive assessment of this cellular therapy treatment protocol. A consideration of this expanded tool set is important in the design of future clinical studies for PD.

Trial Registration
ClinicalTrials.gov NCT03684122; https://clinicaltrials.gov/ct2/show/NCT03684122

International Registered Report Identifier (IRRID)
DERR1-10.2196/29695
Lo visible, lo invisible y las estrategias
Authors: Pannunzio María Florencia 
Published: October 2021

A partir de un abordaje cualitativo analizaremos las estrategias y las apropiaciones que jóvenes agrupados/as en las organizaciones civiles OAJNU y Techo realizaron de Facebook, Twitter e Instagram durante los años 2016-2017. Se identifica que en los usos constantes adquieren un conocimiento especializado que se vincula a la gestión, la pre-figuración de públicos específicos y las lógicas de publicación que cada una de las redes sociales digitales promueve, entre otros aprendizajes.
Large scale propagation and in vitro weaning for the restoration of Viola palustris to support assisted colonisation of a threatened butterfly
Authors: Kendon Jonathan P. , Novotna Alzbeta , Ramsay Margaret M. , Porter Anne , Sarasan Viswambharan 
Published: October 2021

Abstract
The distribution and abundance of Boloria selene (small pearl-bordered fritillary butterfly, SPBF) declined over recent decades in many parts of the UK. Availability of food plants, especially marsh violet (Viola palustris), for the caterpillars of the SPBF has been identified as one of the major causes of this decline. To achieve augmentation of existing colonies and develop new populations of SPBF large numbers of marsh violet propagules were required specifically to feed the larvae. The main objectives of the study were to produce thousands of good quality marsh violet propagules to restore selected habitats in the Heart of Durham, Northern England, using in vitro methods. Preliminary trials showed that in vitro multiplication of seedlings from wild collected seeds through conventional agar-based cultures was lengthy, expensive and turned out to be a non-viable route to achieve the objectives. This study explored the potential of bioreactor-based cloning and cost-effective one step rooting and weaning. Robust propagules, ready for transplantation following rapid propagation and one step rooting and weaning in vitro, were raised in a plug system for transplantation and establishment under field conditions. This was achieved by using simple and cost-effective methods to support the large-scale restoration exercise using 14,000 propagules. Application of high throughput micropropagation and low cost one step weaning systems for time-bound conservation and restoration projects are discussed in detail. This research highlights the important role of in vitro methods to support integrated biodiversity conservation of a native larval host plant and threatened butterfly.
Ppt IMD dan Asi ekslusif
Authors: Hardiyanti Primitasari 
Published: October 2021

Inisiasi Menyusui Dini ( IMD) adalah perilaku pencarian punting payudara ibu sesaatsetelah lahir. Hal ini sangat dibutuhkan, karena bayi setelah lahir langsung mendapatasupan gizi dari ASI. Pemberian ASI secara dini juga sangat bermanfaat bagiibu,terutama untuk merangsangkelancaran ASI. Program IMD merupakan programpendukung dari pemberian ASI Eksklusif pada bayi. IMD banyak memberikan manfaat bagi bayi di antaranya menurunkan angka kematianbayi karena hipotermi, mendapatkan antibodi dari kolostrum, menelan bakteri amanyang berkoloni di usus menyaingi bakteri patogen, membuat kadar glukosa bayi lebihbaik setelah beberapa jam setelah persalinan dan menurunkan intensitas ikterus karenapengeluaran mekonium yang lebih dini.Pemberian ASI secara eksklusif menurutDepKes (2003)Adalah pemberian ASI saja kepada bayi Tanpa di beri makanan dan Minuman lainSejak dari lahir sampai usia 6 bulan, kecuali pemberian obat dan vitamin.Pemberian ASI eksklusif dapat dipengaruhi oleh beberapa faktor,antara lain yaitu; 1. faktor pemudah (predisposingfactors), yang mencakup pendidikan,pengetahuan, nilai-nilai adat atau budaya. 2. Faktor pendukung (enablingfactor), yang mencakup Pendapatan keluarga,ketersediaan3. waktu, dan kesehatan ibu. Faktor pendorong (reinforcementfactor), faktorfaktor ini meliputi dukungan keluarga danDukungan petugas kesehatan.
Ecología política y gestión del agua en territorios rurales
Authors: Soares Denise 
Published: October 2021

English abstract: The article approaches community water management in the rural town of El Mirador, Puebla, Mexico, from the political ecology perspective. To answer the question of how community water committees face the challenges of water management at the local level, we combine quantitative and qualitative methodologies. The results indicate that community households face lack of access to water, and the community committee manages the water from normative, technical, ecological and symbolic spheres, without having technical or financial support from the municipality, acting autonomously. We conclude that the norms established for the management of the resource of common use are consensual, which has fostered both sustainability in the use of water and the strengthening of community ties.Spanish abstract: Este artículo aborda la gestión comunitaria del agua en la localidad rural El Mirador, Puebla, México, desde la perspectiva de la ecología política. Para contestar la pregunta: ¿cómo los comités comunitarios enfrentan los retos de la gestión del agua a nivel local? combinamos metodología cuantitativa y cualitativa, dado que una permite generalizar y otra profundizar relaciones. Los resultados indican que los hogares de la comunidad enfrentan la carencia de acceso al agua y el comité comunitario gestiona el líquido desde ámbitos normativos, técnicos, ecológicos y simbólicos, sin contar con el apoyo del municipio. Concluimos que las normas establecidas para el manejo del recurso de uso común son consensuadas, lo cual ha propiciado tanto sostenibilidad en el uso del agua como el fortalecimiento de lazos comunitarios.French abstract: Cet article évoque la gestion de l’eau dans la communauté rurale d’El Mirador, au Mexique, abordée dans une perspective d’écologie politique. Il répond à la question suivante : comment les comités communautaires font-ils face aux défi s locaux de la gestion de l’eau? Nous combinons les méthodologies quantitative et qualitative, l’une nous permettant de généraliser et l’autre, d’approfondir les relations. Les résultats indiquent que les familles assument le défaut d’accès à l’eau et que le comité communautaire gère les aspects normatifs, techniques, écologiques et symboliques, sans soutien de la municipalité. Nous concluons que les normes établies autour de la gestion de l’eau sont consensuelles, ce qui a favorisé la durabilité dans l’utilisation de l’eau et le renforcement des liens communautaires.
Legal Aspects of the Social Regulator of Contractual Relations in Labor Law of Ukraine
Authors: Голопич Т. П. , Голопич І. М. 
Published: October 2021

Legal aspects of the social regulator of contractual relations in labor law of Ukraine have been revealed. The concept of social partnership and social dialogue as a legal regulatory mechanism of collective relations has been studied. Legal regulation of labor conditions at different levels, through agreements, reflecting the will and interests of the parties to the agreement, has been analyzed.
It has been found out that the personal nature of work, the definition of the specific labor function, duration of working time, remuneration of labor, etc., shall be reflected in a contractual relationship, which requires new forms of relationship between a state, an employer and an employee. Such new forms are acts of social partnership representing the interests of employees, employers, and the state in general. Special attention in this process has been paid to the collective agreement, wherein the interests of the labor collective and the employer are reconciled. The significance of the collective agreement is enhanced in the context of the market economy transformation and the development of new forms of management.
Based on international experience it has been proved that problems of economic and public life are addressed optimally, if the orientation is implemented not towards the confrontation, but towards the achievement of social compliance, adjustment of social partnership on the principles of cooperation between employers and employees, which are realized in forms of negotiations, the conclusion of collective agreements and collective arrangements, coordination of draft regulatory and legislative acts and consultation in decision-making by social partners at all levels.
It has been defined that social partnership is implemented by means of social dialogue, as a set of coordination procedures of interests of association of employees, employers and the state. Social dialogue helps to provide social harmony and stability in the society, it addresses diverse social and economic problems; it is the universal mean of collective relations for each country, it takes into account its traditions and particularities, and it is based on the significant practical experience of real cooperation.
Post-ST-Segment Elevation Myocardial Infarction Follow-Up Care During the COVID-19 Pandemic and the Possible Benefit of Telemedicine: An Observational Study
Authors: Zhang Audrey A. Y. , Chew Nicholas W. S. , Ng Cheng Han , Phua Kailun , Aye Yin Nwe , Mai Aaron , Kong Gwyneth , Saw Kalyar , Wong Raymond C. C. , Kong William K. F. , Poh Kian-Keong , Chan Koo-Hui , Low Adrian Fatt-Hoe , Lee Chi-Hang , Chan Mark Yan-Yee , Chai Ping , Yip James , Yeo Tiong-Cheng , Tan Huay-Cheem , Loh Poay-Huan 
Published: October 2021

Background: Infectious control measures during the COVID-19 pandemic have led to the propensity toward telemedicine. This study examined the impact of telemedicine during the pandemic on the long-term outcomes of ST-segment elevation myocardial infarction (STEMI) patients.Methods: This study included 288 patients admitted 1 year before the pandemic (October 2018–December 2018) and during the pandemic (January 2020–March 2020) eras, and survived their index STEMI admission. The follow-up period was 1 year. One-year primary safety endpoint was all-cause mortality. Secondary safety endpoints were cardiac readmissions for unplanned revascularisation, non-fatal myocardial infarction, heart failure, arrythmia, unstable angina. Major adverse cardiovascular events (MACE) was defined as the composite outcome of each individual safety endpoint.Results: Despite unfavorable in-hospital outcomes among patients admitted during the pandemic compared to pre-pandemic era, both groups had similar 1-year all-cause mortality (11.2 vs. 8.5%, respectively, p = 0.454) but higher cardiac-related (14.1 vs. 5.1%, p &lt; 0.001) and heart failure readmissions in the pandemic vs. pre-pandemic groups (7.1 vs. 1.7%, p = 0.037). Follow-up was more frequently conducted via teleconsultations (1.2 vs. 0.2 per patient/year, p = 0.001), with reduction in physical consultations (2.1 vs. 2.6 per patient/year, p = 0.043), during the pandemic vs. pre-pandemic era. Majority achieved guideline-directed medical therapy (GDMT) during pandemic vs. pre-pandemic era (75.9 vs. 61.6%, p = 0.010). Multivariable Cox regression demonstrated achieving medication target doses (HR 0.387, 95% CI 0.164–0.915, p = 0.031) and GDMT (HR 0.271, 95% CI 0.134–0.548, p &lt; 0.001) were independent predictors of lower 1-year MACE after adjustment.Conclusion: The pandemic has led to the wider application of teleconsultation, with increased adherence to GDMT, enhanced medication target dosing. Achieving GDMT was associated with favorable long-term prognosis.
A Review on the Therapeutic Role of TKIs in Case of CML in Combination With Epigenetic Drugs
Authors: Amir Mohd , Javed Saleem 
Published: October 2021

Chronic myeloid leukemia is a malignancy of bone marrow that affects white blood cells. There is strong evidence that disease progression, treatment responses, and overall clinical outcomes of CML patients are influenced by the accumulation of other genetic and epigenetic abnormalities, rather than only the BCR/ABL1 oncoprotein. Both genetic and epigenetic factors influence the efficacy of CML treatment strategies. Targeted medicines known as tyrosine-kinase inhibitors have dramatically improved long-term survival rates in CML patients during the previous 2 decades. When compared to earlier chemotherapy treatments, these drugs have revolutionized CML treatment and allowed most people to live longer lives. Although epigenetic inhibitors’ activity is disrupted in many cancers, including CML, but when combined with TKI, they may offer potential therapeutic strategies for the treatment of CML cells. The epigenetics of tyrosine kinase inhibitors and resistance to them is being studied, with a particular focus on imatinib, which is used to treat CML. In addition, the use of epigenetic drugs in conjunction with TKIs has been discussed. Resistance to TKIs is still a problem in curing the disease, necessitating the development of new therapies. This study focused on epigenetic pathways involved in CML pathogenesis and tumor cell resistance to TKIs, both of which contribute to leukemic clone breakout and proliferation.
Safflower Polysaccharide Inhibits AOM/DSS-Induced Mice Colorectal Cancer Through the Regulation of Macrophage Polarization
Authors: Wang Qun , Huang Yun , Jia Min , Lu Dong , Zhang Hong-Wei , Huang Dan , Liu San-Hong , Lv Chao 
Published: October 2021

Safflower polysaccharide (SPS) is one of the active fractions extracted from safflower petals (Carthamus tinctorius L.) which has been reported to possess antitumor and immune control roles. However, its antitumor mechanisms by regulating the immune pathway remain barely understood. In this study, a mouse model was established by azoxymethane (AOM)/dextran sodium sulfate (DSS) to evaluate the antitumor effect of SPS on colorectal cancer (CRC). The results showed that 50 mg/kg SPS-1, an active fraction isolated from SPS, could significantly inhibit CRC induced by AOM/DSS and changed the polarization of macrophages to the M1 phenotype. Meanwhile, SPS-1 treatment significantly alleviated the characteristic AOM/DSS-induced pathological symptoms, in terms of decreasing the nucleoplasmic ratio, nuclear polarity extinction, and gland hyperplasia. However, the results in vitro showed that SPS-1 did not directly inhibit the growth of CRC cells but could upregulate the NF-κB signal and trigger M1 macrophage transformation. Thus, the condition medium (CM) of Mφ pretreated with SPS-1 was used against CRC cells. As expected, SPS-1–activated Raw 264.7 markedly exhibited antitumor effects by inhibiting cell proliferation and suppressing cell colony formation. In addition, SPS-1–activated Raw 264.7 could also induce CRC cell apoptosis by upregulating the levels of tumor necrosis factor-α (TNF-α) and nitric oxide (NO). Further results suggested that SPS-1–induced transition of the macrophage phenotype could be suppressed by an NF-κB inhibitor, PDTC. Moreover, SPS-1–activated Raw 264.7 inhibiting CRC cell proliferation and inducing apoptosis were also rescued by PDTC. Taken together, all results suggested that SPS-1 could be a therapeutic option for the prevention and treatment of CRC.
Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020
Authors: Grigoroglou Christos , Walshe Kieran , Kontopantelis Evangelos , Ferguson Jane , Stringer Gemma , Ashcroft Darren M , Allen Thomas 
Published: October 2021

BackgroundNumbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse.AimTo identify characteristics, geographical patterns, and drivers of GP locum use.Design and settingObservational study of routine data from general practices in England.MethodDescriptive analyses of national GP workforce data between December 2017 and September 2020 were conducted to determine the volume and geographical distribution of locum use and examine the characteristics of locums compared with other GP types. Locum full-time equivalent (FTE) was modelled using negative binomial regression and estimated incidence rate ratios (IRRs) for associations between outcome and characteristics of practices and population.ResultsIn December 2019, total locum FTE was 1217.9 compared with 33 996.6 for total GP FTE. Locums represented 3.3% of total GP FTE, which was fewer than other GP types. Median locum age was 42 years (interquartile range [IQR] 36 to 51) FTE and the majority were UK qualified (660 of 1034 [63.8%] total locum FTE), were male (642.6 of 1178.9 [54.5%] total locum FTE), and had long-term employment (834.1 of 1127.9 [74.0%]) total locum FTE. Rurality (IRR 1.250 [95% CI = 1.095 to 1.428]), inadequate Care Quality Commission ratings (IRR 2.108 [95% CI = 1.370 to 3.246), and single-handed practice (IRR 4.611 [95% CI = 4.101 to 5.184) were strong predictors of locum use. There was substantial variation in locum use between regions.ConclusionGP locum use remained stable over time. Compared with other GPs, locums were younger male GPs, a substantial percentage of whom did not qualify in the UK, and those who served underperforming practices in rural areas. This is likely to reflect recruitment or high turnover challenges in these practices/areas and can provide a greater understanding of general practice workforce challenges in England.
Role of locum GPs in antibiotic prescribing and stewardship: a mixed-methods study
Authors: Borek Aleksandra J , Pouwels Koen B , van Hecke Oliver , Robotham Julie V , Butler Christopher C , Tonkin-Crine Sarah 
Published: October 2021

BackgroundMost antibiotics are prescribed in primary care. Locum or sessional GPs (locums) are perceived as contributing to higher prescribing and may face barriers to engaging with antimicrobial stewardship (AMS).AimTo identify how locums’ antibiotic prescribing compares with other general practice prescribers, and how they perceive their role in antibiotic prescribing and AMS.Design and settingMixed-methods study in primary care.MethodData on antibiotic prescribing, diagnoses, and patient and prescriber characteristics were extracted from The Health Improvement Network database. A mixed-effects logistic model was used to compare locums’ and other prescribers’ antibiotic prescribing for conditions that do not usually benefit from antibiotics. Nineteen semi-structured telephone interviews were conducted with locums in England and analysed thematically.ResultsLocums accounted for 11% of consultations analysed. They prescribed antibiotics more often than other GPs and nurse prescribers for acute cough, sore throat, asthma and chronic obstructive pulmonary disease exacerbations, and acute bronchitis. The number of patients receiving antibiotics for these conditions was 4% higher (on absolute scale) when consulting with locums compared with when they consulted with other GPs. Four themes capture the perceived influences on prescribing antibiotics and AMS: antibiotic prescribing as a complex but individual issue, nature and patterns of locum work, relationships between practices and locums, and professional isolation.ConclusionLocums contribute to higher antibiotic prescribing compared with their peers. They experience challenges but also opportunities for contributing to AMS, which should be better addressed. With an increasing proportion of locums in general practice, they have an important role in antibiotic optimisation and AMS.
Pregnancy, Childbirth and Puerperium Health Problems in Women Over 35 Years of Age
Authors: Kiersnowska Iwona , Sys Dorota , Baranowska Barbara , Bączek Grażyna , Węgrzyn Piotr 
Published: October 2021

Background: Due to the choice of postponing motherhood, the average age of women giving birth in Poland has moved into older age groups. This study was conducted to assess pregnancy complications and birth outcomes in women of advanced maternal age (AMA, over 35 years of age) compared with women aged 35 years.
Material and Methods: Data on births was obtained from two third-degree hospitals in Warsaw, Poland for the years 2017 – 2019. Maternal and perinatal outcomes for women of advanced maternal age (n = 3,766) were analyzed using Chi-square tests and the ANOVA Kruskal-Wallis test. Comparisons between the following age groups of women were conducted: age 35 (control group), 36 – 39, 40 – 44 and over 45 years of age. Results of the analysis are presented with unadjusted odds ratios, 95 percent confidence intervals and p-values.
Results: The incidence of pregnancy-induced hypertension (PIH) was found to increase with age in the 36 – 39 (OR 1.76, CI 1.09 – 2.87), 40 – 44 (OR 2.72, CI 1.56 – 4.73) and in the over 45 (OR 6.34, CI 2.04 – 19.69) age groups. The risk of gestational diabetes was seen to increase in women aged 40 – 44 (OR 1.49, CI 1.13 – 1.97) and increases almost three times in women over the age of 45 (OR 2.88, CI 1.41 – 5.87). The frequency of births by Cesarean section was observed to increase by one quarter in the 36 – 39 age group (OR 1.26, CI 1.07 – 1.48), by half in the 40 – 44 age group (OR 1.5, CI 1.28 – 1.96) and almost three times in women over 45 (OR 2.88, CI 1.41 – 5.87). There was no statistical significance for the incidence of preterm delivery, induction of labor and postpartum anemia or the health status of newborns in the studied age groups.
Conclusions: Maternal age of over 35 years old is an independent risk factor for higher rates of pregnancy and perinatal complications in the Polish population.