bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unpacking “Double Reduction” Policy in China: Ideas, Values, and Practices
Authors: Li Jian , He Yunshu 
Published: September 2023

Abstract
Reducing students’ homework burden is to improve the quality and efficiency of school education. The proposal of “double reduction” aims to call for education to return to the essence of educating people, respect the law of education and the law of talent growth, so that students can achieve personalized development while developing in an all-round way. The “double reduction” policy combines the dual value orientation of equitable pursuit and high-quality development. Reducing students’ homework burden and off-campus training burden is the path and basic goal of the “double reduction” policy. It will be a long and challenging process to promote the quality and efficiency of school education, standardize the ecology of off-campus education, and form an effective interaction between them, so that off-campus education can become a good supplement to on-campus education rather than a necessity.
The Russia–Ukraine Crisis Affected Consumer Bullish Market Behaviour Causing Ripple Impressions Across the Global Economy
Authors: Jain Akshat 
Published: September 2023

In this article, we analyse how the crisis that emerged in Europe, specifically in Russia and Ukraine, has severely affected European Bull Market. Because of the political unpredictability and the fallout from the most recent sanctions placed on Russia, the financial markets in Europe have often responded negatively to the current geopolitical crisis. The contribution of the Europe Market is the focus of this article, and it does so by analysing several aspects of their behaviour. At the same time, this article contributes to an investigation into the consequences that the proclamation of war against Ukraine had on the stock markets of European countries, global economy and European economy specifically. In addition, the unfavourable reactions shown in stock prices lasted into the post-event period of time. There is a large range of variance in the degree to which stock values are affected by this crisis across sectors, nations, and the size of the firm. This variance may be seen in a wide range of possible outcomes. In addition to its empirical investigation, the research delves into topics pertaining to the marketing modulation as a future scope. JEL Codes: M31, F01, P36, G01
Facing a dual threat: Pandemic stress and immigration policy vulnerability on mental health among Latinx immigrant parents
Authors: Lemon Emily D , Crookes Danielle M , del Carmen Chacón Liliana , Santiago Carla , Urbina Belisa , Livingston Melvin , Woods-Jaeger Briana 
Published: September 2023

Background: Exclusionary immigration policies rooted in structural racism threaten the wellbeing of Latinx families, increasing stress, anxiety, depression, and distress among immigrant parents. The COVID-19 pandemic has had devastating and disproportionate impacts on communities of color with unique impacts on Latinx immigrant parents in mixed-status families. Aims: From a syndemic theory lens, we explored the convergence of structural racism and the COVID-19 pandemic to explore if the stress of the COVID-19 pandemic may compound harmful immigration-related policies. Methods: Our community-based participatory research cross-sectional study administered 145 surveys among Latinx immigrant parents in mixed-status families in Georgia. We examined the relationship of pandemic stress and perceived statewide immigration policy vulnerability to depressive, anxiety, and PTSD symptoms. We conducted multiple linear regression analyses to test these relationships and their interaction. Results: We found that that greater perceived policy immigration vulnerability and reported pandemic stress were associated with higher symptoms of depression. Increased PTSD symptoms were also associated with immigration policy vulnerability, but not pandemic stress. Tests to assess if pandemic stress strengthened the relationship between policy vulnerability on depressive, anxiety, and PTSD symptoms revealed no statistically significant interactions. Conclusion: Our findings suggest that stress of the COVID-19 pandemic and longstanding anti-immigrant policies in Georgia were salient for and related to the mental health of these Latinx immigrant parents.
Conferone, a coumarin from Ferula flabelliloba, induced toxic effects on adult T-cell leukemia/lymphoma cells
Authors: Rafatpanah Houshang , Golizadeh Marziyeh , Mahdifar Maryam , Mahdavi Shakiba , Iranshahi Mehrdad , Rassouli Fatemeh B 
Published: September 2023

Background Adult T-cell leukemia/lymphoma (ATL) is a lymphoid malignancy caused by HTLV-1 infection, with distinct geographical distribution. Despite advances in cancer treatment, the average survival rate of ATL is low. Conferone is a natural coumarin extracted from Ferula species with a wide range of pharmaceutical effects. In search for a novel chemotherapeutic agent, we investigated the cytotoxicity of conferone on ATL cells. Methods To obtain conferone, the methanolic extract of the roots of F. flabelliloba was subjected to silica gel column chromatography, followed by 1H- and 13C-NMR to confirm its structure. For cytotoxicity assay, MT-2 cells were treated with different concentrations of conferone (2.5, 5, 10, 20, and 40 µM) for 24, 48, and 72 h, and viability was evaluated by a colorimetric assay using alamarBlue. Cell cycle was analyzed by PI staining and flow cytometry, and qPCR was used to study the expression of candidate genes. Results and Conclusion Obtained findings indicated that conferone induced considerable cytotoxic effects on MT-2 cells in a time- and dose-dependent manner. In addition, accumulation of cells in the sub-G1 phase of the cell cycle was detected upon conferone administration. Moreover, conferone reduced the expression of CDK6, c-MYC, CFLIP L, and NF-κB (Rel-A) in MT-2 cells. Accordingly, conferone could be considered as a potent agent against ATL, although complementary investigations are required to define more precisely its mechanism of action.
Role of [68Ga]-pentixafor positron emission tomography/computed tomography imaging in assessing disease activity in patients with lupus nephritis: A pilot study
Authors: Nair Ahalya , Pandit Nandini , Kavadichanda Chengappa 
Published: September 2023

Objective The primary objective of our study was to evaluate renal uptake of 68Ga-pentixafor in patients with lupus nephritis. Eighteen patients who satisfied the inclusion criteria were included in our study. Methods The study participants were patients with histopathologically confirmed lupus nephritis who were referred to our department for 68Ga-pentixafor PET/CT scan. We studied the renal images in these patients for uptake patterns based on purely visual as well as semi-quantitative parameters. The visual parameters included uptake relative to the spleen and liver. Semi-quantitative analysis involved the uptake as given by SUVmax. These parameters were correlated with the patients’ biochemical as well as histological parameters. Kendall’s tau-b test was used to look for an association between renal uptake by visual assessment and histopathological findings. Mean SUVmax values were compared by using the Mann–Whitney U test and a p value < .05 was considered to be statistically significant. Results No significant association between the mean renal SUVmax of the bilateral kidneys in pentixafor PET and histopathological class was observed. We did not observe any heterogeneity in uptake patterns that could be attributed to the disease process in our patients. Conclusion 68Ga-pentixafor PET is not a suitable imaging modality for assessment of disease activity in lupus nephritis patients. There is a void in non-invasive testing for patients with this chronic and often disabling condition which calls for further research in this area.
Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway
Authors: Thy Jonas E , Larsen Marthe , Vigeland Einar , Koch Henrik , Hovda Tone , Hofvind Solveig 
Published: September 2023

Objective Irregular attendance in breast cancer screening has been associated with higher breast cancer mortality compared to regular attendance. Early performance measures of a screening program following regular versus irregular screening attendance have been less studied. We aimed to investigate early performance measures following regular versus irregular screening attendance. Methods We used information from 3,302,396 screening examinations from the Cancer Registry of Norway. Examinations were classified as regular or irregular. Regular was defined as an examination 2 years ± 6 months after the prior examination, and irregular examination >2 years and 6 months after prior examination. Performance measures included recall, biopsy, screen-detected and interval cancer, positive predictive values, and histopathological tumor characteristics. Results Recall rate was 2.4% (72,429/3,070,068) for regular and 3.5% (8217/232,328) for irregular examinations. The biopsy rate was 1.0% (29,197/3,070,068) for regular and 1.7% (3825/232,328) for irregular examinations, while the rate of screen-detected cancers 0.51% (15,664/3,070,068) versus 0.86% (2003/232,328), respectively. The adjusted odds ratio was 1.53 (95% CI: 1.49–1.56) for recall, 1.73 (95% CI: 1.68–1.80) for biopsy, and 1.68 (95% CI: 1.60–1.76) for screen-detected cancer after irregular examinations compared to regular examinations. The proportion of lymph node-positive tumors was 20.1% (2553/12,719) for regular and 25.6% (426/1662) for irregular examinations. Conclusion Irregular attendance was linked to higher rates of recall, needle biopsies, and cancer detection. Cancers detected after irregular examinations had less favorable histopathological tumor characteristics compared to cancers detected after regular examinations. Women should be encouraged to attend screening when invited to avoid delays in diagnosis.
The Activity of Adenosine Deaminase and Dipeptidyl Peptidase IV in Children With Attention Deficit Hyperactivity Disorder
Authors: Naralan Yüksel Sümeyra , Doğan Özlem , Elgün Serenay , Öztop Didem Behice , Kılıç Birim Günay 
Published: September 2023

Objective: In this study, to investigate the place of T cell-mediated immunity in the etiology of ADHD, for which we do not have enough information; we aimed to investigate the activity of DPP IV and ADA, which are T cell-related enzymes, and the relationship of these enzymes with ADHD symptoms in children with ADHD. Methods: Twenty-seven children aged 6 to 12 years with a diagnosis of attention deficit hyperactivity disorder and 27 children aged 6 to 12 years without any psychiatric disease were included in the study. Results: While serum ADA and DPP-IV activity were found to be statistically significantly higher in the group with ADHD. There was no statistically significant correlation between serum ADA and DPP-IV activities and CTRS-R-L and CPRS-R-L in both groups. Conclusion: We think that T cell mediated inflammation may play a role in the etiology of ADHD due to changes in ADA and DPP-IV levels in children.
Changes in the severity of autism symptom domains are related to mental health challenges during middle childhood
Authors: Waizbard-Bartov Einat , Ferrer Emilio , Heath Brianna , Andrews Derek S , Rogers Sally , Kerns Connor M , Wu Nordahl Christine , Solomon Marjorie , Amaral David G 
Published: September 2023

Many autistic children experience changes in core symptom severity across middle childhood, when co-occurring mental health conditions emerge. We evaluated this relationship in 75 autistic children from 6 to 11 years old. Autism symptom severity change was evaluated for total autism symptoms using the autism diagnostic observation schedule calibrated severity score, as well as social-communication symptoms calibrated severity score, and restricted/repetitive behaviors calibrated severity score. Children were grouped based on their symptom severity change patterns. Mental health symptoms (attention-deficit hyperactivity disorder, anxiety, disruptive behavior problems) were assessed via parental interview and questionnaire and compared across the groups. Co-occurring mental health symptoms were more strongly associated with change in social-communication symptom or restricted/repetitive behavior severity than with total autism symptom severity. Two relevant groups were identified. The social-communication symptom-increasing-severity-group (21.3%) had elevated and increasing levels of anxiety, attention-deficit hyperactivity disorder, and disruptive behavior problems compared with children with stable social-communication symptom severity. The restricted/repetitive behavior-decreasing-severity-group (22.7%) had elevated and increasing levels of anxiety; 94% of these children met criteria for an anxiety disorder. Autism symptom severity change during middle childhood is associated with co-occurring mental health symptoms. Children that increase in social-communication symptom severity are also likely to demonstrate greater psychopathology, while decreases in restricted/repetitive behavior severity are associated with higher levels of anxiety. Lay abstract For many autistic children, the severity of their autism symptoms changes during middle childhood. We studied whether these changes are associated with the emergence of other mental health challenges such as anxiety and attention-deficit hyperactivity disorder. Children who had increased social-communication challenges had more anxiety and attention-deficit hyperactivity disorder symptoms and disruptive behavior problems than other children. Children who decreased their restricted and repetitive behaviors, on the contrary, had more anxiety. We discuss why these changes in autism symptoms may lead to increases in other mental health concerns.
The Influence of Aging-Related Decrease in Endothelial Function on the Stiffness of Peripheral Conducting Arteries
Authors: Petrovic Dusan J. 
Published: September 2023

Introduction: The aim of this study is to determine the degree of aging-related decrease in endothelial capacity for endothelium-dependent vasodilatation and its mutual inter-relation with increase in the stiffness of peripheral arteries. Methods: The reactive hyperemia test is useful for noninvasively evaluating the degree of endothelium-dependent vasodilatation. Stiffness index is a parameter used to evaluate vascular tonus and structural changes in the peripheral vasculature. The examination was done on 30 healthy respondents of both sexes and different ages, with no manifested risk factors and/or symptoms of cardiovascular diseases, to evaluate the influence of endothelium-dependent vasodilatation on the brachial artery and the influence of stiffness index on the common carotid artery. Results: With aging, the functional capacity of the endothelium for endothelium-dependent vasodilatation declines, in men as early as in their 20s, and in women more considerably after the age of 50 years. Over the course of aging, a significant stiffness increase was recorded in respondents of both sexes, the correlations being summarized in the following formulas: stiffness index = 0.028 × years of age + 5.0992 in male respondents, and stiffness index = 0.028 × years of age + 5.1991 in female respondents. Conclusion: Decrease in the capacity of peripheral arteries for endothelium-dependent vasodilatation correlates with increase in the stiffness of peripheral arteries.
Catastrophic health expenditure and household impoverishment in Togo
Authors: Sanoussi Yacobou , Zounmenou Alexandre Yedjannavo , Ametoglo Muriel 
Published: September 2023

Background: The main way of financing healthcare in low-income countries continues to be out-of-pocket payments. Despite the efforts of national authorities and international partners to protect households from impoverishment arising from seeking healthcare, the risk of incurring catastrophic healthcare expenses remains very high for households in developing countries. This study aims to analyse catastrophic health expenditures and their effects on household impoverishment in Togo. Design and methods: Data were obtained from the CWIQ survey, a nationally representative survey conducted in 2015 among 2400 households.We calculated the incidence and the intensity of catastrophic health expenditures in Togo through various thresholds and then estimated the effects of these expenditures on the level of households’ impoverishment by determining poverty levels using consumption expenditure before and after making payments for healthcare. Results: The results indicate that the incidence of catastrophic expenditure varies between 6% and 57% depending on the thresholds used. Households at risk of catastrophic expenditure spend between 19% and 64% of their spending on healthcare. Based on total expenditure and above 20%, the richest households are more prone to catastrophic health expenditures. The findings also show that the incidence of impoverishment caused by health expenditure payments is 8.2% in relative terms and 4.52% in absolute terms. In Togo, 4.52% of households are impoverished by catastrophic health expenditures. This impoverishment effect is greater for male-headed households. Conclusions: Health system reforms aiming at accessibility to quality care and the development of pre-payment mechanisms will promote the earlier use of healthcare services and thus reduce the higher healthcare costs generated by later attendance at them.
Osteotomy of the Femoral Lateral Collateral Ligament Insertion for a Tight Lateral Compartment in Complex Arthroscopic Knee Surgery
Authors: Beel Wouter , Papakostas Emmanouil , Getgood Alan 
Published: September 2023

Background: In cases of complex arthroscopic knee surgery in the lateral compartment, such as performing lateral meniscus repair or transplantation, a tight lateral compartment can jeopardize the best possible care and could lead to iatrogenic cartilage injury. This technique shows a way to increase arthroscopic working space in a tight lateral compartment by performing an osteotomy of the femoral insertion of the lateral collateral ligament (LCL), utilizing a novel adjustable loop refixation technique. Indication: The femoral LCL insertion osteotomy can be performed if increased visualization and working space of the lateral compartment are needed during the complex arthroscopic knee surgery. Technique Description: After identification of the LCL femoral insertion, a 2-mm drill is passed through the LCL insertion to prepare for an anatomic reduction. The osteotomy is performed by taking a small bone plug together with the complete LCL insertion. Increased visualization and working space in the lateral compartment are obtained without damaging the intrinsic LCL structure. For reinsertion, the bone plug and proximal LCL is whipstitched with a high-strength suture and fixated to an adjustable loop Ultrabutton. The adjustable loop is shuttled through a predrilled 4.5-mm femoral tunnel and flipped on the medial side. The adjustable button is tensioned in 30° of flexion until the bone plug is anatomically reduced. Results: We present 1 patient who underwent a femoral LCL osteotomy during arthroscopic lateral meniscus allograft transplantation. The osteotomy healed without any issues, and there was no residual LCL laxity; which was confirmed with varus stress radiographs. Discussion/Conclusion: A femoral LCL insertion osteotomy can release a tight lateral compartment without damaging the intrinsic LCL structure. The adjustable loop fixation avoids the use of more traditional screw and washer fixation techniques, which tend to be more prominent and have the potential to back out. An osteotomy is more invasive than the “pie-crusting” technique of the medial collateral ligament for a tight medial compartment. However, it is required due to the poor intrinsic healing capacity of the LCL. Care should be taken to anatomically reduce the bone plug to avoid iatrogenic creation of LCL laxity. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project
Authors: Wollesen Bettina , Schott Nadja , Klotzbier Thomas , Bischoff Laura Luise , Cordes Thomas , Rudisch Julian , Otto Ann-Kathrin , Zwingmann Katharina , Hildebrand Claudia , Joellenbeck Thomas , Vogt Lutz , Schoene Daniel , Weigelt Matthias , Voelcker-Rehage Claudia 
Published: September 2023

Abstract
Background
Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents.

Methods
The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05).

Results
Indices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance.

Discussion and conclusion
Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance.

Trial registration
Trial registration number: DRKS00014957.