bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative study of the bioavailability of Red Sea seagrass, Enhalus acoroides (L.f.) Royle (leaves, roots, and rhizomes) as anticancer and antioxidant with preliminary phytochemical characterization using HPLC, FT-IR, and UPLC-ESI-TOF-MS spectroscopic analysis
Authors: Shaffai Amgad El , Mettwally Walaa S. A. , Mohamed Shimaa I. A. 
Published: April 2023

Abstract
Background
Seagrasses are unique marine flowering plants. Enhalus acoroides (L.f.) Royle (family Hydrocharitaceae), a new record for the Egyptian coast of the Red Sea, was the grass of choice. A comparative study on Enhalus acoroides (L.f.) Royle (leaves, roots and rhizomes) was done to determine the plant organ that shows the highest antiproliferative and antioxidant activities. The total phenolic content was determined using the Folin–Ciocalteu method. The total flavonoid content was estimated by the aluminum chloride assay. Fourier transform infrared (FT-IR) analysis was performed to detect the chemical functional groups in the extract. High-performance liquid chromatography (HPLC) was done for the qualitative and quantitative evaluation of phenolic compounds. UPLC-ESI-TOF–MS was performed for metabolomics profiling of the extract. Antioxidant activity was determined using the DPPH scavenger percentage method. Antiproliferation assay against hepatocellular carcinoma HepG2, human breast cancer cell lines MCF-7, MDA-MB-231 was performed for the three seagrass organs. Mitochondrial membrane potential (ΔΨm) was measured after treatment with three extracts against MCF-7 cell line.

Results
The highest phenolic content is found in the leaves, while roots exhibited the highest DPPH scavenger percentage. The total concentration of phenolic compounds detected by HPLC was leaves > rhizomes > roots. Also leaves exhibit the highest antiproliferative activity and mitochondrial membrane potential depletion effect against MCF-7 cell line tested. UPLC-ESI-TOF–MS metabolite profiling of leaves detected different secondary and primary metabolites to which the activity was retained. Leaves are a new candidate to be used in the treatment of cancer.

Conclusion
Enhalus acoroides (L.f.) Royle leaves extract is a new nutraceutical candidate. Further in-depth studies are required on Enhalus acoroides (L.f.) Royle leaves.

Graphical abstract
Non-inferiority of a hybrid outpatient rehabilitation: a randomized controlled trial (HIRE, DRKS00028770)
Authors: Albers Richard , Lemke Stella , Knapp Sebastian , Krischak Gert , Bethge Matthias 
Published: April 2023

Abstract
Background
Physiotherapeutic telerehabilitation in various musculoskeletal and internal diseases, including back pain, might be comparable to face-to-face rehabilitation or better than non-rehabilitation. In Germany, a standardized back school for patients with chronic back pain is provided in outpatient rehabilitation centers. The effectiveness of this standardized back school was shown in a randomized controlled trial in face-to-face rehabilitation. This study examines non-inferiority of a hybrid rehabilitation applying a digital version of the standardized back school against a rehabilitation applying the face-to-face back school.

Methods/design
We recruit 320 patients in eight German outpatient rehabilitation centers. Patients are randomized equally to the intervention and control groups. Patients aged 18 to 65 years with back pain are included. Patients lacking a suitable private electronic device and German language skills are excluded. Both groups receive the standardized back school as part of the 3-week rehabilitation program. The control group receives the back school conventionally in face-to-face meetings within the outpatient rehabilitation center. The intervention group receives the back school online using a private electronic device. Besides the back school, the patients participate in rehabilitation programs according to the German rehabilitation guideline for patients with chronic back pain. Hence, the term “hybrid” rehabilitation for the intervention group is used. The back school consists of seven modules. We assess data at four time points: start of rehabilitation, end of rehabilitation, 3 months after the end of rehabilitation and, 12 months after the end of rehabilitation. The primary outcome is pain self-efficacy. Secondary outcomes are, amongst others, motivational self-efficacy, cognitive and behavioral pain management, and disorder and treatment knowledge. Guided interviews with patients, physicians, physiotherapists and other health experts supplement our study with qualitative data.

Discussion/aim
Our randomized controlled trial aims to demonstrate non-inferiority of the online back school, compared to conventional implementation of the back school.

Trial registration
German Clinical Trials Register (DRKS00028770, April 05, 2022).
Response rate and factors associated with response in patients with schizophrenia undergoing bilateral electroconvulsive therapy
Authors: Ruangsetakit Chanaichon , Ittasakul Pichai 
Published: April 2023

Background
Schizophrenia is a severe mental illness and a common indication for electroconvulsive therapy (ECT). Research is lacking on the factors that influence response to acute ECT treatment in schizophrenia patients.

Aims
This study examined the response rate and associated factors in patients with schizophrenia undergoing bilateral ECT.

Method
Demographic data, clinical characteristics, ECT data and treatment response were respectively reviewed in patients with schizophrenia undergoing bilateral ECT from January 2013 to June 2022.

Results
Forty-six patients were included. Nine responded after the first three sessions, 17 after six sessions, 20 after nine sessions, 25 after 12 sessions and 28 after the last ECT session, cumulatively. The mean of the baseline Brief Psychiatric Rating Scale psychotic symptom subscale score was significantly higher in responders (17.0) than non-responders (10.9) (P < 0.05). The mean of duration of electroencephalogram seizure was significantly longer in responders (53.9) than in non-responders (42.7). There was no association between demographic and ECT data and treatment response. Among 28 responders, 20 responded to ECT after nine sessions (faster responders) and eight responded later (slower responders). The number of failed antipsychotics prior to ECT was 2.8 for faster responders and 4.4 for slower responders (P = 0.02). Nominal logistic regression showed that the number of failed antipsychotics prior to ECT was associated with speed of response to ECT (P = 0.037, odds ratio = 1.77).

Conclusions
ECT is an effective treatment for schizophrenia and may be influenced by the number of failed antipsychotics prior to ECT.
The role of crinophagy in quality control of the regulated secretory pathway
Authors: Szenci Győző , Csizmadia Tamás , Juhász Gábor 
Published: April 2023

ABSTRACT
In specialized secretory cells that produce and release biologically active substances in a regulated fashion, tight control of both the quantity and quality of secretory material is of paramount importance. During crinophagy, abnormal, excess or obsolete secretory granules directly fuse with lysosomes to yield crinosomes, in which the delivered secretory material is degraded. Crinophagy maintains the proper intracellular pool of secretory granules, and it is enhanced when secretory material accumulates because of compromised secretion. Recent studies highlight that it can even degrade newly formed, nascent secretory granules that shed from the trans-Golgi network. This implies that crinophagy provides a quality control checkpoint acting at the formation of secretory vesicles, and this degradation mechanism might survey secretory granules throughout their maturation. Of note, a plethora of human disorders is associated with defective lysosomal clearance of secretory material via crinophagy or similar pathways, including macro- or micro-autophagic degradation of secretory granules (referred to here as macro- and micro-secretophagy, respectively). In our Review, we summarize key recent advances in this field and discuss potential links with disease.
Sedentary Time Is Independently Related to Adipose Tissue Insulin Resistance in Adults With or at Risk of Type 2 Diabetes
Authors: ENGIN BUKET , WILLIS SCOTT A. , MALAIKAH SUNDUS , SARGEANT JACK A. , BIDDLE GREGORY J. H. , RAZIEH CAMERON , ARGYRIDOU STAVROULA , EDWARDSON CHARLOTTE L. , JELLEYMAN CHARLOTTE , STENSEL DAVID J. , HENSON JOSEPH , ROWLANDS ALEX V. , DAVIES MELANIE J. , YATES THOMAS , KING JAMES A. 
Published: April 2023

ABSTRACT

Introduction
This cross-sectional study examined associations of device-measured sedentary time and moderate-to-vigorous physical activity (MVPA) with adipose tissue insulin resistance in people with or at high risk of type 2 diabetes (T2DM).

Method
Data were combined from six previous experimental studies (within our group) involving patients with T2DM or primary risk factors (median (interquartile range) age, 66.2 (66.0–70.8) yr; body mass index (BMI), 31.1 (28.0–34.4) kg·m−2; 62% male; n = 179). Adipose tissue insulin resistance was calculated as the product of fasted circulating insulin and nonesterified fatty acids (ADIPO-IR), whereas sedentary time and MVPA were determined from wrist-worn accelerometery. Generalized linear models examined associations of sedentary time and MVPA with ADIPO-IR with interaction terms added to explore the moderating influence of ethnicity (White European vs South Asian), BMI, age, and sex.

Results
In finally adjusted models, sedentary time was positively associated with ADIPO-IR, with every 30 min of sedentary time associated with a 1.80-unit (95% confidence interval, 0.51–3.06; P = 0.006) higher ADIPO-IR. This relationship strengthened as BMI increased (β = 3.48 (95% confidence interval, 1.50–5.46), P = 0.005 in the upper BMI tertile (≥33.2 kg·m−2)). MVPA was unrelated to ADIPO-IR. These results were consistent in sensitivity analyses that excluded participants taking statins and/or metformin (n = 126) and when separated into the participants with T2DM (n = 32) and those at high risk (n = 147).

Conclusions
Sedentary time is positively related to adipose tissue insulin sensitivity in people with or at high risk of T2DM. This relationship strengthens as BMI increases and may help explain established relationships between greater sedentary time, ectopic lipid, and hyperglycemia.
Archäozoologische Untersuchung der Tierknochen aus Gruben der spätlatènezeitlichen Siedlung Basel-Gasfabrik, Grabung 1989/5
Authors: Stopp Barbara 
Published: April 2023

Der Beitrag behandelt das Tierknochenmaterial, das aus den 14 Gruben der Grabung 1989/5 stammt. Die stratigraphisch untersuchten Gruben zeigen in erster Linie, wie unterschiedlich in der Zusammensetzung die Schichtpakete einer Grube ausfallen können. Allerdings lässt sich durch diese Unterschiede der Verfüllvorgang der Gruben gut beobachten. Den sechs so analysierten Gruben gemeinsam ist, dass das zuletzt eingebrachte Material immer - und meist auch deutlich - schlechter erhalten ist als dasjenige der unteren Verfüllschichten. Aber auch diese unteren Verfüllungen bilden keine Einheit. Berücksichtigt man alle Untersuchungen, kommt man zu mindestens drei verschiedenen Herkunftsorten für das in die Gruben eingebrachte Material. Dies lässt sich für alle Gruben beobachten, wenn auch nicht immer gleich eindeutig.
Identification of the lipids on an archaeological vessel from Basel-Gasfabrik, a Celtic site on the border of the River Rhine
Authors: Spangenberg Jorge E. 
Published: April 2023

The black carbon (BC) from an archaeological ceramic from the Basel-Gasfabrik site was studied for the isotopic and molecular compositions of the individual fatty acids.
The isotopic composition of the main fatty acids extracted from the organic residue of the Basel-Gasfabrik archaeological ceramicsuggests that the fat(s) used in this vessel were of animal origin (ovine/porcine).
LA REPONSABILIDAD DE CRECER EN EL CONFLICTO
Authors: Useche Acevedo Laura Daniela 
Published: April 2023

Pese al acuerdo sobre la proscripción del reclutamiento de menores, representado principalmente en su carácter de crímen de guerra, no es claro si quienes cumplen la mayoría de edad al interior del grupo armado son sujetos de protección o deben responder ante la justicia penal por los crímenes cometidos, así como el alcance de esta responsabilidad. Al interior de la Corte Penal Internacional la dualidad de criterios se hace evidente cuando, por un lado, se condena únicamente por reclutamiento de menores a Thomas Lubanga, pero a la vez se juzga de manera plena a Dominic Ongwen por los crímenes cometidos siendo mayor de edad sin tener en cuenta su temprano reclutamiento.
De la misma manera, en el escenario colombiano existen posturas a favor y en contra de la responsabilidad, aunque la justicia se ha decantado por una eventual responsabilidad por hechos cometidos durante la minoría de edad pero responsabilidad plena para aquellos perpetrados siendo mayor. Así, la Jurisdicción Especial para la Paz se enfrenta a un escenario en el que deberá conciliar argumentos contradictorios y hacer uso efectivo de sus características únicas con el fin de lograr verdadera justicia para todas las víctimas del conflicto colombiano.
¿Todos los caminos conducen a La Haya? Reflexiones de política criminal tras 17 años de examen preliminar en Colombia
Authors: Martinez Acosta Damaris Eliana 
Published: April 2023

Este ensayo constituye un diagnóstico alrededor de la decisión adoptada por la Fiscalía de la Corte Penal Internacional de cerrar el examen preliminar más extenso de su historia. Así, plantea consideraciones sobre la política criminal de este organismo y las repercusiones y expectativas de tal determinación de acuerdo con el contexto colombiano. Para ello, parte por caracterizar el examen preliminar adelantado por 17 años; luego, valora la incidencia de su cierre; y finalmente, estudia las condiciones actuales de la situación de derechos humanos en Colombia y la capacidad institucional para hacerle frente de cara al papel de la Fiscalía de la Corte. De esta manera identifica las siguientes reflexiones: (i) la necesidad de delimitar las etapas de los exámenes preliminares; (ii) que la decisión de cerrar el examen preliminar en Colombia tuvo (y tendrá) más efectos políticos que prácticos en virtud de la complementariedad positiva; y (iii) los crímenes cometidos luego de la firma del Acuerdo Final de Paz entre el gobierno colombiano y las Fuerzas Armadas Revolucionarias de Colombia – Ejército del Pueblo (FARC-EP) constituyen una preocupación latente a la luz de los fines que persigue el Estatuto de Roma.
Perspectives about social support among unmarried pregnant university students in South Africa
Authors: Msipu Phiri Thandiwe , Nyamaruze Patrick , Akintola Olagoke 
Published: April 2023

Background
Pregnant young women in an academic environment are susceptible to stressors associated with unintended pregnancy and academic demands of universities. The challenges they face may be exacerbated by lack of social support, putting them at risk of psychological disorders such as depression. Women who receive social support during pregnancy and postpartum experience less emotional distress and report greater maternal satisfaction. However, very little is known about the perspectives about social support among unmarried pregnant students in tertiary institutions.

Methods
Participants were purposively selected among unmarried pregnant students and those in the puerperal period at the time of the study. We conducted semi-structured qualitative interviews to explore the perspectives of unmarried pregnant students on the type of support that they need during pregnancy and the puerperium and the period when most support is needed. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis.

Results
The findings show that social supports (emotional, instrumental, informational, and financial) were highlighted as important resources to cope with stressors during pregnancy and post-birth. Emotional support from male partners was the most important type of support needed as it entailed a sense of being loved and cared for. Social support was identified as important throughout the different phases of pregnancy and post birth, with different support needs expressed at each of these phases.

Conclusion
This study identified support needs of unmarried pregnant university students in their transition to motherhood. Given the several challenges that they are faced with, unmarried pregnant students need social support, including male partner support to enhance wellbeing as they try to cope with academic and pregnancy-related stressors.
National cross-sectional study on cost consciousness, cost accuracy, and national medical waste reduction initiative knowledge among pediatric hospitalists in the United States
Authors: Lee Benjamin C. , Hall Matt , Agharokh Ladan , Yu Andrew G. , Parikh Kavita , Shah Samir S. 
Published: April 2023

Background/objective
Despite initiatives to reduce waste and spending, there is a gap in physician knowledge regarding the cost of commonly ordered items. We examined the relationship between pediatric hospitalists’ knowledge of national medical waste reduction initiatives, self-reported level of cost-consciousness (the degree in which cost affects practice), and cost accuracy (how close an estimate is to its hospital cost) at a national level.

Methods
This cross-sectional study used a national, online survey sent to hospitalists at 49 children’s hospitals to assess their knowledge of national medical waste reduction initiatives, self-reported cost consciousness, and cost estimates for commonly ordered laboratory studies, medications, and imaging studies. Actual unit costs for each hospital were obtained from the Pediatric Health Information System (PHIS). Cost accuracy was calculated as the percent difference between each respondent’s estimate and unit costs, using cost-charge ratios (CCR).

Results
The hospitalist response rate was 17.7% (327/1850), representing 40 hospitals. Overall, 33.1% of respondents had no knowledge of national medical waste reduction initiatives and 24.3% had no knowledge of local hospital costs. There was no significant relationship between cost accuracy and knowledge of national medical waste reduction initiatives or high self-reported cost consciousness. Hospitalists with the highest self-reported cost consciousness were the least accurate in estimating costs for commonly ordered laboratory studies, medications, or imaging studies. Respondents overestimated the cost of all items with the largest percent difference with medications. Hospitalists practicing over 15 years had the highest cost accuracy.

Conclusions
A large proportion of pediatric hospitalists lack knowledge on national waste reduction initiatives. Improving the cost-accuracy of pediatric hospitalists may not reduce health care costs as they overestimated many hospital costs. Median unit cost lists could be a resource for educating medical students and residents about health care costs.
Prevalence and associated factors for self-reported symptoms of dry eye among Thai school children during the COVID-19 outbreak
Authors: Tonkerdmongkol Danai , Poyomtip Teera , Poolsanam Chotika , Watcharapalakorn Akarapon , Tawonkasiwattanakun Patarakorn 
Published: April 2023

Purpose
COVID-19 pandemic caused an increase in digital screen time, which seemed to increase the prevalence of dry eye symptoms among the population with abnormally high digital screen usage hours. However, there are no reports of dry eye symptoms in school children with high digital usage hours. Therefore, the present study aimed to assess the prevalence of dry eye symptoms and evaluate the associated factors among school children aged 12 to 18 years during the COVID-19 outbreak.

Methods
Multistage cluster sampling was applied, and six sections of online questionnaires were distributed to selected respondents in November 2021. The odds ratio (OR) with confidence intervals (CIs) for the factors was calculated using binary logistic regression. All statistical significance was determined at p < 0.05.

Results
The findings revealed that 62.5% of 603 students showed symptoms of dry eye (DEQ-5 score ≥ 6). Significant associated factors included being female (adjusted OR (aOR) 1.54; 95% CIs 1.05–2.25), higher-grade student (aOR 1.77; 95% CIs 1.23–2.57), digital screen time use (6 to < 12 hours: aOR 2.00; 95% CIs 1.12–3.57, ≥12 hours: aOR 2.54; 95% CIs 1.39–4.76), and perceived stress (aOR 1.12; 95% CIs 1.08–1.16). The Thai-Perceived Stress Scale-10 scores were positively correlated with the scores on the 5-item dry eye questionnaire (Spearman’s r = 0.38, p-value < 0.01).

Conclusion
A high prevalence of dry eye symptoms might be common among school children during the COVID-19 outbreak. Significant risk factors include being female, being a higher-grade level student, prolonged use of digital screens, and perceived stress. However, contact lens use, smoking, and the most common digital device usage patterns were not found to be contributing factors.
The Funding of The North Atlantic Treaty Organization
Authors: Matthijs Herman 
Published: April 2023

This study examines the financing system of the budgets of the North Atlantic Treaty Organization (N.A.T.O.). The NATO is not a supranational organization, with partly exception of the military coordination by SHAPE, but an intergovernmental organization. So far, it’s the only existing military institution at present worldwide. This 2023 study concerns only the three internal NATO budgets. Therefore, this article is based at the only reference material available, namely the primary budgetary sources of the NATO. It must also be pointed out that NATO does prepare an annual report concerning the political and military situation. But there is no equivalent concerning an overview of its finances and administrative functioning. The aspects to be investigated are as follows:

who is funding the NATO budgets and how?
what happens with the money given to NATO?
how is NATO’s budget prepared and approved?

This article doesn’t treat the military budgets of the member states or the financing of the Parliamentary Assembly of the NATO.