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This July 2022 issue of the JME contains several articles https://www.kraenzle.com/levitra-cost/ addressing ethical issues related to erectile dysfunction treatment as well as reproductive ethics—a buy discount levitra timely topic, given the leaked U.S. Supreme Court document, anticipating the overturn of Roe v. Wade.On the erectile dysfunction treatment front, original articles in this issue include an analysis of ethical issues related to sharing research samples and data between low/middle-income countries and high-income countries,1 a retrospective analysis of European scientific societies’ triage policies early in the levitra,2 an assessment of the fairness of the allocation framework used by the WHO for their erectile dysfunction treatments Global Access Facility (COVAX),3 balancing physicians’ freedom to express opinions on medical matters with public interest when they run contrary to each other,4 and a survey of Americans’ views on race-based and place-based erectile dysfunction treatment prioritisation.5 The articles include a mix of looking back and looking forward.On buy discount levitra the reproductive ethics front, articles include an analysis of when the government is justified in coercing parents and the implications for abortion,6 and a Feature Article on the ethics of assisted gestative technologies7 —along with many insightful commentaries on that topic.Some of the main arguments that the reader will find in this issue include:That ethical considerations in biobanking (sample collection, storage, sharing) during public health emergencies like the erectile dysfunction treatment levitra ought to include respect for research subjections, promoting the common good, solidary, benefit sharing, and reciprocity.

A review of research ethics guidance and regulatory requirements is required to ensure that they reflect these considerations.1That the European Union (EU) ought to provide criteria for resource allocation within its member states in the management of a levitra. A review of policies found that buy discount levitra Italian and Spanish medical societies both prioritised greater probability of survival and better prognosis/longer life-years, whereas Swiss and German medical societies advocated for preservation of as many lives as possible.2That in principle, fair global allocation of treatments would involve distributing doses to those whose need is greatest (a targeted approach), but this approach would fail to account for the self-interested nature of states, making it unlikely that they would participate in COVAX, resulting in its collapse. Thus, an equal distribution approach averts more deaths than a targeted approach.3That when physicians engage in “citizen speech” (speech relating to broad matters in healthcare and public policy), they deserve the greatest level of protection of free speech.

€œPhysician speech” (when a physician, acting on the authority of her position, offers specific medical buy discount levitra guidance to the public) should be subject to a greater degree of regulation, however. €œClinical speech” or “professional speech” ought to be significantly regulated to align with professional standards of care.4That policy makers might consider public acceptability views related to erectile dysfunction treatment resource allocation. A U.S.

Based survey found that a little over 50% of people supported place prioritisation in allocation of erectile dysfunction treatments (prioritising zip codes that have been hit harder by erectile dysfunction treatment) and about 40% supported race-based prioritisation (prioritising Black, Indigenous, and Hispanic populations because they have been hit harder by erectile dysfunction treatment).5That since it is permissible for the government to coerce mothers into feeding their infants (when a transfer is not possible), there is a good reason to think that the state should coerce women into not having an abortion—that abortion should be illegal if the fetus is a person.6And finally, that the field ought to use and develop the conceptual category of “assisted gestative technologies” (eg, uterine transplants, artificial wombs) since that these technologies raise distinct ethical, legal and social issues from those related to assisted conception.7There is much to absorb and think about in buy discount levitra this issue of JME—readers will appreciate the range of issues discussed. Perennial issues in medical ethics continue to warrant further discussion as well as future issues as science and medical technology develops. And ethicists continue to think critically about how to handle the erectile dysfunction treatment levitra as buy discount levitra well as future ones.

This issue illustrates the broad and encompassing way that bioethicists engage with the most critical ethical issues of today and tomorrow.Ethics statementsPatient consent for publicationNot applicable.Ethics approvalNot applicable.Conflict over the right of the state and professional bodies to regulate the speech of physicians whose views defy societal norms or consensus standards of care dates back centuries to controversies surrounding complementary remedies, patent medicines and contraceptives.1–4 Since the World War II, the US Food and Drug Administration has targeted purveyors of ineffective treatments, such as orgone and laetrile, while the authorities have largely turned a blind eye to those physicians who advocate against public health measures such as vaccination.5 6 American law has carved out a wide berth for dissenting views, a safe harbour known as the respectable minority doctrine.7 Until recently, it was unheard of for a provider to be disciplined for setting a poor example for patients through personal lifestyle choices, such as by smoking cigarettes in front of a hospital.8 While leading ethicists including Arthur Caplan have called for the revocation of the licenses of physicians who oppose childhood vaccination, in the highest profile American case to date, that of prominent treatment sceptic Jack Wolfson, the Arizona Board of Osteopathic Examiners in Medicine and Surgery refused to take action on the grounds that the controversial cardiologist had a right to ‘express his opinion’.9 10 However, the erectile dysfunction treatment levitra has drawn renewed attention to the rights of physicians to express views and engage in conduct that runs contrary to the expertise of the medical establishment. For example, the Oregon Medical Board suspended the license of physician Steven LaTulippe for refusing to buy discount levitra wear a mask and warning his patients that doing so was ‘very dangerous’, while an oncology nurse in that state, Ashley Grames, was placed on administrative leave, and later consented to stop practising nursing entirely, for not physically distancing or wearing a mask outside of work.11 12 Yet physicians touting debunked cures for erectile dysfunction treatment (eg, hydroxychloroquine) or claiming that the levitra is a ‘manufactured crisis’ continue to speak out in the USA without sanction—although with increasing professional and public backlash.13 Meanwhile in Italy, the Rome Doctors Guild announced that it had warned or suspended 10 physicians ‘accused of unwarranted criticism of vaccinations’.14 15 The challenging issue of physician dissent has become only more fraught in the high-stakes context of a global levitra that has already claimed millions of lives.Law and ethics surrounding the freedom of expression of dissenting physicians has evolved piecemeal as contentious cases have arisen. Opinion 8.12 of the American Medical Association’s Code of Ethics imposes on physicians an obligation to ensure that all of the information they provide to the public is ‘accurate’ and ‘based on valid scientific evidence and insight gained from professional experience’, while many state regulations remain unclear on the subject.16 Nevertheless, authorities have increasingly turned to a bifurcated model of regulation that distinguishes between speech that occurs in the clinical context and that which occurs outside the medical setting.

The ‘professional speech doctrine’ takes the approach that while physicians deserve the same right to expression as other individuals outside their clinical work—such as when writing pamphlets or speaking in the public square—their speech may be curtailed substantially during encounters with patients.17 18 This doctrine essentially classifies direct patient counselling as a form of professional conduct as distinguished from traditionally protected categories of speech. American courts of appeals have used that distinction in addressing state bans on gay conversion therapy, Florida’s restriction on physician inquiries related to firearms and California’s requirement that anti-abortion crisis pregnancy centres postwarnings that ‘free or low-cost’ abortions are available elsewhere.19–21 Unfortunately, the approach buy discount levitra affords no middle ground. Yet the erectile dysfunction treatment levitra has shed light on a swath of speech that is not directed at individual patients in the examination room or surgery, yet nonetheless offers specific medical advice to the public that differs substantially from merely expressing general ideas on healthcare, medicine and policy.

This paper briefly reviews the competing values at stake with regard to physician expression and then proposes a three-tiered approach for analysing and regulating such expression.The debate buy discount levitra over restricting physician speechBroad protections for the free speech rights of physicians can be justified on numerous public policy grounds. Free expression increases the likelihood that providers will contribute to the marketplace of ideas, and today’s dissenting views may prove tomorrow’s innovations and future generations’ orthodoxies. From Mendel and Semmelweis to buy discount levitra the work of Barry Marshall and Robin Warren linking Helicobacter pylori to peptic ulcers, scientific breakthroughs have often been met with scepticism and hostility.

Of course, many wrong ideas will have to be permitted in the proverbial marketplace if the best ideas are to gain traction. Prohibiting physician dissent runs the risk of suppressing such ideas and driving potential innovators from the field entirely. A sceptic of the medical consensus might choose a career in academic science or industry, fearing regulation of his/her ideas buy discount levitra by overzealous medical boards.

Moreover, the blades of censorship and censure, once unsheathed, can be used to slice haphazardly through public discourse. Advocating for racial equality, female suffrage, gay rights, family planning, sex education, drug legalisation and aid-in-dying have all proven anathema to some buy discount levitra medical critics in the past—and once speech can be limited, history shows that authorities will use that ability to challenge views they oppose. Beyond the policy considerations, physicians may also assert a fundamental right to expression.

Why should one give buy discount levitra up one’s right to voice one’s opinions after receiving a medical degree any more than when becoming licensed as a barber or a plumber?. Yet some fundamental differences distinguish restrictions on the speech of medical professionals from those of ordinary citizens. In most Western nations, physicians in essence operate as part of a buy discount levitra guild.

Their numbers are fixed by the government or professional bodies in order to regulate quality and increase reimbursement.22 In the USA, for instance, anyone with the skill and training can pay a fee to become a barber. In contrast, residency positions are limited like taxicab medallions or liquor licenses or radio frequencies, and—with rare exceptions—such training is required for licensure.23 Many European nations are even more restrictive in their access to opportunities to practice medicine.24 As such, once an individual accepts the privilege of becoming a physician, it does not seem unreasonable to ask that individual to accept additional responsibilities. One of these buy discount levitra burdens might arguably be limits on speech and conduct that significantly compromises the public’s health.

State regulations and professional standards already impose such duties in other areas through ‘role morality’25. Barbers are welcome buy discount levitra to have romantic relationships with their clients, but physicians who have sex with patients are usually subject to discipline. In many nations, certain other professionals are already limited in their right to express themselves based on the nature of their work.

For example, in many jurisdictions, judges are prohibited from making statements that might call the impartiality of the buy discount levitra courts into question. In the USA, the Hatch Act prevents many government employees from engaging in a range of political endeavours that implicate free speech.26 In addition, the training and expertise that physicians receive increases the likelihood that laypersons will rely on their statements. As a result, one might argue, they have a higher burden to maintain the accuracy of their statements than do private citizens.

Similarly, in buy discount levitra practising medicine, physicians inevitably become role models in matters of health and safety. Needless to say, a clear conflict exists here between this responsibility and private liberty. For instance, buy discount levitra it is hard to imagine a state medical board requiring doctors to eat healthily or forgo tobacco.

The question remains whether certain conduct exists that is legal yet so extreme as to justify official sanction.27The American courts have historically distinguished speech from conduct, protecting the former far more extensively than the latter.28 This distinction proves reasonably effective when applied to altercations in bars, or distinguishing between academics discussing the hypothetical overthrow of the government from militants attempting revolution. In the medical context, this buy discount levitra division proves much less useful. The regulation of certain forms of conduct, such as the wearing of masks, is certainly reasonable.

However, both telling patients not to wear masks and lobbying the legislature against mask mandates are both speech, yet forms of speech fundamentally different in kind. An approach that buy discount levitra transcends the traditional speech-conduct distinction is necessary.A three-tiered frameworkThis paper proposes a three-tiered framework for assessing and regulating the expression of physicians. Speech/Conduct in the first tier (‘citizen speech’), which relates broadly to matters of healthcare and public policy, deserves the greatest level of protection.

Speech/Conduct in the second tier (‘physician speech’) involves situations in which a physician, acting on the authority buy discount levitra of his/her position, offers specific medical guidance to the public. This speech, as discussed below, should be subject to a greater degree of regulation. Finally, speech/conduct in the third tier (‘clinical buy discount levitra speech’), which is closely related to the concept of ‘professional speech’, should be subject to significant regulation with regard to the standards of care of the profession.

Each of these three tiers of speech is discussed in more detail below.Tier 1. Citizen speechThe justification for regulating physician speech is at its weakest when the physician is speaking as an ordinary citizen. Such speech might be on a political buy discount levitra or social topic entirely unrelated to medicine, or it might be on a medically related matter in which the physician is speaking as an advocate for policy change.

Whether the physician agrees with the consensus opinion of the medical establishment or not is irrelevant. Such an approach would protect those physicians who support expanding access to healthcare and those who oppose doing so, providers who want antiracism measures imposed and those who do not consider antiracism a priority, those who support lockdowns to control buy discount levitra the erectile dysfunction levitra and even those who oppose such measures. These ideas, whether wise or foolish, are best contested in the marketplace, not before professional regulators.

Permitting such debate increases the likelihood of innovation and progress, and suppressing such debate runs the risk of tarnishing the credibility of the profession, especially if one buy discount levitra of these suppressed ideas proves true. In fact, citizen speech of this sort likely requires more protection in the medical profession than currently exists. The structure of buy discount levitra academic medicine in the USA, for instance, sees most clinical faculty holding joint appointments at both medical schools and hospitals.

The latter provide a large percentage of their financial support. Even with assurances of academic freedom and tenure from their medical schools, these faculty are constrained in their ability to speak on matters of public policy by fear of termination by their hospitals. Physicians have allegedly faced discipline for criticising their home institutions on a wide range of issues from diversity buy discount levitra to levitra preparedness.29 30 Political pressure from social activists on both the political right and left (so-called ‘cancel culture’), augmented by the rise of social media, also suppresses citizen speech by physicians.

Sometimes universities and medical schools are complicit in this suppression. For example, the University of Pennsylvania’s Perelman School of Medicine issued a statement disavowing former associate dean buy discount levitra of curriculum Stanley Goldfarb’s controversial Wall Street Journal column opposing the rise of social justice-related curricula in medical education.31 Whatever the merits of Goldfarb’s arguments—and this author does not happen to agree with them—danger lies in universities distancing themselves publicly from the controversial ideas of their own faculty. In public discourse, the right to be wrong without fear of reprisal is essential for intellectual progress.Tier 2.

Physician speechIn some circumstances, doctors will address the general public on specific buy discount levitra medical matters that implicate care choices. While no individual doctor-patient relationship exists under the circumstances, this situation is fundamentally different from that of a physician speaking broadly on a matter of public concern. Laypeople are likely to rely on such statements and to act accordingly, often at the expense of their own health.

That is not to say that all opinions offered to the public by physicians should buy discount levitra be more heavily regulated merely because members of the public might rely on them. Rather, citizen speech only becomes physician speech when it is presented as factual. So a physician is buy discount levitra well within his/her rights as a citizen to discourage the public from accepting the measles, mumps and rubella (MMR)-II treatment because it was originally derived from fetal tissue and he views its use as morally objectionable.32 The public can recognise that the physician is offering an opinion based on his/her own personal values and can weigh the recommendation through their own ethical lens.

In contrast, the state should be permitted to regulate more strictly a physician who urges the public not to accept the MMR-II treatment because it causes autism, which numerous studies have shown to be empirically false, or because it does not work.33An analogy might be drawn to a civil engineer commenting on bridge safety. If the engineer declares on television that suspension buy discount levitra bridges are safe, and a particular bridge fails, that is analogous to citizen speech and does not merit sanction. In contrast, most people would agree that if an engineer meets a driver on a road during a storm and declares that the bridge up ahead is not washed out, while in fact he knows that it is, his conduct clearly merits punishment.

Physician speech is analogous to the engineer going on television and announcing the bridge is not washed out—when, in fact, it is. Merely because the advice is offered buy discount levitra collectively, rather than individually, does not absolve the speaker from responsibility. Similarly, offering generally commentary on social media stands well within the rights of physicians.

However, offering specific false information on these media—such as stating that the MMR-II treatment causes autism on a public Facebook post or Twitter buy discount levitra feed—is just as dangerous as the engineer deceiving drivers about the washed-out bridge and should be just as open to regulation. Needless to say, challenges will arise regarding blended or mixed speech that contains both statements of value and false statements of fact. For example, buy discount levitra a physician might criticise a particular intervention as both ‘immoral and ineffective’.

While some difficulty may arise in parsing out these distinctions, it does not mean that regulators should not attempt to do so.The standard for evaluating physician speech should be the malpractice standard. In other words, if the advice given collectively or publicly were offered to an individual patient in a clinical setting, and he or she acted on it, would that speech justify a malpractice claim?. Such an approach protects recommendations that may not reflect the majority consensus, but nonetheless have enough expert buy discount levitra support to qualify for immunity under the respected minority doctrine.

While the malpractice standard should apply, civil liability—rather than state regulation—is a poor mechanism for regulating such speech. Potential plaintiffs may receive false medical information from many sources and injured parties will have buy discount levitra incentive to falsely attribute their own poor choices to dissenting physicians after the fact. At the opposite extreme, followers of dissenting physicians may refuse to take action even after suffering injuries, thereby allowing deleterious physician speech to continue unchecked.While it is clear that the state or licensing bodies should be the regulators of physician speech, how to regulate such speech is a more challenging question.

While the state or medical board might be justified in prohibiting certain statements, especially during a public health crisis such as the erectile dysfunction treatment levitra, that intervention is not buy discount levitra the only available step. At a minimum, the medical authorities might require anyone advancing such misleading physician speech to issue a concrete disclaimer stating they are not offering clinical advice. Regulators might go one step further and require such physicians to make clear to audiences the absence of medical authority buy discount levitra or empirical evidence to justify their position—or even to explain to the public the actual standard of care.

(This approach actually remedies one of the issues that arises with blended speech, as such an approach may force speakers to distinguish value-based and fact-based statement by appending disclaimers to the latter.) Regulators might also choose to prevent those advocating actionable physician speech from profiting from such speech. Sharing false information with the public is one matter, growing rich off the proceeds of such false information is another matter entirely. Whatever specific regulatory steps they take, regulators should consider the dangers posed by such physician speech when acting, rather than deferring to the speaker buy discount levitra as though the speech were no different than ordinary citizen speech.Tier 3.

Clinical speechState licensing boards and courts have a long history of regulating speech and expression in the context of the physician-patient relationship. Arguably, one of the key purposes of medical licensure and of tort liability is to ensure that certain clinical standards are met during these buy discount levitra encounters. Needless to say, physicians are generally afforded considerable flexibility in offering clinical advice and management.

Extensive debate exists surrounding whether the state should be able to regulate clinicians’ speech in these encounters on a wide range of political and moral issues including abortion, aid-in-dying, conversion therapy, and gun buy discount levitra safety. Those debates are beyond the scope of this paper. Also, the exact boundary between physician speech and clinical speech can prove murky on occasion, such as when potential patients at the office of Florida physician Jack Cassell were greeted with a sign in 2010 that read “If you voted for Obama … seek urologic care elsewhere”.34 However, states are clearly within their authority to penalise or revoke the licenses of providers who provide medical information to patients during clinical encounters that is false and dangerous, such as discouraging vaccination on safety or efficacy grounds.

Applying this principle becomes somewhat more challenging in the setting buy discount levitra of social media. Is a Facebook account or Twitter feed with numerous followers offering a general opinion or offering medical advice to each of them?. Does it matter if some of these followers are also patients of the provider (which also raises other questions regarding professional boundaries that buy discount levitra lie beyond the scope of this paper)?.

In other words, when does physician speech on social media become clinical speech?. The key question appears to be whether the recipient of the information might buy discount levitra reasonably interpret that guidance to be offered as part of a clinical encounter or ongoing physician-patient relationship. If so, it can be regulated like any other direct clinical communication between doctors and their patients.By whose authority?.

One question that is bound to arise related to the proposed three-tiered model is what mechanism should be used to operationalise and enforce these rules. The two leading possibilities are professional organisations—such as buy discount levitra the American Medical Association, the American College of Physicians, etc—or, as suggested above, state licensing authorities. Solid arguments can be advanced for each of these positions.

The benefit of regulation by professional organisations is that such an approach allows physicians, who have both insight into the norms of their profession and incentives to protect its reputation buy discount levitra and interests, to govern themselves. However, recent history has demonstrated that such an approach often lacks teeth. Even after medical organisations proscribe member participation in such morally fraught endeavours as force feeding buy discount levitra prisoners, capital punishment and so-called enhanced interrogation, non-member physicians continue to engage in such practices with impunity.

The most striking example of this may be the inability of the American Psychiatric Association (APA) to enforce a rule preventing the diagnosis of public figures, as psychiatrists opposed to the ‘Goldwater rule’ merely resign their APA membership and continue to engage in the APA-proscribed practice. States licensing authorities, in contrast, have the power to act decisively against all licensees, regardless of their standing with professional organisations. Since many dissenting physicians are already outliers alienated from traditional professional organisations and their norms, the regulation of their speech is likely better left to state authorities.ConclusionThe goal of this paper is not to persuade regulators to suppress any buy discount levitra particular set of ideas nor to penalise doctors who hold any specific viewpoints.

Rather, the aim is to reframe the debate surrounding physician expression. The current distinction between speech that occurs in the clinical setting and speech that occurs in the marketplace ignores a crucial third category of statements (‘physician speech’) that are expressions of clinical guidance offered outside the individual buy discount levitra physician-patient relationship. In the era prior to the rise of mass media and the internet, the ability of dissenting physicians to offer empirically questionable advice to the public was relatively circumscribed, so the bifurcated dichotomy of citizen speech and professional or clinical speech proved workable.

In contrast, the current international health crisis has emphasised how inadequate such an approach is for the regulation of dissident medical providers during a levitra. In no other field are experts permitted to offer life-threatening advice under the colour of professional authority and to avoid regulation solely because they offer false information collectively rather than to individual clients or patients. Freedom of expression will suffer little if regulators separate ‘physician speech’ from more traditional forms of citizen speech and then monitor and regulate such utterances more closely.Data availability statementThere are no data in this work.Ethics statementsPatient consent for publicationNot required..

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On one sweltering buy discount levitra day in May, the city of Jacobabad topped 51 °C. €œThese were not normal heatwaves — they were the worst in the world. We had the hottest place on Earth in Pakistan,” says Malik Amin Aslam, the country’s former minister for climate change, who is based in Islamabad. Warmer air buy discount levitra can hold more moisture. So meteorologists warned earlier this year that the extreme temperatures would probably result in “above normal” levels of rain during the country’s monsoon season, from July to September, says Zia Hashmi, a water-resources engineer at the Global Change Impact Studies Centre in Islamabad, speaking in his personal capacity.

Glacial melt The intense heat also melted glaciers in the northern mountainous regions, increasing the amount of water flowing into tributaries that eventually make their way into the buy discount levitra Indus river, says Athar Hussain, a climate scientist at COMSATS University Islamabad. The Indus is Pakistan’s largest river, and runs the length of the country from north to south, feeding towns, cities and large swathes of agricultural land along the way. It isn’t clear exactly how much excess glacial melt has flowed into rivers this year, but Hashmi visited some high-altitude glaciated regions in July and noticed high flows and muddy water in the Hunza River, which feeds into the Indus. He says the mud suggests that there has been rapid melting, buy discount levitra because fast water picks up sediment as it moves downstream. Several glacial lakes have burst through the dams of ice that normally restrain them, releasing a dangerous rush of water.

The heatwaves also coincided with buy discount levitra another extraordinary event — a depression, or a system of intense low air pressure, in the Arabian Sea, which brought heavy rain to Pakistan’s coastal provinces as early as June. €œWe rarely have large-scale depression systems arriving there,” says Hussain. These unusual features were then exacerbated by the early arrival of the monsoon on 30 June, which “was wetter generally over a larger region for a very prolonged period of time”, says Andrew King, a climate scientist at the University of Melbourne, Australia. The effect buy discount levitra is that Pakistan has received almost three times its average annual rainfall for the monsoon period so far. The southern provinces of Sindh and Baluchistan have received more than five times that average.

€œThe flooding is all over,” says Hashmi. Once on buy discount levitra land, much of that water has nowhere to go. More than 1.2 million houses, 5,000 kilometres of road and 240 bridges have been destroyed. In Sindh, an elongated lake has formed, tens of kilometres wide, and more water will continue to pour into it, says Aslam. €œThe worst is not over.” buy discount levitra Other factors Some weather agencies have also predicted that the ongoing La Niña climate event — a phenomenon that is typically associated with stronger monsoon conditions in India and Pakistan — will continue until the end of the year, says King.

€œIt’s not a super strong link, but it probably is playing a role in enhancing the rainfall.” Human-induced global warming could also be intensifying downpours. Climate models suggest that a warmer world will contribute buy discount levitra to more intense rainfall, says Hussain. Between 1986 and 2015, temperatures in Pakistan rose by 0.3 °C per decade — higher than the global average. Researchers and public officials also say that other factors have probably added to the devastation, including an ineffective early-warning system for floods, poor disaster management, political instability and unregulated urban development. A lack of drainage and storage infrastructure, as buy discount levitra well as the large number of people living in flood zones, are also implicated.

€œThese are governance issues, but they are minuscule in relation to the level of the tragedy that we are seeing occur,” says Aslam. This article is reproduced with permission and was first published on September 2 2022..

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The erectile dysfunction levitra drastically impacted our everyday lives and while treatments were (and some still are) in development, various generic levitra usa medicines and supplements were suggested for repurposing, although mostly with no or with limited success. Among proposed over-the-counter (OTC) substances, vitamin C (ascorbic acid) stood out as it was widely available, affordable, safe and used (with more or less success) in the past for the prevention and treatment of respiratory s in the population.Today’s popularity of vitamin C use in respiratory s can be linked to the 1970s when the Nobel prize laureate Linus Pauling popularised his theory that vitamin C can be used prophylactically against the common cold and that it can ameliorate its symptoms. As vitamin C is an essential micronutrient and antioxidant required for a broad range of biological processes, its proposed beneficial effect in respiratory generic levitra usa s is not really that farfetched. Vitamin C has been demonstrated to have beneficial in vitro effects on multiple immune cells.

Notably, it can accumulate in phagocytic cells and amplify phagocytosis, chemotaxis, generation of reactive oxygen species (ROS) and ultimately generic levitra usa enhance the antimicrobial activity of phagocytes. The role of vitamin C in lymphocytes is not fully explained, but it has been shown to enhance the proliferation and differentiation of both T and B lymphocytes, possibly due to an effect on gene regulation. It also supports epithelial barrier functioning and assists the oxidant scavenging in the skin, thus potentially protecting against environmental oxidative stress.1 Although the rationale behind the use of vitamin C in respiratory s is sound and it is well known that vitamin C deficiency results in impaired immunity and higher susceptibility to s, results …As researchers, we found the article, generic levitra usa ‘Peer reviews. A peer reviewer’s view’1 thought provoking.

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Vitamin C has been demonstrated to have beneficial in vitro effects on multiple immune cells. Notably, it can accumulate in phagocytic cells and amplify phagocytosis, chemotaxis, generation of reactive oxygen species (ROS) and buy discount levitra ultimately enhance the antimicrobial activity of phagocytes. The role of vitamin C in lymphocytes is not fully explained, but it has been shown to enhance the proliferation and differentiation of both T and B lymphocytes, possibly due to an effect on gene regulation.

It also supports epithelial barrier functioning and assists the oxidant scavenging in the skin, thus potentially protecting against environmental oxidative stress.1 Although the rationale behind the use of vitamin C in respiratory s is sound and it is well known that vitamin C deficiency results in impaired immunity and higher susceptibility to s, results …As researchers, we found the article, ‘Peer reviews buy discount levitra. A peer reviewer’s view’1 thought provoking. The author states that buy discount levitra a detailed analysis of retracted papers reveals that faked peer reviews are not uncommon.

Shockingly, 75% of 250 retracted papers that had faked peer review were written by Chinese authors.2 Nowadays, because researchers are eager to be recognised and cited, the peer review system is greatly challenged. Between 2007 and 2018, the retraction rate of Chinese authors’ Science Citation Index (SCI) papers was the highest in the world, reaching 22.7/10 000 papers, five times that of the USA.3 Retractions were issued because buy discount levitra of fraud, inconsistent reporting, plagiarism, mistakes, duplication, legal and ethical concerns, and disputed authorship. A study shows that the article types which are frequently retracted are original research works, randomised trials and reviews, and there is a strong association between the retracted items and the total number of publications across countries.4 Inappropriate statistical analysis is a common reason for retractions in top journals, while plagiarism in reviews is a problem in lower-impact periodicals.4 Lei and Zhang pointed out that in the past 20 years, the number of retracted papers from Chinese authors had been increasing, three-quarters of which were triggered by fake peer review, plagiarism and falsification.5 Although this problem has occurred frequently with Chinese papers, it is not just a Chinese problem, but a question of how scientists should be evaluated.

Since Chinese scholars play an increasingly important role in global scientific research, it is necessary to have a general discussion on the causes and countermeasures for academic misconduct.One important cause of misconduct is buy discount levitra that the academic evaluation system is unreasonable. In China, the scientific evaluation function of SCI ….

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Salary. Grade 8 £56,060 – £64,405 per annum, including London Weighting AllowanceBuilding and Campus. James Black Centre, Denmark HillContact. Mauro Giacca, mauro.giacca@kcl.ac.ukHiring manager/s.

Dina Parekh, Monica Nelson-Iye, Steve BuntingJob descriptionThe Kings College London, School of Cardiovascular and Metabolic Medicine &. Sciences (SCMMS) comprises over 65 academic groups, hosts 400 personnel and 110 PhD students and provides an outstanding multi-disciplinary environment for the pursuit of cutting-edge cardiovascular and metabolic research (https://www.kcl.ac.uk/scms). We study the fundamental molecular, cellular, and physiological processes that underly normal and abnormal cardiovascular and metabolic function in state-of-the art core facilities. We drive the translation of this strong basic science into advances in clinical practice to improve prevention, diagnosis and treatment, across Guy’s, St Thomas’ and Denmark Hill campuses.As part of King’s Health Partners, we have an excellent environment for basic-clinical interaction and a strong focus on mentoring and career development.

The School is a partner of the NIHR Biomedical Research Centre at Guy’s and St. Thomas’, which offers world class facilities for translational studies and phase I/II clinical trials. The School hosts the British Heart Foundation Centre of Research Excellence at King's, which brings together a unique range of internationally renowned scientists and clinicians from across the School and King’s College London to focus on basic and applied research in cardiovascular diseases.The School invites applications for Four new Faculty positions. The positions are open to applicants from Lecturer to Professorial grade and remuneration will be commensurate with experience.We seek applications from creative individuals with a bold vision who have demonstrated excellence in research.

We are particularly interested in candidates with experience in one or more of the following areas:Human iPSC-based disease modelling, in particular in the field of inherited cardiomyopathies and with an interest in pursuing studies on gene editing.Molecular and cellular biology of cardiomyocytes, including investigations on mechanobiology, biology of the sarcomere and the role of non-coding RNAs in myocardial function.Autophagy, particularly in maintaining homeostasis and preventing ageing of the heart or vasculature.Cardiac metabolism, especially with a focus on adaptation in heart failure.We particularly welcome candidates with proven experience in cutting edge technologies, including, for example, use of high throughput screens as investigational tools, implementation of single cell/nucleus sequencing, establishing methods for ex vivo cardiac muscle generation, investigations in primary myocardial slices, studies on non coding RNAs or the development models using CRISPR/Cas9 technologies. The successful candidates will have a track record of outstanding first or lead author publications, demonstrable ability to drive independent research, secure research funding and contribute to teaching.The successful candidates will be offered state of the art laboratory facilities as well as a competitive salary and an attractive starting package.Contract typeThis post will be offered on an indefinite contract This is a full time post - 100% full time equivalent.

Salary. Grade 8 £56,060 – £64,405 per annum, including London Weighting AllowanceBuilding and Campus. James Black Centre, Denmark HillContact. Mauro Giacca, mauro.giacca@kcl.ac.ukHiring manager/s.

Dina Parekh, Monica Nelson-Iye, Steve BuntingJob descriptionThe Kings College London, School of Cardiovascular and Metabolic Medicine &. Sciences (SCMMS) comprises over 65 academic groups, hosts 400 personnel and 110 PhD students and provides an outstanding multi-disciplinary environment for the pursuit of cutting-edge cardiovascular and metabolic research (https://www.kcl.ac.uk/scms). We study the fundamental molecular, cellular, and physiological processes that underly normal and abnormal cardiovascular and metabolic function in state-of-the art core facilities. We drive the translation of this strong basic science into advances in clinical practice to improve prevention, diagnosis and treatment, across Guy’s, St Thomas’ and Denmark Hill campuses.As part of King’s Health Partners, we have an excellent environment for basic-clinical interaction and a strong focus on mentoring and career development.

The School is a partner of the NIHR Biomedical Research Centre at Guy’s and St. Thomas’, which offers world class facilities for translational studies and phase I/II clinical trials. The School hosts the British Heart Foundation Centre of Research Excellence at King's, which brings together a unique range of internationally renowned scientists and clinicians from across the School and King’s College London to focus on basic and applied research in cardiovascular diseases.The School invites applications for Four new Faculty positions. The positions are open to applicants from Lecturer to Professorial grade and remuneration will be commensurate with experience.We seek applications from creative individuals with a bold vision who have demonstrated excellence in research.

We are particularly interested in candidates with experience in one or more of the following areas:Human iPSC-based disease modelling, in particular in the field of inherited cardiomyopathies and with an interest in pursuing studies on gene editing.Molecular and cellular biology of cardiomyocytes, including investigations on mechanobiology, biology of the sarcomere and the role of non-coding RNAs in myocardial function.Autophagy, particularly in maintaining homeostasis and preventing ageing of the heart or vasculature.Cardiac metabolism, especially with a focus on adaptation in heart failure.We particularly welcome candidates with proven experience in cutting edge technologies, including, for example, use of high throughput screens as investigational tools, implementation of single cell/nucleus sequencing, establishing methods for ex vivo cardiac muscle generation, investigations in primary myocardial slices, studies on non coding RNAs or the development models using CRISPR/Cas9 technologies. The successful candidates will have a track record of outstanding first or lead author publications, demonstrable ability to drive independent research, secure research funding and contribute to teaching.The successful candidates will be offered state of the art laboratory facilities as well as a competitive salary and an attractive starting package.Contract typeThis post will be offered on an indefinite contract This is a full time post - 100% full time equivalent.

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