bluuebunny/crossref_metadata_2025_split huggingface dataset:
How does internationalization begin? The role of age at entry and export experience in the early stages of the process
Authors: Casillas Jose C , Acedo Francisco J , Rodríguez-Serrano M Ángeles 
Published: May 2020

This article deals with two important concepts in the prior literature on the internationalization process: age at entry and export experience. Against previous research, we analyze how both of them influence simultaneously international behavior in the early stages of the internationalization process as a trade-off. For that aim, we analyze the influence of both variables on international behavior in the early stages of the internationalization process, from a dynamic perspective, looking at initial export behavior and speed during this period. We analyze export development process of 106 Spanish small and medium-sized enterprises (SMEs), most of them international new ventures, in their first 8 years of export activity, combining the effect of age at entry and experiential learning during this period, finding that age at entry and export experience exert not only a direct effect but also a moderation influence on initial export development, observing a trade-off between such influence as experience grows. JEL CLASSIFICATION: M16
Internationalization of Chinese SMEs: The role of networks and global value chains
Authors: Su Fang , Khan Zaheer , Kyu Lew Yong , Il Park Byung , Shafi Choksy Umair 
Published: May 2020

This article examines the role of networks and global value chains (GVCs) and how they influence emerging economy small- and medium-sized enterprises’ (EE-SMEs) internationalization. Drawing on the insights, experiences, and perspectives of entrepreneurs and senior managers of small- and medium-sized enterprises (SMEs) that have originated from China, the study adopts qualitative approach and examines nine firms’ internationalization. We find that Chinese born-global manufacturing SMEs benefit from networks with quick insidership position into GVCs, but suffer from various obstacles that hinder their further development. The findings further indicate that network ties substantially facilitate EE-SMEs’ internationalization, but also restrict their future global development, as their low position within the GVCs impedes further business development and capability building. The case firms’ lower position within the GVCs weakens the networks’ influence on their GVC upgrading. The research identifies key enablers of GVC engagement and obstacles of GVC upgrading of the case firms which play an important role in the EE-SMEs’ internationalization. JEL CLASSIFICATION: M10; M16
A fully human anti-BMP6 antibody reduces the need for erythropoietin in rodent models of the anemia of chronic disease
Authors: Petzer Verena , Tymoszuk Piotr , Asshoff Malte , Carvalho Joana , Papworth Jonathan , Deantonio Cecilia , Bayliss Luke , Wake Matthew Stephen , Seifert Markus , Brigo Natascha , Valente de Souza Lara , Hilbe Richard , Grubwieser Philipp , Demetz Egon , Dichtl Stefanie , Volani Chiara , Berger Sylvia , Böhm Felix , Hoffmann Alexander , Pfeifhofer-Obermair Christa , von Raffay Laura , Sopper Sieghart , Arndt Stephanie , Bosserhoff Anja , Kautz Léon , Perrier Prunelle , Nairz Manfred , Wolf Dominik , Weiss Guenter , Germaschewski Volker , Theurl Igor 
Published: May 2020

AbstractRecombinant erythropoietin (EPO) and iron substitution are a standard of care for treatment of anemias associated with chronic inflammation, including anemia of chronic kidney disease. A black box warning for EPO therapy and concerns about negative side effects related to high-dose iron supplementation as well as the significant proportion of patients becoming EPO resistant over time explains the medical need to define novel strategies to ameliorate anemia of chronic disease (ACD). As hepcidin is central to the iron-restrictive phenotype in ACD, therapeutic approaches targeting hepcidin were recently developed. We herein report the therapeutic effects of a fully human anti-BMP6 antibody (KY1070) either as monotherapy or in combination with Darbepoetin alfa on iron metabolism and anemia resolution in 2 different, well-established, and clinically relevant rodent models of ACD. In addition to counteracting hepcidin-driven iron limitation for erythropoiesis, we found that the combination of KY1070 and recombinant human EPO improved the erythroid response compared with either monotherapy in a qualitative and quantitative manner. Consequently, the combination of KY1070 and Darbepoetin alfa resulted in an EPO-sparing effect. Moreover, we found that suppression of hepcidin via KY1070 modulates ferroportin expression on erythroid precursor cells, thereby lowering potentially toxic-free intracellular iron levels and by accelerating erythroid output as reflected by increased maturation of erythrocyte progenitors. In summary, we conclude that treatment of ACD, as a highly complex disease, becomes more effective by a multifactorial therapeutic approach upon mobilization of endogenous iron deposits and stimulation of erythropoiesis.
A rare intraoperative spinal cord injury caused by thoracic 8 nerve root interruption during posterior vertebral column resection surgery for severe congenital kyphoscoliosis: a case report
Authors: Wang Shujie , Ren Zhifu , Yang Zhen , Zhang Jianguo 
Published: May 2020

Abstract
Background
To our knowledge, the exposed nerve roots in thoracic spine are usually sacrificed to facilitate osteotomy during posterior vertebral column resection (PVCR) for severe spinal deformity. Currently we report a case with severe spine deformity in which intraoperative neurological monitoring (IOM) loss after interrupting T8 nerve root finally led to spinal cord injury during PVCR surgery.

Case presentation
The patient was a 14-year-old female with severe congenital kyphoscoliosis (CKS) without preoperative neurologic deficits. The IOM events (MEP loss and SSEP latency prolong) were showed when T8 nerve root at concave side was interrupted. And then we reduce the scope of osteotomy to control bleeding, raised blood pressure (MAP, 65–80) to increase blood supply for spinal cord, placed the bilateral rod to stabilized the spinal cord, used the methylprednisolone, explored the presence or absence of spinal cord compression, and prepared to change the surgical plan from PVCR to PSO. After that the IOM signals partial recovered from the lowest point. Postoperatively the patients showed transient motor function deficits of left lower limbs weak without somatosensory deficits, and come back to preoperative status 6 months later.

Conclusions
Interrupting the thoracic spine nerve root is danger to trigger the spinal cord injury during PVCR procedure of severe CKS. That probably because the increasing tension of contralateral anterior horn area of spinal cord via the nerve root pulling.
Association between hip muscle cross-sectional area and hip pain and function in individuals with mild-to-moderate hip osteoarthritis: a cross-sectional study
Authors: Peiris Waruna L. , Cicuttini Flavia M. , Constantinou Maria , Yaqobi Abbas , Hussain Sultana Monira , Wluka Anita E. , Urquhart Donna , Barrett Rod , Kennedy Ben , Wang Yuanyuan 
Published: May 2020

Abstract
Background
To examine the associations between hip muscle cross-sectional area and hip pain and function in community-based individuals with mild-to-moderate hip osteoarthritis.

Methods
This study included 27 participants with mild-to-moderate hip osteoarthritis. Cross-sectional area of hip muscles, including psoas major, rectus femoris, gluteus maximus, gluteus medius and minimus, adductor longus and magnus, obturator internus, and obturator externus, were measured from magnetic resonance images. Hip pain and function were evaluated using the Hip Disability and Osteoarthritis Outcome Score (HOOS) categorised into 5 subscales: pain, symptoms, activity of daily living, sport and recreation function, and hip-related quality of life (for each subscale 0 representing extreme problems and 100 representing no problems).

Results
Mean age of the 27 participants was 63.2 (SD 7.6) years and 66.7% (n = 18) were female. After adjusting for age and gender, greater cross-sectional area of adductor longus and magnus was associated with a higher HOOS score in quality of life (regression coefficient 1.4, 95% confidence interval (CI) 0.2–2.7, p = 0.02), activity of daily living (regression coefficient 1.3, 95% CI 0.1–2.6, p = 0.04) and sport and recreation function (regression coefficient 1.6, 95% CI 0.1–3.0, p = 0.04). There was a trend towards an association between greater cross-sectional area of psoas major and a higher quality of life score (regression coefficient 3.6, 95% CI − 0.5 to 7.7, p = 0.08). The cross-sectional area of hip muscles was not significantly associated with HOOS pain or symptom score.

Conclusion
Greater cross-sectional area of hip adductors was associated with better function and quality of life in individuals with mild-to-moderate hip osteoarthritis. Greater cross-sectional area of hip flexors might be associated with better quality of life. These findings, while need to be confirmed in longitudinal studies, suggest that targeting the hip adductor and flexor muscles may improve function and quality of life in those with mild-to-moderate hip osteoarthritis.
Iatrogenic biological fracture of the cervical spine during gradual halo traction for kyphotic deformity correction: case report
Authors: Lim Austin Samuel Laifun , Sali Azizul Akram Bin , Cheung Jason Pui Yin 
Published: May 2020

Abstract
Background
Severe kyphotic deformities carry high risk for neurological injuries as osteotomies are often required for correction. Surgeons often utilize a staged approach for dealing with these conditions starting with a period of halo traction to stretch tight soft tissues and partially correct the deformity, followed by surgery. Halo traction is a relatively safe procedure and complications are uncommon. We report a unique case of iatrogenic fracture of the cervical spine during gradual halo traction for deformity correction of a severe cervical kyphosis.

Case presentation
An 80-year-old female with previous cervical spine tuberculosis infection and C5-C6 anterior spinal fusion developed severe cervical kyphosis of 64° from C2-C6 and neck pain requiring deformity correction surgery. Gradual increase in traction weight was applied, aiming for a maximum traction weight of 45 pounds or half body weight. During the 1st stage halo-gravity traction, sudden neck pain and a loud cracking sound was witnessed during increase of the traction weight to 14 pounds. Imaging revealed a fracture through the C4 and reduction in kyphosis deformity to 11° from C2-C6. There was no neurological deficit. No further traction was applied and the patient underwent an in-situ occipital to T3 fusion without osteotomies. At 3-year follow-up, the patient was symptom-free and radiographs showed solid fusion and maintenance of alignment.

Conclusions
Iatrogenic fracture may occur with halo traction. Elderly patients with osteoporotic and diseased bone should be closely monitored during the treatment. A fracture without complications was a fortunate complication as the patient was able to avoid any high-risk osteotomies for deformity correction.

Level of evidence
IV
Effectiveness of circular external fixator in periprosthetic fractures around the knee
Authors: Nozaka Koji , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Saito Hidetomo , Kijima Hiroaki , Tsuchie Hiroyuki , Mita Motoki , Shimada Yoichi 
Published: May 2020

AbstractBackgroundThe incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee.MethodsWe included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases.ResultsA 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3 ± 5.2 weeks (range, 8–38 weeks). The walking ability was the same level as before the injury in 13 cases.DiscussionThere are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures.ConclusionCircular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients.Level of evidenceLevel IV, retrospective case series.
Genomic history of the Italian population recapitulates key evolutionary dynamics of both Continental and Southern Europeans
Authors: Sazzini Marco , Abondio Paolo , Sarno Stefania , Gnecchi-Ruscone Guido Alberto , Ragno Matteo , Giuliani Cristina , De Fanti Sara , Ojeda-Granados Claudia , Boattini Alessio , Marquis Julien , Valsesia Armand , Carayol Jerome , Raymond Frederic , Pirazzini Chiara , Marasco Elena , Ferrarini Alberto , Xumerle Luciano , Collino Sebastiano , Mari Daniela , Arosio Beatrice , Monti Daniela , Passarino Giuseppe , D’Aquila Patrizia , Pettener Davide , Luiselli Donata , Castellani Gastone , Delledonne Massimo , Descombes Patrick , Franceschi Claudio , Garagnani Paolo 
Published: May 2020

Abstract
Background
The cline of human genetic diversity observable across Europe is recapitulated at a micro-geographic scale by variation within the Italian population. Besides resulting from extensive gene flow, this might be ascribable also to local adaptations to diverse ecological contexts evolved by people who anciently spread along the Italian Peninsula. Dissecting the evolutionary history of the ancestors of present-day Italians may thus improve the understanding of demographic and biological processes that contributed to shape the gene pool of European populations. However, previous SNP array-based studies failed to investigate the full spectrum of Italian variation, generally neglecting low-frequency genetic variants and examining a limited set of small effect size alleles, which may represent important determinants of population structure and complex adaptive traits. To overcome these issues, we analyzed 38 high-coverage whole-genome sequences representative of population clusters at the opposite ends of the cline of Italian variation, along with a large panel of modern and ancient Euro-Mediterranean genomes.

Results
We provided evidence for the early divergence of Italian groups dating back to the Late Glacial and for Neolithic and distinct Bronze Age migrations having further differentiated their gene pools. We inferred adaptive evolution at insulin-related loci in people from Italian regions with a temperate climate, while possible adaptations to pathogens and ultraviolet radiation were observed in Mediterranean Italians. Some of these adaptive events may also have secondarily modulated population disease or longevity predisposition.

Conclusions
We disentangled the contribution of multiple migratory and adaptive events in shaping the heterogeneous Italian genomic background, which exemplify population dynamics and gene-environment interactions that played significant roles also in the formation of the Continental and Southern European genomic landscapes.
What is the impact of the adjunctive use of omega-3 fatty acids in the treatment of periodontitis? A systematic review and meta-analysis
Authors: Kruse Anne B. , Kowalski Carolyn D. , Leuthold Sylvia , Vach Kirstin , Ratka-Krüger Petra , Woelber Johan P. 
Published: May 2020

Abstract
Background
Host modulation therapy has gained increasing interest in periodontal therapy. This systematic review aimed to evaluate the effects of adjunctive administration of omega-3 fatty acids in periodontal therapy.

Methods
The search strategy was determined using the “patient, intervention, comparison, outcome” model. A resulting search term was generated using keywords, and the databases were fed. The databases PubMed, Cochrane Library, and LIVIVO were used. Studies were selected for the literature review based on previously specified inclusion and exclusion criteria. Randomized, controlled, blinded studies, longitudinal studies, comparative studies, and clinical studies were included in the review. Additionally, they used omega-3 fatty acids in the treatment of periodontitis. The following parameters were observed: clinical attachment level (CAL), probing depth (PD), gingival index (GI), bleeding on probing (BOP) and plaque index (PI). A meta-analysis was performed for PD and CAL after 3 months. By analyzing the risk of bias, the validity of the results of each study was demonstrated, and its credibility and quality were assessed.

Results
Of 14 studies found, six were included. The results showed a significant reduction in PD and CAL compared to that in the placebo groups in four out of six involved studies, which was confirmed by the meta-analysis. In one study, a significant reduction in BOP was found. GI was significantly reduced in three included studies. PI also showed a significant reduction in three studies.

Conclusions
Within the study limitations, omega-3 fatty acids appear to have a positive effect on periodontal wound healing with regard to reduction in CAL and PD. Based on the results, patients receiving periodontal treatment might benefit from nutritional counseling.
Added value of contrast-enhanced mammography (CEM) in staging of malignant breast lesions—a feasibility study
Authors: Åhsberg Kristina , Gardfjell Anna , Nimeus Emma , Rasmussen Rogvi , Behmer Catharina , Zackrisson Sophia , Ryden Lisa 
Published: May 2020

Abstract
Objectives
The aim of this feasibility study was to evaluate the added value of contrast-enhanced mammography (CEM) in preoperative staging of malignant breast lesions, beyond standard assessment with digital mammography and ultrasound, as a base for a future prospective randomized trial.

Materials and methods
Forty-seven patients, with confirmed or strongly suspected malignant breast lesions after standard assessment (digital mammography (DM) and ultrasound (US)), scheduled for primary surgery, were invited to undergo CEM as an additional preoperative procedure. The primary endpoint was change in treatment due to CEM findings, defined as mastectomy instead of partial mastectomy or contrariwise, bilateral surgery instead of unilateral or neoadjuvant treatment instead of primary surgery. Accuracy in tumour extent estimation compared to histopathology was evaluated by Bland-Altman statistics. Number of extra biopsies and adverse events were recorded.

Results
In 10/47 patients (21%), findings from CEM affected the primary treatment. Agreement with histopathology regarding extent estimation was better for CEM (mean difference − 1.36, SD ± 18.45) in comparison with DM (− 4.18, SD ± 26.20) and US (− 8.36, SD ± 24.30). Additional biopsies were taken from 19 lesions in 13 patients. Nine biopsies showed malignant outcome. No major adverse events occurred.

Conclusion
The feasibility of preoperative additional CEM was found to be satisfactory without any serious negative effects. Results imply an added value of CEM in preoperative staging of breast cancer. Further evaluation in larger prospective randomized trials is needed.

Trial registration
ClinicalTrials.gov, NCT03402529. Registered 18 January 2018—retrospectively registered
Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies
Authors: Agodirin Olayide S. , Aremu Isiaka , Rahman Ganiyu A. , Olatoke Samuel A. , Akande Halimat J. , Oguntola Adetunji S. , Olasehinde Olalekan , Ojulari Sheriff , Etonyeaku Amarachukwu , Olaogun Julius , Romanoff Anya 
Published: May 2020

PURPOSE The prevalence of themes linked to delay in presentation of breast cancer (BC) and their underlying factors vary considerably throughout Africa. Regional differences and trends are largely unreported. The purpose of this research was to provide summary estimates of the prevalence and distribution of the themes and underlying factors linked to delay in the presentation of BC, regional variation, and trends in an effort to identify targets for intervention. DESIGN We screened articles found through PubMed/Medline, African Journal OnLine, Science Direct, Google/Google Scholar, and ResearchGate. We included patient-reported surveys on the reasons linked to delayed presentation under 6 previously identified themes: symptom misinterpretation, fear, preference for alternative care, social influence, hospital-related factors, and access factors. The meta-analytical procedure in MetaXL used the quality-effect model. RESULTS Twelve of the 236 identified articles were eligible for this review. The overall summary estimate of late presentation (> 90 days) was 54% (95% CI, 23 to 85) and was worst in the eastern and central regions. Symptom misinterpretation was the most common theme (50%; 95% CI, 21 to 56), followed by fear (17%; 95% CI, 3 to 27), hospital-related theme (11%; 95% CI, 1 to 21), preference for alternative care (10%; 95% CI, 0 to 21), social influence (7%; 95% CI, 0 to 14), and access-related theme (6%; 95% CI, 0 to 13). The most common factor underlying symptom misinterpretation was mischaracterizing the breast lesion as benign (60%; 95% CI, 4 to 100) which surpassed lack of awareness in the last decade. Misdiagnosis and failure to refer were the dominant hospital-related factors. CONCLUSION Modifiable factors such as mischaracterizing malignant masses as benign, fear, misdiagnosis, and failure to refer were the prevalent factors contributing to delays throughout Africa. These factors are promising targets for intervention.