bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of the child-at-risk protection system in Egypt: a fiscal and institutional perspective
Authors: El Husseiny Israa A. , Gamal El-Din Amira , Amin Khaled Zakaria 
Published: June 2020

Purpose
This paper aims to fill a gap in the existing literature by shedding the light on four main issues. First, the relationship between child-at-risk protection and sustainable development and the key factors contributing to the failure or success of child-at-risk protection systems. Second, the main characteristics and limitations of the current institutional arrangements of the child-at-risk protection system in Egypt. Third, the budget allocations to child protection-relevant entities in Egypt. Fourth, the way forward to enhance the effectiveness of the child-at-risk protection system in Egypt.

Design/methodology/approach
The methodology used in this paper is of a qualitative nature. The authors relied on desk review of the international and national reports (including the un-published ones) and the relevant literature on the topic. Additionally, the authors reviewed the relevant laws and regulations and analyzed the fiscal data extracted from Egypt’s State budget. Also, semi-structured interviews were conducted with some officials from the different governmental entities covered by the study.

Findings
From the institutional perspective, the authors find that the current child-at-risk protection system in Egypt needs effective institutional arrangements, as it is attributed with the limited activation of the child protection committees, lack of coordination mechanisms and overlapping mandates with regards to case management. Hence, the authors propose two institutional approaches that could help in enhancing the performance of the current system. While the first approach has decentralized nature, the other is centralized. From the fiscal perspective, the authors analyze the trend and composition of the budget allocations to the child protection-relevant entities in Egypt. They show that such allocations are relatively small especially when items not related to child protection are excluded.

Originality/value
The paper analyzes the main characteristics and limitations of the current institutional arrangements of the child-at-risk protection system in Egypt. Moreover, it proposes two alternative institutional approaches to deal with such limitations and enhance the effectiveness of the current system. The paper also provides an analysis of the budget allocations to the child protection-relevant entities in Egypt. These issues have not been addressed sufficiently in the Egyptian context.
Research on intelligent manufacturing development approach for China's local valve industry
Authors: Chang Victor , Xu Yuanyuan Kate , Zhang Jingqi , Xu Qianwen 
Published: June 2020

PurposeThe purpose of this paper is to investigate the current situation of China's local valve industry, the maturity of intelligent manufacturing and the way to promote intellectual development.Design/methodology/approachFirstly, a macro analysis of the valve market environment from the domestic and international perspective was conducted. Secondly, online surveys and in-depth interviews were administered to understand the current status of IM development and future development goals. Finally, case studies were conducted to demonstrate whether the hypothesis of the development approach is feasible.FindingsThis study finds that the overall maturity level of the local valve industry is still in the planning stage since the local valve industry lacks concentration and is relatively scattered. In addition, the feasible development approach is dependent on smart devices to improve production efficiency, ensure quality management and effectively control costs.Research limitations/implicationsThe research is conducted and focused on the Yangtze River Delta region instead of the whole country, and the size of the sample is small. Therefore, there may be some characteristics omitted in the analysis.Practical implicationsManufacturers can upgrade to smart manufacturing through intelligent software platforms in order to complete an automatic interaction of data and devices. In addition, manufacturers should complete cross-regional collaborative development through the industrial Internet of things.Originality/valueThere is little or none of research work completed for the development strategy of the valve industry internationally. Therefore, research findings of this area can provide a fundamental understanding of China's local valve industry and contribute to the existing knowledge.
Risk as strategy: defending against catastrophic turns of fortune
Authors: Calandro Jr. Joseph 
Published: June 2020

Purpose
The author offers executives a strategic process for proactively mitigating the risk of catastrophic unwanted Black Swan surprises that can severely, and often abruptly, impair a balance sheet.

Design/methodology/approach
One practical way to apply the author’s approach is through hedging concentrated balance sheet exposures when market volatility is low or contracting.

Findings
Though no one can reliably anticipate pandemics and related stock market turbulence, executives do not have to predict the future to economically protect their balance sheets from Black Swan events.

Practical implications
Managers can construct Black Swan scenarios to assess how an unforeseen, disadvantageous future could develop and which risk management derivative would best mitigate it.

Originality/value
This strategic approach to managing balance-sheet-threatening risks could help a firm outperform its competitors during future crises and catastrophes.
Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation
Authors: Hendrix Amy D. , Conway Lauren K. , Baxter Michael A. 
Published: June 2020

AbstractChild abuse pediatricians often carry the stigma that their sole role is to diagnose maltreatment. In reality, child abuse pediatricians use their clinical experience and current evidence‐based medicine to make the best medical diagnoses for the children they evaluate. To better understand the legal conclusion of suspected maltreatment cases with medical examinations, this study sought to: (i) evaluate the percentage of children seen for suspected maltreatment that led to a clinical diagnosis of maltreatment, (ii) determine the number and type of criminal charges associated, and (iii) analyze the legal outcomes of cases as they proceeded through the judicial system. This study retrospectively reviewed the legal outcomes of 1698 children medically evaluated in 2013–2014 as part of an investigation by a multidisciplinary team at a children’s advocacy center in a mid‐sized city in Oklahoma. Data were collected from electronic medical records, the district attorney’s office, and a public court docket. Of the original cohort, 477 (28.09%) children yielded a medical diagnosis of at least one type of maltreatment. Further analysis yielded 115 unique court cases involving 138 defendants and 151 children. A total of 286 charges were filed resulting in 190 convictions. While maltreatment allegations yield a high number of children that must be evaluated, a comprehensive medical evaluation helps determine which cases do not have sufficient medical findings for a diagnosis of maltreatment. The findings in this study indicate that a majority of suspected maltreatment cases seen by child abuse pediatricians did not result in criminal court outcomes.
Crystal Growth and Crystallization Time Scales of the Panzhihua Layered Intrusion: Constraint from Crystal Size Distribution
Authors: LI Xuejun , LUO Zhaohua , LI Xiaowei , WANG Yu , YANG Zongfeng , LI Jie , LIU Xiao 
Published: June 2020

AbstractThe Panzhihua layered intrusions is generated closely related to the Emeishan LIPs. This paper analyzes the spatial distribution of plagioclase and pyroxene. The quantitative texture analysis of 2209 plagioclase shows that the characteristic length of plagioclase is 0.54 to 0.96 mm, the intercept variation range is large, from –0.67 to 0.96, and the slope is –1.85 to –1.04, the Aspect Ratio shows from 1.84 to 2.59 and fractal dimension D is 1.908–1.933. The quantitative texture analysis of 2342 pyroxene shows that the characteristic length of pyroxene is 0.38–0.64 mm, the intercept shows from 0.46 to 2.26, The slope ranges from –2.6 to –1.47, the Aspect Ratio value varies from 1.53 to 1.71, the fractal dimension D is 0.93 to 1.13. All the CSDs results of the Panzhihua intrusions indicate that plagioclase and pyroxene form in an open magma system and undergo four replenishment of magma injection. The plagioclase crystals do not grow as the lathlike shape, and the fractal growth leads to complex crystal surface. The plagioclase undergoes deformation compaction during the crystal process, and then is oriented. The pyroxene crystals grow along an approximately triaxial ratio and undergo texture adjustment and small crystal dissolution reabsorption. When all crystals in magma system grows up to 2 mm, the pyroxene undergoes cumulation in the Panzhihua layered intrusions. The plagioclase crystallization time scale is 171.23–304.41 years, representing that the crystallization is the more uniform in central part of the melt. The nucleation density continuously increases during the crystallization process of the magma system. The time scale to reach the final maximum crystal nucleation density is 15.28–58.98 years.
Middle East and North Africa: Terrorism and Conflicts
Authors: Kim Wukki , Sandler Todd 
Published: June 2020

AbstractDuring 2002–2018, the Middle East and North Africa (MENA) accounted globally for 36.1 per cent of terrorist incidents, 49.3 per cent of terrorist‐induced casualties, and 21.4 per cent of conflict deaths. One focus here is to investigate how MENA's terrorist attacks and conflicts compare with those in the world's other six regions during selected periods, drawn from 1970–2018. There is a well‐defined shift of terrorism from Latin America, Europe and Central Asia to MENA, South Asia, and sub‐Saharan Africa after 1989. A second focus is to employ panel regressions to contrast the drivers of global terrorism with those of MENA terrorism. Democracy and civil conflicts are main drivers of MENA terrorism, followed by population. Regional peacekeeping can have an ameliorating effect on terrorism by limiting conflict. The Arab Spring and associated regime changes are shown to have ushered in a wave of terrorism in MENA. Policy recommendations conclude the study.
Association of CD8 T cell apoptosis and EGFR mutation in non‐small lung cancer patients
Authors: Zhao Chao , Su Chunxia , Li Xuefei , Zhou Caicun 
Published: June 2020

BackgroundThe abundance of tumor infiltrating CD8 T cells is an important parameter for antitumor effect of PD‐1/PD‐L1 immune checkpoint inhibitors, which is less in epidermal growth factor receptor (EGFR) mutation than wild‐type non‐small cell lung cancer (NSCLC). The mechanism still requires further study.MethodsIn total 190 surgical lung adenocarcinoma samples were included. EGFR mutation was detected using amplification‐refractory mutation system. CD8 T cells and apoptosis were assessed by immunohistochemistry and immunofluorescence staining in tumor samples. Exosomes extracted from lung cancer cell lines with and without EGFR mutation were used to test the function of promoting apoptosis in vitro.ResultsThe ratio of CD8 tumor infiltration lymphocytes was significantly lower in EGFR‐mutant than in wild‐type patients (P = 0.026). A higher ratio of apoptosis was also prone to occur in EGFR‐mutant patients (P = 0.035). The distribution of apoptosis was not statistically associated with the ratio of CD8 TILs. An in vitro experiment indicated that exosomes secreted by EGFR‐mutant non‐small cell lung cancer cell lines PC9 and HCC827 were more capable of promoting CD8 T cell apoptosis than EGFR wild‐type cell lines H1299 and SK‐MES‐1 (P = 0.007 and P = 0.010, respectively).ConclusionsNon‐small cell lung cancer EGFR mutation could promote CD8 T cell apoptosis more than wild‐type. Inhibiting CD8 + TILs apoptosis may strengthen immunotherapy effects in EGFR‐mutant NSCLC patients.
Dopamine D2/3 receptor availability in alcohol use disorder and individuals at high risk: Towards a dimensional approach
Authors: Gleich Tobias , Spitta Gianna , Butler Oisin , Zacharias Kristin , Aydin Semiha , Sebold Miriam , Garbusow Maria , Rapp Michael , Schubert Florian , Buchert Ralph , Heinz Andreas , Gallinat Juergen 
Published: June 2020

AbstractAlcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine‐related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying 18F‐fallypride positron emission tomography (18F‐PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low‐risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future.
Peri‐operative administration of tranexamic acid in lower limb arthroplasty: a multicentre, prospective cohort study
Authors: Lloyd T. D. , Neal‐Smith G. , Fennelly J. , Claireaux H. , Bretherton C. , Carr A. J. , Murphy M. , Kendrick B. J. , Palmer A. J. R. ,   collaborators
Published: June 2020

SummaryIn the UK, tranexamic acid is recommended for all surgical procedures where expected blood loss exceeds 500 ml. However, the optimal dose, route and timing of administration are not known. This study aimed to evaluate current practice of peri‐operative tranexamic acid administration. Patients undergoing primary total hip arthroplasty, total knee arthroplasty or unicompartmental knee arthroplasty during a 2‐week period were eligible for inclusion in this prospective study. The primary outcome was the proportion of patients receiving tranexamic acid in the peri‐operative period. Secondary outcomes included: dose, route and timing of tranexamic acid administration; prevalence of pre‐ and postoperative anaemia; estimated blood loss; and red blood cell transfusion rates. In total, we recruited 1701 patients from 56 NHS hospitals. Out of these, 1523 (89.5%) patients received tranexamic acid and of those, 1052 (69.1%) received a single dose of 1000 mg intravenously either pre‐ or intra‐operatively. Out of the 1701 patients, 571 (33.6%) and 1386 (81.5%) patients were anaemic (haemoglobin < 130 g.l−1) in the pre‐ and postoperative period, respectively. Mean (SD) estimated blood loss for all included patients was 792 (453) ml and 54 patients (3.1%) received a red blood cell transfusion postoperatively. The transfusion rate for patients with pre‐operative anaemia was 6.5%, compared with 1.5% in patients without anaemia. Current standard of care in the UK is to administer 1000 mg of tranexamic intravenously either pre‐ or intra‐operatively. Approximately one‐third of patients present for surgery with anaemia, although the overall red blood cell transfusion rate is low. These data provide useful comparators when assessing the efficacy of tranexamic acid and other patient blood management interventions in future studies.
Are high‐cost drug funding mechanisms fit for purpose? A retrospective study of individual funding requests in an NHS tertiary hospital
Authors: Sanghvi Sonali , Allen Rachel , Cho Steven , Ferner Robin E. , Urquhart Robert , Sofat Reecha 
Published: June 2020

AimsTo report on a retrospective study of individual funding request (IFR) submissions from a large tertiary hospital and describe gaps in current mechanisms for funding of high‐cost medicines in England.MethodsData on the number and outcome of IFR submissions submitted to commissioners between 2014/15 and 2018/19 was extracted from the electronic patient health record and a local high‐cost drug database.ResultsIn total, 230 IFRs were submitted: 112 to NHS England and 118 to a Clinical Commissioning Group (CCG). The decline rate for IFRs was 71% for NHS England and 34% for CCGs. Lack of exceptionality was the primary reason cited for declining IFRs submitted between 2016–18 (n = 42/45; 93%). Half of the patients whose IFR was declined received treatment funded through other routes, the majority (13/23; 57%) from internal hospital budget. This was governed via a local high‐cost drug panel. Positive clinical outcomes were observed in 50% (4/8) of patients who received NHS England IFR‐funded treatment, 54% (19/35) who received CCG IFR‐funded treatment and 91% (21/23) who were funded via other routes.ConclusionThe high rate of IFR decline signals inefficient use of resource expended in the IFR process. Gaps in access to high‐cost medicines remain for patients with rare and refractory disease requiring urgent treatment, largely due to the demand for exceptionality from NHS commissioners. Local mechanisms address this unmet need but have limitations. An outcomes‐based evaluation approach to commissioning and greater transparency of previous funding decisions by commissioners may improve efficiency and equity in the IFR system.
Fatigue in children and adolescents with immune thrombocytopenia
Authors: Grace Rachael F. , Klaassen Robert J. , Shimano Kristin A. , Lambert Michele P. , Grimes Amanda , Bussel James B. , Breakey Vicky R. , Pastore Yves D. , Black Vandy , Overholt Kathleen , Bhat Rukhmi , Forbes Peter W. , Neunert Cindy 
Published: June 2020

AbstractImmune thrombocytopenia (ITP), an acquired autoimmune disorder of low platelets and risk of bleeding, has a substantial impact on health‐related quality of life (HRQoL). Patients with ITP often report significant fatigue, although the pathophysiology of this is poorly understood. In this observational cohort of 120 children receiving second‐line therapies for ITP, we assessed reports of fatigue using the Hockenberry Fatigue Scale. Children and adolescents with ITP reported a similarly high level of fatigue with 54% (29/54) of children and 62% (26/42) of adolescents reporting moderate‐to‐severe fatigue. There was no correlation between fatigue and age or gender. Adolescents with newly diagnosed and persistent ITP had higher mean fatigue scores than those with chronic ITP (P = 0·03). Fatigue significantly improved in children and adolescents by 1 month after starting second‐line treatments, and this improvement continued to be present at 12 months after starting treatment. Fatigue scores at all time‐points correlated with general HRQoL using the Kids ITP Tool, but did not correlate with bleeding symptoms, platelet count, or platelet response to treatment. Fatigue is common in children and adolescents with ITP and may benefit from ITP‐directed treatment even in the absence of bleeding symptoms.
Favourable multi‐institutional experience with penoscrotal decompression for prolonged ischaemic priapism
Authors: Baumgarten Adam S. , VanDyke Maia E. , Yi Yooni A. , Keith Christopher G. , Fuchs Joceline S. , Ortiz Nicolas M. , Cordon Billy H. , Pagliara Travis J. , Ward Ellen E. , Jaderlund John W. , Teeple Charles S. , Christine Brian S. , Yafi Faysal A. , Hudak Steven J. , Morey Allen F. 
Published: June 2020

ObjectivesTo report our multi‐institutional experience using penoscrotal decompression (PSD) for the surgical treatment of prolonged ischaemic priapism (PIP).Materials and MethodsWe retrospectively reviewed clinical records for patients with PIP treated with PSD between 2017 and 2020. Priapisms were confirmed as ischaemic based on clinical presentations and cavernosal blood gas abnormalities. Treatment with irrigation and injection of α‐agonists in all patients had failed prior to PSD. Patient characteristics, peri‐operative variables and outcomes, and changes in International Index of Erectile Function (IIEF) scores were evaluated.ResultsWe analysed 25 patients who underwent a total of 27 PSD procedures. The mean duration of priapism at initial presentation was 71.0 h. Irrigations and injections in all patients had failed, while corporoglanular shunt treatment in 48.0% of patients (12/25) had also failed prior to PSD. Of the 10 patients who underwent unilateral PSD, two (20.0%) had priapism recurrence. Both were treated with bilateral PSD, with prompt and lasting detumescence. Among the 15 patients undergoing primary bilateral PSD, none had priapism recurrence. Of the 15 patients with documented sexual function status at last follow‐up, nine (60%) reported spontaneous erectile function adequate for penetration, while six (40%) reported erectile dysfunction. The median (interquartile range) decrease in IIEF‐5 score was 3.5 (0–6.75) points after PSD. Two patients underwent uneventful inflatable penile prosthesis placement following PSD.ConclusionsPenoscrotal decompression presents a simple, safe, highly effective and easily reproducible procedure for resolution of PIP. PSD should be considered as a viable salvage or alternative strategy to corporoglanular shunt procedures.