bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Breadth–Depth Trade‐Off and Varieties of Preferential Trade Agreements
Authors: Chacha Mwita , Nussipov Adil 
Published: December 2021

AbstractThe varieties of preferential trade agreements have increased in recent decades. Regional blocs concluding deals with third‐party actors have contributed immensely to these changes in trade agreements. These varieties have motivated our reexamination of the breadth–depth trade‐off in trade agreements. We argue that a breadth–depth trade‐off is present in initial plurilateral agreements. Large groups of states at this initial stage exhibit greater preference heterogeneity that discourages deeper cooperation. Conversely, we expect the breadth–depth trade‐off to be absent in follow‐up plurilateral agreements and region‐to‐third‐party agreements. For the former, the initial pacts serve a learning function that enables deeper cooperation. For the latter, institutional mechanisms lessen preference heterogeneity and transforms negotiations to approximate bilateral trade talks that alleviate the breadth–depth trade‐off. Our test on 234 trade agreements finds support for our argument. Our paper highlights the importance of distinguishing trade negotiation configurations to better understand how membership affects the depth of agreements.
Underestimation of impaired glucose tolerance and usefulness of a continuous glucose monitoring system in chronic liver disease
Authors: Ogawa Yutaro , Nakahara Takashi , Ono Masafumi , Kawaguchi Takumi , Isoda Hiroshi , Hiramatsu Akira , Uchikawa Shinsuke , Fujino Hatsue , Murakami Eisuke , Kawaoka Tomokazu , Yamauchi Masami , Tsuge Masataka , Munekage Kensuke , Ochi Tsunehiro , Hayes C Nelson , Imamura Michio , Aikata Hiroshi , Takahashi Hirokazu , Torimura Takuji , Chayama Kazuaki 
Published: December 2021

AbstractBackground and AimThe prevalence of glucose intolerance in chronic liver disease patients is high, but glucose intolerance may be overlooked in a single blood test. The purpose of this study is to evaluate blood glucose variability in patients with chronic liver disease by a continuous glucose monitoring system (CGMS) and to examine the discrepancy between hemoglobin A1c (HbA1c) levels estimated from average blood glucose levels and HbA1c.MethodsThis study included 335 patients with chronic liver disease associated with glucose intolerance. A fasting blood test and 72‐h CGMS were performed. The estimated HbA1c was calculated from the average blood glucose level, and the correlation between hepatic functional reserve and blood glucose‐related parameters was analyzed. From the obtained data, we created a new formula to calculate HbA1c without using CGMS.ResultsAs hepatic functional reserve decreased, average blood glucose and insulin resistance increased while HbA1c decreased (P < 0.0001). The discrepancy between the estimated HbA1c calculated from the mean blood glucose level and the serum HbA1c (ΔHbA1c) increased as the liver reserve decreased. Using multiple regression analysis, a formula based on fasting blood glucose, HbA1c, body mass index, albumin, and liver function was constructed, and its validity was demonstrated in a study using a different control group.ConclusionsHemoglobin A1c may be underestimated because of decreased hepatic functional reserve. CGMS was useful in assessing accurate glycemic control of blood glucose and in detecting postprandial hyperglycemia and nocturnal hypoglycemia. Patients with chronic hepatic impairment should be corrected for hepatic functional reserve before glycemic control.
The roles of kisspeptin and neurokinin B in GnRH pulse generation in humans, and their potential clinical application
Authors: Anderson Richard A. , Millar Robert P. 
Published: December 2021

AbstractThe delivery of gonadotropin‐releasing hormone (GnRH) in a pulsatile mode to the gonadotropes has long been known to be essential for normal reproductive function. There have been numerous studies aimed at dissecting out the mechanisms underlying GnRH pulse generation. The discovery of kisspeptin as an upstream regulator of GnRH attracted the possibility that pulsatile kisspeptin governed the pulsatile secretion of GnRH. Subsequent studies have shown the importance of the neurokinin B (NKB) system in modulating kisspeptin secretion and this GnRH. A number of studies in laboratory rodents have supported this notion. By contrast, we present data from clinical studies in men and women, in a range of contexts, showing that continuous infusion of kisspeptin 10 at receptor‐saturating levels gives rise to an increase in luteinizing hormone (LH) (GnRH) pulse frequency. This has been demonstrated in normal healthy and hypogonadal men, in normal women during the mid‐cycle LH surge, in men and women with mutations in the genes encoding NKB or its receptor, neurokinin 3 receptor (NK3R), in women with polycystic ovary syndrome treated with NK3R antagonist, and in women treated with NK3R antagonist during the LH surge. These finds indicate that pulsatile secretion and action of kisspeptin on GnRH neurons is not required for the generation of LH (GnRH) pulses in humans. We also report that there is an absence of desensitization in humans exposed to continuous infusion of kisspeptin‐10 at receptor‐saturating concentrations over 22 h and briefly review GnRH, kisspeptin and NKB analogs and their clinical application.
mHealth interventions targeting movement behaviors in Asia: A scoping review
Authors: Edney Sarah , Chua Xin Hui , Müller Andre Matthias , Kui Kiran Yan , Müller‐Riemenschneider Falk 
Published: December 2021

SummarymHealth interventions can promote healthy movement behaviors (physical activity, sedentary behavior, and sleep). However, recent reviews include few studies from Asia, despite it being home to over 60% of the world population. The aim is to map the current evidence for mHealth interventions targeting movement behaviors in Asia. Six databases were searched up until August 2021. Included studies described an mHealth intervention targeting one or more movement behaviors, delivered in a country/territory in Asia, to a general population. A total of 3986 unique records were screened for eligibility in duplicate. Eighty studies with 1,413,652 participants were included. Most were randomized (38.8%) or quasi‐experimental (27.5%) trials. Studies were from 17 countries/territories (out of 55); majority were high‐ (65.0%) or upper middle‐income (28.7%). Physical activity was targeted most often (93.8%), few targeted sedentary behavior (7.5%), or sleep (8.8%). Most targeted one movement behavior (90.0%), and none targeted all three together. Interventions typically incorporated a single mHealth component (70.0%; app, pedometer, text messages, wearable) and were delivered remotely (66.3%). The average intervention length was 121.8 (SD 127.6) days. mHealth interventions in Asia have primarily targeted physical activity in high‐ and upper middle‐income countries. There are few interventions targeting sedentary behavior or sleep, and no interventions in low‐income countries.
Creating and Redirecting Threats
Authors: Mardellat Victor 
Published: December 2021

AbstractIn the third volume of On What Matters, Derek Parfit argued that the distinction between imposing a newly created threat on someone and making what threatens some people instead threaten someone else has no genuine moral significance. This article's central thesis is that although there is much to learn from Parfit's arguments, they are ultimately unsuccessful at establishing that the redirected versus newly created threats distinction is morally irrelevant. In particular, I show that my Causal Sequences Principle specifies this distinction in such a way that it is immune to Parfit's objections against the Redirection Principle. It follows that any moral theory that can provide a sound rationale for the Causal Sequences Principle can solve the trolley problem.
Ultrasound‐guided tenoscopic decompression of digital sheath synoviocoeles in 10 horses
Authors: Hawkins Alex , Chapman Lucy , Meter Mark , Smith Roger K. 
Published: December 2021

AbstractObjectiveTo report the diagnostic features and clinical outcome of horses with digital flexor tendon sheath (DFTS) synoviocoeles treated tenoscopically under ultrasonographic guidance.Study designRetrospective case series.AnimalsClient‐owned horses (n = 10).MethodsMedical records were searched for horses with lameness localized to the region of the DFTS and clinical evidence of a fluid‐filled mass (synoviocoele) associated with the DFTS. Diagnostic imaging and surgical findings, together with long‐term outcome, were reported.ResultsLameness and synoviocoeles were unilateral (5 forelimbs, 5 hindlimbs; 3 lateral and 2 medial in both) and located proximal to the palmar/plantar annular ligament. Synoviocoeles had a firm consistency and focal pain with inability to deflate on non–weight‐bearing examination. Intrathecal DFTS anesthesia was positive in 7/8 horses in which it was performed, with the remainder localized to the region of the synoviocoele using perineural and/or intralesional anesthesia. Communication between the DFTS and synoviocoele was suspected ultrasonographically in all cases and confirmed on contrast tenography (6/6). Tenoscopic fenestration of the communication between the DFTS and synoviocoele under ultrasonographic guidance, with treatment of concurrent intrathecal injury (4/10), resolved the lameness in all horses re‐evaluated by a veterinarian (9/9) and allowed return to full athletic function in all cases at long‐term follow up (median 5 years; range 1.25‐9 years).ConclusionTenoscopic decompression was an effective treatment for DFTS synoviocoeles, which, along with treatment of concurrent intrathecal injury, carried an excellent prognosis and avoided the need for resection via an extrasynovial approach.
Online (Remote) Teaching for Laboratory Based Courses Using “digital Twins” of the Experiments
Authors: Deniz Sabri , Müller Ulf Christian , Steiner Ivo , SERGI Thomas 
Published: December 2021

Abstract
Covid-19 pandemic has introduced radical changes to the engineering education so that most of the teaching moved to the off-campus setting of online classes. However, conducting the laboratory classes, a fundamental part of engineering education has remained to be a challenge. To address to this situation, an ambitious approach is taken to re-establish the laboratory experience entirely online with the help of digital twins of the laboratory experiments.
Laboratory based undergraduate courses are important parts of the curriculum at the Lucerne University of Applied Sciences (HSLU), Switzerland. During the Covid-19 pandemic, it was necessary to adapt to the new environment of remote learning and modify the laboratory experiments so that they can be carried out online. The approach was to develop digital twins of each laboratory experiment with web applications and to provide an environment together with supporting videos and interactive problems so that the laboratory experiments can be carried out remotely.
This paper explains the development of the digital twins of the laboratory experiments and provides information about the selected experiments such as potential vortex, linear momentum equation, diffuser flow, radial compressor, fuel cell, and pump test rig.
A remote or distance learning has many hurdles, a major one being how to teach hands-on laboratory courses outside of an actual laboratory. The experience at the HSLU showed that teaching online laboratories using the digital twins of the experiments can work and the students can take part in remote laboratories that meet the learning objectives.
Reflecting on experiences of care: an exploratory qualitative descriptive study of the perspectives of stroke survivors, families and staff
Authors: Bulsara Caroline , Saunders Rosemary , Emery Laura , Etherton-Beer Christopher 
Published: December 2021

ObjectiveThe aim of this study was to identify barriers and enablers from the perspectives of stroke survivors, carers and staff to understand the experiences of care.DesignThe study used a qualitative descriptive methodology and employed semistructured interview technique.SettingA metropolitan stroke rehabilitation unit in Western Australia providing rehabilitation services for inpatients and outpatients.ParticipantsOverall, 10 participants (four staff, four stroke survivors and two primary carers) were interviewed. Transcripts were analysed using thematic analysis.ResultsExperiences of care focused on lack of time, urgency to regain mobility, postshock recovery, uncertainty about the future and the importance of accepting help once home. There was a degree of mismatch between staff experiences of the reality of what can be provided and the experiences and expectations of stroke survivors and families. However, the benefits of a specialised rehabilitation unit were found to contribute to a positive patient experience overall. The specialised unit demonstrated that services must optimise staff time with patients and carers in the poststroke rehabilitation journey to ensure benefits for the long-term well-being for both.ConclusionSeeking patient, family and staff experiences of care can provide valuable insights into facilitating better patient, family and staff engagement for preparation for home-based rehabilitation for stroke survivors and their caregivers. Further research with a larger sample across diverse hospital settings would provide even greater insight into strategies to best address the reality of rehabilitation care and readiness of patients when returning home to the community.
Risk factors associated with the coexistence of stunting, underweight, and wasting in children under 5 from 31 sub-Saharan African countries
Authors: Amadu Iddrisu , Seidu Abdul-Aziz , Duku Eric , Boadu Frimpong James , Hagan Jnr. John Elvis , Aboagye Richard Gyan , Ampah Belinda , Adu Collins , Ahinkorah Bright Opoku 
Published: December 2021

ObjectiveThis study investigated the risk factors associated with the coexistence of stunting, underweight, and wasting among children under age 5 in sub-Saharan Africa (SSA).DesignData of 127, 487 under-5 children from 31 countries in SSA were pooled from the Demographic and Health Surveys collected between 2010 and 2019. We examined the risk of coexistence of stunting, underweight, and wasting using multinomial logistic regression models. The results were presented using relative risk ratios (RRR) with corresponding confidence intervals (CIs).SettingThirty-one sub-Saharan African countries.ParticipantsChildren under age 5.Outcome measuresThe outcome variables were three child anthropometrics: stunting (height-for-age z-scores); underweight (weight-for-age z-scores) and wasting (weight-for-height z-scores).ResultsThe prevalence of coexistence of stunting, underweight, and wasting varied across countries, with the highest (12.14%) and lowest (0.58%) prevalences of coexistence of stunting, underweight and wasting in Benin and Gambia respectively. The risk of coexistence of the three indicators of undernutrition was higher among children aged 1 year (RRR=3.714; 95% CI 3.319 to 4.156) compared with those aged 0. The risk of coexistence of the three dimensions was lower among female children (RRR=0.468 95% CI 0.420 to 0.51), but higher for those with small size at birth (RRR=3.818; CI 3.383 to 4.308), those whose mothers had no education (RRR=3.291; 95% CI 1.961 to 5.522), not working (RRR=1.195; 95% CI 1.086 to 1.314), had no antenatal visits during pregnancy (RRR=1.364; 95% CI 1.20 to 1.541), children delivered at home (RRR=1.372; CI 1.232 to 1.529), those from poor households (RRR=1.408; 95% CI 1.235 to 1.605), those whose mothers had no access to media (RRR=1.255; 95% CI 1.144 to 1.377) and living in households with an unimproved toilet facility (RRR=1.158; 95% CI 1.032 to 1.300).ConclusionsFindings suggest the urgent need for consideration of the coexistence of stunting, wasting and underweight among under-5 children in policy design and programming of interventions to eradicate child malnutrition in SSA. In the short-term, national-level policies and interventions need to be well tailored considering the compositional characteristics.
Assessment of the effect of a comprehensive chest radiograph deep learning model on radiologist reports and patient outcomes: a real-world observational study
Authors: Jones Catherine M , Danaher Luke , Milne Michael R , Tang Cyril , Seah Jarrel , Oakden-Rayner Luke , Johnson Andrew , Buchlak Quinlan D , Esmaili Nazanin 
Published: December 2021

ObjectivesArtificial intelligence (AI) algorithms have been developed to detect imaging features on chest X-ray (CXR) with a comprehensive AI model capable of detecting 124 CXR findings being recently developed. The aim of this study was to evaluate the real-world usefulness of the model as a diagnostic assistance device for radiologists.DesignThis prospective real-world multicentre study involved a group of radiologists using the model in their daily reporting workflow to report consecutive CXRs and recording their feedback on level of agreement with the model findings and whether this significantly affected their reporting.SettingThe study took place at radiology clinics and hospitals within a large radiology network in Australia between November and December 2020.ParticipantsEleven consultant diagnostic radiologists of varying levels of experience participated in this study.Primary and secondary outcome measuresProportion of CXR cases where use of the AI model led to significant material changes to the radiologist report, to patient management, or to imaging recommendations. Additionally, level of agreement between radiologists and the model findings, and radiologist attitudes towards the model were assessed.ResultsOf 2972 cases reviewed with the model, 92 cases (3.1%) had significant report changes, 43 cases (1.4%) had changed patient management and 29 cases (1.0%) had further imaging recommendations. In terms of agreement with the model, 2569 cases showed complete agreement (86.5%). 390 (13%) cases had one or more findings rejected by the radiologist. There were 16 findings across 13 cases (0.5%) deemed to be missed by the model. Nine out of 10 radiologists felt their accuracy was improved with the model and were more positive towards AI poststudy.ConclusionsUse of an AI model in a real-world reporting environment significantly improved radiologist reporting and showed good agreement with radiologists, highlighting the potential for AI diagnostic support to improve clinical practice.
Cohort study to explore the association between the COVID-19 pandemic lockdown and admissions for violence in North East and North Cumbria
Authors: Brown Andrea , Collingwood Paul , Newton Julia L 
Published: December 2021

ObjectivesExplore the association between the first national lockdown associated with the COVID-19 pandemic on admissions for violence and the relationship with deprivation.DesignPopulation-based longitudinal cohort study.SettingNorth East and North Cumbria (NENC) area of England.ParticipantsAll individuals living in the NENC (total population 3.1 million) admitted 2017/2018, 2018/2019, 2019/2020.Main outcome measuresHospital Episode Statistics were extracted at Lower Layer Super Output Area and the Index of Multiple Deprivation 2019 decile applied. Directly standardised rates were explored for number of accident and emergency (A&E) attendances (per 1000); Alcohol-related admissions using Public Health England (PHE) Fingertips tool (per 100 000, ID 91414) and emergency admissions for violence (including sexual violence) (per 100 000) (ID 11201 classified by International Classification of Diseases (ICD)10 codes X85 to Y09).ResultsA&E attendances are higher in NENC compared with England (409.9 per 1000 v 359.2). A&E attendance was 81% higher in 2019/20 in the most deprived compared with the least deprived. Attendances dropped during the first national COVID-19 lockdown and by September 2020 had not returned to ‘normal’ levels.Admissions related to violence are a third higher in NENC (29% to 34% higher across 3 years) rates 7–10 times higher in most deprived than least deprived areas. Admission rates reduced during the first UK lock down but this bounced back by August higher than any of the previous 12 months.ConclusionEmergency admissions with violence appear to associate with the COVID-19 pandemic being initially higher than before the first national lockdown. This is in the context of overall A&E attendances which are lower post lockdown. Given that emergency admissions with violence have been consistently higher in the NENC compared with England over recent years, we suggest that targeted action is required in NENC to address health inequalities.
Trajectories of success and/or distress: protocol for an observational cohort study investigating changing psychological distress among emerging Ecuadorian adults over a year
Authors: Paz Clara , Osejo-Taco Gabriel , Evans Chris 
Published: December 2021

IntroductionEmerging adulthood is a period of instability with changes in personal relationships and often a series of job changes before life trajectories clarify and more lasting decisions are possible. These changes often produce distress, and they might explain why most of the symptoms that impact the individual’s mental health throughout their lives appear at this stage, although full-blown disorders are often only diagnosed subsequently. The objective of this study is to analyse the intraindividual changes in psychological distress and health-related quality of life in both student and non-student emerging adults over 1 year. Between-individual differences in variability will be analysed and life events will be recorded to identify possible associations.Methods and analysisParticipants will be emerging adults (18–29 years of age) students and non-students. The primary outcome will be psychological distress measured using the Clinical Outcomes in Routine Evaluation-Outcome Measure and the secondary outcome will be health-related quality of life measured by the EuroQol five-dimension-three-level. Sociodemographic and life events will be recorded. Information will be collected using an online survey.Analyses, described in a data analysis plan with the registration, will check the psychometric properties of the measures, describe the distribution of scores on the outcome measures, their relationship to group and other demographic variables and how they change over the seven assessment points across a year and explore any relationship between scores and life events.Ethics and disseminationThis study received ethical approval by the Comité de Ética y Bioética (Ethics and Bioethics Committee) of the Universidad de Las Américas, Quito-Ecuador (2020-0807). Results will be published in peer-reviewed journals and presented at relevant meetings. Brief reports of these publications will be disseminated using social media to reach the community and private or public organisations interested in emerging adults.Trial registration numberNCT04596345