bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uganda's fiscal policy reforms: What have we learned?
Authors: Mawejje Joseph , Odhiambo Nicholas M. 
Published: March 2021

AbstractThis article attempts to provide an exploratory review of policy reforms, trends, and determinants of fiscal deficits in Uganda, a low‐income country that has undertaken many successful economic reforms. Fiscal policy reforms initially sought to stabilize the economy in the post‐crisis period with structural adjustment and economic recovery programs. With the restoration of macroeconomic stability, fiscal objectives shifted to poverty eradication following the promulgation of the Poverty Eradication Action Plan. More recently, a key fiscal policy objective is to unlock key growth and competitiveness constraints with the rolling out of National Development Plans. These reforms achieved much success in the early years, especially in the areas of macroeconomic stabilization and growth because they received support and political goodwill from the highest echelons of government. However, fiscal slippages during more recent years have often threatened to reverse the hard‐earned gains from these reform programs. Consequently, fiscal outcomes have been characterized by revenue shortfalls, budget execution challenges, accumulation of arrears, and rising debt.
Economic growth takeoffs and the extensive and intensive margins of trade
Authors: Bista Rishav , Sheridan Brandon J. 
Published: March 2021

AbstractIn this study, we use a gravity model to investigate the relationship between exports and sudden, prolonged increases in economic growth. Our main contribution is we decompose exports into the extensive and intensive margins when considering this relationship. Using the definition of takeoffs in a country's growth process from Aizenman & Spiegel, we identify 142 economic growth takeoffs. We find that the extensive margin is an important mechanism for export growth and, ultimately, economic growth. We also find evidence that exports increase significantly immediately before, and during, a growth episode, with the extensive margin being entirely responsible for the observed increase in exports. Finally, we find that developing countries see a larger percentage point increase in the extensive margin and decrease in the intensive margin during a takeoff. These results suggest that takeoffs may spur a reduction in the fixed costs to exporting, which propel an increase in the extensive margin. Therefore, export diversification appears to be a potential policy option for those seeking to increase the chances of a growth takeoff in their country, and takeoffs seem to present an opportunity for further export diversification.
Moisture sensor for exudative wounds – A pilot study
Authors: Henricson Joakim , Sandh Jenny , Iredahl Fredrik 
Published: March 2021

AbstractBackgroundExudative wounds cause discomfort for patients. Introduction of a moisture sensor to dressings could facilitate change of dressings only when needed. The aim of this pilot study was to evaluate the ability of a newly developed moisture sensor to detect moisture in relation to the absorbing capacity of the dressing.Materials and MethodsIn five patients, with one leg ulcer each, three dressing changes per patient were observed. Interval of dressing change was according to clinical need and healthcare professional's decision. Sensor activation, dressing weight and complications were registered. To investigate the effect of dressing on sensor activation, half of the observations were made without an extra layer of non‐woven between the dressing and sensor (Variant A), and half with (Variant B).ResultsThe sensor indicated time for dressing change in six out of fifteen observations. Variants A and B did not differ regarding activation or the timing of the activation.ConclusionsThe addition of a moisture sensor for facilitating management of exudative wounds is promising. We recommend future larger studies evaluating the potential clinical benefits and risks of the addition of a moisture sensor. We also recommend evaluation of potential home monitoring of wounds by a moisture sensor.
Identifying temporal patterns of multilateral spatial interactions: Using international trades as an example
Authors: Luo Wei , Yuan May 
Published: March 2021

AbstractGravity models, popular for estimating spatial interactions, assume independent spatial interactions from locations to all other locations and, therefore, overlook potential latent multilateral influences in play. This research combines self‐organizing map (SOM) and trajectory analysis to classify patterns of spatial interactions and trace changes in the patterns simultaneously across all locations and decipher the development and dependence of multilateral interactions in space and time. We use international trading among 207 countries from 1900 to 2014 to demonstrate the proposed SOM–trajectory analysis. We create SOMs of annual international trade for all countries, trace each country's changes in trading patterns over 115 years, and compare the trajectories for countries. The combined SOM–trajectory analysis elicits the hidden trading development and geographic influences brought into play. The proposed method is adaptable to other domains of spatial interactions (e.g., immigration) to characterize the temporal patterns of multilateral spatial interactions at locations individually or contextually.
A perspective on the potential detrimental role of inflammation in pig orthotopic heart xenotransplantation
Authors: Thompson Charles P. , Jagdale Abhijit , Walcott Gregory , Iwase Hayato , Foote Jeremy B. , Cron Randall Q. , Hara Hidetaka , Cleveland David C. , Cooper David K. C. 
Published: March 2021

AbstractThere is a critical shortage of deceased human donor organs for transplantation. The need is perhaps most acute in neonates and infants with life‐threatening congenital heart disease, in whom mechanical support devices are largely unsuccessful. If orthotopic (life‐supporting) heart transplantation (OHTx) were consistently successful in the genetically engineered pig‐to‐nonhuman primate (NHP) model, a clinical trial of bridging with a pig heart in such patients might be justified. However, the results of pig OHTx in NHPs have been mixed and largely poor. We hypothesise that a factor is the detrimental effects of the inflammatory response that is known to develop (a) during any surgical procedure that requires cardiopulmonary bypass, and (b) immediately after an NHP recipient is exposed to a pig xenograft. We suggest that the combination of these two inflammatory responses has a direct detrimental effect on pig heart graft function, but also, and possibly of more importance, on recipient baboon pulmonary function, which further impacts survival of the pig heart graft. In addition, the inflammatory response almost certainly adversely impacts the immune response to the graft. If our hypothesis is correct, the potential steps that could be taken to reduce the inflammatory response or its effects (with varying degrees of efficacy) include (a) white blood cell filtration, (b) complement depletion or inactivation, (c) immunosuppressive therapy, (d) high‐dose corticosteroid therapy, (e) cytokine/chemokine‐targeted therapy, (f) ultrafiltration or CytoSorb hemoperfusion, (g) reduction in the levels of endogenous catecholamines, (h) triiodothyronine therapy and (i) genetic engineering of the organ‐source pig. Prevention of the inflammatory response, or attenuation of its effects, by judicious anti‐inflammatory therapy may contribute not only to early survival of the recipient of a genetically engineered pig OHTx, but also to improved long‐term pig heart graft survival. This would open the possibility of initiating a clinical trial of genetically engineered pig OHTx as a bridge to allotransplantation.
Media coverage and framing of road traffic safety in India
Authors: Gupta Medhavi , Kakar Inayat Singh , Peden Margaret , Altieri Elena , Jagnoor Jagnoor 
Published: March 2021

BackgroundMedia coverage of road traffic collisions (RTCs) may influence preventative action. India experiences some of the highest RTC mortality and morbidity rates globally, but advocacy and effective action to mitigate this has been limited. We conducted an analysis of Indian media in English to assess whether coverage met the WHO’sReporting on Road Safetyguidelines for evidence-based reporting of RTCs.MethodsEnglish-language articles published online between March 2018 and February 2019 were assessed against the seven recommended story angles and seven recommended key elements in the WHO guidelines.Results458 articles were included in the analysis. The most common story angle was descriptions of single collisions, which was not a WHO-recommended story angle. These included limited key elements such as use of human story or linking to road safety risks or evidence-based solutions. However, some articles did follow the WHO-recommended story angles, with 22.1% discussing specific road safety solutions and a further 6.3% discussing vulnerable groups. Almost all articles avoided the use of technical language, but only 2.0% explicitly stated that RTCs were preventable. More than half identified at least one evidence-based solution. Very few articles discussed economic or health impacts of RTCs, including the burden they present to the public health system.ConclusionIndian media in English can improve reporting by focusing on human stories and documenting experiences of those injured in RTCs. Coverage should also focus more on evidence-based solutions, emphasising the systems approach which encourages government action rather than changes to individual behaviour.
Critical analysis of the Armed Forces Covenant Fund Trust Aged Veterans Fund
Authors: Di Lemma Lisa C G , Finnegan A , Howe S 
Published: March 2021

BackgroundRelatively little research is available regarding the specific needs of older military veterans and the services introduced to support them. In 2016, the Armed Forces Covenant Fund Trust launched the Aged Veterans Fund (AVF), to understand the impact that military service may have on ageing, and to support initiatives targeting their health and well-being. This fund was financed for 5 years and included 19 UK portfolio projects.MethodThe paper presents a retrospective evaluation on the processes and impact of the AVF, with the intent of informing policy, educational services, service providers and stakeholders of the lessons learnt. The inclusion criteria was veterans and their families aged 65 years of age or over. In 2019, data were drawn from documentary evidence related to the programmes. Qualitative analysis were performed on 78 eligible sources and 10 themes were identified.ResultsProgrammes were rolled out via collaborative partnerships referrals, focusing on person-centred or skill-exchange approaches. Challenges were encountered, such as capacity and timelines issues. A limited amount of associated cost-savings was observed, even if examples of sustainability and high satisfaction were reported. Evidence was found of programmes boosting health and well-being outcomes, in raising awareness, and in positively impacting on clinical practice, such as re-admission rates.ConclusionThe AVF programmes were successful in their intent to provide support to older veterans and their families. The findings provide indicators of the next steps required for the support of ageing veterans. Further investigation of the cost-effectiveness of age-friendly veterans’ services is needed.
Systematic review and meta-analysis of the risk of rheumatoid arthritis-associated interstitial lung disease related to anti-cyclic citrullinated peptide (CCP) antibody
Authors: Kamiya Hiroyuki , Panlaqui Ogee Mer 
Published: March 2021

ObjectiveTo clarify the risk of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) related to anti-cyclic citrullinated peptide (CCP) antibody.Eligibility criteriaPatients with RA with and without ILD were eligible. The primary outcome was the prevalence or incidence of ILD. Primary studies of any design aside from a case report were eligible.Information sourcesMedline, EMBASE, Science Citation Index Expanded and Cochrane Central Register of Controlled Trials were searched from the inception through 12 November 2019.Data extraction and risk of biasTwo reviewers independently selected eligible reports, extracted relevant data and assessed risk of bias using a modified Quality in Prognostic Studies tool.Data synthesisMeta-analysis was conducted using a random-effects model.Quality of evidenceThe Grades of Recommendation, Assessment, Development and Evaluation system was applied.ResultsAmong 29 out of 827 records retrieved through electronic databases and four additional reports identified from other sources, 29 studies were focused for the review. A total of 10158 subjects were included and the mean age at inclusion was between 45.8 and 63.9 years. The mean RA duration was between 4.3 and 14.9 years. The positivity of anti-CCP antibody ranged from 50.7% to 95.8%. All studies except for two were deemed as high risk of bias. A pooled analysis of univariate results demonstrated that the presence of anti-CCP antibody was significantly associated with RA-ILD with an OR of 2.10 (95% CI: 1.59 to 2.78). Similarly, the titre of anti-CCP antibody was significantly higher for RA-ILD with a standardised mean difference of 0.42 (95% CI: 0.20 to 0.65). These results were confirmed by multivariate analysis in the majority of studies and consistent by any subgroup and sensitivity analyses.ConclusionThe presence and higher titres of anti-CCP antibody were suggested to be significantly associated with an increased risk of RA-ILD. However, the quality of evidence was rated as low or very low.
Prevalence and predictors of birth preparedness and complication readiness in the Kassena-Nankana district of Ghana: an analytical cross-sectional study
Authors: Saaka Mahama , Alhassan Lawal 
Published: March 2021

ObjectivesTo assess birth preparedness and complication readiness (BPACR) and associated factors among mothers who had given birth in the past 12 months prior to the study.DesignAn analytical cross-sectional study.SettingThe study was carried out in the rural areas of Kassena-Nankana district located in the Upper East Region of Ghana.ParticipantsThe study population comprised 600 postpartum women who had delivered within the last 12 months prior to the study.Primary outcome measureThe primary outcome measure was BPACR.ResultsThe prevalence of BPACR among recently delivered women was very low as less than 15% were able to mention at least three of the five basic components of birth preparedness/complication readiness that were fulfilled. After adjustment for confounding effect using multivariable logistic regression analysis, high educational level (adjusted OR (AOR)=3.40 (95% CI: 1.88 to 6.15)), better knowledge about obstetric danger signs during pregnancy (AOR=4.88 (95% CI: 2.68 to 8.90)), older women (≥35 years) (AOR=2.59 (95% CI: 1.11 to 6.02)), women of low household wealth index (AOR=4.64 (95% CI: 1.97 to 10.91)) and women who received lower content of antenatal care services (AOR=3.34 (95% CI: 1.69 to 6.60)) were significant predictors of BPACR.ConclusionThis study concludes that BPACR practices were low. High educational attainment of the woman, having adequate knowledge about obstetric danger signs during pregnancy, older women (≥35 years) and women of low household wealth index were significant predictors of BPACR. The predictors identified should be given high priority by health authorities in addressing low prevalence of BPACR.
Which parameters support disposition decision in suspected COVID-19 cases in the emergency department (ED): a German clinical cohort study
Authors: Möckel Martin , Stegemann Miriam Songa , Burst Volker , Kümpers Philipp , Risse Joachim , Koehler Felix Carlo , Schunk Domagoj , Hitzek Jennifer , Dietrich Tamara Elene , Slagman Anna 
Published: March 2021

ObjectivesOne major goal of the emergency department (ED) is to decide, whether patients need to be hospitalised or can be sent home safely. We aim at providing criteria for these decisions without knowing the SARS-CoV-2 test result in suspected cases.SettingTertiary emergency medicine.ParticipantsAll patients were treated at the ED of the Charité during the pandemic peak and underwent SARS-CoV-2 testing. Patients with positive test results were characterised in detail and underwent a 14-day-follow-up.Primary and secondary outcome measuresLogistic regression and classification and regression tree (CART) analyses were performed to identify predictors (primary endpoint), which confirm safe discharge. The clinical endpoint was all-cause mortality or need for mechanical ventilation during index stay or after readmission.ResultsThe primary test population of suspected COVID-19 consisted of n=1255 cases, 45.2% were women (n=567). Of these, n=110 tested positive for SARS-CoV-2 (8.8%). The median age of SARS-CoV-2-positive cases was 45 years (IQR: 33–66 years), whereas the median age of the group tested negative for SARS-CoV-2 was 42 years (IQR: 30–60 years) (p=0.096). 43.6% were directly admitted to hospital care.CART analysis identified the variables oxygen saturation (<95%), dyspnoea and history of cardiovascular (CV) disease to distinguish between high and low-risk groups. If all three variables were negative, most patients were discharged from ED, and the incidence of the clinical endpoint was 0%. The validation cohort confirmed the safety of discharge using these variables and revealed an incidence of the clinical endpoint from 14.3% in patients with CV disease, 9.4% in patients with dyspnoea and 18.2% in patients with O2 satuaration below 95%.ConclusionsBased on easily available variables like dyspnoea, oxygen saturation, history of CV disease, approximately 25% of patients subsequently confirmed with COVID-19 can be identified for safe discharge.Trial registration numberDRKS00023117.
Dysmenorrhoea as a risk factor for pain with intrauterine device insertion
Authors: Schneyer Rebecca , Lerma Klaira , Conti Jennifer , Shaw Kate 
Published: March 2021

BackgroundUnderstanding predictors of pain with gynaecological procedures may facilitate individualised counselling and pain management. We aimed to study the effect of dysmenorrhoea on intrauterine device (IUD) insertion pain.MethodsThis was a planned secondary analysis of a randomised trial evaluating self-administered lidocaine gel versus placebo for IUD insertion pain. We included those participants who reported menses in the past 3 months. We assessed dysmenorrhoea (in the past 3 months) and procedural pain using a 100 mm visual analogue scale (VAS). We categorised dysmenorrhoea as none/mild (<40 mm), moderate (40–69 mm) or severe (≥70 mm). We assessed participant pain scores at speculum insertion, tenaculum placement, IUD insertion, and overall. We compared median procedural pain scores by dysmenorrhoea group with three-way and post hoc pairwise analyses.ResultsWe analysed 188 participants. Demographic characteristics were similar among the three dysmenorrhoea groups. Pairwise comparisons revealed higher median procedural pain scores in the severe dysmenorrhoea group compared with the none/mild dysmenorrhoea group at speculum insertion (25 mm vs 8 mm; p=0.007), tenaculum placement (51 mm vs 31 mm; p=0.04) and IUD insertion (74 mm vs 61 mm; p=0.04). Overall pain did not differ among the three groups (p=0.32).ConclusionsPatients with severe dysmenorrhoea experienced increased pain with all aspects of IUD insertion, including speculum and tenaculum placement, compared with those with only mild or no dysmenorrhoea. Clinicians may consider this finding when providing individualised counselling and pain management for patients undergoing IUD insertion and other gynaecological procedures. Larger studies are needed to validate the effect of dysmenorrhoea severity on pain throughout IUD insertion.
The growing amplification of social media: measuring temporal and social contagion dynamics for over 150 languages on Twitter for 2009–2020
Authors: Alshaabi Thayer , Dewhurst David Rushing , Minot Joshua R. , Arnold Michael V. , Adams Jane L. , Danforth Christopher M. , Dodds Peter Sheridan 
Published: March 2021

AbstractWorking from a dataset of 118 billion messages running from the start of 2009 to the end of 2019, we identify and explore the relative daily use of over 150 languages on Twitter. We find that eight languages comprise 80% of all tweets, with English, Japanese, Spanish, Arabic, and Portuguese being the most dominant. To quantify social spreading in each language over time, we compute the ‘contagion ratio’: The balance of retweets to organic messages. We find that for the most common languages on Twitter there is a growing tendency, though not universal, to retweet rather than share new content. By the end of 2019, the contagion ratios for half of the top 30 languages, including English and Spanish, had reached above 1—the naive contagion threshold. In 2019, the top 5 languages with the highest average daily ratios were, in order, Thai (7.3), Hindi, Tamil, Urdu, and Catalan, while the bottom 5 were Russian, Swedish, Esperanto, Cebuano, and Finnish (0.26). Further, we show that over time, the contagion ratios for most common languages are growing more strongly than those of rare languages.
Effect analysis of surface metal layer on step height standard
Authors: Zhang Xiaodong , Li Suoyin , Han Zhiguo , Zhao Lin , Feng Yanan , Xu Xiaoqing , Wu Aihua 
Published: March 2021

In order to improve the measurement accuracy of the step height measuring instrument, a semiconductor process was used to prepare the step height standard for calibrating the instrument. Aiming at the problem of deviation in the white light interferometer measuring step height standard, the cause of the measurement deviation was theoretically analyzed, combining the optical theory and the principle of instrument. In addition, referring to the semiconductor sputtering process, a method of sputtering metal layer on the surface of the step structure was proposed, and a set of universal step height standards with a nominal value of [Formula: see text] nm were developed for the step height measuring instrument. Finally, the step height standards with the sputtered metal layer were compared and measured, using the white light interferometer and nanometer measuring machine (NMM). The measurement error of the white light interferometer can be effectively controlled within 1%, which is beneficial to verify the measurement capability of the step height measuring instrument.