bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconceptualizing the meaning of indirect force and the scope of its regulation under international law
Authors: Udorji Chosen 
Published: December 2024

Abstract
The preponderance and transformation of state use of indirect force continues to raise conceptual questions about defining which indirect acts of a state will fall within the scope of Article 2(4) of the United Nations Charter. The above problem of clarity is tied to the nature of indirect force itself, which is often predominantly carried out in secrecy. As such, it is often difficult to identify the aiding state or trace the chain of causation directly to that state. The ICJ’s traditional (narrow) conception of indirect force has not helped in clarifying this grey area of international law. This article argues that this traditional framing of the meaning of indirect force under international law is problematic in that it fails to show why assistance to groups or to state(s), if involving arming and training against a target state, should be conceptually different from other forms of assistance involving logistical or financial support if both scenarios involved the aiding state(s) positively assisting the attacker. By viewing this practice through both doctrinal and critical theoretical lenses, particularly in the context of Critical Legal Studies, incorporating Indeterminacy theory and Third World Approach to International Law, this article seeks to demonstrate that the inadequate scrutiny of the state use of indirect force can be attributed to the inherent weakness of positivist legal frameworks in accommodating the tensions between state sovereignty and state power. This article proposes a broader (yet balanced) approach that incorporates a constructive knowledge parameter to account for positive indirect acts of offending states that are excluded under the current traditional framework.
Employing habitat suitability modeling to assess the distribution and envenomation potential of scorpion species in Iran
Authors: Erfanian Mohammad Bagher , Barahoei Hossein , Zeynali Mohammad Mahdi , Mirshamsi Omid 
Published: December 2024

Abstract
Iran is a biodiversity hotspot of scorpions with 80 recorded species. Thus, scorpion envenomation is a serious public health problem in the country. Here, we used habitat suitability modeling to assess the spatial distribution of scorpions in Iran. Only 45 species had sufficient georeferenced data. We used bioclimatic variables, soil temperature layers, and 9 modeling algorithms to perform habitat suitability modeling. We employed an ensemble approach to obtain the final models. We calculated the richness map and drew distribution maps for genera with more than 1 species. Also, we assessed the scorpions’ species richness inside and outside of national parks. Finally, we created a risk map of encountering a venomous scorpion. The results showed that the highest scorpion richness is in the southern and southwestern parts of Iran, especially in the coastal areas of the Persian Gulf. We observed 3 biodiversity hotspots for scorpions that are located in the south and southwestern, central parts, and eastern parts of Iran. Except for northern parts, there is a possibility of encountering a venomous scorpion in other parts of Iran. The 3 biodiversity hotspots are also the areas with the highest chance of encountering a venomous species. We found that the hotspots are not protected and are located in areas facing land-use changes. Thus, hotspots have the highest human–scorpion conflicts. Our results provide new insight into the distribution of scorpion species in Iran. Conservation actions that ensure both human safety and species richness are essential and can be achieved by halting further land degradation in scorpion habitats and providing easy-to-understand manuals for local people.
Relationship Between Hepatic Iron Concentration and Glycemic Metabolism, Prediabetes, and Type 2 Diabetes: A Systematic Review
Authors: Kirkutyte Indre , Latunde-Dada Gladys Oluyemisi 
Published: December 2024

Abstract

Context
Emerging research has suggested a potential link between high iron levels, indicated by serum ferritin levels, and the development of type 2 diabetes (T2D). However, the role of hepatic iron concentration (HIC) on T2D development and progression is not well understood.

Objectives
This study aims to systematically review the literature on HIC and/or the degree of hepatic iron overload (HIO) in individuals with prediabetes and/or diagnosed T2D, and to analyze associations between HIC and markers of glucose metabolism.

Data Sources
The databases Medline, PubMed, Embase, CINAHL, and Web of Knowledge were searched for studies published in English from 1999 to March 2024. This review followed the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

Data Extraction
Data were extracted following the established eligibility criteria. Study characteristics and biomarkers related to prediabetes, T2D, and HIO were extracted. The risk of bias was analyzed using the Newcastle-Ottawa Scale. Data were stratified by the exposure and analyzed in subgroups according to the outcome. Data regarding the HIC values in controls, individuals with prediabetes, and individuals with T2D and the association estimates between HIC or HIO and markers of glycemic metabolism, prediabetes, or T2D were extracted.

Data Analysis
A total of 12 studies were identified, and data from 4110 individuals were analyzed. HIO was not consistently observed in prediabetic/T2D populations; however, elevated HIC was frequently observed in prediabetic and T2D individuals, and was associated with the disruption of certain glycemic markers in some cases.

Conclusion
The extent of iron overload, as indicated by hepatic iron load, varied among the prediabetic and T2D populations studied. Further research is needed to understand the distribution and regulation of iron in T2D pathology.
Patient–caregiver concordance on death preparedness over Taiwanese cancer patients’ last 6 months
Authors: Wen Fur-Hsing , Hsieh Chia-Hsun , Chou Wen-Chi , Chen Jen-Shi , Chang Wen-Cheng , Tang Siew Tzuh 
Published: December 2024

Abstract

Background
Worldwide patient–caregiver concordance on cognitive prognostic awareness (PA) has been extensively examined, but concordance on sufficient (ie, cognitive and emotional) death preparedness is unexplored. We comprehensively examine the evolution of patient–caregiver concordance on death preparedness over the patient’s last 6 months.

Materials/Methods
This study re-examined data from 2 cohort studies on 694 dyads of cancer patients and their caregivers recruited from a single medical center in Taiwan. Patient and caregiver death-preparedness states were individually identified by latent transition analysis. Patient–caregiver concordance was examined by percentages and kappa coefficients.

Results
No-, cognitive-, emotional-, and sufficient-death-preparedness states were identified for both groups. The no-death-preparedness state reflects neither accurate PA nor adequate emotional preparedness for death. The sufficient-death-preparedness state reflects accurate PA and adequate emotional preparedness for death. In the cognitive- and emotional-death-preparedness states, participants had only accurate PA or adequate emotional-death preparedness, respectively. Prevalence of the sufficient-death-preparedness state increased substantially for patients but decreased slightly for caregivers. Membership in the no- and emotional-preparedness states declined throughout the last 6 months with substantially lower prevalence for caregivers than for patients, whereas the prevalence of the cognitive-death-preparedness state increased. Concordance was poor throughout the patient’s last 6 months (percent concordance: 31.6% [95% CI, 24.7%, 38.5%]-43.5% [39.2%, 47.9%], kappa: 0.077 [−0.009, 0.162]-0.115 [0.054, 0.176]) with significant improvement in the last month only.

Conclusion
Poor patient–caregiver concordance on death-preparedness states likely reflects the cultural practice of family-consent prognostic disclosure, patients’ adjustment for death, and difficulties in patient–caregiver communication on end-of-life (EOL) issues, indicating targets for improving EOL care.
Neural dynamics of social verb processing: an MEG study
Authors: Amoruso Lucia , Moguilner Sebastian , Castillo Eduardo M , Kleineschay Tara , Geng Shuang , Ibáñez Agustín , García Adolfo M 
Published: December 2024

Abstract
Human vocabularies include specific words to communicate interpersonal behaviors, a core linguistic function mainly afforded by social verbs (SVs). This skill has been proposed to engage dedicated systems subserving social knowledge. Yet, neurocognitive evidence is scarce, and no study has examined spectro-temporal and spatial signatures of SV access. Here, we combined magnetoencephalography and time-resolved decoding methods to characterize the neural dynamics underpinning SVs, relative to nonsocial verbs (nSVs), via a lexical decision task. Time-frequency analysis revealed stronger beta (20 Hz) power decreases for SVs in right fronto-temporal sensors at early stages. Time-resolved decoding showed that beta oscillations significantly discriminated SVs and nSVs between 180 and 230 ms. Sources of this effect were traced to the right anterior superior temporal gyrus (a key hub underpinning social conceptual knowledge) as well as parietal, pre/motor and prefrontal cortices supporting nonverbal social cognition. Finally, representational similarity analyses showed that the observed fronto-temporal neural patterns were specifically predicted by verbs’ socialness, as opposed to other psycholinguistic dimensions such as sensorimotor content, emotional valence, arousal, and concreteness. Overall, verbal conveyance of socialness seems to involve distinct neurolinguistic patterns, partly shared by more general sociocognitive and lexicosemantic processes.
Impact of a trace mineral injection at weaning on growth, behavior, and inflammatory, antioxidant, and immune responses of beef calves
Authors: Vedovatto Marcelo , Ferreira Matheus F L , Edwards Ashley K , Gurie Jeffrey A , Marcon Hiam , Ranches Juliana , Reis Barbara R , Vieira Douglas G , Lima Eduardo A , Santos Mariana , Franco Gumercindo L 
Published: December 2024

Abstract
Two experiments evaluated the effects of an injectable trace mineral (ITM) solution at weaning on trace mineral (TM) status, inflammatory and antioxidant responses, grazing behavior, response to vaccination, and growth of beef calves. Experiment 1 used 86 Nellore calves (40 females and 46 males; body weight [BW] = 198 ± 30.8 kg; 8 ± 1 mo of age) weaned (day 0) and assigned into one of two treatments: saline (0.9% NaCl) or ITM (60 mg of Zn/mL, 15 mg of Cu/mL, 5 mg of Se/mL, and 10 mg of Mn/mL). Saline and ITM were administered subcutaneously at a dose of 1 mL/45 kg of BW. On day 0, calves were vaccinated against infectious bovine rhinotracheitis (IBR), parainfluenza-3 (PI3), bovine viral diarrhea virus types 1 and 2 (BVDV-1 and 2) and bovine respiratory syncytial virus (BRSV). Blood samples and BW were collected on days 0, 3, 8, 15, 51, and 100, and grazing behavior was evaluated on days 1, 2, 4, 5, 6, 7, and 9. The ITM did not affect (P ≥ 0.56) serum mineral concentrations of Zn and Cu, but decreased (P ≤ 0.02) plasma concentrations of cortisol on days 3 and 8 and haptoglobin on day 3. The ITM increased (P &lt; 0.01) plasma concentration of superoxide dismutase on days 8, 15, and 51 and tended to decrease (P = 0.08) plasma concentration of glutathione peroxidase on day 3. Furthermore, there were no effects of treatment (P ≥ 0.14) on most of the behavior variables evaluated, ITM reduced (P = 0.01) the seeking time on days 0 and 4. Furthermore, ITM tended to increase (P = 0.10) the serum titer concentration against IBR on days 15 and 51 but did not affect (P ≥ 0.12) titer concentration against PI3, BVDV-1, and 2, and growth. Experiment 2 used 50 Brangus male calves (BW = 264 ± 34.1 kg; 8 ± 1 mo of age) weaned on day 0, vaccinated against respiratory diseases, stratified by BW, and randomly assigned to saline or ITM as described in experiment 1. Liver samples were collected on days 0, 14, and 197, blood samples on days 0, 14, and BW on days 0, 14, 44, 78, 122, 162, and 197. The ITM increased (P ≤ 0.03) the liver concentration of Cu and Se on day 14 but did not affect (P ≥ 0.17) the liver concentration of Zn and Mn. In addition, ITM increased (P = 0.05) the serum titer concentration against BVDV-2 but did not affect (P ≥ 0.20) the titer concentrations against IBR, PI3, BVDV-1, and BRSV, and did not affect (P ≥ 0.29) the growth. In conclusion, ITM application at weaning improved Cu and Se status, enhanced antioxidant and immune responses, and reduced stress and inflammation in calves, though it did not affect growth.
Impact of a personalized intervention on preoperative anxiety and determination of the minimal clinically important difference in anxiety levels – a randomized clinical trial.
Authors: Salzmann Stefan , Kikker Laura , Tosberg Ellen , Becker Noah , Spies Markus , Euteneuer Frank , Rüsch Dirk 
Published: December 2024

Background:
Preoperative anxiety is common and most patients experiencing preoperative anxiety would welcome support to cope with their anxiety. Studies examining the effectiveness of information to reduce anxiety have been inconsistent. In addition, it is unclear whether results reported to be statistically significant are also clinically relevant. This study’s primary objective was to test the hypothesis that a personalized and information-based intervention would reduce anesthesia-related anxiety.

Methods:
In this single-center, prospective, randomized, controlled trial, 122 adults awaiting elective surgery under general anesthesia were randomized (1:1) to receive a personalized and information-based intervention in addition to standard preanesthetic consultation (intervention group) or standard preanesthetic consultation (control group) the day before surgery. Anxiety was assessed at two time points before and at four time points after randomization until induction of anesthesia to state their anxiety level using the Amsterdam Preoperative Anxiety and Information Scale (two items each for anesthesia- and surgery-related anxiety, each item’s score range: 1-5). Constrained linear mixed models were used to analyze the intervention effects. Patients' subjective changes in anxiety (reduced vs. not reduced) and associated numeric scores were used to determine the minimal clinically important difference.

Results:
The intervention led to reduced anesthesia- and surgery-related anxiety in the intervention group compared to the control group after randomization (indicated by significant two-way interactions for anesthesia-related anxiety (F(5, 96.291) = 7.449, p<.001) and surgery-related anxiety (F(5, 112.486) = 5.466, p<.001)). The minimal clinically important difference in Amsterdam Preoperative Anxiety and Information Scale anxiety scores was 1.03 and 1.13 points for anesthesia- and surgery-related anxiety, respectively.

Conclusions:
A personalized and information-based intervention can reduce anesthesia- and surgery-related anxiety to a statistically significant and clinically relevant degree. Future studies should include an active control group to evaluate this intervention’s specific effects which may be helpful only in patients seeking anxiety-reducing interventions.
Optimal Duration of Antibiotic Therapy for Primary Osteomyelitis Discitis
Authors: Edelbach Brandon , Glaser Dylan , Almekkawi Ahmad K. , Caruso James P. , Sbaiti Ghewa , Aoun Salah G. , Bagley Carlos A. 
Published: December 2024

Study Design.
Systematic Review and Network-Meta-analysis

Purpose.
This study aimed to systematically review the literature on management of primary osteomyelitis discitis and perform a network meta-analysis comparing the efficacy of different antibiotic treatment durations.

Background.
Primary osteomyelitis discitis is a challenging condition with varying management strategies.

Methods.
A comprehensive literature search was conducted. Studies reporting outcomes for treatment of primary osteomyelitis discitis were included. A random-effects network meta-analysis was performed comparing antibiotic treatment durations of <4 weeks, 4-8 weeks, 8-12 weeks, and 12-16 weeks. The surface under the cumulative ranking curve (SUCRA) was used to rank treatment effectiveness.

Results.
Sixty-three articles with 4,233 patients were included. Staphylococcus aureus was the most common causative agent (57.6%). The 4-8 week antibiotic duration ranked highest across fixed-effect and random-effects models (SUCRA 0.8207 and 0.8343). The 12-16 week duration ranked highest in the fixed-effect model (SUCRA 0.8460) but dropped substantially in the random-effects model (SUCRA 0.3067). The <4 week duration showed mixed results. The 8-12 week duration consistently ranked lowest. No statistically significant differences were found between durations for symptomatic relief.

Conclusion.
Antibiotic therapy for 4-8 weeks may provide the optimal balance of efficacy and treatment duration for most patients with primary osteomyelitis discitis. However, treatment should be individualized based on clinical response. Further prospective studies are needed to clarify optimal management strategies for this complex condition.
Redefining Clinically Significant Blood Loss in Complex Adult Spine Deformity Surgery
Authors: Daher Mohammad , Xu Andrew , Singh Manjot , Lafage Renaud , Line Breton G. , Lenke Lawrence G. , Ames Christopher P. , Burton Douglas C. , Lewis Stephen M. , Eastlack Robert K. , Gupta Munish C. , Mundis Gregory M. , Gum Jeffrey L. , Hamilton Kojo D. , Hostin Richard , Lafage Virginie , Passias Peter G. , Protopsaltis Themistocles S. , Kebaish Khaled M. , Schwab Frank J. , Shaffrey Christopher I. , Smith Justin S. , Bess Shay , Klineberg Eric O. , Diebo Bassel G. , Daniels Alan H. ,   on behalf of the International Spine Study Group (ISSG)
Published: December 2024

Study Design.
Retrospective analysis of prospectively-collected data

Objective.
This study aims to define clinically relevant blood loss in adult spinal deformity (ASD) surgery.

Background.
Current definitions of excessive blood loss following spine surgery are highly variable and may be suboptimal in predicting adverse events (AE).

Methods.
Adults undergoing complex ASD surgery were included. Estimated blood loss (EBL) was extracted for investigation, and estimated blood volume loss (EBVL) was calculated by dividing EBL by the preoperative blood volume utilizing Nadler’s formula. LASSO regression was performed to identify five variables from demographic and peri-operative parameters. Logistic regression was subsequently performed to generate a receiver operating characteristics (ROC) curve and estimate an optimal threshold for EBL and EBVL. Finally, the proportion of patients with AE plotted against EBL and EBVL to confirm the identified thresholds.

Results.
In total 552 patients were included with a mean age of 60.7±15.1 years, 68% females, mean CCI was 1.0±1.6, and 22% experienced AEs. LASSO regression identified ASA score, baseline hypertension, preoperative albumin, and use of intra-operative crystalloids as the top predictors of an AE, in addition to EBL/EBVL. Logistic regression resulted in ROC curve which was used to identify a cut-off of 2.3 liters of EBL and 42% for EBVL. Patients exceeding these thresholds had AE rates of 36% (odds-ratio: 2.1, 95% CI [1.2-3.6]) and 31% (odds-ratio: 1.7, 95% CI [1.1-2.8]), compared to 21% for those below the thresholds of EBL and EBVL, respectively.

Conclusion.
In complex ASD surgery, intraoperative EBL of 2.3 liters and an EBVL of 42% are associated with clinically-significant AEs. These thresholds may be useful in guiding preoperative-patient-counseling, healthcare system quality initiatives, and clinical perioperative bloodloss management strategies in patients undergoing complex spine surgery. Additionally, similar methodology could be performed in other specialties to establish procedure-specific clinically-relevant bloodloss thresholds.
A Systematic Review and Meta-analysis of Single-group Studies Assessing the Role of Calcium Hydroxylapatite in Aesthetic Enhancements and Satisfaction
Authors: Amiri Mojgan , Meçani Renald , Niehot Christa D. , Phillips Terri L. , Goldie Katherine , Kolb Janina , Muka Taulant , Daughtry Hua 
Published: December 2024

Background:
Many studies assess aesthetic effectiveness of calcium hydroxylapatite (CaHA), with single-group designs as the most frequently applied designs in practice. This study systematically reviewed CaHA’s effectiveness for aesthetic purposes among these studies.

Methods:
A comprehensive search was conducted across 5 bibliographic databases. Single-group studies with at least 10 human adults were included. Summary measures of patients satisfaction and global aesthetic improvement scores were combined using the generalized linear mixed model. This systematic review adhered to the PRISMA reporting standards.

Results:
Of 3131 records, 46 single-group studies, majority focused on facial areas (n = 32), were included for final qualitative analysis. A total number of 27 studies were included in the meta-analysis. Findings of the meta-analysis showed that 98% (95% confidence interval [CI], 91%–99%; I
2, 0.0%) of patients were satisfied with the injection results in the facial area and 90% (95% CI, 67%–97%, I
2, 35%) in other treated body areas. Also, patients reported 89% (95% CI, 76%–96%; I
2, 65%) improvement on the global aesthetic improvement scale in facial areas and 94% (95% CI, 75%–99%; I
2, 0.0%) in other treated regions. Similarly, investigators reported global aesthetic improvement in 92% of patients (95% CI, 33%–100%; I
2, 92%) in facial areas and 95% (95% CI, 1%–100%; I
2, 89%) in other treated areas.

Conclusions:
Our findings showed aesthetic improvements and satisfaction following CaHA injections in both facial and nonfacial areas. However, studies focusing on nonfacial regions are limited. We recommend more rigorously designed trials to better understand CaHA’s clinical effects.
The Association of County-Level Presidential Election Outcome and COVID-19 Mortality in Colorado, 2020-2022
Authors: DeBie Kelly A. , Gutilla Margaret J. , Keller Kayleigh P. , Peel Jennifer L. , Rojas-Rueda David , Neophytou Andreas M. 
Published: December 2024

Context:
The Coronavirus disease 2019 (COVID-19) pandemic occurred during a time of political tension in the United States. County-level political environment may have been influential in COVID-19 outcomes.

Objective:
This study examined the association between county-level political environment and age-adjusted COVID-19 mortality rates from 2020 to 2022.

Design & Setting:
Political environment was measured by the 2020 Presidential election results and compared with age-adjusted COVID-19 mortality rates by county in Colorado.

Main Outcome Measures:
Rate ratios (RR) and 95% confidence intervals (CI) were estimated using negative binomial regression incorporating a population offset term. Models adjusted for populational differences using the demographics percentile from Colorado’s EnviroScreen Environmental Justice Tool.

Results:
Age-adjusted county mortality rates ranged from 14.3 to 446.8.0 per 100 000. 2021 COVID-19 mortality rates were nearly twice as high in counties voting for Donald Trump compared to those voting for Joseph Biden (adjusted RR = 1.98, 95% CI: 1.59, 2.47). Results for 2020 and 2022 mortality models were also in the positive direction, though the confidence intervals crossed null values.

Conclusion:
These results build on a growing body of evidence that political environment may have been influential for COVID-19 mortality, helping to understand the drivers of health outcomes. Implications for the public health system as we shift into the endemic period of COVID-19 include motivation for collaborative work to restore and rebuild trust among and between stakeholders and the community, as well as increase health education given its’ influence on both individual and community behaviors.