bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and characterization of constrained non-exonic bases lacking predictive epigenomic and transcription factor binding annotations
Authors: Grujic Olivera , Phung Tanya N. , Kwon Soo Bin , Arneson Adriana , Lee Yuju , Lohmueller Kirk E. , Ernst Jason 
Published: August 2019

AbstractAnnotations of evolutionarily constraint provide important information for variant prioritization. Genome-wide maps of epigenomic marks and transcription factor binding provide complementary information for interpreting a subset of such prioritized variants. Here we developed the Constrained Non-Exonic Predictor (CNEP) to quantify the evidence of each base in the human genome being in a constrained non-exonic element from over 60,000 epigenomic and transcription factor binding features. We find that the CNEP score outperforms baseline and related existing scores at predicting constrained non-exonic bases from such data. However, a subset of such bases are still not well predicted by CNEP. We developed a complementary Conservation Signature Score by CNEP (CSS-CNEP) using conservation state and constrained element annotations that is predictive of those bases. Using human genetic variation, regulatory sequence motifs, mouse epigenomic data, and retrospectively considered additional human data we further characterize the nature of constrained non-exonic bases with low CNEP scores.
The role of government and the international competitiveness of SMEs
Authors: Appiah Kenneth , Osei Collins , Selassie Habte , Osabutey Ellis 
Published: August 2019

Purpose
The nature of international markets and the challenges with respect to the competitiveness of small- and medium-sized enterprises (SMEs) makes it imperative to examine government support. This study aims to assess the role and effectiveness of government and the export promotion agencies in supporting exports by non-traditional horticultural SMEs in Ghana.

Design/methodology/approach
The study used a qualitative research design, which involved semi-structured interviews with senior managers of six export facilitating institutions to gain an understanding of the services offered to SMEs with respect to exports of non-traditional horticultural products.

Findings
The findings reveal inadequate cost-efficient sources of non-traditional horticultural export financing for SMEs. This is a hindrance to the international competitiveness of exporting SMEs in developing countries such as Ghana. In addition, effective and coordinated support from export promotion agencies was found to be critical.

Originality/value
The study highlights the importance of government’s role in policymaking and implementation of export-led programmes for horticultural exporting firms in Ghana. Despite their strategic importance, this area of research has not attracted the attention of researchers, with little or no information on the horticultural international competitiveness of non-traditional horticultural products.
Landscape‐dependent time versus energy optimizations in pelicans migrating through a large ecological barrier
Authors: Efrat Ron , Hatzofe Ohad , Nathan Ran 
Published: August 2019

Abstract

During migration, birds are often forced to cross ecological barriers, facing challenges due to scarcity of resources and suitable habitats. While crossing such barriers, birds are expected to adjust their behaviour to reduce time, energy expenditure and associated risks.

We studied the crossing of the Sahara Desert by the Great White Pelican (Pelecanus onocrotalus), a large wetland‐specialist. We focused on decisions made by migrating pelicans along different parts of the southbound autumn migration, their response to local environmental conditions and the implications for time and energy optimizations. We compared the observed pelicans' migration routes with simulated ‘direct‐pass’ (shortest, mostly across the desert) and ‘corridor‐pass’ (along the Nile River) routes, and used GPS, body acceleration and atmospheric modelling to compare flight behaviour along the Nile River versus the desert.

The observed route was significantly shorter and faster than the simulated corridor‐pass route and not significantly different from the simulated direct‐pass one. Daily flights over the desert were longer than along the Nile River, with flying time extending to late hours of the day despite unfavourable atmospheric conditions for soaring–gliding flight. Moreover, the pelicans' behavioural response to atmospheric conditions changed according to the landscape over which they flew. Overall, the pelicans showed stronger behavioural adjustments to atmospheric conditions over the desert than along the Nile River.

Our findings suggest that migrating pelicans primarily acted as time minimizers while crossing the Sahara Desert, whereas energetic optimization was only considered when it did not substantially compromise time optimization. The pelicans took the almost shortest possible route, only following the Nile River along its south‐oriented parts, and frequently staged overnight in the desert far from water, despite being large, wet‐habitat specialists. Correspondingly, their behavioural response to atmospheric conditions changed according to the landscape over which they were flying, switching between time (over the desert) and energy (over the Nile River) optimization strategies. Our results suggest that the interaction between landscape and atmospheric conditions depict a flexible, yet primarily time‐dominated, migration optimization strategy.

A free Plain Language Summary can be found within the Supporting Information of this article.
How to Handle the Fiscal Crisis in Greece: Empirical Evidence Based on a Survey of Economic Experts
Authors: Mosler Martin , Potrafke Niklas , Reischmann Markus 
Published: August 2019

AbstractWe asked economic experts polled by the CESifo World Economic Survey how to handle the fiscal crisis in Greece in the year 2015. The sample includes about 850 experts from 110 countries. We find systematic differences in experts’ recommendations. Our results suggest that policy advice is related to an expert's personal and country‐level attributes. Country‐level characteristics, especially credit default swaps as a measure of fiscal stability, predict views on whether Greece should exit the eurozone. An expert's educational background, age and professional affiliation predict opinions on the credit programmes of the International Monetary Fund. We propose that policymakers who seek balanced policy advice should consult experts from different countries and personal backgrounds.
Forensic Significance of Gunshot Impact Marks on Inanimate Objects: The Need for Translational Research
Authors: Nordin Farah Ad‐din , Bominathan Uma Rashmika , Abdullah Ahmad Fahmi Lim , Chang Kah Haw 
Published: August 2019

AbstractWherever an impact mark is found, either on the surface or on the recovered projectile, it is important for forensic investigators to extract useful information in solving shooting‐related cases. This article reviews a collection of works on examination of impact marks upon striking of projectiles on inanimate objects, emphasizing on the retrievable information from a shooting scene and their forensic significance in shooting event reconstruction. Literature suggested that impact marks on target surfaces and the degree of deformation on striking projectiles vary according to different combinations of ammunition and surface materials. It was noted that conditions in real‐case scenarios further differed unpredictably in comparison with controlled studies, where forensic investigation should be treated as case‐specific basis. Furthermore, the way forensic science is researched and applied operationally has to be reconsidered to reduce the gap via translational approach for more effective use of forensic evidence.
Mandibular advancement splints for obstructive sleep apnoea – a cautionary tale
Authors: Spencer S , Goss A , Cheng A , Stein B , Sambrook P 
Published: August 2019

AbstractBackgroundObstructive sleep apnoea is a serious medical condition of increasing prevalence that has a multitude of treatment modalities. The aim of this study was to review the results of patients treated with mandibular advancement splints in the Oral and Maxillofacial Surgery Unit of South Australia to inform ongoing practice in this area.MethodsThe casenotes of patients who received a splint for obstructive sleep apnoea between January 2008 and June 2014 were audited. Data collection included referral and demographic details, sleep study results, splint type and follow‐up details.ResultsThree hundred and four patients were identified as having been provided a mandibular advancement splint for obstructive sleep apnoea, of which 82 had diagnostic and splint‐in‐situ sleep studies available for comparison. It was observed that 27 had clinically significant objective improvement, 40 had no clinically significant change and 15 had clinically worse OSA following MAS therapy. Mean reductions in Apnoea‐Hypopnoea Index and Respiratory Disturbance Index were eight events (27%) and 13 events (33%) per hour respectively with treatment.ConclusionsBased on this study, mandibular advancement splint therapy is a viable treatment for a subset of patients with obstructive sleep apnoea. Protocol driven, multi‐disciplinary care with auditing of results is recommended.
Big is efficient: Evidence from agricultural cooperatives in Ethiopia
Authors: Gezahegn Tafesse W. , Van Passel Steven , Berhanu Tekeste , D'Haese Marijke , Maertens Miet 
Published: August 2019

AbstractIn Ethiopia, there is a renewed interest in agricultural cooperatives as an institutional tool to improve the welfare of smallholder farmers. One of the pathways through which cooperatives benefit their members is scale economies. However, the establishment of cooperatives in Ethiopia seems to pay little attention to the size of the organizations. This article aims at investigating the effect of size on cost efficiency of agricultural cooperatives. More specifically, the purpose is to examine whether a single cooperative can serve a given number of farmers at a lower cost than two or more smaller cooperatives could. We employ the concept of cost subadditivity to compare the cost efficiency of large versus small cooperatives, and by extension unilateral actions. We estimate a flexible production technology using cross‐sectional cooperative‐level data. Findings show that costs would drop by 78% to 181% if farmers join hands in relatively large rather than small cooperatives.
Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system
Authors: Leisegang Kristian , Henkel Ralf , Agarwal Ashok 
Published: August 2019

AbstractObesity and metabolic syndrome (MetS) are global epidemics, driven by an obesogenic environment. This is mediated by complex underlying pathophysiology, in which chronic inflammation is an important aetiological and mechanistic phenomenon. A shift towards a subclinical TH1–lymphocyte mediated innate and chronic inflammatory response is well defined in obesity and MetS, demonstrated in multiple systems including visceral adiposity, brain (hypothalamus), muscles, vasculature, liver, pancreas, testes, epididymis, prostate and seminal fluid. Inflammatory cytokines disrupt the hypothalamic‐pituitary‐testes axis and steroidogenesis cascades (hypogonadotropic hypogonadism), spermatogenesis (poor semen parameters, including DNA fragmentation and detrimental epigenetic modification) and results in subclinical prostatitis and prostate hyperplasia. This review aims to highlight the role of chronic inflammation in obesity and MetS, cytokines in male reproductive physiology and pathophysiology, the impact on steroidogenesis and spermatogenesis, prostate pathology and erectile dysfunction. Currently, it is recommended that clinical assessment of male infertility and reproductive dysfunction in obese and MetS patients includes inflammation assessment (highly sensitive C‐reactive protein), and appropriate advice and therapeutic options are incorporated in the management options. However, the mechanisms and therapeutic options remain poorly understood and require significant interdisciplinary research to identify potential novel therapeutic strategies.
Incidences of obstetric outcomes and sample size calculations: A Danish national registry study based on all deliveries from 2008 to 2015
Authors: Hoegh Stinne , Thellesen Line , Christensen Karl Bang , Bergholt Thomas , Hedegaard Morten , Sorensen Jette Led 
Published: August 2019

AbstractIntroductionIn high‐income countries the majority of pregnancies have a good outcome, and many adverse obstetric outcomes rarely occur. This makes demonstrating clinically relevant and statistically significant effects of new interventions a challenge. The objective of the study was to report incidences of important obstetric outcomes and to calculate sample sizes for tentative studies.Material and methodsThe study was a registry‐based study. Data were retrieved from the Danish Medical Birth Registry and included all deliveries in Denmark from 2008 to 2015. The total population included 465 919 deliveries. The study population comprised intended vaginal deliveries with a single fetus in cephalic presentation at term (n = 381 567). Incidences were reported for 20 outcomes considering the relevance for the patients and the severity of the outcomes. We calculated the sample sizes required in tentative obstetric studies to detect risk reductions of 25 and 50%, for tests at the 5% level, using a power of 80 and 90%. For the randomized controlled trials we calculated the sample size required for comparing two proportions with equal‐sized groups. For the cohort study we calculated the sample size also required for two proportions but with unequal sized groups. Outcome measures for sample size calculation were neonatal mortality, Apgar score <7 at 5 minutes and emergency cesarean section.ResultsThe incidence of neonatal mortality, Apgar score <7 at 5 minutes and emergency cesarean section was 0.05, 0.58 and 10.5%, respectively. Using neonatal mortality as the outcome in a tentative randomized controlled trial with an expected risk reduction of 50% and power of 80%, our calculation showed a sample size of 195 036 deliveries. Using Apgar score <7 at 5 minutes or emergency cesarean section as the outcome, 16 254 and 818 deliveries, respectively, were required. In tentative cohort studies, the required sample sizes were larger due to the unequal proportion of exposed/non‐exposed women.ConclusionsMost adverse obstetric outcomes occur rarely; thus, very large sample sizes are required to achieve adequate statistical power in randomized controlled trials. Multicenter studies, international collaborations or alternative study designs to randomized controlled trials could be considered.
Multimorbidity and medication complexity: New challenges in heart transplantation
Authors: Gomis‐Pastor Mar , Roig Mingell Eulalia , Mirabet Perez Sonia , Brossa Loidi Vicente , Lopez Lopez Laura , Diaz Bassons Alba , Aretio Pousa Ana , Feliu Ribera Anna , Ferrero‐Gregori Andreu , Guirado Perich Lluís , Mangues Bafalluy Mª Antonia 
Published: August 2019

AbstractIntroductionMultimorbidity and therapeutic complexity are a recognized problem in the heart transplant (HTx) population. However, little is known about how best to quantify this complexity or the strategies that could reduce its burden.MethodsThis single‐center, observational study included adult heart transplant recipients (HTxR) >1.5 years from transplant. We assessed multimorbidity (>2 comorbidities) and the patient‐level Medication Regimen Complexity Index Spanish version (pMRCI‐S) score. We also analyzed the independent predictors of pMRCI‐S and the impact of the index score on specific clinical variables.ResultsWe included 135 chronic‐stage HTxR. Comorbidities significantly increased after HTx (6 ± 3 vs 2 ± 2, P‐value < .001). Patients took 12 ± 3 chronic drugs/d, 58% of them to treat comorbidities. The mean total pMRCI‐S score was 42 ± 11, higher than in several other chronic diseases. The medication category drugs to treat comorbidities predicted a higher total pMRCI‐S score (OR = 3.12, 95% CI 2.8‐3.43, P‐value < .001). Therapeutic complexity after HTx had an impact on solid malignancies (OR = 1.1, 95% CI 1.02‐1.18, P‐value = .02) and renal function (OR=−0.81, 95% CI −1.21‐(−0.42), P‐value < .001).ConclusionsThe multimorbidity and pMRCI‐S scores obtained in HTx population were worrisomely high. The pMRCI score is a sensitive method that allows identification of the factors determining therapeutic complexity after HTx and selection of strategies to reduce pMRCI‐S values.
“Donorship” and strategic policy‐making: Germany’s Middle Eastern and North African aid programme since the Arab uprisings
Authors: Furness Mark 
Published: August 2019

AbstractMotivationGermany’s official aid to Middle Eastern and North African (MENA) countries has more than doubled since 2011, ostensibly to support their own responses to development and humanitarian challenges following the Arab uprisings. The dramatic increases in aid have not been accompanied by a public strategy setting out Germany’s objectives in the region, and the role of aid in conjunction with other policy tools in achieving them.PurposeWhat strategic objectives does the German government have for its MENA aid, and have these objectives changed in response to the Arab uprisings? Does the practice of Germany’s aid spending actually address development and humanitarian challenges in the MENA region, as these are defined by MENA countries themselves? In order to address these questions, this article develops key insights from the historical institutionalist and aid effectiveness literature that explain strategic policy‐making in complex decision‐making systems.Approach and MethodsTwo propositions are discussed in a structured review of the policy and practice dimensions of Germany’s MENA aid programme: first, that Germany’s aid and foreign policy system has not been able to articulate a clear strategy due to political differences and bureaucratic inertia; and second that the priorities tend to favour German and European security interests rather than the region’s own development and humanitarian priorities.FindingsThe analysis reveals that, while new priorities for development co‐operation in response to the Arab uprisings have been set, Germany’s MENA aid programme shows signs of policy incoherence and fragmentation. This is unlikely to change without a “whole‐of‐government” strategy for Germany’s MENA engagement. Furthermore, while there is little evidence of purposeful securitization of aid, short‐term stability has been privileged over support for political change.Policy ImplicationsA whole‐of‐government strategy based on the Sustainable Development Goals could balance German interests with the MENA region’s development priorities, ironing out the most problematic incoherencies, and thereby increasing partner country ownership.
Reattachment of fractured teeth using a multimode adhesive: Effect of different rewetting solutions and immersion time
Authors: Brasil Maia Guilherme , Pereira Raquel Vitório , Poubel Déborah Lousan do Nascimento , Almeida Júlio César Franco , Dias Ribeiro Ana Paula , Rezende Liliana Vicente Melo de Lucas , Garcia Fernanda Cristina Pimentel 
Published: August 2019

AbstractBackground/AimsFollowing coronal tooth fracture, keeping the fragment hydrated is of the utmost importance in the tooth fragment bonding technique. The aim of this study was to evaluate the effects of different immersion times in different storage media on multimode adhesive bonding between reattached fragments and teeth.Materials and MethodsA total of 195 bovine incisors were fractured and randomized into the following storage groups (n = 15): G0—control group (sound tooth); GA—saline solution: for 1 hour (A1) or 24 hours (A2); GB—artificial saliva: for 1 hour (B1) or 24 hours (B2); GC—coconut water: for 1 hour (C1) or 24 hours (C2); GD—tap water: for 1 hour (D1) or 24 hours (D2); GE—milk: for 1 hour (E1) or 24 hours (E2); GF—dry (dehydration): for 1 hour (F1) or 24 hours (F2). Tooth fragments were then reattached using a multimode adhesive in a self‐mode technique with a flowable resin composite. Fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min). The data were submitted to two‐way analysis of variance and the post hoc Tukey test (5%).ResultsThe group submitted to the dehydration factor (GF) exhibited a mean value of 599.1 ± 144.2 N, while those submitted to all hydration protocols (GA, GB, GC, GD, GE) exhibited a mean value of 751.8 ± 285.4 N. Dehydration significantly affected the fracture strength values (P = .005). No significant interaction between the rewetting solutions was observed (P > .05).ConclusionsHydration of the tooth fragment increased fracture resistance, regardless of the storage solution and/or immersion time.
Higher rates of disengagement among young adults attending a general adult community mental health team: Time to consider a youth‐specific service?
Authors: Roche Eric , O'Sullivan Roisin , Gunawardena Sashini , Cannon Mary , Lyne John Paul 
Published: August 2019

AbstractAimThe initial onset of mental illness occurs most frequently in adolescence or early adulthood. In order to inform the development of mental health services tailored for youth, we sought to compare the characteristics of young (18–25 years old) and older (over 25 years old) adults following referral to a general adult community mental health team.MethodsAll individuals referred to a Dublin‐based community mental health team and offered an appointment between January 1 and December 31, 2016 were included in the study. Information in relation to engagement patterns, demographic characteristics and clinical characteristics was collected.ResultsA total of 298 appointments were offered during the study period among which 94 (31.6%) were for young adults. Significant differences in demographic and clinical characteristics between the two age groups were evident. Young adults were significantly less likely to have been prescribed psychotropic medication at the point of referral (63% vs. 82% respectively, χ2 = 12.30, p < .001). Older adults were four times more likely to demonstrate a good level of early engagement in treatment than young adults (AOR 4.00, 95% CI 1.11–14.37, p = .03).ConclusionsYoung adults had distinct clinical needs and a lower level of engagement in the early stage of treatment compared with their older counterparts in this community team. Further research and stakeholder consultation is needed to more clearly identify the issues in relation to patient engagement. These insights will help to inform the development of youth‐specific community mental health services.