bluuebunny/crossref_metadata_2025_split huggingface dataset:
Features of the Japanese Diplomatic Strategy towards the Gulf States
Authors: Al Badawi Habib 
Published: October 2024

Abstract
This research note examines the diplomacy of Japan toward the Gulf states and Iran in the Middle East. It discusses how the Arab Gulf states and Iran are major commercial partners of Japan in the region, and how Japan’s goals in the Middle East are to promote shared prosperity, collaborate in areas such as energy, infrastructure, and the digital economy, and foster governance and civil society by combating corruption, protecting national sovereignty, and protecting vulnerable populations. The study also examines the military presence of Japan in the Red Sea and the Japan Maritime Self-Defense Force mission of protecting ships in the Strait of Hormuz to prevent terrorism, protect a vital oil shipping route, and foster a secure and stable region. Finally, the research outlines the five Kono Principles, which represent the outlook of Japan for future collaboration with the Middle East.
Epistemes of Palestine
Authors: Shibib Khalid 
Published: October 2024

Abstract
The conflict resulting from settler colonialism in historic Palestine has entered its second century. Behind the conflicting narratives and socio-political ideologies and doctrines are collective cognition or knowledge systems (epistemes). Both Palestinian and Zionist minds, being multi-centric, with their main bases focusing on historic Palestine, are undergoing dynamic changes. The Nakba of 1948, and the dispersion of the Palestinian population ever since, divided and diversified the Palestinian knowledge system in and outside historic Palestine. This article is an attempt to “epistemize” the narration and interpretation of this highly political and ideological struggle. It attempts to identify the building units of the Palestinian identity, which have directed the past and could determine paradigms of Palestinian struggle in the decades to come. It also tries to highlight the urgency and feasibility of networking dispersed Palestinian communities towards a new, reunited, Palestinian epistemic body.
The Rise and Decline of Ennahda Party
Authors: Maher Nora 
Published: October 2024

Abstract
Tunisia’s democratic trajectory has seen much regression in the past decade after the toppling of the former regime of Ben Ali and the rise of Ennahda party to power, following Tunisia’s uprising. Employing democratic theory, the research contends that, despite growing popular discontent with Ennahda’s performance, Ennahda remained Tunisia’s leading party even with its declining parliamentary representation until the 2021 setback in Tunisia’s democratic path. People’s disappointment with Ennahda emanated from volatile politics and socio-economic problems rather than ideology, and although the party reconsidered its strategy, which enabled it to withstand fractured polity and secure a leading seat in the political landscape until Kais Said’s power grab in 2021, it still bore much responsibility for poor government performance. In conclusion, Said’s hold on power is likely to persist and the future of Ennahda, in light of the on-going consolidation of power in Tunisia, depends on domestic and international efforts to regain democracy.
Modulation of the Quasi-Biennial Oscillation on the East Asian Surface Air Temperature in Boreal Winter
Authors: Zhang Ruhua , Zhou Wen , Zhang Yue , Xu Xiran 
Published: October 2024

Abstract
This study analyzes the response of East Asian surface air temperature (SAT) to the quasi-biennial oscillation (QBO) in boreal winter using the JRA-55 reanalysis dataset and the CAM6 model. East Asian SAT patterns in response to the boreal winter QBO vertical profile are derived from singular value decomposition (SVD) analysis. The leading mode of SVD (SVD1) shows an evident cold center over East Asia, while warm and cold centers show an east–west dipole in the second mode of SVD (SVD2). The corresponding QBO pattern in SVD1 has two opposite centers, with an upper-stratospheric easterly phase and a lower-stratospheric westerly phase; however, there is only one middle-stratospheric westerly center in SVD2. The SVD1-like QBO tends to cause more significant East Asian SAT anomalies than the SVD2-like QBO pattern. This difference originates from the response of the stratospheric polar vortex and the North Pacific circulation to the QBO. The SVD1-like QBO forces a cyclonic anomaly over the midlatitude North Pacific and an anticyclonic anomaly over China via a subtropical path and polar path, leading to a zonal pressure gradient and meridional wind anomaly over East Asia. Temperature advection driven by this meridional wind affects cooling and warming over East Asia. By contrast, there are no significant responses to the SVD2-like QBO over the midlatitude North Pacific, and thus, the corresponding East Asian SAT response is weak.

Significance Statement
East Asian surface air temperature (SAT) variation is often attributed to variations in lower-atmospheric dynamics and sea surface temperature. Few studies focus on the role of the QBO. In this study, we diagnose the influence of the stratospheric QBO on East Asian SAT during boreal winter. Both reanalysis and simulated results indicate that the response of East Asian SAT is sensitive to the selection of multilevel QBO indices. This sensitivity comes from the changes in QBO’s subtropical and polar influencing path. Our results provide a new perspective on East Asian SAT changes.
Using QALYs as an Outcome for Assessing Global Prediction Accuracy in Diabetes Simulation Models
Authors: Dakin Helen A. , Gao Ni , Leal José , Holman Rury R. , Tran-Duy An , Clarke Philip 
Published: October 2024

Objectives (1) To demonstrate the use of quality-adjusted life-years (QALYs) as an outcome measure for comparing performance between simulation models and identifying the most accurate model for economic evaluation and health technology assessment. QALYs relate directly to decision making and combine mortality and diverse clinical events into a single measure using evidence-based weights that reflect population preferences. (2) To explore the usefulness of Q2, the proportional reduction in error, as a model performance metric and compare it with other metrics: mean squared error (MSE), mean absolute error, bias (mean residual), and R2. Methods We simulated all EXSCEL trial participants ( N = 14,729) using the UK Prospective Diabetes Study Outcomes Model software versions 1 (UKPDS-OM1) and 2 (UKPDS-OM2). The EXSCEL trial compared once-weekly exenatide with placebo (median 3.2-y follow-up). Default UKPDS-OM2 utilities were used to estimate undiscounted QALYs over the trial period based on the observed events and survival. These were compared with the QALYs predicted by UKPDS-OM1/2 for the same period. Results UKPDS-OM2 predicted patients’ QALYs more accurately than UKPDS-OM1 did (MSE: 0.210 v. 0.253; Q2: 0.822 v. 0.786). UKPDS-OM2 underestimated QALYs by an average of 0.127 versus 0.150 for UKPDS-OM1. UKPDS-OM2 predictions were more accurate for mortality, myocardial infarction, and stroke, whereas UKPDS-OM1 better predicted blindness and heart disease. Q2 facilitated comparisons between subgroups and (unlike R2) was lower for biased predictors. Conclusions Q2 for QALYs was useful for comparing global prediction accuracy (across all clinical events) of diabetes models. It could be used for model registries, choosing between simulation models for economic evaluation and evaluating the impact of recalibration. Similar methods could be used in other disease areas. Highlights Diabetes simulation models are currently validated by examining their ability to predict the incidence of individual events (e.g., myocardial infarction, stroke, amputation) or composite events (e.g., first major adverse cardiovascular event). We introduce Q2, the proportional reduction in error, as a measure that may be useful for evaluating and comparing the prediction accuracy of econometric or simulation models. We propose using the Q2 or mean squared error for QALYs as global measures of model prediction accuracy when comparing diabetes models’ performance for health technology assessment; these can be used to select the most accurate simulation model for economic evaluation and to evaluate the impact of model recalibration in diabetes or other conditions.
Lesions of the Palm – Mimickers of Dupuytren’s Disease
Authors: Saad Ahmed , Perumandla Mohan Rao , Arbuthnot Charlie , Iyengar Karthikeyan P. , Botchu Rajesh 
Published: October 2024

Background and Aims: Dupuytren’s contracture is a prevalent, hereditary fibroproliferative disorder affecting the palmar aponeurosis, which can resemble various neoplastic and non-neoplastic disorders of the hand. This resemblance poses a diagnostic challenge for healthcare professionals. This observational study aims to evaluate the range of conditions that can be mistaken for Dupuytren’s contracture over a 12-year period (2008–2020) at a specialised orthopaedic oncology centre. Materials and Methods: A retrospective analysis of palmar lesions referred to our tertiary orthopaedic oncology hospital was conducted. Data were gathered from oncology, radiology and histopathology databases. We specifically examined lesions located solely on the palmar aponeurosis, excluding the thenar and hypothenar regions. Patient demographics, clinical features, imaging results and clinical management outcomes were documented for descriptive analysis. Results: A total of 21 palmar lesions meeting the inclusion criteria were identified. The average age of the participants was 48 years (ranging from 3 to 69 years). There was no significant difference in gender distribution, with 11 females and 10 males represented in the cohort. The majority of the identified lesions were benign tumours (16), with one case of malignant rhabdomyosarcoma. Among the benign tumours, lipomas were the most common ( n = 5). Other benign tumours included three neurofibromas, a schwannoma, a granuloma, a ganglion cyst, a giant cell tumour (GCT), an angiomyxoma, a myofibroma, a cavernous haemangioma, a non-specific fibrovascular lesion and four additional non-neoplastic lesions. Conclusion: A variety of benign, malignant or neoplastic conditions of the hand can closely resemble Dupuytren’s contracture, particularly in the initial stages of their development. A thorough clinical examination, combined with a high level of suspicion, along with supplementary investigations and histopathological analysis, is essential for accurate diagnosis and effective management of patients.
Physical and psychological aspects of multiple sclerosis: Revisiting the Multiple Sclerosis Impact Scale (MSIS-29)
Authors: Young Carolyn A , Rog David J , Sharrack Basil , Tanasescu Radu , Kalra Seema , Chhetri Suresh K , Wilde Lisa , Mills Roger J , Tennant Alan 
Published: October 2024

Background: The MSIS-29 measures the physical and psychological impact of MS. Objective: The associations between MSIS-29 domains and demographic/clinical aspects were examined and trajectories analysed over time. Methods: Data were collected in the Trajectories of Outcome in Neurological Conditions study for a diverse population of people with MS, with follow-up for up to 5 years. Following Rasch analysis, minimal important change (MIC) was computed for ensuing total, physical and psychological domains. Results: Fit to the Rasch model using data from 5921 participants validated physical, psychological and total domains, and the conversion table transforms raw scores to interval-level metric equivalents. These domains showed significant differences across demographic (age, gender, employment, education, and marital status) and clinical (subtype, treatment, and duration) factors with large effect sizes. The MIC scores were physical: 9.1, total: 14.1, which were both above measurement error, and psychological: 5.5 which was not, so 1.6% of participants reported psychological change which was clinically important but not statistically significant. Trajectory analysis showed three groups, one stable and two with significant slopes, improving and deteriorating. Conclusion: The MSIS-29 has shown adequate fit to the Rasch model after accommodating problems with local item dependency, through a bi-factor solution. The domains showed good discrimination across key factors.
Insurance and Structural Access Quality and Effects on AAA Mortality: A National Healthcare Quality and Disparities Report Analysis
Authors: Ramirez Andrew , Azuma Masashi , Popov Aron Frederik , Schmitto Jan D. , Moser G. William , Mokashi Suyog 
Published: October 2024

Background The National Health care Quality and Disparities Report (NHDQR) presents trends for measures related to access to care, affordable care, care coordination, effective treatment, healthy living, patient safety, and person-centered care. This study aims to determine the significance of insurance quality and access to care on AAA repair outcomes. Methods Data was obtained through the Agency for Health care Research and Quality database from 2016-2020. AAA repair mortality rates per 1000 persons, insurance quality, and structural access were compared between the 31 reportable U.S. states in which data was analyzed using linear regression models and ANOVA. Insurance quality and structural access groups were categorized as weak, average, and strong, based on NHDQR Reports measures. Results No association was found between access to care and AAA mortality at specific time points (2016 and 2020; P-value = .90 and .29 respectively) and when comparing states that showed improvement from 2016 to 2020 (weak categorization to strong; P value = .27). An association was found between private insurance quality and AAA repair mortality at baseline (2016; P-value = .022) and in those that showed improvement or worsening in private insurance quality over the study period ( P-value = .042). Conclusions Our findings suggest that there is no association between structural access quality and AAA mortality although an association exists between AAA mortality and private insurance quality.
Impact of smoke-free legislation on stroke risk: A systematic review and meta-analysis
Authors: Chua Zhuo Xun , Yeh Lai Amanda Chern , Lam Timothy Jia Rong , Ong Jamie Si Pin , Lim Shermane Yun Wei , Kumar Shivaram , Lim Mervyn Jun Rui , Tan Benjamin Yong Qiang , Aik Joel , Ho Andrew Fu Wah 
Published: October 2024

Purpose: Secondhand smoke significantly increases the risk of cerebrovascular diseases, prompting recent public smoking bans. We aimed to ascertain the effects of smoke-free legislation on stroke incidence and mortality. Methods: We systematically searched Medline, Embase, Cochrane Library, and Scopus up to August 13, 2023, for studies reporting changes in stroke incidence following partial or comprehensive smoking bans. A random-effects meta-analysis was conducted on hospital admissions and mortality for stroke, stratified based on comprehensiveness of the ban ((i) workplaces-only, (ii) workplaces and restaurants, (iii) workplaces, restaurants and bars). The effect of post-ban follow-up duration was assessed visually by a forest plot, while meta-regression was employed to evaluate for any dose-response relationship between ban comprehensiveness and stroke risk. Findings: Of 3987 records identified, 15 studies analysing bans across a median follow-up time of 24 months (range: 3–67) were included. WRB bans were associated with reductions in the rates of hospital admissions for stroke (nine studies; RR, 0.918; 95% CI, 0.872–0.967) and stroke mortality (three studies; RR, 0.987; 95% CI, 0.952–1.022), although the latter did not reach statistical significance. There was no significant difference in the risk of stroke admissions for studies with increased ban comprehensiveness and no minimum duration for significant post-ban effects to be observed. Discussion and conclusion: Legislative smoking bans were associated with significant reductions in stroke-related hospital admissions, providing evidence for its utility as a public health intervention.
Reduction Quality in Posterior Malleolar Fractures Using a Modified Posteromedial Ankle Approach
Authors: Pino Felipe , Lagos Leonardo , Urbina Christian , Vargas Fernando , Parra Mauricio , Bravo Francisco , Bastias Christian 
Published: October 2024

Background: Anatomical reduction of posterior malleolar fracture is a key goal in achieving good functional outcomes in patients with ankle fractures. Although there are many approaches for managing this type of fracture, no studies have shown reduction quality of posterior malleolar fracture in postoperative CT scan using the modified posteromedial ankle approach. Methods: A retrospective case series of 66 patients of 2 health centers with type 2, 3, and 4 posterior malleolar fractures according to Bartonicek classification treated using the modified posteromedial ankle approach was performed. The postoperative CT scan was used to assess syndesmotic reduction and articular step-off and residual gap in posterior malleolus reduction. Results: Reduction of posterior malleolus fracture was determined to be <2 mm in 62 patients and >2 mm in 4 cases. Syndesmotic reduction quality was considered to be anatomical in 61 patients. Four patients showed mild anterior fibular translation in the axial plane and were not reoperated. One syndesmotic malreduction was considered poor. Conclusion: In this study, we found that 92% (61 of 66) of patients with posterior malleolar fracture were reduced with <2 mm step-off using this modified posteromedial ankle approach and fracture fixation strategy. Level of Evidence: Level IV, case series.
Effectiveness and Safety of Hair Growth Formulation Containing Tectona grandis L.f (Teak) Leaf Extract: A Randomized, Double-Blind, Placebo-Controlled Study on Males with Androgenic Alopecia
Authors: Tanuphol Nutchaninad , Waranuch Neti , Wisuitiprot Vanuchawan , Wisuitiprot Wudtichai , Insumrong Kamonlak , Temkitthawon Prapapan , Suphrom Nungruthai , Jampachaisri Katechan , Girard Corine , Ingkaninan Kornkanok 
Published: October 2024

Background Androgenic alopecia (AGA) is commonly known as male patterned baldness. A high level of dihydrotestosterone (DHT) plays a significant role in AGA development. Inhibition of the enzyme steroid 5-alpha reductase (S5AR), responsible for converting testosterone into DHT, has been shown to delay the progression of AGA. Teak ( Tectona grandis L.f) leaf extract exhibited a potent S5AR inhibitory activity. To prove the effectiveness and safety of teak leaf extract as a hair growth promotor, a double-blind, randomized placebo-controlled trial was conducted. Methods Eighty-one AGA subjects were randomly assigned to receive either a hair tonic containing 1% teak leaf extract (HT-teak), 5%minoxidil (positive control), or a placebo administered twice daily, for 24 weeks. Efficacy was assessed through target area hair count (TAHC), anagen-to-telogen ratio (A/T), hair shedding every 4 weeks, and patients’ subjective assessments of hair regrowth were assessed at the end of the experiment. Data was analyzed using repeated measure ANOVA. Results Both the HT-teak and minoxidil groups exhibited a significant increase in TAHC and A/T, along with a decrease in hair shedding compared to baseline values. Conversely, the placebo group showed no observable signs of hair regrowth. Furthermore, the HT-teak group reported the highest satisfaction scores, and there were no indications of skin irritation or systemic effects on sexual dysfunction and palpitation after 24 weeks of HT-teak application. Conclusion Teak leaf extract, as incorporated in HT-teak, demonstrates potential as an alternative mild hair growth promoter for individuals with AGA, offering both efficacy and safety. Trial registration This study was retrospectively registered on International Standard Randomised Controlled Trial Number (ISRCTN.com); ISRCTN24541842 (registered on January 8, 2024).
The crucial and versatile roles of bacteria in global biogeochemical cycling of iodine
Authors: Jiang Zhou , Jiang Yongguang , Hu Yidan , Dong Yiran , Shi Liang 
Published: October 2024

Abstract
Iodine (I) is a trace element with health and environmental significance. Iodate (IO3-), iodide (I-) and organic iodine (org-I) are the major species of iodine that exist in the environment. Dissimilatory IO3--reducing bacteria reduce IO3- to I- directly under anoxic conditions via their IO3- reductases that include periplasmic iodate reductase IdrABP1P2, extracellular DMSO reductase DmsEFAB and metal reductase MtrCAB. IdrAB and DmsEFAB reduce IO3- to hypoiodous acid (HIO) and H2O2. The reaction intermediate HIO is proposed to be disproportionated abiotically into I- and IO3- at a ratio of 2:1. The H2O2 is reduced to H2O by IdrP1P2 and MtrCAB as a detoxification mechanism. Additionally, dissimilatory Fe(III)- and sulfate-reducing bacteria reduce IO3- to I- directly via their IO3- reductases and indirectly via the reduction products Fe(II) and sulfide in the presence of Fe(III) and sulfate, respectively. I--oxidizing bacteria oxidize I- to molecular iodine (I2) directly under oxic conditions via their extracellular multicopper iodide oxidases IoxAC. In addition to I2, a variety of org-I compounds are also produced by the I--oxidizing bacteria during I- oxidation. Furthermore, ammonia-oxidizing bacteria oxidize I- to IO3- directly under oxic conditions, probably via their intracellular ammonia-oxidizing enzymes. Many bacteria produce extracellular reactive oxygen species that can oxidize I- to triiodide (I3-). Bacteria also accumulate I- during which I- is oxidized to HIO by their extracellular vanadium iodoperoxidases. The HIO is then transported into the bacterial cells. Finally, bacteria methylate I- to org-I CH3I, probably via their methyltransferases. Thus, bacteria play crucial and versatile roles in the global biogeochemical cycling of iodine via IO3- reduction, I- oxidation and accumulation and org-I formation.
Multicomponent services for symptoms in serious respiratory illness: a systematic review and meta-analysis
Authors: Spathis Anna , Reilly Charles C. , Bausewein Claudia , Reinke Lynn F. , Romero Lorena , Smallwood Natasha E. , Ekström Magnus , Holland Anne E. 
Published: October 2024

BackgroundPeople living with serious respiratory illness experience a high burden of symptoms. This review aimed to determine whether multicomponent services reduce symptoms in people with serious illness related to respiratory disease.MethodsElectronic databases were searched to identify randomised controlled trials (RCTs) evaluating multicomponent services that enrolled patients due to symptoms, rather than underlying disease, and provided at least one nonpharmacological intervention. The primary outcome was chronic breathlessness and secondary outcomes were health-related quality of life (HRQoL), cough, fatigue and adverse events. At least two authors independently screened studies, assessed risk of bias and extracted data.ResultsFive RCTs, involving 439 patients, were included. In comparison to usual care, multicomponent services improved breathlessness mastery (Chronic Respiratory Questionnaire (CRQ) mastery scale, mean difference (MD) 0.43 points, 95% CI 0.20–0.67, three RCTs, 327 participants) and HRQoL (CRQ total score, MD 0.24 points, 95% CI 0.04–0.40, two RCTs, 237 participants). Fatigue did not improve with multicomponent services and no studies evaluated cough. No serious adverse events were reported. The one study evaluating mortality found increased survival in those accessing a multicomponent service. The certainty of evidence was very low, mainly due to detection and reporting bias.ConclusionMulticomponent services improve breathlessness mastery and HRQoL, with minimal risk. These findings support the use of multicomponent symptom-directed services for people living with serious respiratory illness.