bluuebunny/crossref_metadata_2025_split huggingface dataset:
UK fiscal policy and external balance under Bretton Woods: Twin deficits or distant relatives?
Authors: Banerjee Joshua J. 
Published: June 2024

AbstractThe United Kingdom (UK) is typically regarded as the sine qua non case of an economy experiencing chronic external imbalances under the post‐war Bretton Woods system, apparently unable to reconcile the divergent objectives of robust economic growth and current account equilibrium. This paper investigates the famed ‘twin deficits hypothesis’, which ascribed responsibility for the UK's current account woes to an excessively lax fiscal policy. Calling on two distinct approaches to identifying fiscal shocks, we find evidence decisively against the traditional twin deficits view, and uncover serious shortcomings in the way that both policymakers and academics conceptualized the transmission of fiscal policy to the current account. Our results demonstrate that factors other than fiscal policy are of considerably greater importance for understanding the UK's historical experience, and we elaborate on the need for a reappraisal of some classic policy debates concerning external adjustment under the Bretton Woods system.
The factivity of practical knowledge
Authors: Ometto Dawa , van Miltenburg Niels 
Published: June 2024

AbstractAnscombean accounts claim that intentional action is essentially characterized by an agent's practical knowledge of what she is doing. Such accounts are threatened by cases in which an agent seemingly fails to know what she is doing because of a mistake in the performance. It thus seems that such accounts are incompatible with the factivity of practical knowledge. We argue that Anscombean accounts should not be defended, as has recently been suggested, by drawing on familiar anti‐skeptical strategies from epistemology, but rather by attending closely to the specifically practical character of agential knowledge.
Long‐term evaluation of anterior thalamic deep brain stimulation for epilepsy in the European MORE registry
Authors: Kaufmann Elisabeth , Peltola Jukka , Colon Albert J. , Lehtimäki Kai , Majtanik Milan , Mai Jürgen K. , Bóné Beata , Bentes Carla , Coenen Volker , Gil‐Nagel Antonio , Goncalves‐Ferreira Antonio J. , Ryvlin Philippe , Taylor Rod , Brionne Thomas C. , Gielen Frans , Song Shannon , Boon Paul ,   the MORE study group
Published: June 2024

AbstractObjectiveShort‐term outcomes of deep brain stimulation of the anterior nucleus of the thalamus (ANT‐DBS) were reported for people with drug‐resistant focal epilepsy (PwE). Because long‐term data are still scarce, the Medtronic Registry for Epilepsy (MORE) evaluated clinical routine application of ANT‐DBS.MethodsIn this multicenter registry, PwE with ANT‐DBS were followed up for safety, efficacy, and battery longevity. Follow‐up ended after 5 years or upon study closure. Clinical characteristics and stimulation settings were compared between PwE with no benefit, improvers, and responders, that is, PwE with average monthly seizure frequency reduction rates of ≥50%.ResultsOf 170 eligible PwE, 104, 62, and 49 completed the 3‐, 4‐, and 5‐year follow‐up, respectively. Most discontinuations (68%) were due to planned study closure as follow‐up beyond 2 years was optional. The 5‐year follow‐up cohort had a median seizure frequency reduction from 16 per month at baseline to 7.9 per month at 5‐year follow‐up (p < .001), with most‐pronounced effects on focal‐to‐bilateral tonic–clonic seizures (n = 15, 77% reduction, p = .008). At last follow‐up (median 3.5 years), 41% (69/170) of PwE were responders. Unifocal epilepsy (p = .035) and a negative history of epilepsy surgery (p = .002) were associated with larger average monthly seizure frequency reductions. Stimulation settings did not differ between response groups. In 179 implanted PwE, DBS‐related adverse events (AEs, n = 225) and serious AEs (n = 75) included deterioration in epilepsy or seizure frequency/severity/type (33; 14 serious), memory/cognitive impairment (29; 3 serious), and depression (13; 4 serious). Five deaths occurred (none were ANT‐DBS related). Most AEs (76.3%) manifested within the first 2 years after implantation. Activa PC depletion (n = 37) occurred on average after 45 months.SignificanceMORE provides further evidence for the long‐term application of ANT‐DBS in clinical routine practice. Although clinical benefits increased over time, side effects occurred mainly during the first 2 years. Identified outcome modifiers can help inform PwE selection and management.
Boundaries in online couples therapy: “Can anything exist without boundaries?”
Authors: Aviram Alon 
Published: June 2024

AbstractObjectiveThis research delved into the experiences of couples and therapists in online couples therapy with an emphasis on therapeutic boundaries.BackgroundAlthough the popularity of online therapy has surged, limited understanding exists about the meanings and experiences tied to therapeutic boundaries in this context, underscoring the need for its examination to enhance online therapy's effectiveness.MethodA purposive sample of 51 participants, including 36 individuals (comprising 18 couples who underwent separate interviews), and 15 couple and family therapists were interviewed in four online focus groups. Constructivist grounded theory guided the data analysis to discern therapeutic boundary dimensions.ResultsThe analysis identified three dimensions of therapeutic boundaries: (a) boundaries between the therapist and couple, (b) boundaries between the couple and their family, and (c) boundaries between the therapists and their own families.ConclusionThe study offers insights into the nuanced concept of liminality within therapists' and couples' transition to online couples therapy, particularly emphasizing disruptions in conventional therapeutic paradigms.ImplicationsTo uphold the integrity and bolster the therapeutic alliance in online couples therapy, there is a compelling need for therapists to transition toward novel means of establishing boundaries, moving away from traditional constructs.
Southern Africa's Great Escarpment as an amphitheater of climate‐driven diversification and a buffer against future climate change in bats
Authors: Taylor Peter J. , Kearney Teresa C. , Clark Vincent Ralph , Howard Alexandra , Mdluli Monday V. , Markotter Wanda , Geldenhuys Marike , Richards Leigh R. , Rakotoarivelo Andrinajoro R. , Watson Johan , Balona Julio , Monadjem Ara 
Published: June 2024

AbstractHosting 1460 plant and 126 vertebrate endemic species, the Great Escarpment (hereafter, Escarpment) forms a semi‐circular “amphitheater” of mountains girdling southern Africa from arid west to temperate east. Since arid and temperate biota are usually studied separately, earlier studies overlooked the biogeographical importance of the Escarpment as a whole. Bats disperse more widely than other mammalian taxa, with related species and intraspecific lineages occupying both arid and temperate highlands of the Escarpment, providing an excellent model to address this knowledge gap. We investigated patterns of speciation and micro‐endemism from modeled past, present, and future distributions in six clades of southern African bats from three families (Rhinolophidae, Cistugidae, and Vespertilionidae) having different crown ages (Pleistocene to Miocene) and biome affiliations (temperate to arid). We estimated mtDNA relaxed clock dates of key divergence events across the six clades in relation both to biogeographical features and patterns of phenotypic variation in crania, bacula and echolocation calls. In horseshoe bats (Rhinolophidae), both the western and eastern “arms” of the Escarpment have facilitated dispersals from the Afrotropics into southern Africa. Pleistocene and pre‐Pleistocene “species pumps” and temperate refugia explained observed patterns of speciation, intraspecific divergence and, in two cases, mtDNA introgression. The Maloti‐Drakensberg is a center of micro‐endemism for bats, housing three newly described or undescribed species. Vicariance across biogeographic barriers gave rise to 29 micro‐endemic species and intraspecific lineages whose distributions were congruent with those identified in other phytogeographic and zoogeographic studies. Although Köppen–Geiger climate models predict a widespread replacement of current temperate ecosystems in southern Africa by tropical or arid ecosystems by 2070–2100, future climate Maxent models for 13 bat species (all but one of those analyzed above) showed minimal range changes in temperate species from the eastern Escarpment by 2070, possibly due to the buffering effect of mountains to climate change.
Association between markers of hepatitis B virus infection and risk of virological rebound in people with HIV receiving antiretroviral therapy
Authors: Malagnino Vincenzo , Cozzi‐Lepri Alessandro , Svicher Valentina , Girardi Enrico , Perno Carlo Federico , Saracino Annalisa , Cuomo Gianluca , Rusconi Stefano , Puoti Massimo , D'Arminio Monforte Antonella , Andreoni Massimo , Sarmati Loredana ,   ICONA Foundation Study Group
Published: June 2024

AbstractObjectivesThe aim of this analysis was to investigate the impact of hepatitis B virus (HBV) coinfection on the risk of HIV viral rebound (VR) after achieving suppression for the first time following initiation of antiretroviral therapy (ART) in the real‐world setting.DesignPatients living with HIV (PLWH) who were enrolled in the ICONA Foundation Study cohort and achieved viral suppression ≤50 copies/mL for the first time after starting ART were prospectively evaluated and divided in three exposure groups according to serology test results: (a) HIV‐monoinfected; (b) HIV‐positive/HBcAb‐positive/HBsAg‐negative; (c) HIV‐positive/HBsAg‐positive. The occurrence of VR, defined as two consecutive HIV‐RNA values >50 copies/mL after achieving viral suppression for the first time (baseline), was investigated.MethodsStandard survival analysis by means of Kaplan–Meier curves and Cox regression analysis with the serology exposure fitted as a time‐fixed covariate measured at baseline was employed after controlling for key confounding factors.ResultsOf a total of 5657 patients included, 4090 (72%) were HIV‐monoinfected, 1342 (23.7%)were HBcAb‐positive, and 225 (3.9%) were HbsAg‐positive coinfected. Overall, 654 (11.5%) PLWH experienced VR > 50 copies/mL during follow‐up. After controlling for all sources of measured confounding, coinfected PLWH showed an increased risk of experiencing VR compared with those who were HIV‐monoinfected. In particular, the strongest associations were seen for the HIV/HBsAg‐positive participants [adjusted hazard ratio (aHR) = 1.56, 95% confidence interval (CI): 1.03–2.38, p = 0.037] but an excess of risk was also seen in those who were HIV‐positive/HBcAb‐positive/HBsAg‐negative (aHR = 1.25, 95% CI: 1.00–1.55, p = 0.047).ConclusionsCoinfection with HBV seems to have an impact on the probability of maintaining HIV viral suppression achieved for the first time after ART initiation. Of note, even PLWH positive for HBcAb, a marker of inactive HBV infection, appeared to be at higher risk of VR compared with those who were HIV‐monoinfected and their HIV‐RNA should be carefully monitored.
Functional and esthetic effects of botulinum toxin injection into the masseter muscles: evaluation of 80 patients from a dermatological perspective
Authors: Ozdemir Cetinkaya Pinar , Karaosmanoglu Nermin , Özkesici Kurt Birgül , Aksu Cerman Aslı , Altunay Iknur Kivanc 
Published: June 2024

AbstractBackgroundMasseter muscle hypertrophy is characterized by a symmetrical or asymmetrical increase in muscle volume. Although it can be asymptomatic, it may be associated with bruxism. Therefore, patients may seek intervention for esthetic and/or functional concerns. This study aimed to establish patient characteristics, purpose of undergoing botulinum toxin injection into the masseter muscles, efficacy, and side effects of the procedure at a dermatology clinic.MethodsA retrospective chart review was carried out over a period of one year from January 2022 to January 2023 for the patients who underwent botulinum toxin injection into the masseter muscles. The general characteristics of patients, the purpose of botulinum toxin treatment, relief levels regarding bruxism according to the Visual Analog Scale (VAS), side effects, and complications were recorded.ResultsThe study group comprised 74 female and 6 male patients with a mean age of 31.20 ± 6.71 years. Eighteen (22.5%) patients were treated only for narrowing the lower face contour, 28 (35%) patients were treated only for the relief of bruxism, and 34 (42.5%) patients were treated for both indications. Fifteen (18.8%) patients experienced 16 treatment‐related side effects, including two (2.5%) with smile asymmetry and two (2.5%) with paradoxical bulging.ConclusionsBotulinum toxin injection into the masseter muscles with the intention of lower face contouring and/or relieving bruxism offers a minimally invasive, safe, and effective treatment option. Although it has a favorable safety profile, the risks of significant side effects or complications remain.
Structural phase transitions in multicomponent La0.2Nd0.2Sm0.2Gd0.2RE50.2NbO4 (RE5 = Ho, Y, Tb, Eu, Pr) oxides
Authors: Dawczak Arkadiusz , Mielewczyk‐Gryń Aleksandra , Gazda Maria 
Published: June 2024

AbstractIn this work, the influence of compositional complexity on the structural and thermal properties of multicomponent rare‐earth ortho‐niobates from the La0.2Nd0.2Sm0.2Gd0.2RE50.2NbO4 (RE5 = Ho, Y, Tb, Eu, Pr) series was investigated. Based on X‐ray powder diffraction studies using synchrotron radiation, it was found that all tested materials were pure single‐phase compositions and showed stability in the monoclinic I2/c crystal structure at room temperature. High‐temperature X‐ray powder diffraction studies and dilatometry studies confirmed the presence of a structural phase transition between low‐temperature (I2/c) and high‐temperature (I41/a) polymorphs. The structural phase transition temperatures are between 676°C and 701°C. Interestingly, despite their compositional complexity, the structural phase transition temperature behaves similarly to conventional ortho‐niobates, that is, it depends on the radius of the A‐cation; that is, as the ionic radius increases, the phase transition temperature decreases. The transition has been categorized as a second‐order phase transition based on the observed relationship between the Landau order parameter and spontaneous strain. The coexistence of the tetragonal and monoclinic phases has been seen in all compositions around the temperature of the structural phase transition. The presence of two orientation states in the monoclinic structure leads to the so‐called spontaneous strain, which consists of longitudinal (u) and shear (v) strain components. The values of these strains at 300°C range between 2.42 and 2.58 × 10−2 for longitudinal, 2.98 and 3.04 × 10−2 for shear, and 5.46 and 5.57 × 10−2 for scalar spontaneous strain. It was found that the spontaneous strain in each of the materials under test was very little impacted by the variation in the complexity of the A sublattice's composition. In addition, thermal expansion coefficients of both polymorphs were determined, which range from 12.7 × 10−6 K−1 to 13.2 × 10−6 K−1 for the monoclinic structure and 9.7 × 10−6 K−1 to 9.9 × 10−6 K−1 for the tetragonal one.
Hard edges, soft edges, and species range evolution: A genomic analysis of the Cumberland Plateau salamander
Authors: Watts Emily F. , Waldron Brian P. , Kuchta Shawn R. 
Published: June 2024

AbstractAimGene flow from central to edge populations is thought to limit population growth at range edges by constraining local adaptation. In this study, we explore the thesis that range edges can differ in their dynamics and be either ‘hard’ (e.g. a river) or ‘soft’ (e.g. ecological gradients). We hypothesize that soft edge populations will have smaller effective population sizes than central populations and that gene flow will be greater from the centre to the edge than vice versa. Conversely, we hypothesize that hard edge populations should have similar effective population sizes to central populations and that gene flow will be equal between the two.LocationKentucky, West Virginia, and Virginia, USA.Taxon
Plethodon kentucki (Caudata: Plethodontidae).MethodsWe evaluated landscape suitability using an ecological niche model, then we compared gene flow and effective population sizes between edge and central populations and quantified gene flow between populations. Finally, we characterized landscape genetic variation, testing for isolation by distance and isolation by environment.ResultsWe found continuously decreasing habitat quality along soft edges, with hard edges more variable. Additionally, we found that soft edges had lower effective population sizes than central populations and that gene flow was greater from the centre of the range to the soft edges than the reverse. In hard edges, by contrast, we found effective population sizes in edge populations were similar to central populations, with relatively equal gene flow in both directions.Main ConclusionsUnderstanding why species have range limits is central to investigations of the structure of biodiversity, yet the evolutionary dynamics of range edges remain poorly understood. We show that within a single species with a small range, the evolutionary dynamics operating at range boundaries may depend on the nature of the boundary.
Using multimodal learning analytics as a formative assessment tool: Exploring collaborative dynamics in mathematics teacher education
Authors: Moon Jewoong , Yeo Sheunghyun , Banihashem Seyyed Kazem , Noroozi Omid 
Published: June 2024

AbstractBackgroundTraditionally, understanding students' learning dynamics, collaboration, emotions, and their impact on performance has posed challenges in formative assessment. The complexity of monitoring and assessing these factors have often limited the depth and breadth of insights.ObjectivesThis study aims to explore the potential of multimodal learning analytics as a formative assessment tool in math education. The focus is on discerning how collaborative discourse behaviours and emotional indicators interplay with lesson evaluation performance.MethodsUsing undergraduate students' multimodal data, which includes collaboration data, facial behaviour data, and emotional data, the study explored the patterns of collaboration and emotion. Through the lens of multimodal learning analytics, we conducted exploratory data analysis to identify meaningful relationships between specific types of collaborative discourse, facial expressions, and performance indicators. Moreover, the study evaluated a machine learning model's potential to predict target learning outcomes by integrating data from multiple channels.ResultsThe analysis revealed key features from both discourse and emotion data as significant predictors. These findings underscore the potential of a multimodal analytical approach in understanding students' learning process and predicting outcomes.ConclusionsThe study emphasizes the importance and feasibility of a multimodal learning analytic approach in the context of math education. It highlights the academic and practical implications of such an approach, along with its limitations, pointing towards future research directions in this area.
Racial and ethnic differences in telemedicine use among community‐dwelling older adults with dementia
Authors: Qin Qiuyuan , Temkin‐Greener Helena , Veazie Peter , Cai Shubing 
Published: June 2024

AbstractBackgroundRoutine ambulatory care is essential for older adults with Alzheimer's disease and related dementias (ADRD) to manage their health conditions. The federal government expanded telemedicine coverage to mitigate the impact of the COVID‐19 pandemic on ambulatory services, which may provide an opportunity to improve access to care. This study aims to examine differences in telemedicine use for ambulatory services by race, ethnicity, and community‐level socioeconomic status among community‐dwelling older adults with ADRD.MethodsThis retrospective cohort study used Medicare claims data between April 01, 2020 and December 31, 2021. We included community‐dwelling Medicare fee‐for‐service beneficiaries aged 65 years and older with ADRD. The outcome variable is individual's use (yes/no) of telemedicine evaluation and management (tele‐EM) visits in each quarter. The key independent variables are race, ethnicity, and community‐level socioeconomic status.ResultsThe analytical sample size of the study was 2,068,937, including 9.9% Black, 82.7% White, and 7.4% Hispanic individuals. In general, we observed a decreasing trend of tele‐EM use, and the average rate of quarterly tele‐EM use was 23.0%. Tele‐EM utilization varied by individual race, ethnicity, and community‐level socioeconomic status. On average, White and Black individuals in deprived communities were 3.5 and 2.4 percentage‐points less likely to use tele‐EM compared with their counterparts in less‐deprived communities (p < 0.001). However, Hispanic individuals in deprived communities were 2.4 percentage‐points more likely to utilize tele‐EM compared with those in less‐deprived communities (p < 0.001). Additionally, we observed various racial and ethnic differences in telemedicine use in deprived communities versus less‐deprived communities.ConclusionsWe observed various racial and ethnic differences in telemedicine use, both within and between communities by socioeconomic status. Telemedicine is a viable healthcare delivery option that may influence healthcare access for racial and ethnic minorities and for individuals in socioeconomically deprived communities. Further policies or interventions may be needed to ensure all individuals have equal access to newly available care delivery models.
Potential therapeutic effect of a ketogenic diet for the treatment of lymphoedema: Results of an exploratory study
Authors: Lodewijckx Inge , Matthys Christophe , Verheijen Joke , Verscuren Raf , Devoogdt Nele , Van der Schueren Bart , Goffin Karolien , Fourneau Inge , Thomis Sarah 
Published: June 2024

AbstractBackgroundLymphoedema is a chronic and progressive disease characterised by excessive accumulation of lymph in the interstitial compartment, leading to tissue swelling and fibroadipose deposition. Lymphangiogenesis is partly regulated by ketone body oxidation, and a ketogenic diet (KD) has shown therapeutic efficacy in a preclinical mouse tail lymphoedema model. Therefore, we aimed to investigate the potential therapeutic effect of a KD in patients with secondary lymphoedema.MethodsNine patients with unilateral stage 2 lymphoedema secondary to lymphadenectomy were included in this quasi‐experimental exploratory study consisting of a short run‐in phase to gradually induce ketosis, followed by a classic KD (CKD) and modified Atkins diet (MAD) phase during which patients consumed a CKD and MAD, respectively. Lymphatic function and oedema volume, the primary outcomes, were assessed at baseline and at the end of both the CKD and MAD phase. Secondary outcomes included health‐related and lymphedema‐specific quality of life (QoL).ResultsSeven out of nine patients completed the study protocol. Lymphatic function was improved upon consumption of both a CKD (dermal backflow score [mean ± SD]: 7.29 ± 2.98 vs. 10.86 ± 2.19 at baseline; p = 0.03) and MAD (6.71 ± 2.06; p = 0.02), whereas oedema volume did not decrease during the course of the study (excess limb volume [mean ± SD]: 20.13 ± 10.25% at end of CKD and 24.07 ± 17.77% at end of MAD vs. 20.79 ± 12.96% at baseline; p > 0.99 and p > 0.30, respectively). No changes were observed in health‐related, nor lymphoedema‐specific QoL at the end of CKD and MAD.ConclusionsThe consumption of a KD improved lymphatic function and was associated with a clinically meaningful reduction in oedema volume in some patients (3/7 at end of CKD, 2/7 at end of MAD) with unilateral stage 2 secondary lymphoedema. These results highlight the potential of a KD to improve lymphatic function in patients with lymphoedema. However, further studies are required to substantiate our findings.