bluuebunny/crossref_metadata_2025_split huggingface dataset:
A PILOT FEASIBILITY STUDY INVESTIGATING BALANCE DELIVERY TO OLDER ADULTS WITH CHRONIC CONDITIONS IN REHAB SETTINGS
Authors: Choma Elizabeth , Peckenpaugh Jackson , Treat-Jaconson Diane , Martin Lauren , Wolfson Julian , Keller-Ross Manda , McMahon Siobhan 
Published: December 2023

Abstract
Little is known about the integration of balance exercise delivery into physical rehabilitation settings for older individuals with chronic conditions and fall risk. We assessed the feasibility, acceptability and limited efficacy of delivering evidence-based balance exercises to older adults with fall risk enrolled in cardiac rehabilitation (CR) for peripheral artery and/or cardiovascular disease through an explanatory sequential mixed methods pilot study. Phase one included a two-arm randomized trial comparing feasibility, acceptability and functional balance among 10 participants receiving an 8-week balance program delivered adjacent to CR and 10 participants receiving CR only. Phase two included semi-structured interviews to elicit perceived barriers/facilitators of program receipt. Data was analyzed using descriptive statistics to summarize feasibility and acceptability indicators and one-way ANCOVA to test balance effects (Short Physical Performance Battery [SPPB], Mini-BESTest). Qualitative data was analyzed through content analysis. Participants had a mean age of 72.3 (7.3). On average, treatment group participants attended 7.2 (1.8) out of 8 meetings and self-reported completion of 4.5 (1.8) exercise sessions/week. Adjusting for baseline values, the treatment group exhibited greater changes in the SPPB than the usual care group after 8 weeks (10.71±0.36 vs. 9.59±0.36; adjusted difference=1.13 [95% CI, 0.3,2.2]; p=0.045). Mini-BESTest scores were not significantly different (p=0.061). Participants expressed satisfaction with program duration and frequency, quality of instructional materials, challenge level, ease of home exercise completion, convenient delivery location, and improved balance self-awareness/skills. These findings could inform the design of future efficacy trials investigating balance integration within CR settings to improve reach of fall prevention efforts.
LINKING HEALTH ATTRIBUTES TO ACUTE-CARE USAGE IN SOUTH FLORIDA VETERANS, A PILOT SURVEY STUDY
Authors: Munoz Richard , Bursac Zoran , Gomez Carlos , Hansen Jared , Garcia Sandra , Ruiz Diana , Desir Marianne , Dang Stuti 
Published: December 2023

Abstract
“High-Need, High-Risk” (HNHR) Veteran patients are identified quarterly by the Department of Veterans Affairs (VA) as having the top 5% predicted probability of hospitalization or mortality. We fielded a pilot survey to 2,543 older “HNHR” Veterans receiving care at the Miami VA Medical Center between October 2017 and September 2018, where 634 replied; mean age 70.61, standard deviation, 8.98, racially/ethnically White (403, 61.24%), Black (240, 36.47%), Hispanic (537, 81.61%) and nineteen women (3%). The survey contained 42 self-reported questions covering physical, mental, and social determinants of health, and access/use of healthcare resources. Two measured prior 6-month acute-care utilization outcomes: emergency room visits (ERV) and inpatient hospital admissions (IHA). Logistic regression was used to find health attributes associated with both outcomes, and latent class analysis was used to group Veterans into clinically relevant latent classes, analyzing health attributes endorsed by each. We found that transportation access issues to receiving healthcare were associated with both outcomes (OR = 2.980, p = 0.014), underscoring the role of social determinants of health. Self-perceptions of general health (OR = 0.806, p = 0.04), and a Veteran attending the Miami VA frailty clinic (OR = 0.435, p &lt; 0.001), were associated with ERV and IHA, respectively. We identified four latent classes distinctly grouping patients by endorsing 1) depression; 2) not having a caregiver and being unmarried; 3) functional issues, and 4) being homebound and receiving home healthcare. These latent classes will help better inform clinical recommendations and program development to better meet needs for “HNHR” Veterans.
Trading Repaired and Refurbished Goods: How Sustainable is EU Exhaustion of Trade Marks?
Authors: Geiregat Simon 
Published: December 2023

Abstract
Analysing EU, Benelux and German case law, this article examines whether the exhaustion doctrine in trade mark law contributes to a more sustainable economy. It considers that ecological motives seem not to have played a role either in the policy choice against international exhaustion, or in the Court of Justice of the European Union (CJEU) case law on legitimate reasons and the repackaging of medication.
Although exhaustion could, theoretically, incentivise traders to give new life to goods that were legitimately marketed before, the analysis shows that this is a risky business because of the thin and blurry line between lawful renewal activities and creating a false impression of affiliation. As such, it is unclear to what extent de-branding, re-branding, and co-branding can prevent liability for infringement, although co-branding renewed products is probably often the only way to do so. As an alternative to buy–renew–resell, traders could consider providing renewal services. On closer analysis, however, offering services puts them in an even less favourable position, and this seems hard to justify.
In addition to trade mark rights, copyright and/or design rights will often cumulatively apply to mark-bearing products. Although the latter rights are also subject to a principle of exhaustion, the effects of exhaustion can de facto be overruled by the exception for legitimate reasons proper to trade mark law. Moreover, it is argued that repair exceptions in copyright and design legislation have limited effect and that announced legislative reforms are unlikely to change that.
The unattractiveness of renewal businesses is further aggravated by the recurrent use of open norms and references to common practices. It is concluded that IP laws often leave it to the discretion of rightholders whether to offer sustainable post-sale solutions. Besides having clearer guidance on what is allowed, this paper suggests that exhaustion case law should take sustainability arguments into account, for instance by considering what would happen to goods if they were not renewed by the trader. To a large extent, the judiciary already has tools at its disposal to incorporate these kinds of elements.
The Disease Severity Index for Inflammatory Bowel Disease Is a Valid Instrument that Predicts Complicated Disease
Authors: Swaminathan Akhilesh , Fulforth James M , Frampton Chris M , Borichevsky Grace M , Mules Thomas C , Kilpatrick Kate , Choukour Myriam , Fields Peter , Ramkissoon Resham , Helms Emily , Hanauer Stephen B , Leong Rupert W , Peyrin-Biroulet Laurent , Siegel Corey A , Gearry Richard B 
Published: December 2023

Abstract

Background
The disease severity index (DSI) for inflammatory bowel disease (IBD) combines measures of disease phenotype, inflammatory activity, and patient-reported outcomes. We aimed to validate the DSI and assess its utility in predicting a complicated IBD course.

Methods
A multicenter cohort of adults with IBD was recruited. Intraclass correlation coefficients (ICCs) and weighted Kappa assessed inter-rater reliability. Cronbach’s alpha measured internal consistency of DSI items. Spearman’s rank correlations compared the DSI with endoscopic indices, symptom indices, quality of life, and disability. A subgroup was followed for 24 months to assess for a complicated IBD course. Area under the receiver operating characteristics curve (AUROC) and multivariable logistic regression assessed the utility of the DSI in predicting disease progression.

Results
Three hundred and sixty-nine participants were included (Crohn’s disease [CD], n = 230; female, n = 194; mean age, 46 years [SD, 15]; median disease duration, 11 years [interquartile range, 5-21]), of which 171 (CD, n = 99; ulcerative colitis [UC], n = 72) were followed prospectively. The DSI showed inter-rater reliability for CD (ICC 0.93, n = 65) and UC (ICC 0.97, n = 33). The DSI items demonstrated inter-rater agreement (Kappa &gt; 0.4) and internal consistency (CD, α &gt; 0.59; UC, α &gt; 0.75). The DSI was significantly associated with endoscopic activity (CDn=141, r = 0.65, P &lt; .001; UCn=105, r = 0.80, P &lt; .001), symptoms (CDn=159, r = 0.69, P &lt; .001; UCn=132, r = 0.58, P &lt; .001), quality of life (CDn=198, r = −0.59, P &lt; .001; UCn=128, r = −0.68, P &lt; .001), and disability (CDn=83, r = −0.67, P &lt; .001; UCn=52, r = −0.74, P &lt; .001). A DSI of 23 best predicted a complicated IBD course (AUROC = 0.82, P &lt; .001) and was associated with this end point on multivariable analyses (aOR, 9.20; 95% confidence interval, 3.32-25.49).

Conclusions
The DSI reliably encapsulates factors contributing to disease severity and accurately prognosticates the longitudinal IBD course.
Single-center Experience With Upadacitinib for Adolescents With Refractory Inflammatory Bowel Disease
Authors: Spencer Elizabeth A , Bergstein Suzannah , Dolinger Michael , Pittman Nanci , Kellar Amelia , Dunkin David , Dubinsky Marla C 
Published: December 2023

Abstract

Background
Upadacitinib (UPA) is a novel selective JAK inhibitor approved for adults with ulcerative colitis (UC) and with positive phase 3 data for Crohn’s disease (CD). Pediatric off-label use is common due to delays in pediatric approvals; real-world data on UPA are needed to understand the safety and effectiveness in pediatric IBD.

Methods
This is a single-center retrospective case series study of adolescents (12-17 years) with inflammatory bowel disease IBD on UPA. The primary outcome was postinduction steroid-free clinical remission (SF-CR) defined as Pediatric UC Activity Index (PUCAI) or Pediatric CD Activity Index (PCDAI) ≤10. Secondary outcomes include postinduction clinical response (decrease ≥12.5 in PUCAI/PCDAI), postinduction C-reactive protein (CRP) normalization, 6-month SF-CR, and intestinal ultrasound response and remission. Adverse events were recorded through last follow-up.

Results
Twenty patients (9 CD, 10 UC, 1 IBD-U; 55% female; median age 15 years, 90% ≥2 biologics) were treated with UPA for ≥12 weeks (median 51 [43-63] weeks). Upadacitinib was used as monotherapy in 55% and as combination with ustekinumab and vedolizumab in 35% and 10%, respectively. Week 12 SF-CR was achieved in 75% (15/20) and 80% (16/20) with CRP normalization. About 3/4 (14/19) achieved SF-CR at 6 months. Adverse event occurred in 2 patients (10%): Cytomegalovirus colitis requiring hospitalization and hyperlipidemia requiring no treatment. In the 75% with ultrasound monitoring, response and remission were achieved in 77% and 60%, respectively.

Conclusion
While awaiting pediatric registration trials, our data suggest that UPA is effective in inducing and maintaining SF-CR in adolescents with highly-refractory IBD with an acceptable safety profile.
Quantification of intraspecific and interspecific competition in fish species of the Aegean Sea
Authors: Koutsidi Martha , Lazaris Alexis , Peristeraki Panagiota , Tserpes George , Tzanatos Evangelos 
Published: December 2023

Abstract
Competition shapes species coexistence and community assembly, playing a central role in maintaining biodiversity and ecosystem resilience. Here, we used an asymmetric competition index that quantifies the possible competitive effect of a species on any other, using southern Aegean Sea nekton biomass from the Mediterranean International Trawl Survey dataset, combined with data on six traits relevant to trophic ecology and spawning. We modeled the effect of selected haul-level covariates on the competition index, and we indicated competition variation across depth and habitats. Most species experienced stronger inter- than intra-specific competition. Both the higher-than-expected significance of interspecific competition (in comparison to intraspecific that is generally anticipated to be higher) and the existence of an extensive network of multiple competitive interactions indicated, are associated with high biodiversity, combined to the absence of dominance by one or a few species in the community (no species is disproportionally highly abundant in comparison to others); the latter may be relevant to community stability and resilience. The quantification of competition across marine ecosystems can help predict how fish communities will respond to future resource availability and environmental conditions.
Effects of dietary supplementation of different levels of gamma-aminobutyric acid on reproductive performance, glucose intolerance, and placental development of gilts
Authors: Ma Shuo , Li Jinfeng , Ye Hongxuan , Huang Shuangbo , Huang Zihao , Wu Deyuan , Ma Kaidi , Xie Junyan , Yin Yulong , Tan Chengquan 
Published: December 2023

Abstract
This study aimed to investigate the effects of dietary gamma-aminobutyric acid (GABA) supplementation on reproductive performance, glucose intolerance, and placental development of gilts during mid-late gestation. Based on the principle of backfat thickness consistency, 124 gilts at 65 d of gestation were assigned to three dietary groups: CON (basic diet, n = 41), LGABA (basic diet supplemented with 0.03% GABA, n = 42), and HGABA (basic diet supplemented with 0.06% GABA, n = 41). The litter performance, glucose tolerance, placental angiogenesis, and nutrients transporters were assessed. The LGABA group improved piglet vitality and placental efficiency and decreased area under the curve of glucose tolerance test compared to the CON group (P &lt; 0.05). Meanwhile, the LGABA group enhanced placental vessel density, platelet endothelial cell adhesion molecule-1 levels and gene expression of fibroblast growth factor 18 (P &lt; 0.05). Furthermore, LGABA showed an uptrend in glucose transporter type 1 mRNA level (P = 0.09). Taken together, this study revealed that the dietary supplementation of 0.03% GABA can improve piglet vitality, glucose intolerance, and placental development of gilts.
Intraspecific morphological variations in the Iranian endemic freshwater crab Potamon strouhali (Decapoda: Brachyura: Potamidae)
Authors: Najafi Movahhed , Keikhosravi Alireza , Naderloo Reza 
Published: December 2023

Abstract
Potamon strouhali Pretzmann, 1976 is endemic to Iran, and distributed in a small heterogeneous region of the southern Persian plateau that includes two main drainage basins, the Khalij Fars-Oman and Markazi basins. Two subspecies of P. strouhali were previously recognized, but these, together with another species described that same year, P. eiseltiPretzmann, 1976, were all considered to be one species based on shared gonopod morphology. We examined individuals from the complete distributional range covering the type localities of all three taxa using morphological and morphometric-geometric data. The linear morphometric results using 21 characters and geometric-morphometric analysis of carapace shape were consistent. The results of the analysis indicated that P. strouhali has two main morphological populations and the subspecies are thus junior subjective synonyms of these two morphotypes. Potamon eiselti and P. s. shurium are attributed to morphotype 1 and P. s. strouhali to morphotype 2.
Immigrants’ subjective well-being in Europe: Variation by regional attitudes towards immigrants
Authors: Šedovič Michaela 
Published: December 2023

Abstract
Research suggests that migrants’ well-being varies with their lived environment. This variation’s potential but under-researched driver is non-migrants’ attitude towards immigrants (ATI). Using pooled European Social Survey data (2010–18) for twenty-two destination countries, I address the question, ‘Are more positive ATI in regions where migrants live associated with their higher life satisfaction?’. To answer it, I estimate models of life satisfaction regressed on a summed index of six measures of ATI aggregated to the regional level and control for individual-level predictors and country, year, and origin fixed effects. I find a significant association between more negative regional ATI and lower migrant well-being. Its strength is comparable with the most important known individual-level predictors of well-being (e.g., education). My descriptive results further show that the length of stay at the destination moderates the strength of association (only those more recently arrived are affected). Despite well-attested links between feelings of discrimination and well-being, I show that those who express greater discrimination are not more sensitive to ATI. This suggests that each measure speaks to a separate mechanism for experiencing discrimination. Showing that ATI is strongly related to migrants’ well-being implies that the lived environment should be at the forefront of the migration outcomes research.
Predicting intracranial involvement: Unveiling perineural spread in COVID-19-associated mucormycosis, a novel phenomenon
Authors: Nidhin Das K , Sharma Vidhu , Gupta Diksha , Tiwari Sarbesh , Elhence Poonam , Jain Vidhi , Soni Kapil , Goyal Amit 
Published: December 2023

Abstract
This study aimed to investigate the risk factors associated with intracranial involvement in COVID-19-associated mucormycosis (CAM) and to develop a nomogram model for predicting the risk of intracranial involvement, with a specific focus on perineural spread. An ambispective analysis was conducted on 275 CAM patients who received comprehensive treatment. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors, and a nomogram was created based on the results of the multivariable analysis. The performance of the nomogram was evaluated using a receiver operating characteristic (ROC) curve, and the discriminatory capacity was assessed using the area under the curve (AUC). The model's calibration was assessed through a calibration curve and the Hosmer Lemeshow test. In the results, the multivariable logistic regression analysis revealed that age (OR: 1.23, 95% CI 1.06–3.79), HbA1c (OR: 7.168, 95% CI 1.724–25.788), perineural spread (OR: 6.3, 95% CI 1.281–19.874), and the disease stage were independent risk factors for intracranial involvement in CAM. The developed nomogram demonstrated good discriminative capacity with an AUC of 0.821 (95% CI 0.713–0.909) as indicated by the ROC curve. The calibration curve showed that the nomogram was well-calibrated, and the Hosmer Lemeshow test yielded a P-value of 0.992, indicating a good fit for the model. In conclusion, this study found that CAM particularly exhibits perineural spread, which is a predictive factor for intracranial involvement. A nomogram model incorporating age, HbA1c, disease stage, and perineural spread was successfully developed for predicting intracranial involvement in CAM patients in both in-patient and out-patient settings.
Alaska’s climate sensitive Yukon–Kuskokwim Delta supports seven million Arctic-breeding shorebirds, including the majority of six North American populations
Authors: Lyons James E , Brown Stephen C , Saalfeld Sarah T , Johnson James A , Andres Brad A , Sowl Kristine M , Gill Robert E , McCaffery Brian J , Kidd Lindall R , McGarvey Metta , Winn Brad , Gates H River , Granfors Diane A , Lanctot Richard B 
Published: December 2023

Abstract
Baseline information about declining North American shorebird populations is essential to determine the effects of global warming at low-lying coastal areas of the Arctic and subarctic, where numerous taxa breed, and to assess population recovery throughout their range. We estimated population sizes on the Yukon–Kuskokwim Delta (YKD) in western Alaska on the eastern edge of the Bering Sea. We conducted ground-based surveys during 2015 and 2016 at 589 randomly selected plots from an area of 35,769 km2. We used stratified random sampling in 8 physiographic strata and corrected population estimates using detection ratios derived from double sampling on a subset of plots. We detected 11,110 breeding individuals of 21 taxa. Western Sandpiper (Calidris mauri), Red-necked Phalarope (Phalaropus lobatus), Dunlin (subspecies C. alpina pacifica), and Wilson’s Snipe (Gallinago delicata) were the most abundant taxa. We estimated that ~7 million individual shorebirds were breeding on the entire YKD in 2015 and 2016. Our surveys of this region provided robust population estimates (coefficient of variations ≤ 0.35) for 14 species. Our results indicate that the YKD supports a large proportion of North America’s breeding populations of the Pacific Golden-Plover (Pluvialis fulva), the western population of a Whimbrel subspecies (Numenius phaeopus hudsonicus), a Bar-tailed Godwit subspecies (Limosa lapponica baueri), Black Turnstone (Arenaria melanocephala), a Dunlin subspecies (C. alpina pacifica), and Western Sandpiper. Our study highlights the importance of breeding shorebirds of this relatively pristine but climatically sensitive deltaic system. Estuaries and deltaic systems worldwide are rapidly being degraded by anthropogenic activities. Our population estimates can be used to refine prior North American population estimates, determine the effects of global warming, and evaluate conservation success by measuring population change over time.