bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy Storage Governance in the Asia-Pacific through the Law of the Sea Convention: Exploring Bottlenecks and Enablers of Regulating Offshore Wind Combined with Energy Storage
Authors: Colombo Esmeralda 
Published: June 2023

Abstract
Following projections of high economic and demographic growth, the Asia-Pacific region is poised to take the lead in the global production of offshore wind energy. A critical barrier is the intermittency of renewables, increasing the need for energy storage capacity to conserve energy harvested from the ocean. The bankability of energy storage systems combined with offshore wind power remains low and depends on varied policy frameworks. Meanwhile, the potential of the Law of the Sea (los) Convention for storage governance is underexplored. This paper highlights current regulatory bottlenecks and enablers to energy storage based on the los Convention and comparative policy research. It focuses on hydrogen as an energy carrier to store offshore wind energy, demonstrating how energy justice and environmental stewardship can result from ocean-based storage capacity developments. Ultimately, it aims to facilitate access to financing to increase the storage capacity of the Asian-Pacific sustainable blue economy.
A New wto Protocol on Fisheries Subsidies: Potential Implications for the South China Sea Disputes
Authors: Espenilla Jacqueline F. 
Published: June 2023

Abstract
For close to two decades, wto member countries have discussed the possibility of disciplining the practice of subsidizing fishing activities. Concrete progress has been made as there is now a consensus on eliminating certain forms of fisheries subsidies that contribute towards overcapacity, overfishing and illegal unreported and unregulated fishing. In June 2022, at the end of 12th Ministerial Conference in Geneva, Switzerland, the Agreement on Fisheries Subsidies (afs) was finally adopted. Against this backdrop, this paper will attempt to investigate the role that the afs might play in arresting the collapse of global fish stocks. Part i provides a brief background on the state of global fisheries and the role of subsidies in their depletion. Part ii discusses the key features of and contentious issues in the afs. Finally, Part iii considers the potential implications of the afs on disputed waters such as the South China Sea.
Canada
Authors: Smith J.J.P. 
Published: June 2023

Abstract
With the question of sovereignty over Hans Island settled between Canada and Denmark, all territorial claims among Arctic states have been resolved. The 2022 agreement between the two states is discussed in the context of their cooperation in oceans matters, including a contemporaneous minor adjustment of a 1972 seabed boundary and coordinated extended continental shelf claims. The provision for the access of indigenous Inuit people to Hans Island is considered. The 2022 agreement as an exemplar of acting in mutual interest toward resolving a maritime territorial dispute is reviewed.
The U.S.-China “Taiwan Strait” Confrontation: Korea to Follow International Law and Maintain Strategic Ambiguity
Authors: Lee Seokwoo 
Published: June 2023

Abstract
Korea’s respect for the United States Forces Korea (usfk)’s strategic flexibility as an ally to the U.S. is an entirely separate issue from Korea becoming a party to the Taiwan conflict. To uphold peace and security in the Taiwan Strait, Korea should instead, respect the “one China” policy that is central to the security of East Asia and the diplomatic relations between China and other countries. As such, regarding the issues surrounding the Taiwan Strait, for diplomatic security, restraint and strategic ambiguity are necessary to stabilize the status quo.
A Decadal Climate Service for Insurance: Skillful Multiyear Predictions of North Atlantic Hurricane Activity and U.S. Hurricane Damage
Authors: Lockwood Julia F. , Dunstone Nick , Hermanson Leon , Saville Geoffrey R. , Scaife Adam A. , Smith Doug , Thornton Hazel E. 
Published: June 2023

Abstract
North Atlantic Ocean hurricane activity exhibits significant variation on multiannual time scales. Advance knowledge of periods of high activity would be beneficial to the insurance industry as well as society in general. Previous studies have shown that climate models initialized with current oceanic and atmospheric conditions, known as decadal prediction systems, are skillful at predicting North Atlantic hurricane activity averaged over periods of 2–10 years. We show that this skill also translates into skillful predictions of real-world U.S. hurricane damage. Using such systems, we have developed a prototype climate service for the insurance industry giving probabilistic forecasts of 5-yr-mean North Atlantic hurricane activity, measured by the total accumulated cyclone energy (ACE index), and 5-yr-total U.S. hurricane damage (given in U.S. dollars). Rather than tracking hurricanes in the decadal systems directly, the forecasts use a relative temperature index known to be strongly linked to hurricane activity. Statistical relationships based on past forecasts of the index and observed hurricane activity and U.S. damage are then used to produce probabilistic forecasts. The predictions of hurricane activity and U.S. damage for the period 2020–24 are high, with ∼95% probabilities of being above average. We note that skill in predicting the temperature index on which the forecasts are based has declined in recent years. More research is therefore needed to understand under which conditions the forecasts are most skillful.

Significance Statement
The purpose of this article is to explain the science and methods behind a recently developed prototype climate service that uses initialized climate models to give probabilistic forecasts of 5-yr-mean North Atlantic Ocean hurricane activity, as well as 5-yr-total associated U.S. hurricane damage. Although skill in predicting North Atlantic hurricane activity on this time scale has been known for some time, a key result in this article is showing that this also leads to predictability in real-world damage. These forecasts could be of benefit to the insurance industry and to society in general.
Efficacy and safety of vena cava filters in preventing pulmonary embolism: A systematic review and meta-analysis
Authors: Miao Huang-Tai , Li Xiao-Ying , Zhou Can , Liang Ying , Nie Shao-Ping 
Published: June 2023

Objectives To assess the treatment effectiveness of inferior vena cava filters (IVCF) versus non-IVCF for patients undergoing varies conditions. Methods We systematically searched the databases to identify eligible RCTs from their inception up to 9/20/2020. The primary endpoint was pulmonary embolism (PE), while the secondary endpoints included deep-vein thrombosis (DVT), major bleeding, and all-cause mortality. The RRs with 95% CIs were applied as effect estimates for the treatment effectiveness of IVCF versus non-IVCF and calculated by using the random-effects model. Results 1,137 patients of 5 RCTs were enrolled. There were no significant differences between IVCF and non-IVCF for the risk of PE, major bleeding, and all-cause mortality, while the risk of DVT was significantly increased for patients treated with IVCF. Conclusions The use of IVCF did not yield any benefits on PE, major bleeding, and all-cause mortality risk for patients undergoing various conditions, while the risk of DVT was significantly increased for patients treated with IVCF.
Effects of interleukin-23 on the activation of mucosal-associated invariant T cells from oral lichen planus
Authors: Wang Fang , Zhang Xiu-Li , Yang Jing-Ya , Zhou Gang 
Published: June 2023

Objective Oral lichen planus (OLP) is a T cell-mediated inflammatory condition in the oral cavity. Mucosal-associated invariant T (MAIT) cells are gaining more relevance in immune diseases because they can be activated by cytokines without T cell receptor stimulation. Herein, we tested the effect of interleukin-23 (IL-23) on the activation status of OLP MAIT cells. Methods Peripheral blood mononuclear cells (PBMCs) isolated from OLP patients were stimulated by IL-23 in the absence or presence of phorbol myristate acetate (PMA) and ionomycin. The activation status of MAIT cells was analyzed by flow cytometry after staining for CD3, CD4, CD8, CD161, TCR Vα7.2, and CD69. Results The fraction of MAIT cells in OLP peripheral blood was approximately 0.38% to 3.97%, and CD8+ subpopulations overwhelmed CD4+ cells. The mean percentages of OLP MAIT cells in PBMCs and CD8+MAIT cells in MAIT cells were approximately 40%. PMA and ionomycin significantly increased CD69 expression on OLP T cells, MAIT cells, and CD8+MAIT cells. Cells with enhanced activation had different responsiveness to exogenous IL-23, showing increased CD69 expression on OLP T cells, decreased CD69 on OLP CD8+MAIT cells, and no significant change on OLP MAIT cells. Conclusions IL-23 showed different effects on the activation status of OLP MAIT cells and CD8+MAIT cells.
Changes in terpene biosynthesis and submergence tolerance in cotton
Authors: Sun Liangqing , Wang Junjuan , Cui Yupeng , Cui Ruifeng , Kang Ruiqing , Zhang Yuexin , Wang Shuai , Zhao Lanjie , Wang Delong , Lu Xuke , Fan Yapeng , Han Mingge , Chen Chao , Chen Xiugui , Guo Lixue , Ye Wuwei 
Published: June 2023

AbstractBackgroundFlooding is among the most severe abiotic stresses in plant growth and development. The mechanism of submergence tolerance of cotton in response to submergence stress is unknown.ResultsThe transcriptome results showed that a total of 6,893 differentially expressed genes (DEGs) were discovered under submergence stress. Gene Ontology (GO) enrichment analysis showed that DEGs were involved in various stress or stimulus responses. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis indicated that DEGs related to plant hormone signal transduction, starch and sucrose metabolism, glycolysis and the biosynthesis of secondary metabolites were regulated by submergence stress. Eight DEGs related to ethylene signaling and 3 ethylene synthesis genes were identified in the hormone signal transduction. For respiratory metabolism, alcohol dehydrogenase (ADH,GH_A02G0728) and pyruvate decarboxylase (PDC,GH_D09G1778) were significantly upregulated but 6-phosphofructokinase (PFK,GH_D05G0280), phosphoglycerate kinase (PGK,GH_A01G0945andGH_D01G0967) and sucrose synthase genes (SUS,GH_A06G0873andGH_D06G0851) were significantly downregulated in the submergence treatment. Terpene biosynthetic pathway-related genes in the secondary metabolites were regulated in submergence stress.ConclusionsRegulation of terpene biosynthesis by respiratory metabolism may play a role in enhancing the tolerance of cotton to submergence under flooding. Our findings showed that the mevalonate pathway, which occurs in the cytoplasm of the terpenoid backbone biosynthesis pathway (ko00900), may be the main response to submergence stress.
Ability of the Analgesia Nociception Index variations to identify a response to a volume expansion of 250 mL of crystalloids in the operating room (REVANI): a prospective observational study
Authors: de Courson Hugues , Chadefaux Grégoire , Abel Benjamin , Georges Delphine , Verchere Eric , Biais Matthieu 
Published: June 2023

Abstract
Background
Analgesia Nociception Index (ANI) is a device based on analysis of the R-R interval and respiratory sinus arrhythmia to assess the balance between sympathetic and parasympathetic activity. The autonomic system is directly affected by load changes. Therefore, monitoring sympathetic tone and its change could theoretically allow tracking of load changes during volume expansion. The aim of the present study was to determine whether changes in ANI are able to track the increase in stroke volume caused by volume expansion (SV).

Methods
This prospective observational study included mechanically ventilated patients undergoing neurosurgery and benefiting from SV monitoring. Exclusion criteria were cardiac dysfunction, arrhythmias, beta-blockade therapy, and dysautonomia. SV was optimized by fluid administration of 250 ml of crystalloid fluid. A positive fluid increase was defined as a SV increase of 10% or more from baseline. Changes in SV and medium ANI (ANIm) were recorded before and 4 to 5 min after volume expansion.

Results
Sixty-nine patients had 104 fluid challenges (36 positive and 68 negative). Volume expansion resulted in a greater ANI increase in responders than in nonresponders. The change in ANIm > 5 predicted fluid responsiveness with a sensitivity of 68.4% (95% CI: 67.4% to 69.5%) and a specificity of 51.2% (95% CI: 50.1% to 52.3%). The area under the receiver operating characteristic curve was 0.546 (95% CI: 0.544 to 0.549) and appeared to be affected by remifentanil dose and baseline ANI.

Conclusion
Changes in ANIm induced by fluid challenge is not able to predict fluid responsiveness in mechanically ventilated patients undergoing neurosurgery.

Trial registration
Clinical trial registration: NCT04223414.
Free drug provision for tuberculosis increases patient follow-ups and successful treatment outcomes in the Indian private sector: a quasi experimental study using propensity score matching
Authors: Sodhi Ridhima , Penkunas Michael J. , Pal Arnab 
Published: June 2023

AbstractBackgroundThe private sector is an important yet underregulated component of the TB treatment infrastructure in India. The Joint Effort for Elimination of Tuberculosis (Project JEET) aims to link private sector TB care with the constellation of social support mechanisms available through the Indian National TB Elimination Programme (NTEP), including the provision of free fixed-dose combination (FDCs) drugs to patients. This quasi-experimental study analysed routinely collected data to determine the impact of free drugs on patient follow-ups and treatment outcomes.MethodsWe used data for private sector patients enrolled with Project JEET who were diagnosed with pulmonary and extrapulmonary TB between 1 January 2019 and 31 March 2020, and completed treatment by 31 December 2021. Propensity score matching was used to create a dataset to compare the number of follow-ups and proportion of successful treatment outcomes for patients on free drugs to a control group who paid out-of-pocket. 11,621 matched pairs were included in the analysis. Logistic regression and ordinary least squares regression models were used to estimate the impact of free drugs on number of follow-ups and treatment success, where latter is defined as treatment completion or cure.ResultsAfter controlling for potential confounders, patients on free drugs received on average 2.522 (95% C.I.: 2.325 to 2.719) additional follow-ups compared to patients who paid out of pocket. This equates to a 25% mean and 32% median increase in follow-ups for patients availing free drugs. For treatment success, patients receiving free drugs had 45% higher odds of a successful treatment (Odds Ratio: 1.452, 95% C.I.: 1.288 to 1.637).ConclusionsPatients receiving free drugs were found to follow up with their treatment coordinator more frequently, in part likely to enable drug refilling, compared to patients who were paying out of pocket. These additional contacts would have offered opportunities to address concerns regarding side effects, provide additional treatment information, and connect with social support services, all of which subsequently contributed to patients’ continual engagement with their treatment. This potentially represents the unmeasured effect of free drugs on continual social support, which translates into a higher odds of treatment success for patients.
Mastectomy with Reconstruction Including Robotic Endoscopic Surgery (MARRES): a prospective cohort study of the Korea Robot-Endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG) and Korean Breast Cancer Study Group (KBCSG)
Authors: Ryu Jai Min , Lee Jeea , Lee Jeeyeon , Ko BeomSeok , Kim Joo Heung , Shin Hyukjai , Park Hyung Seok ,   Korea Robot-endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG)
Published: June 2023

Abstract
Background
Robotic nipple-sparing mastectomy (RNSM) has emerged as a new treatment option for breast cancer and risk-reducing mastectomy (RRM) for women who have a high risk of pathogenic variants. Even though several studies have reported that RNSM is a feasible procedure, some argue that it should only be performed by specialized surgeons, and data on oncologic outcomes and patient-reported outcomes (PROs) are limited. Recently, the United States Food and Drug Administration and several surgeons warned that robotic breast surgery should be performed only by specialized surgeons and recommended that the benefits, risks, and alternatives of all available treatment options be discussed with patients so they can make informed treatment decisions. The Korea Robot-Endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG) has been established to evaluate, standardize, and teach this state-of-the-art procedure. We have designed a multicenter prospective cohort study entitled Mastectomy with Reconstruction Including Robot Endoscopic Surgery (MARRES) to report surgical, PRO, and oncologic outcomes.

Methods
MARRES is a multi-institution cohort study prospectively collecting data from patients undergoing mastectomy and reconstruction. The patient inclusion criteria are adult women older than 19 with breast cancer or a high risk of breast cancer (patients with BRCA1/2, TP53, PALB2 mutations, etc.), who have scheduled therapeutic or RRM and want immediate reconstruction. Surgical outcomes, including pre- and postoperative photos, oncologic outcomes, cost-effectiveness, and PRO, are collected. The primary endpoints are postoperative complication rates within 30 postoperative days and the Clavien-Dindo grade of postoperative complications within 180 postoperative days. The secondary endpoints are 5-year postoperative recurrence-free survival and cancer incidence rate (for those who underwent RRM), patient satisfaction with reconstruction expectations preoperative (baseline) and results within 6 to 12 postoperative months, surgeon satisfaction with postoperative results in 6 postoperative months, and cost-effectiveness of the definitive surgery. Patient recruitment will be completed in April 2025, and the target number of enrolled patients is 2000.

Discussion
This study will provide evidence about the surgical outcomes, oncologic outcomes, and patient satisfaction with RNSM and endoscopic nipple-sparing mastectomy (NSM), compared with conventional NSM.

Trial registration
ClinicalTrials.gov Identifier NCT04585074. Registered April 8, 2020.
Delphi panel to obtain clinical consensus about using long-acting injectable antipsychotics to treat first-episode and early-phase schizophrenia: treatment goals and approaches to functional recovery
Authors: Arango Celso , Fagiolini Andrea , Gorwood Philip , Kane John M. , Diaz-Mendoza Sergio , Sahota Navdeep , Correll Christoph U. 
Published: June 2023

Abstract
Background
Schizophrenia is mostly a chronic disorder whose symptoms include psychosis, negative symptoms and cognitive dysfunction. Poor adherence is common and related relapse can impair outcomes. Long-acting injectable antipsychotics (LAIs) may promote treatment adherence and decrease the likelihood of relapse and rehospitalization. Using LAIs in first-episode psychosis (FEP) and early-phase (EP) schizophrenia patients could benefit them, yet LAIs have traditionally been reserved for chronic patients.

Methods
A three-step modified Delphi panel process was used to obtain expert consensus on using LAIs with FEP and EP schizophrenia patients. A literature review and input from a steering committee of five experts in psychiatry were used to develop statements about patient population, adverse event management, and functional recovery. Recruited Delphi process psychiatrists rated the extent of their agreement with the statements over three rounds (Round 1: paper survey, 1:1 interview; Rounds 2–3: email survey). Analysis rules determined whether a statement progressed to the next round and the level of agreement deemed consensus. Measures of central tendency (mode, mean) and variability (interquartile range) were reported back to help panelists assess their previous responses in the context of those of the overall group.

Results
The Delphi panelists were 17 psychiatrists experienced in treating schizophrenia with LAIs, practicing in seven countries (France, Italy, US, Germany, Spain, Denmark, UK). Panelists were presented with 73 statements spanning three categories: patient population; medication dosage, management, and adverse events; and functional recovery domains and assessment. Fifty-five statements achieved ≥ 80% agreement (considered consensus). Statements with low agreement (40-79%) or very low agreement (< 39%) concerned initiating dosage in FEP and EP patients, and managing loss of efficacy and breakthrough episodes, reflecting current evidence gaps. The panel emphasized benefits of LAIs in FEP and EP patients, with consensus that LAIs can decrease the risk of relapse, rehospitalization, and functional dysfunction. The panel supported links between these benefits and multidimensional longer-term functional recovery beyond symptomatic remission.

Conclusions
Findings from this Delphi panel support the use of LAIs in FEP and EP schizophrenia patients regardless of disease severity, number of relapses, or social support status. Gaps in clinician knowledge make generating evidence on using LAIs in FEP and EP patients critical.
An economic evaluation of two PCR-based respiratory panel assays for patients admitted to hospital with community-acquired pneumonia (CAP) in the UK, France and Spain
Authors: Miners Lisa , Huntington Susie , Lee Nathaniel , Turner Katy M. E. , Adams Elisabeth 
Published: June 2023

Abstract
Background
On admission to hospital, patients with community-acquired pneumonia (CAP), undergo extensive diagnostic testing. Two high-throughput laboratory-based PCR panels which return a result in 5.5 hours (h) have been developed to test for pathogens commonly associated with upper (Respiratory 1 Panel) and lower (Respiratory 3 Panel) respiratory tract infections (GeneFirst, Oxford). These could replace multiple diagnostic tests currently used.

Methods
An online survey, completed by senior clinicians in the UK, France and Spain, was used to collect data on the diagnostic testing of immunocompetent and immunocompromised adults admitted to hospital with CAP, including the cost of diagnostics. Data were used to inform a cost-comparison model. For each country, the average cost of diagnostic testing per patient was calculated separately for immunocompetent and immunocompromised patients.
The model compared three testing strategies with standard of care (SoC). In the Panel 1 strategy, the Respiratory 1 Panel was used for patients that would otherwise have tests which could be replaced by Respiratory 1 Panel, equivalent strategies for Respiratory 3 Panel and for both panels combined were assessed.

Results
In total, 48 surveys were completed (UK = 17; France = 15; Spain = 16). Compared with SoC, the Panel 1 + 3 strategy was most favourable, resulting in cost savings for immunocompetent and immunocompromised patients respectively, of €22.09 (£18.50) and €26.12 (£21.88) in the UK, €99.60 and €108.77 in France and €27.07 and €51.87 in Spain.

Conclusion
In all three countries, the use of these respiratory panels could reduce the average cost of diagnostics used for patients admitted to hospital with CAP.