bluuebunny/crossref_metadata_2025_split huggingface dataset:
Better Life's Essential 8 Is Associated With Lower Risk of Diabetic Kidney Disease: A Community‐Based Study
Authors: Gao Jingli , Liu Yang , Ning Ning , Wang Jing , Li Xiaolan , Wang Aitian , Chen Shuohua , Guo Liang , Wu Zhaogui , Qin Xueying , Ma Yanan , Wu Shouling 
Published: August 2023

Background
Diabetic kidney disease (DKD) is a common diabetic complication and increases the complexity of diabetes management. No prospective study has focused on the association between DKD and Life's Essential 8 (LE8). Our study aims to examine the association between LE8 and DKD risk.

Methods and Results

A total of 7605 participants, aged 54.32±9.77 years, and 4688 participants, aged 56.11±10.38 years, were included in the longitudinal and trajectory analyses, respectively, from 2006 to 2020. The DKD was confirmed using data collected during each follow‐up. LE8 was based on 4 health behaviors and 4 health factors. The range of each metric was 0 to 100, and the overall LE8 score was calculated as the unweighted average of all 8 component metric scores. The trajectories of LE8 during 2006 to 2010 were classified using latent mixture models. Cox models and restricted cubic splines were applied. After a median follow‐up of 12.41 and 6.71 years in longitudinal and trajectory analyses, respectively, the DKD incidence decreased, with the LE8 level increasing (
P
‐trend<0.05), and the linearity assumption for this relationship (
P
‐nonlinear=0.685) had been satisfied. Adjusted hazard ratios (HRs) for the highest tertile were 0.77 (95% CI, 0.69–0.87) and 0.70 (95% CI, 0.62–0.78) in baseline and time‐updated LE8 scores, respectively, compared with the lowest tertile. Adjusted HR was 0.53 (95% CI, 0.41–0.69) for the stable‐high pattern compared with the stable‐low pattern.

Conclusions
Although LE8 is an indicator of cardiovascular health, the beneficial impact of a high LE8 score is also evident in the protection of renal health among patients with diabetes.
The Shortcomings of Video Conferencing Technology, Methods for Revealing Them, and Emerging XR Solutions
Authors: Hove Dani Paul , Watson Benjamin 
Published: August 2023

Abstract
Video conferencing has become a central part of our daily lives, thanks to the COVID-19 pandemic. Unfortunately, so have its many limitations, resulting in poor support for communicative and social behavior and ultimately, “Zoom fatigue.” New technologies will be required to address these limitations, including many drawn from mixed reality (XR). In this paper, our goals are to equip and encourage future researchers to develop and test such technologies. Toward this end, we first survey research on the shortcomings of video conferencing systems, as defined before and after the pandemic. We then consider the methods that research uses to evaluate support for communicative behavior, and argue that those same methods should be employed in identifying, improving, and validating promising video conferencing technologies. Next, we survey emerging XR solutions to video conferencing's limitations, most of which do not employ head-mounted displays. We conclude by identifying several opportunities for video conferencing research in a post-pandemic, hybrid working environment.
Concept-Based Language Instruction Effects for Second and Heritage Language Learners: The Case of Korean Speech Level
Authors: Yoon Hye Min , Bond Kaylen , Walter Daniel R. 
Published: August 2023

Abstract
Concept-Based Language Instruction (C-BLI) has been shown to be an effective approach for teaching second language (L2) learners complex grammatical features. However, it is unclear whether C-BLI is equally effective for heritage language (HL) learners. 30 L2 and 27 HL learners of Korean completed a series of tasks designed in a pre-intervention-post-test model that focused on speech level through verbal morphology of honorific second-person address forms. The positive change seen in self-reported understanding of speech level from pre- to post-test in both groups was not significantly different, indicating equal self-reported gains in understanding, regardless of group. However, the qualitative analysis showed differences in the ways that L2 and HL learners verbalized their understanding and appropriateness judgments of speech level. The findings provide evidence that HL learners benefit equally in overall growth, although slightly differently in how they develop, from C-BLI.
Giving Spoilers the Space: How Transparency Efforts Doomed the Trans-Atlantic Trade and Investment Partnership (ttip)
Authors: Noteboom Vincent J. W. 
Published: August 2023

Abstract
The Trans-Atlantic Trade and Investment Partnership (ttip) underwent three years of negotiations by the EU and US, both experienced and capable negotiators, yet the negotiations failed, raising questions. This article delves into the factors that caused ttip’s demise by examining the negotiation structure, the impact of secrecy versus transparency, and the disruptive influence of spoilers. The change in negotiation structure caused a cascading effect, enabling disruptive actors to flourish, and causing the negotiators to switch from an integrative negotiation strategy into a distributive strategy. To enhance the chances of success and avoid similar pitfalls, this article presents recommendations: (1) maintaining a consistent negotiation structure, (2) coordinating any structural changes with the negotiation partner, (3) expanding the agreement’s scope to garner more internal political support, and (4) establishing political backing before commencing negotiations. By addressing these issues, future negotiations can mitigate risks and improve their chances of achieving desired outcomes.
Children Vicariously Bearing the Future of the Faiths
Authors: Darmanin Mary 
Published: August 2023

Abstract
This article assesses the role of children in perpetuating the chain of memory of the faiths in Europe. Drawing on indepth interviews with parents/guardians and fifty-two children on the religious socialization of Roman Catholic, Muslim, and non-religious children in Malta, it argues that Roman Catholic children are now the bearers of “vicarious religion” of communities that have become “unchurched,” while Muslim children steady the “precarious” memory of Islam in Europe. The article explores how children propel adults’ religious practices, keeping parents and grandparents connected to the faiths, churches, and mosques. Given the moral panic regarding voluntary childlessness as a threat to the perpetuation of the faiths, the vital role children play in the chain of religious memory is acknowledged.
Is Secularization a Pervasive Trend in Europe?
Authors: Meulemann Heiner , Schmidt-Catran Alexander W. 
Published: August 2023

Abstract
Between 2002 and 2016, church attendance and self-attributed religiosity declines linearly, if all countries included in the European Social Survey are taken together. This analysis differentiates within Europe between two ideological and three denominational divides. Two questions are examined. First, is secularization pervasive across these groups? Second, how pervasive does secularization remain as a macro-level trend, when cohort membership and other individual-level qualities are controlled for? We find that the trend in secularization is well-explained by cohort succession in Western as well as in Catholic and Protestant countries. In Eastern Orthodox countries, however, an increase in religiosity is observed, which cannot be explained by individual-level properties. We speculate that it is triggered by a coalition of national churches and political elites.
Spatially Explicit Correction of Simulated Urban Air Temperatures Using Crowdsourced Data
Authors: Brousse Oscar , Simpson Charles , Kenway Owain , Martilli Alberto , Krayenhoff E. Scott , Zonato Andrea , Heaviside Clare 
Published: August 2023

Abstract
Urban climate model evaluation often remains limited by a lack of trusted urban weather observations. The increasing density of personal weather sensors (PWSs) make them a potential rich source of data for urban climate studies that address the lack of representative urban weather observations. In our study, we demonstrate that carefully quality-checked PWS data not only improve urban climate models’ evaluation but can also serve for bias correcting their output prior to any urban climate impact studies. After simulating near-surface air temperatures over London and southeast England during the hot summer of 2018 with the Weather Research and Forecasting (WRF) Model and its building Effect parameterization with the building energy model (BEP–BEM) activated, we evaluated the modeled temperatures against 402 urban PWSs and showcased a heterogeneous spatial distribution of the model’s cool bias that was not captured using official weather stations only. This finding indicated a need for spatially explicit urban bias corrections of air temperatures, which we performed using an innovative method using machine learning to predict the models’ biases in each urban grid cell. This bias-correction technique is the first to consider that modeled urban temperatures follow a nonlinear spatially heterogeneous bias that is decorrelated from urban fraction. Our results showed that the bias correction was beneficial to bias correct daily minimum, daily mean, and daily maximum temperatures in the cities. We recommend that urban climate modelers further investigate the use of quality-checked PWSs for model evaluation and derive a framework for bias correction of urban climate simulations that can serve urban climate impact studies.

Significance Statement
Urban climate simulations are subject to spatially heterogeneous biases in urban air temperatures. Common validation methods using official weather stations do not suffice for detecting these biases. Using a dense set of personal weather sensors in London, we detect these biases before proposing an innovative way to correct them with machine learning techniques. We argue that any urban climate impact study should use such a technique if possible and that urban climate scientists should continue investigating paths to improve our methods.
Moored Observations of the West Greenland Coastal Current along the Southwest Greenland Shelf
Authors: Foukal Nicholas P. , Pickart Robert S. 
Published: August 2023

Abstract
We present the first continuous mooring records of the West Greenland Coastal Current (WGCC), a conduit of fresh, buoyant outflow from the Arctic Ocean and the Greenland Ice Sheet. Nearly two years of temperature, salinity, and velocity data from 2018 to 2020 demonstrate that the WGCC on the southwest Greenland shelf is a well-formed current distinct from the shelfbreak jet but exhibits strong chaotic variability in its lateral position on the shelf, ranging from the coastline to the shelf break (50 km offshore). We calculate the WGCC volume and freshwater transports during the 35% of the time when the mooring array fully bracketed the current. During these periods, the WGCC remains as strong (0.83 ± 0.02 Sverdrups; 1 Sv ≡ 106 m3 s−1) as the East Greenland Coastal Current (EGCC) on the southeast Greenland shelf (0.86 ± 0.05 Sv) but is saltier than the EGCC and thus transports less liquid freshwater (30 × 10−3 Sv in the WGCC vs 42 × 10−3 Sv in the EGCC). These results indicate that a significant portion of the liquid freshwater in the EGCC is diverted from the coastal current as it rounds Cape Farewell. We interpret the dominant spatial variability of the WGCC as an adjustment to upwelling-favorable wind forcing on the West Greenland shelf and a separation from the coastal bathymetric gradient. An analysis of the winds near southern Greenland supports this interpretation, with nonlocal winds on the southeast Greenland shelf impacting the WGCC volume transport more strongly than local winds over the southwest Greenland shelf.
Bound to Lead: US-Taiwan Relations, Security Networks, and The Future of AUKUS
Authors: Lai Christina 
Published: August 2023

In 2021 the US, UK, and Australia established a trilateral security partnership known as AUKUS. This new security arrangement carries strategic implications for Taiwan's national security and prospects for regional order in Asia. It also leads to empirical puzzles: how will members of multiple alliances respond to rising threats? Under what conditions can a patron state avoid unwanted entrapment and imperial overstretch? This article contributes to existing scholarship in US foreign policy and alliance management in Asia. It offers concrete thoughts on how a US policy of strategic clarity toward Taiwan and its contingency would enhance AUKUS's resilience, while US allies in Asia and Europe could maintain a collective stance of strategic ambiguity that would lessen internal tensions among the member states. Such an arrangement could not only help stabilize Asia's regional order, but also secure Taiwan's autonomy against Beijing's forced reunification.
Using a systems thinking approach to explore the complex relationships between schizophrenia and premature mortality
Authors: Ali Suhailah , Wright Eryn , Charlson Fiona 
Published: August 2023

Background: People with schizophrenia have a higher risk of mortality compared to the general population, which has not improved over time. The majority of premature deaths are due to comorbid physical diseases, driven by interrelated factors operating at the individual level, through health systems and influenced by social determinants of health. A holistic understanding of this problem and the causal pathways linking these factors together is lacking. Aims: This study aims to understand why the mortality gap between people with schizophrenia and the general population is not improving by developing a causal loop diagram (CLD), a systems thinking approach which enables empirical research and theoretical knowledge to be combined into a visual representation of causal relationships and feedback loops. Method: The CLD was constructed using published literature, including both quantitative and qualitative studies, to identify key variables and relationships, and refined through consultation with experts in the topic area. Results: A total of 21 variables and 68 connections were included in the CLD, with 23 distinct feedback loops identified. Stigma and social support had the most connections, while unemployment was involved in the greatest number of feedback loops. Most feedback mechanisms served to reinforce behavioural risk factors, inadequate healthcare and social disadvantage. Conclusions: The CLD has created a holistic and dynamic understanding of the causal pathways driving the mortality gap between people with schizophrenia and the general population, providing insights into why it has persisted over time. One of the key findings was the critical role of social determinants in shaping health outcomes, highlighting the need for person-centred models of care and multisectoral government action.
Suicidal behaviour among adults in Cabo Verde in 2020
Authors: Pengpid Supa , Peltzer Karl 
Published: August 2023

Background: The aim of the investigation was to evaluate past 12-month suicidal behaviour (PSB) among adults in Cabo Verde. Methods: Data from 4,563 adults (mean age 41.4 years) that participated in the 2020 Cabo Verde STEPS survey were analysed. Results: Results indicate that the proportion of PSB (attempt 0.6%, plan 1.5% and ideation 3.3%) was 3.7% (2.4% men/5.0% women). In adjusted logistic regression analysis, younger age, female sex, unemployed, widowed or divorced, alcohol family problem, heart attack, angina or stroke, current smokeless tobacco use and low fruit/vegetable intake were associated with PSB. Conclusion: Almost 4% of participants had PSB and several associated factors were identified that can guide public health interventions.
Impact of lymphedema in the management of venous leg ulcers
Authors: Moon Tina , O’Donnell Thomas F , Weycker Derek , Iafrati Mark 
Published: August 2023

Introduction Lymphedema (LED) in patients with venous leg ulcers (VLU) [VLU+LED] can impair ulcer healing and predispose to cellulitis. There is little data, however, demonstrating how lymphatic dysfunction may impact the clinical course, treatment, and healthcare expenditures for VLU+LED versus VLU−LED patients. Objective To determine how lymphatic dysfunction might influence treatment and expenditures among VLU patients in a large deidentified healthcare claims database. Methods A retrospective cohort design and data from the IBM MarketScan Database (April 2013 to March 2019) were employed. Study population comprised VLU patients, and was stratified into two subgroups: VLU+LED (index date = date of first LED diagnosis) and VLU−LED (index dates randomly assigned to match distribution of index dates for VLU+LED). Within each subgroup, patients with <1 year of healthcare claims information before and after their index dates were excluded. Demographics, comorbidities, procedures/treatments, as well as all-cause post-index medical resource utilization and expenditures ($/patient/year) of the two groups were compared. Stabilized inverse probability treatment weights (IPTWs) were employed to adjust for differences between groups in baseline characteristics. Results A total of 5466 VLU patients were identified (VLU+LED: N = 299; VLU−LED: N = 5167). Overall ambulatory encounters (AMB ENC) and their components were higher in VLU+LED, which were reflected in increased expenditures for this group (Table 1). Treatment with endovenous ablation (EVA) or stenting for venous hypertension as well as for specific measures for LED were higher in the 1-year post-index period for VLU+LED. The use of LED specific therapy was low for both groups, but a greater percentage of VLU+LED patients received therapy, which was predominantly manual lymphatic drainage (17.4%) rather than pneumatic compression (10.7%). Conclusions The clinical presence of LED in patients with VLU is a marker for a more complex disease process with more episodes of cellulitis and expenditures, but a surprisingly low specific treatment for LED.
Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia—A cohort study
Authors: Galyfos George , Chamzin Alexandros , Charalampopoulos Georgios , Liasis Nikolaos , Sigala Frangiska , Filis Konstantinos 
Published: August 2023

Objectives to evaluate direct oral anticoagulants (DOACs) in patients with hereditary thrombophilia and deep venous thrombosis (DVT). Methods This is a retrospective observational study. Results In total, 45 patients were treated between 01/2012 and 12/2022 (mean follow-up: 1.5 +/− 0.3 years). The most frequent thrombophilias were heterozygous V Leiden (20%), heterozygous MTHFR C677T (37.8%), heterozygous MTHFR A1298C (24.4%), and hyperhomocysteinemia (26.7%). The patients received rivaroxaban ( n = 19), apixaban ( n = 15), and dabigatran ( n = 11). Three cases presented symptoms’ recurrence without evidence of thrombosis’ recurrence (two under rivaroxaban and one under apixaban; p > .05). These patients improved under parenteral anticoagulation and were further treated with dabigatran. No other event or major bleeding occurred during the follow-up. The presence of more than two factors was associated with acute recurrence of symptoms (OR = 25.9; 95% CI [1.454–461.262]; p = .026). Conclusions DOACs seem to be safe and efficient for patients with hereditary thrombophilia and DVT. The presence of more than two thrombophilia factors is associated with a higher risk for symptom recurrence. Although statistically non-significant, symptoms’ recurrence was also observed more frequently among patients under anti-Xa inhibitors than antithrombin inhibitors. This should be verified in larger comparative studies.
Is there a relationship between ‘getting up and dressed’ and functional and physical outcomes in geriatric rehabilitation inpatients? A quasi-experimental study
Authors: Goonan Rose , Mohandoss Edward , Marston Celia , Kay Jaqueline , De Silva Anurika Priyanjali , Maier Andrea B , Reijnierse Esmee , Klaic Marlena 
Published: August 2023

Objectives To evaluate the physical and functional outcomes of the ‘Ending Pyjama Paralysis’ intervention in an inpatient geriatric rehabilitation unit. Design Quasi-experimental mixed-methods design nested within the ‘REStORing health of acutely unwell adulTs’ (RESORT) prospective, observational, longitudinal cohort of geriatric rehabilitation inpatients study. Setting Geriatric rehabilitation wards in a major metropolitan public hospital between June 2019 and March 2020. Intervention The ‘Ending Pyjama Paralysis’ movement originated in the UK. Its aim was to encourage patients to ‘Get up, Get dressed and Get moving’ to reduce hospital-associated functional decline. However, the physical and functional benefits of this campaign have not yet been evaluated. The ‘Ending Pyjama Paralysis’ was adopted as an integrated intervention on two out of four geriatric rehabilitation wards. The two control wards received usual care. Main Measures Physical measures included the Short Physical Performance Battery, and functional measures included the Katz Index of Independence in Activities of Daily Living and Lawton and Brody’s Instrumental Activities of Daily Living, which were completed on admission and discharge. A linear mixed-effects model was used to analyse the results. Results A total of 833 admissions were included in this study. Of these, 512 patients were in the control group, and 321 were in the intervention group. There were no significant differences in both physical and functional measures between the intervention and control groups. Conclusion The ‘Ending Pyjama Paralysis’ campaign did not result in enhanced functional or physical benefits in geriatric rehabilitation inpatients in this setting when applied in addition to usual care.
Assessment of a Real-world Learning Curve for the Endoscopic Resection of Gastric Gastrointestinal Stromal Tumors
Authors: Sun Ying , Liu Luojie , Shi Dongtao , Ma Chao , Xu Xiaodan 
Published: August 2023

Background Endoscopic resection (ER) is a proven treatment for gastric gastrointestinal stromal tumors (gGISTs). We aimed to assess the learning curve (LC) associated with ER for gGISTs and identify determinants. Methods We conducted an analysis of 289 patients who underwent the ER of gGISTs by an experienced endoscopist. To characterize the LC, we employed cumulative sum analysis of the duration of surgery. The participants were divided into an early phase (cases 1–50) and a later phase (case 51–289), which were compared. Furthermore, we identified risk factors for the conversion from endoscopic to laparoscopic resection (LR). Results The durations of surgery and hospitalization were shorter, and there were fewer complications and fasting days in the later phase. The conversion rates to LR were 6.0% and 2.5% in the early and later phases, respectively. The tumor diameter (≥3.0 cm) and invasion beyond the muscularis propria were significant risk factors for conversion to LR (odds ratio 17.92, 95% confidence interval 2.66–120.87; and 58.03, 6.40–525.84; respectively). Conclusions The LC for ER of gGISTs lasts for approximately 50 cases. In addition, tumors ≥3.0 cm in diameter and those that invade beyond the muscularis propria are more likely to require conversion to LR.