bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of trade and customs digitalization on agrifood trade: A gravity approach
Authors: Bueno Rezende de Castro André , Kornher Lukas 
Published: December 2022

Abstract
Transaction costs create inefficiencies in agricultural markets, and poor trade digitalization lowers agrifood productivity of developing countries. This paper argues that trade facilitation via digitalization cuts transaction costs thereby increasing agrifood trade because it streamlines trade and customs operational procedures. Our methodology represents trade digitalization by the variables paperless trade and digitalized non-tariff measures compliance. Additionally, our empirical strategy utilizes cross-country data employing a gravity model with fixed effects and socioeconomic controls. We find a high-bar evidence that a one-standard deviation improvement in e-trade facilitation at the exporter level and in non-tariff measures digitalization at the importer level increase agrifood exports by 9.7 per cent and 1.3 per cent, respectively, with larger magnitudes for processed products and for Sub-Saharan African and Asian countries. Consequently, trade facilitation via customs digitalization is inevitable to avoid trade diversion in an increasingly competitive globalized world. There are opportunities for developing countries to benefit from such digitalization because the relationship is stronger between agrifood exports and e-trade facilitation at the origin, which increases the agency of countries in the Global South.
Behind the Politics of Resilience: the Limits of the EU’s Response to Syrian Refugees in Lebanon
Authors: André Lyla 
Published: December 2022

Abstract
The Syrian crisis that began expanding in 2012 has sent millions of refugees into neighbouring countries and beyond and proved to be a testing ground for the European Union’s new approach to humanitarian crises. Focused on European Union-funded educational programmes carried out in response to the Syrian refugee crisis in Lebanon, this article argues that the European Union’s approach has nevertheless negatively impacted refugees’ lives because of its embeddedness in the international regime of resilience that has gained ground in the field of refugee protection. Indeed, while the resilience regime appears to be a continuation of the neoliberal system of rule, it in fact represents a paradigmatic shift that implies political and moral retreat from donors’ responsibility. Applied to refugee management, the agenda of “resilience” thus contradicts the rationale for burden-sharing that previously involved a “shared responsibility” between external donors and the hosting State. Based on Kratochwil’s praxis approach, this article therefore aims to empirically expand upon the recent literature centred on “resilience” and “self-reliance” in the field of refugee management. In doing so, it demonstrates how neoliberal features of resilience further hinder refugees’ lives as these features entail a total separation from an adequate rights-based approach.
New strategies to combat workplace incivility and promote joy
Authors: Kroning Maureen , Annunziato Sara 
Published: December 2022

Abstract:
Eighty-five percent of nurses report incivility in healthcare. Promoting a culture of civility—from nursing school to the workplace—is vital to ensuring healthy learning and work environments and ultimately safe patient care. This article presents a nursing program's journey in addressing incivility among the nurse faculty and the results achieved.
Nurses' role in promoting medication adherence
Authors: Zoromski Lorraine M. , Frazier Sharon 
Published: December 2022

Abstract:
A patient's willingness and desire to adhere to their medication plan are affected by their beliefs about taking medications, their self-efficacy, health literacy level, ability to afford prescription drug costs, and relationship with their clinicians. This article details strategies for creating a collaborative relationship with the patient, developing trust, and nurturing medication adherence.
Comparison of specialty examination scores pre- and post-pandemic
Authors: Authement Renae , Mundine Jennifer , Beatty Brooke 
Published: December 2022

Abstract

Objective:
To determine if nursing student application of knowledge declined due to remote learning during the COVID-19 pandemic. Health Education Systems Incorporated Fundamentals version one (HESI Fundamentals V-1) specialty examination scores of first-semester nursing students in the traditional BSN program were compared with pre- and post-remote course delivery.

Methods:
The study used a comparative quantitative research design and involved a convenience sample of 200 nursing students in their first semester of a nursing program at a university located in the south-central region of the US. Their HESI Fundamentals V-1 scores in the spring 2020 semester were compared with their scores in the fall 2020 semester.

Results:
Using statistical analysis of an independent one-tailed t-test, the mean HESI scores in fall 2020 were significantly higher than the mean HESI scores in spring 2020.

Conclusion:
While remote learning caused concerns for nursing instructors and students, the HESI scores support that student application of knowledge improved even after the delivery of remote learning.
Femoral Head Deformity Associated With Hip Displacement in Nonambulatory Cerebral Palsy: Results at Skeletal Maturity
Authors: Ulusaloglu Armagan C. , Asma Ali , Rogers Kenneth J. , Shrader M. Wade , Miller Freeman , Howard Jason J. 
Published: December 2022

Background:
Maintaining femoral head shape (FHS) and acetabular sphericity are important goals in preventing long-term osteoarthritis in hips in children with cerebral palsy (CP). As acetabular morphology has been widely studied, our objective was to determine FHS in CP after triradiate cartilage (TRC) closure, a proxy for skeletal maturity, and the risk factors associated with residual deformity and osteoarthritis.

Methods:
In this retrospective cohort study, patients with CP [Gross Motor Function Classification System (GMFCS) IV to V], minimum 4 yearly hip radiographs after age 10 years, and at least 1 radiograph after age 16 years, were included. Primary outcome was FHS (Rutz), stratified as “less severe” (Rutz A to B) and “more severe” (Rutz C to D). Secondary outcomes included migration percentage (MP), age at TRC closure, previous reconstructive (femoral with/without pelvic osteotomies) surgery, previous intrathecal baclofen, Tönnis osteoarthritis grade, and GMFCS level. Statistical analyses included χ2 analysis and multiple logistic regression.

Results:
One hundred sixty-three patients (326 hips) met the inclusion criteria, with TRC closure at age 14.0 (SD: 1.8) years. At final follow-up of 4.4 (SD: 2.4) years after TRC closure, 17% (55 hips), had a “more severe” FHS. From TRC closure to final follow-up, the frequencies of “less severe” hips decreased (−10%, P<0.001), while “more severe” increased (+115%, P<0.001). In multiple regression analysis, MP at TRC closure was the only significant risk factor associated with a “more severe” FHS at final follow-up (P=0.03). Receiver operating characteristic curve analysis determined MP≥30.5% to be associated with a “more severe” FHS at final follow-up (P<0.009). The FHS was not affected by reconstructive surgery, sex, GMFCS level, or intrathecal baclofen use. “Less severe” hips had lower Tönnis grades (0 to 1) compared with “more severe” hips (Tönnis grades 2 to 3) at final follow-up (P<0.001).

Conclusions:
FHS at skeletal maturity was not influenced by prior reconstructive surgery but was negatively affected when MP≥30.5% at the time of TRC closure. The extent of residual femoral head deformity correlated with the severity of osteoarthritis at final follow-up.

Level of Evidence:
Level III.
Synergistic sulfonamides plus clindamycin as an alternative therapeutic regimen for HIV-associated Toxoplasma encephalitis: a randomized controlled trial
Authors: Li Yao , Zeng Yanming , Lu Yanqiu , He Xuejiao , Wu Yushan , Zhang Wei , Huang Yanqun , Chen Hui , Chen Yaokai 
Published: December 2022

Abstract

Background:
The preferred therapeutic regimen for Toxoplasma encephalitis (TE) is a combination of pyrimethamine and sulfadiazine, and trimethoprim-sulfamethoxazole (TMP-SMX) plus azithromycin is the widespread alternative therapeutic regimen. The synergistic sulfonamides tablet contains TMP, sulfadiazine, and SMX and hypothetically could be used for TE treatment. This study aimed to compare the efficacy and safety of synergistic sulfonamides plus clindamycin (regimen B) with TMP-SMX plus azithromycin (regimen A) for the treatment of human immunodeficiency virus (HIV) human immunodeficiency virus-associated TE.

Methods:
This was an open-labeled, multi-center randomized controlled trial recruited from 11 centers. Each recruited patient was randomly assigned to receive Regimen A or Regimen B for at least 6 weeks. The overall response was evaluated by assessment of the clinical response of TE-associated clinical features and the radiological response of TE-associated radiological findings. The overall response rate, clinical response rate, radiological response rate, and adverse events were assessed at 2, 6, and 12 weeks. Death events were compared between the two regimens at 6, 12, and 24 weeks.

Results:
A total of 91 AIDS/TE patients were included in the final analysis (44 in regimen A vs. 47 in regimen B). The overall response rate, which refers to the combined clinical and radiological response, was 18.2% (8/44) for regimen A and 21.3% (10/47) for regimen B at week 6. The results of clinical response showed that, in comparison with regimen A, regimen B may perform better with regards to its effect on the relief of clinical manifestations (50.0% [22/44] vs. 70.2% [33/47], P = 0.049). However, no significant differences in radiological response, mortality events, and adverse events were found between the two regimens at week 6.

Conclusions:
Synergistic sulfonamides plus clindamycin, as a novel treatment regimen, showed no significantly different efficacy and comparable safety in comparison with the TMP-SMX plus azithromycin regimen. In addition, the regimen containing synergistic sulfonamides may exhibit advantages in terms of clinical symptom alleviation.

Trial Registration:
ChiCTR.org.cn, ChiCTR1900021195.
Five Fraction External Beam Partial Breast Irradiation
Authors: Campbell Shauna R. , Shah Chirag S. , Sittenfeld Sarah M.C. , Hoekstra Nienke 
Published: December 2022

Objective:
Mature follow up from multiple randomized trials have demonstrated the safety and efficacy of external beam partial breast irradiation (PBI) for appropriately selected patients with early stage breast cancer. Despite this evidence, external beam PBI remains underutilized. In this user guide we outline patient selection, workflow, and address possible challenges to aid in implementation of evidence-based external beam PBI.

Materials and Methods:
Review of the current guidelines for PBI suitability, surgical considerations, treatment technique, simulation, contouring, and treatment planning, citing the latest published literature to support PBI utilization.

Results:
Prospective data supports the use of 30 Gy in 5 fractions delivered with intensity modulated radiation therapy on a daily or every other day basis for a significant proportion of early stage breast cancer patients. The surgical cavity must be clearly visualized on treatment planning scan, recommend 3-5 weeks post-operatively, and the recommended clinical target volume expansion on the surgical cavity is 0.5-1.0 cm. A planning target volume expansion, based on motion management and image guidance, of 0.5-1.0 cm should be used. Organ at risk dose constraints of heart V3Gy ≤10% and contralateral breast Dmax ≤1 Gy are often achievable.

Conclusions:
Five fraction external beam PBI is a highly effective treatment with very limited toxicity for patients with early stage breast cancer following breast conserving surgery. Commonly utilized intensity modulated treatment planning techniques with plan delivery on standard linear accelerators results significant normal tissue sparing and makes implementation feasible at most radiation oncology centers.
Higher TYROBP and lower SOX6 as predictive biomarkers for poor prognosis of clear cell renal cell carcinoma: A pilot study
Authors: Lv Xian-Qiang , Zhang Kai-bo , Guo Xu , Pei Long , Li Feng 
Published: December 2022

Background:
Clear cell renal carcinoma (ccRCC) is the most common subtype of renal cancer, accounting for approximately 75% of all histological types of renal cancer, and is the leading cause of death from renal cancer. However, the molecular mechanism of tyrosine kinase binding protein (TYROBP) and sex-determining region Y Box-6 (SOX6) in the ccRCC was not precise.

Methods:
Bioinformatics analysis was performed to explore the hub role of TYROBP and SOX6 on the ccRCC. A total of 6 patients with clear cell renal cell carcinoma (ccRCC) were recruited. HE staining was performed to observe the pathology result of ccRCC. Immunohistochemistry and Immunofluorescence assay was made to detect the protein expression of TYROBP. Total RNA was extracted using TRIzol to examine the mRNA expression of TYROBP via the Real time quantitative polymerase chain reaction. The strong correlation between the expression of TYROBP and the survival time of ccRCC patients was performed by the BP neural network and support vector machine.

Results:
Compared with the control group, the expression of SOX6 was downregulated in the samples with ccRCC. However, the expression of TYROBP was higher in the samples with ccRCC than in the control group. Compared with the patients with high SOX6 expression, the patients with low SOX6 expression have a poor survival prognosis (HR=0.39, P < .05). However, the patients with high TYROBP expression have a shorter survival time than the patients with low TYROBP expression (HR=1.66, P < .05). The genes related with TYROBP and SOX6 are mainly enriched in the regulation of cell activation, leukocyte activation, negative regulation of cell activation, myeloid leukocyte activation, positive regulation of response to external stimulus, immune response-regulating signaling pathway. The interaction between TYROBP, SOX6, and kidney neoplasms was drawn, and the inference score of TYROBP and SOX6 on the kidney neoplasms was high.

Conclusion:
In conclusion, TYROBP is highly expressed in renal clear cell carcinoma, and when this molecule is highly expressed, the survival prognosis of renal carcinoma is poor. TYROBP and SOX6 may be potential targets for diagnosing and treating renal clear cell carcinoma.
A systematic review and meta-analysis of acupuncture combined with Tuina in the treatment of insomnia
Authors: Luo Shu-Wen , Huang Nian-Ping , Xiang Qian , Huang Xin-Quan , Tan Zhi-Wen , Teng Xin , Li Xue-Jie , Tu Xing , Gao Xing-Liang 
Published: December 2022

Background:
Insomnia is a sleep disorder with insufficient sleep time or/and poor sleep quality. Relevant epidemiological studies have shown that insomnia symptoms occur in about 35% to 50% of the adult population, and it is one of the most common diseases in the elderly. Patients who often suffer from insomnia are prone to symptoms such as fatigue, weakened cognitive function, depression, and even mental illness, which bring serious physical and mental damage to individuals and a heavy economic burden to social medical care and families. Traditional Chinese medicine and modern medicine have their own advantages in the treatment of insomnia, and there is currently a lack of reports on the comparison of acupuncture combined with massage and conventional medicine.

Objective:
To evaluate the clinical efficacy of acupuncture combined with Tuina in the treatment of insomnia.

Methods:
Search for clinical randomized controlled trials (RCTs) of acupuncture combined with Tuina in the treatment of insomnia from PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Database, and China Science and Technology Journal Database. The RevMan5.4 software was used for Meta- analysis after literature screening, data extraction and quality evaluation.

Results:
A total of 29 studies were included with a total of 2688 cases. Compared with drugs or acupuncture alone, acupuncture combined with Tuina has advantages in the total clinical effectiveness, as well as the Pittsburgh Sleep Quality Index (PSQI) and Statistical Self-Rating Anxiety Scale score (SAS) (OR = 3.59, 95% confidence interval [CI] [2.77, 4.66], Z = 9.62 [P < .00001]) (MD = −2.44, 95% CI [−2.93, −1.95], Z = 9.72 [P < .00001]) (MD = −8.42, 95% CI [−10.23, −6.61], Z = 9.09 [P < .00001]). There was no statistically significant difference in Statistical Self-rating Depression Scale score (SDS) (MD = −5.26, 95% CI [−11.29, 0.78], Z = 1.71 [P > .05]).

Conclusion:
Acupuncture combined with Tuina has obvious clinical advantages in the treatment of insomnia. This result is expected to provide a reference for the clinical treatment of insomnia, but the long-term effect of clinical efficacy still needs further study.
A case study on the application evaluation of integrative medical service model for the improvement of quality of life for dementia patients and caregivers
Authors: Cheong Moon Joo , Lee Do-Eun , Kim Jeesu , Son Il-Hong , Kim Sung Chul , Kang Hyung Won 
Published: December 2022

Background:
Since 4 major diseases and geriatric diseases require consistent management, individuals with any of these diseases cannot live alone and need caregivers’ assistance. Given these characteristics, an integrative medical service model for 4 major diseases and geriatric diseases was developed in Korea, currently. Dementia, one of the typical geriatric diseases, requires caregivers’ assistance from the beginning because of its enormous burden. Thus, it is necessary to provide an integrative medical service that can improve the quality of life (QoL) for both patients and caregivers. Therefore, this study aims to collect various feedback by applying an integrative medical service, which was developed to improve the QoL in patients with dementia and their caregivers, to a single case, and to modify and improve the integrative medical service model based on the results.

Method/design:
The integrative medical service program, which was developed to improve the QoL in patients with dementia and their caregivers in Korea, will be used for a patient-caregiver pair. This is an observational study with quantitative and qualitative feedback from various viewpoints. The program will be conducted in 8 sessions (twice a week, within 120 minutes). The patient will receive both Western and Korean medicine, and an integrative service will be provided to improve cognitive rehabilitation and QoL. Feedback collected at each session will be reflected on the program of the subsequent session.

Results:
This study will then modify and improve the program with feedback and provide integrative medical services to a patient with dementia and caregiver.

Discussion:
Patients with dementia need a program that would help them maintain cognitive function, and caregivers need a program that would improve their QoL by reducing the caregiving burden. This study is unique because the developed program is performed after modification based on feedback from the previous session. Accordingly, the patient and caregiver can check which program is the most satisfactory and helpful in improving their QoL. We expect that this study can modify the integrative medical service model to the optimized patient-based model. This study can also be used as basic data for a clinical pathway development study that applies the modified model to medical institutes.
Effects of low-intensity resistance exercise with blood flow restriction after high tibial osteotomy in middle-aged women
Authors: Park Han-Soo , Song Jun-Seob , Kim Eun-Kuk 
Published: December 2022

Background:
High tibial osteotomy (HTO) is an effective surgical method for treating medial compartment osteoarthritis. However, in most cases after surgery, muscle strength is decreased, and rapid muscle atrophy is observed. Therefore, the purpose of this study is to verify the effects of low-intensity resistance exercise (LIE) with blood flow restriction (BFR) on the cross-sectional area (CSA) of thigh muscles, knee extensor strength, pain, and knee joint function and investigate proper arterial occlusion pressure (AOP) in middle-aged women who underwent HTO.

Method:
This study was designed as a prospective randomized controlled trial. Forty-two middle-aged women who underwent HTO were randomly divided into three groups and participated in LIE with (40% or 80% AOP applied) or without BFR. The main outcome was the measurement of the CSA of thigh muscles (at 30% and 50% distal length of the femur) before and 12 weeks after treatment. Additionally, knee extension muscle strength, pain, and joint function were evaluated before and 6 and 12 weeks after treatment.

Results:
CSA of thigh muscles at 30% and 50% distal length of the femur decreased in the AOP 40% and control groups and was the largest in the AOP 80% group 12 weeks after treatment. Knee extension strength increased in all groups and was the highest in the AOP 80% group 6 and 12 weeks after treatment. Pain improved in all groups, with no intergroup differences. Knee joint function improved in all groups and was superior in the 80% AOP group 12 weeks after treatment.

Conclusion:
LIE with BFR at 80% AOP was effective in preventing atrophy of the thigh muscle, increasing muscle strength, and improving function. BFR at 40% AOP had no difference in the results when compared with the group in which BFR was not applied. Therefore, LIE with an AOP of 80% is recommended for patients undergoing HTO.
Percutaneous transforaminal endoscopic discectomy combined with acupuncture for lumbar disc herniation: A protocol for systematic review and meta-analysis
Authors: Feng Shugui , Yang Qiang , Zhao Lei , Wang Guoqiang , Yang Chenyi 
Published: December 2022

Background:
Lumbar disc herniation (LDH) is a common orthopedic disease, which is one of the main causes of global chronic pain and motor function defect. For intractable LDH, the surgical treatment of percutaneous transforaminal endoscopic discectomy (PTED) is often used in clinical practice. Although the operation is relatively mature, there may still be some limitations and surgical risks delaying the recovery process of patients. Some studies have found that the combination of acupuncture therapy and PTED can bring more benefits to patients, but these conclusions are still lack of evidence support. Therefore, this study will adopt the method of meta-analysis to estimate the effectiveness and safety of acupuncture combined with PTED in patients with LDH, in order to provide a basis for clinical decision-making.

Methods:
This study will conduct a systematic search of the following databases: the Chinese databases China National Knowledge Infrastructure, formerly Chinese Biomedical Database, Wanfang Data, Chongqing VIP Database for Chinese Technical Periodicals, the PubMed, Medline, Embase, Web of Science and The Cochrane library, from their inception to December 1, 2022. In addition, we will search their references to avoid missing other eligible studies. The language will be limited to English and Chinese. RevMan 5.4 will be used to perform the meta-analysis. And GRADE Profiler software will be used to rate the quality of evidence.

Results:
The results will be submitted to a peer-reviewed journal.

Conclusion:
This study can provide evidence support for acupuncture combined with PTED in the treatment of LDH.