bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Free Trade Area on Trade, Revenue and Welfare in Nigeria
Authors: Chukwu Ndubuisi O. , Omeje Ambrose Nnaemeka , Ofoezie Kasie Emmanuel , Ugwu Michael Okike , Mba Augustine Jideofor 
Published: November 2022

This study offers an analytical evaluation of the effects of Free Trade Area (FTA) agreements on trade, revenue, and welfare in Nigeria. The study applied World-Integrated Trade Solution/Software for Market Analysis and Restrictions on Trade (WITS-SMART), anchored on a partial equilibrium model (PEM) for its simulations. The study simulated 100% tariff elimination on selected products under Harmonized System (HS)-2 classification code sourced from Trade Analysis Information Systems (TRAINS) and Common Format for Transient Data Exchange (COMTRADE). The study’s findings show that the African Continental Free Trade Area (AfCFTA) agreement will benefit Nigeria’s economy from trade creation estimated at US$8,860.419 million, including a favorable welfare gain to the value of US$740.571 million. Nevertheless, Nigeria will sustain losses in trade revenue, valued at US$6,142.061 million. The study recommends proficient revenue management and well-diversified revenue collection sources, such as improvement in Value Added Tax and Ad-Valorem duty, to cushion the effects of the revenue loss resulting from tariff elimination in the FTA. JEL Classification F1, F2, F4, F5, F6, I3
Foreign Direct Investment and Financial Development in Selected MENA Region Countries: Panel ARDL Approach
Authors: El Fakiri Ahlam , Cherkaoui Kenza 
Published: November 2022

This article empirically examines the linkage between foreign direct investment (FDI) and financial development (FD) in 16 selected countries of the MENA region (Algeria, Bahrain, Egypt, Iran, Israel, Jordan, Kuwait, Lebanon, Malta, Mauritania, Morocco, Oman, Qatar, Saudi Arabia, Tunisia, and the United Arab Emirates) over the period 2000–2018. The research investigates the long- and short-run effects of FD on FDI inflows using panel ARDL. This model is based on the dynamic fixed effect (DFE) estimator. The article employs three proxies of FD as developed by the IMF, namely, the overall financial development (OFD), financial markets’ development (FM), and financial institutions’ development proxy (FI). The purpose was to analyze the impact of FD by covering the depth, efficiency, and access to financial markets and their institutions. The findings suggest that even though no significant relationship is established in the short run, the long-run coefficients of the overall FD proxy and FM proxy are positive and statistically significant. The estimates suggest that a 1% increase in the overall FD proxy and FM proxy results in an increase of 172% and 150% of FDI inflows to MENA region countries, respectively. JEL Classification F21, F23, G15, O16
Premaxillary Setback in Bilateral Cleft Lip and Palate Repair
Authors: Stanton Eloise , Kondra Katelyn , Jimenez Christian , Shakoori Pasha , Yen Stephen , Urata Mark M. , Hammoudeh Jeffrey A. , Magee William P. 
Published: November 2022

Objective The aim of this study is to evaluate surgical outcomes and maxillofacial growth in patients undergoing primary lip repair with or without premaxillary setback. Design Retrospective review. Setting Children's Hospital of Los Angeles, California. Patients and Participants Patients with bilateral cleft lip  ±  palate (BCLP) who underwent lip repair with or without premaxillary setback from January 1975 to September 2021. Interventions No intervention was performed. Main Outcome Measure(s) Patient demographics, comorbidities, and syndromic status were obtained. Indications for premaxillary setback, incidence of midface hypoplasia, orthodontic and/or orthognathic treatments, follow-up, complications, and revisions were recorded and analyzed. Comparisons among long-term outcomes, particularly the development of midface hypoplasia were made between groups. Results Thirty-one patients who underwent BCLP repair with premaxillary setback (BCLP  +  PS) and 31 matched control patients who underwent BCLP repair without premaxillary setback (BCLP − PS) were included. Among the 2 groups, multiple logistic regression demonstrated that when controlling for comorbidities, syndromic status, timing of lip repair, and timing of palate repair, premaxillary setback was neither significantly associated with the development of midface hypoplasia ( P  =  .076) nor the timing of midface hypoplasia development ( P  =  .940) in those that ultimately acquired this facial dysmorphology. Conclusions While a high incidence of midface hypoplasia was seen in both BCLP  ±  PS and BCLP − PS, our findings demonstrate no difference in midface hypoplasia irrespective of premaxillary setback in the setting of BCLP. Future prospective studies investigating the downstream ramifications of our suggested selection criteria for premaxillary setback are warranted.
Cardiac Biomarkers and Geriatric Assessment in Metastatic Castrate-Resistant Prostate Cancer During Abiraterone Acetate Therapy – A Cardio-Oncology Study
Authors: Wilk Michał , Waśko-Grabowska Anna , Skoneczna Iwona , Szczylik Cezary , Szmit Sebastian 
Published: November 2022

Background Abiraterone acetate (AA) is a drug used in advanced prostate cancer. However, known clinical factors with predictive and prognostic value are scarce. This study evaluated cardiovascular (CV) factors and geriatric scales as potential markers of superior response during AA therapy. Methods This is a prospective observational study. Serum levels of high sensitivity troponin T (hsTnT), D-dimer, NT-proBNP and left ventricle ejection fraction (LVEF) were used for CV evaluation. Questionnaires of G8, VES-13, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (iADL), and Geriatric Depression Scale (GDS) were included in the geriatric screening assessment. All measures were taken before AA initiation. Survival curves and Cox proportional hazard models (univariate and multivariate) were used to determine the predictors for a longer time to treatment failure (TTF). Results Forty nine patients were included in the study. Overall median TTF was 7.9 months (95% CI: 5.9-12.4). In univariate analysis, factors associated with inferior TTF were ( P-value < .05): visceral metastases - HR 2.34; 95% CI: 1.24-4.45, history of coronary artery disease - HR 3.02; 95% CI: 1.19-7.66; LVEF < 50% - HR 2.53; 95% CI: 1.03-6.17; P = .041; age-adjusted D-dimer > upper reference limit (URL) - HR 3.53; 95% CI: 1.81-6.85; P < .001; hsTnT > URL - HR 2.17; 95% CI: 1.13-4.16; P = .016; NT-proBNP ≥ 300 pg/mL - HR 2.3; 95% CI: 1.22-4.34; P = .01; G8 score ≤14 points - HR 2.47; 95% CI: 1.29-4.74; P = .007. In multivariate analysis, age-adjusted D-dimer > URL, G8 score ≤ 14 points and visceral metastases remained statistically significant in prediction of inferior TTF. The number of these factors was associated with shorter median TTF: 0-1 factor – 14.1 months; 2 factors – 5.9 months; 3 factors – 2.7 months; P < .001, log-rank). Conclusions Age-adjusted D-dimer, and geriatric G8 scores may predict TTF in men with metastatic castration-resistant prostate cancer during AA therapy. These observations require further study in a larger population.
Correlates of Autonomic Function, Hemodynamics, and Physical Activity Performance During Exercise Stress Testing Among Firefighters
Authors: Dzikowicz Dillon J. , Carey Mary G. 
Published: November 2022

Background Autonomic dysfunction is an important propagator of cardiometabolic disease and can be measured using multiple metrics such as heart rate variability (HRV) and heart rate recovery (HRR). The relationships between HRV and HRR have not been fully examined, nor have the relationships between HRV, HRR, and other physiological measures linked to cardiometabolic disease (e.g., blood pressure recovery). Evaluation of these additional relationships may provide new insights into the association between autonomic function and cardiometabolic disease especially among high-risk groups like firefighters. Methods 92 firefighters (96% male, 81% white) without overt cardiovascular disease underwent exercise testing with continuous heart rate (HR) and blood pressure (BP) monitoring. HRR was the difference between maximal HR and HR 1-minute post-exercise; BP recovery (BPR) was the difference between maximal BP and BP 2-minute post-exercise. Afterwards, participants underwent 24-hour electrocardiographic monitoring to measure HRV. Unadjusted Spearman correlations and adjusted partial Spearman correlations were computed. Between group analyses were also conducted with Kruskal–Wallis test. Results Associations between HRV and HRR poorly converged (RMSSD and HRR, unadjusted = 0.235; adjusted = 0.144). SDNN Index exhibited the strongest association with parasympathetic tone exhibited by overall lower HRs (unadjusted = −0.600; adjusted = −0.631). HRR demonstrated stronger associations with systolic and diastolic BP responses during exercise (SBP Recovery unadjusted = 0.267; adjusted = 0.297; DBP Recovery unadjusted = −0.276; adjusted = −0.232). Conclusions Overall, while HRV metrics converged and were associated with lower resting heart rates, HRV and HRR poorly converged. Interestingly, HRR was related with measures of hemodynamics indicating a potential relationship with vascular function during both maximal exercise and exercise recovery.
Efficacy and safety of brolucizumab for serous drusenoid pigment epithelium detachment non-responder to bevacizumab and aflibercept
Authors: Saitta Andrea , D’Eliseo Lucia Aurora , D’Eliseo Domenico 
Published: November 2022

Introduction We report the case of a woman with drusenoid pigment epithelial detachment (DPED) in age-related macular degeneration who was successfully treated with two monthly intravitreal injections of brolucizumab after failing to respond to previous intravitreal injections of bevacizumab and aflibercept. Case description A 56-year-old woman with mixed DPED and overlying subretinal fluid in her right eye was initially treated with three intravitreal injections of bevacizumab and three intravitreal injections of aflibercept with no visual and anatomical improvement. Switching to intravitreal injection of brolucizumab was performed. After two consecutive monthly intravitreal injections of brolucizumab, optical coherence tomography (OCT) showed first subretinal fluid resolution and then DPED collapse in the following months. After nine months, the best corrected visual acuity had improved from 20/40 to 20/20. There were no signs of retinal atrophy and exudative activity on OCT examination. No serious or minor adverse events were reported during the follow-up period. Conclusions Switching to intravitreal brolucizumab injection might be an effective therapeutic option for treatment of mixed DPED with subretinal fluid refractory to other anti-VEGF drugs.
A meta-analysis of vascular access outcomes in hemodialysis patients aged 75 years or older
Authors: Alexandra Ntemka , Christos Argyriou , Miltos Lazarides K , George Georgiadis S 
Published: November 2022

Background: Several existing guidelines advocate the access creation without any specific recommendations for those patients over 75 years of age. The aim of this meta-analysis is to compare the outcomes of different vascular access procedures in the sub-group of elderly ESRD patients ⩾75 years of age. Methods: A literature search was performed using the MEDLINE and SCOPUS electronic databases. The analysis focused on studies with subgroups of elderly patients ⩾75 years of age with different vascular access procedures, and compared the failure rates of autologous versus prosthetic vascular access. Articles comparing patency rates of distal (forearm) versus proximal upper arm AVFs were also investigated. Results: Twelve relevant studies were identified and included in the meta-analysis. The pooled results revealed a statistically significant unassisted (primary) failure rate at 24 months in favor of autologous AVFs [odds ratio (OR): 0.56, 95% CI: 0.38–0.83, p = 0.003]. A secondary analysis revealed significantly higher 12 months unassisted (primary) and secondary failure rates of forearm AVFs compared with proximal upper arm AVFs (OR: 2.14, 95% CI: 1.53–2.97, p < 0.00001 and OR: 1.76, 95% CI: 1.12–2.78, p < 0.01 respectively). Conclusion: An increased risk of failure of prosthetic vascular access procedures was found compared with autologous AVFs in patients ⩾75 years of age. Elderly patients ⩾75 years should not be excluded from creation of an autologous access, with proximal upper arm AVFs having better patency rates.
Straight lateral thigh femoropopliteal-femoral arteriovenous graft an alternative vascular access for patients with exhausted upper limbs dialysis access
Authors: Allam Ahmed K , Salem Atef A , Ibrahim Samia G , Abd Elsamea Ahmed M , Afifi Haitham S 
Published: November 2022

Introduction: The durability of hemodialysis vascular access remains a troublesome issue for the patients as well as vascular surgeons that requires frequent reinterventions to maintain the access function. Aim: This study aimed to evaluate straight thigh polytetrafluethylene (PTFE) arteriovenous graft (AVG) in patients with exhausted upper extremities dialysis access. Method: Our study was a retrospective analysis of prospectively collected data of 30 patients were operated upon for straight pattern lateral thigh PTFE AVG between 2016 and 2018. The primary outcome was efficacy and patency of AVG, and secondary outcome was procedure safety, including infection, thrombosis, ligation, lower limb functional status, and mortality. Results: A 30 patients with 30 Lower Limb AVG with maximum 30-month follow-up period. The mean age was 48 years. Males were ( n = 15/30). Thrombophilia patients were ( n = 7/30). Primary patency at 6 months was 100%. It declined to 93% at 12 months, 73% at 18 months, 47% at 24 months, and 40% at 30 months. The secondary patency was 97% at 18 months, 83% at 24 months, and 73% at 30 months. More than half of the patients showed complications ( n = 18/30), the most frequent was thrombosis ( n = 16/18). A secondary procedure was needed for 17 patients, the most frequent was thrombectomy ( n = 11/17), adjunctive culprit lesion repair was the key for regaining graft patency. Graft removal was necessary in six patients due to infection ( n = 4) and ruptured graft aneurysm ( n = 2). Conclusion: Lateral straight thigh PTFE AVG is a reliable and durable alternative modality with adequate dialysis efficacy in patients with exhausted upper extremities dialysis accesses. Secondary procedures due to complications were frequent but no significant major bleeding as regard patients with ruptured graft were non-significant and no distal threatening ischemia or related deaths were observed.
The Role of the Kynurenine Pathway in the (Patho) physiology of Maternal Pregnancy and Fetal Outcomes: A Systematic Review
Authors: van Zundert Sofie KM , Broekhuizen Michelle , Smit Ashley JP , van Rossem Lenie , Mirzaian Mina , Willemsen Sten P , Danser AH Jan , De Rijke Yolanda B , Reiss Irwin KM , Merkus Daphne , Steegers-Theunissen Régine PM 
Published: November 2022

Introduction: Tryptophan is the precursor of kynurenine pathway (KP) metabolites which regulate immune tolerance, energy metabolism, and vascular tone. Since these processes are important during pregnancy, changes in KP metabolite concentrations may play a role in the pathophysiology of pregnancy complications. We hypothesize that KP metabolites can serve as novel biomarkers and preventive therapeutic targets. This review aimed to provide more insight into associations between KP metabolite concentrations in maternal and fetal blood, and in the placenta, and adverse maternal pregnancy and fetal outcomes. Methods: A systematic search was performed on 18 February 2022 comprising all KP metabolites, and keywords related to maternal pregnancy and fetal outcomes. English-written human studies measuring KP metabolite(s) in maternal or fetal blood or in the placenta in relation to pregnancy complications, were included. Methodological quality was assessed using the ErasmusAGE quality score (QS) (range: 0-10). A meta-analysis of the mean maternal tryptophan and kynurenine concentrations in uncomplicated pregnancies was conducted. Results: Of the 6262 unique records, 37 were included (median QS = 5). Tryptophan was investigated in most studies, followed by kynurenine, predominantly in maternal blood (n = 28/37), and in the second and third trimester of pregnancy (n = 29/37). Compared to uncomplicated pregnancies, decreased tryptophan in maternal blood was associated with an increased prevalence of depression, gestational diabetes mellitus, fetal growth restriction, spontaneous abortion, and preterm birth. Elevated tryptophan was only observed in women with pregnancy-induced hypertension compared to normotensive pregnant women. In women with preeclampsia, only kynurenic acid was altered; elevated in the first trimester of pregnancy, and positively associated with proteinuria in the third trimester of pregnancy. Conclusions: KP metabolite concentrations were altered in a variety of maternal pregnancy and fetal complications. This review implies that physiological pregnancy requires a tight balance of KP metabolites, and that disturbances in either direction are associated with adverse maternal pregnancy and fetal outcomes.
Fingerprick blood samples to measure serum natalizumab concentrations
Authors: Toorop Alyssa A , Steenhuis Maurice , Loeff Floris C , Weijers Suzanne S , Killestein Joep , Rispens Theo , Kempen Zoé LE van 
Published: November 2022

Background: Natalizumab via subcutaneous administration was recently approved for patients with multiple sclerosis. Objective: In light of personalized extended dosing, in which treatment intervals are prolonged to a concentration cut-off, it would be preferable to measure natalizumab drug concentrations in capillary blood. Methods: In this cross-sectional study in patients treated with intravenous (IV) natalizumab, capillary blood samples by fingerprick and venous blood samples were collected in 30 participants prior to IV administration of natalizumab. Results: Natalizumab concentrations were similar with a mean bias of −0.36 μg/mL (95% CI: 1.3 to −2 μg/mL). Conclusions: This study shows that physicians can monitor natalizumab drug concentrations by a fingerprick, which could be used for personalized extended dosing.
The association between non-parental childcare intensity and parental mental health across Europe
Authors: Somogyi Nikolett , Van Lancker Wim , Van de Velde Sarah 
Published: November 2022

Background: Young children are spending an increasing amount of time in non-parental childcare. Despite this trend, few studies have examined how the intensity of non-parental childcare associates with mental health in parents, particularly taking the institutional context concerning childcare into account. Methods: Data from the European Union Statistics on Income and Living Conditions EU-SILC (2013) were used to develop a multi-level linear regression model. The sample was restricted to parents in dual-earner couples and with at least one child below the age of three ( N=6709). Mental health was assessed using the Mental Health Inventory-5. Results: Highest levels of mental health were found in parents who use a moderate level of non-parental childcare, while full-time childcare was associated with lower levels of mental health. Working parents reported better mental health in countries where spending on formal childcare was higher, or where using formal childcare use was more widespread for this age group. Conclusions: While this study does not allow to establish a causal relationship between the researched indicators, it does indicate that mental-health problems are not randomly distributed among parents but tend to cluster more densely within parents who use higher intensities of childcare and in countries with less supportive childcare policies. Research that ignores social contexts might therefore be limited in terms of generalisation.
Telehealth care system for chronic disease management of middle-aged and older adults in remote areas
Authors: Lan Yu Li , Chen Hsing Chu 
Published: November 2022

Background With the global spread of the coronavirus disease pandemic, governments have become more interested in applying telehealth technology in 2020. Objective This study integrates the technology acceptance model and information system success model to explore the influence of satisfaction, attitudes, and continued use of telehealth systems among middle-aged and older people in remote areas. Methods The study participants were patients over 40 years (inclusive) who lived in remote townships in eastern Taiwan, were diagnosed with diabetes or hypertension, and used the telehealth care system. In total, 545 questionnaires were returned, resulting in a recovery rate of 99%. Results Accepting the hypothesized structural equation model, this study found that information, system, and service quality were influenced by the mediating effect of perceived ease of use and the perceived usefulness of the technology acceptance model. The use of telehealth care systems among chronic patients increased significantly.
Theoretical and Pre-Clinical Models of Vacuum Assisted Closure
Authors: Orgill Dennis P. , McNulty Amy K. 
Published: November 2022

Vacuum Assisted Closure (VAC) has changed how physicians treat complex and chronic wounds. For over 20 years, we have studied the mechanism of action of these devices in both an academic based research laboratory and in an industry-based laboratory. We performed a literature review of the theoretical and pre-clinical published studies from the two labs which related to the biomechanics of open pore reticulated polyurethane interfaces. The VAC device applies a direct mechanical interface to the wound surface. The interaction of the foam under suction with the wound surface causes surface deformation and cell stretch. The suction removes fluid from the tissues. There are increases in angiogenesis with better vessel morphology than standard dressings. The effect is dependent on the pore size of the foam, the pressure of application and the waveform of application. Undoubtedly, patient factors such as age, diabetes and radiation affect the response. Pre-clinical studies can help in the design and optimization of mechanical-based wound healing devices. Current work on the effects of these devices on lymphatics and scarring are areas of active investigation.