bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender, achievement, and subject choice in English education
Authors: Cavaglia Chiara , Machin Stephen , McNally Sandra , Ruiz-Valenzuela Jenifer 
Published: October 2020

AbstractIn common with other OECD countries, there is a gender gap in educational achievement in England favouring girls. This carries through to tertiary education. On the other hand, boys are far more likely to engage in STEM in post-16 vocational education and at university. The underachievement of boys overall, but over-representation in STEM, presents significant challenges for policy. This paper documents changes in the gender gap over the last 20 years in England and discusses findings in the light of international evidence. It concludes that education policies, in academic and in vocational spheres, can be designed to reduce gender inequalities that exist in both.
Banking, Trade, and the Making of a Dominant Currency
Authors: Gopinath Gita , Stein Jeremy C 
Published: October 2020

Abstract
We explore the interplay between trade-invoicing patterns and the pricing of safe assets in different currencies. Our theory highlights the following points: (i) a currency’s role as a unit of account for invoicing decisions is complementary to its role as a safe store of value; (ii) this complementarity can lead to the emergence of a single dominant currency in trade invoicing and global banking, even when multiple large candidate countries share similar economic fundamentals; (iii) firms in emerging-market countries endogenously take on currency mismatches by borrowing in the dominant currency; and (iv) the expected return on dominant-currency safe assets is lower than that on similarly safe assets denominated in other currencies, thereby bestowing an “exorbitant privilege” on the dominant currency. The theory thus provides a unified explanation for why a dominant currency is so heavily used in both trade invoicing and in global finance.
Transformative academic institutions: An experimental framework for understanding regional impacts of research
Authors: Aranguren María José , Canto-Farachala Patricia , Wilson James R 
Published: October 2020

AbstractPublic and private research funding to academic institutions is increasingly conditional on demonstrating societal impact. Research is expected to produce new knowledge that is both relevant in academia and of direct practical use in society. Universities are well placed to serve as links between global academic communities and local problem owners. However, playing this pivotal role is problematic because in practice there is a tendency to frame the dual role of producing socially relevant and academic knowledge in terms of an artificial distinction between applied consultancy and basic research. Considering the challenges faced by universities in playing a more proactive role in addressing the practical challenges faced by their home regions, we propose the term transformative academic institutions to refer to research centres created within universities to proactively engage in the socioeconomic development of the regions in which they are rooted. We propose an experimental framework that can help map the relationship between their role in a global academic knowledge community and their role in the (local) practical knowledge community. The framework is developed from on our own experience working in an academic institution that conducts research to strengthen regional socioeconomic development processes. We experiment with the framework through an application to our own research context in the period 2016–19. Our findings show that this relationship can be mapped by assessing: (1) how well academic research questions are aligned to themes identified in regional policy discourse; and (2) whether academic knowledge has demonstrably led to changes actioned by regional stakeholders.
Prevalence and risk factors of relapse in patients with ANCA-associated vasculitis receiving cyclophosphamide induction: a systematic review and meta-analysis of large observational studies
Authors: He Peng , Hu Jin-ping , Tian Xiu-juan , He Li-jie , Sun Shi-ren , Huang Chen 
Published: October 2020

AbstractBackgroundClinical relapses are common in patients with ANCA-associated vasculitis (AAV). The aim of this systematic review was to estimate time-point prevalence and risk factors of relapse.MethodsWe searched PubMed, Embase, and Cochrane Library databases from their inception to March 30, 2020. Cohorts and post-hoc studies were included for the estimation of summary cumulative relapse rates (CRRs) and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Sensitivity and meta-regression analyses were also performed.ResultsOf the 42 eligible studies, 24 studies with 6236 participants were used for the pooled analyses of CRRs. The summary 1-year, 3-year, and 5-year CRRs were 0.12 (95% CI, 0.10–0.14), 0.33 (0.29–0.38), and 0.47 (0.42–0.52), respectively. In meta-regressions, the baseline age was positively associated with 1-year CRR. The proportion of granulomatosis with polyangiitis was positively associated with 5-year CRR. Twenty-eight studies with 5390 participants were used for the meta-analysis of risk factors for relapse, including a lower level of baseline serum creatine, proteinase 3 (PR3)-ANCA positivity at diagnosis, an ANCA rise, extrarenal organ involvement (including lung, cardiovascular, upper respiratory, and gastrointestinal involvement), intravenous (vs oral) cyclophosphamide induction, a shorter course of immunosuppressant maintenance, and maintenance with mycophenolate mofetil (vs azathioprine).ConclusionsOur systematic review demonstrated that the 1-year, 3-year, and 5-year cumulative probabilities of relapse were ∼12%, 33%, and 47% in AAV patients receiving cyclophosphamide induction, respectively. Early identification of risk factors for relapse is helpful to the risk stratification of patients so as to achieve personalized treatment.
Incidence and predictors of severe infections in ANCA-associated vasculitis: a population-based cohort study
Authors: Rathmann Jens , Jayne David , Segelmark Mårten , Jönsson Göran , Mohammad Aladdin J 
Published: October 2020

Abstract

Objective
To determine the incidence rate, predictors and outcome of severe infections in a population-based cohort of ANCA-associated vasculitis (AAV).

Methods
The study included 325 cases of AAV (152 female) diagnosed from 1997 through 2016 from a defined geographic area in Sweden. All severe infection events (requiring hospitalization and treatment with intravenous antimicrobials) were identified. The Birmingham vasculitis activity score (BVAS) was used to evaluate disease activity, and organ damage was assessed using the vasculitis damage index (VDI). Patients were followed from time of AAV diagnosis to death or December 2017.

Results
A total of 129 (40%) patients suffered at least one severe infection. In 2307 person-years (PY) of follow-up, 210 severe infections were diagnosed. The incidence rate of severe infections was 9.1/100 PY and was highest during the first year following AAV diagnosis at 22.1/100 PY (P &lt; 0.001). Pneumonia, sepsis and urinary tract infection were the most common infections. Opportunistic infections constituted only 6% of all severe infections. In Cox regression analysis age and BVAS at diagnosis were the only factors independently predicting severe infection [hazard ratio: 1.54 (P &lt; 0.001) and 1.27 (P = 0.001), respectively]. Severe infection was associated with poorer prognosis with respect to median VDI score 12 months post-AAV diagnosis, renal survival and mortality. Severe infections were the cause of death in 32 patients (22% of all deaths).

Conclusion
. Severe infection is a common problem in AAV, with the most important prognostic factors being older age and high disease activity at diagnosis. Severe infections are associated with permanent organ damage and high mortality.
Increasing the relevance of science for practice and practice for science: Quantitative empirical insights
Authors: Binder Claudia R , Fritz Livia , Hansmann Ralph , Balthasaar Andreas , Roose Zilla 
Published: October 2020

AbstractWe present results of a survey conducted with researchers and practitioners involved in a Swiss National Research Programme on steering energy consumption. We analyse what motivates practitioners and researchers to engage in a collaborative research project, their perception of the collaboration intensity in different project phases, and the extent to which the research project provided useful results for practitioners. Our analyses demonstrate that the intensity of collaboration is a key driver of successful collaboration as it fosters trust between researchers and practitioners. Thereby, it increases the usefulness of the research project for practitioners and their perceived contribution to the success of the research project. Research programmes should thus (1) foster trust through incentivising collaboration between research and practice; (2) facilitate the development of a shared understanding of researchers’ and practitioners’ respective roles; and (3) support the inclusion of practitioners in the project development phase through financial support during the proposal-writing phase.
Diagnostics and the neglected tropical diseases roadmap: setting the agenda for 2030
Authors: Souza Ashley A , Ducker Camilla , Argaw Daniel , King Jonathan D , Solomon Anthony W , Biamonte Marco A , Coler Rhea N , Cruz Israel , Lejon Veerle , Levecke Bruno , Marchini Fabricio K , Marks Michael , Millet Pascal , Njenga Sammy M , Noordin Rahmah , Paulussen René , Sreekumar Esvawaran , Lammie Patrick J 
Published: October 2020

Abstract
Accurate and reliable diagnostic tools are an essential requirement for neglected tropical diseases (NTDs) programmes. However, the NTD community has historically underinvested in the development and improvement of diagnostic tools, potentially undermining the successes achieved over the last 2 decades. Recognizing this, the WHO, in its newly released draft roadmap for NTD 2021–2030, has identified diagnostics as one of four priority areas requiring concerted action to reach the 2030 targets. As a result, WHO established a Diagnostics Technical Advisory Group (DTAG) to serve as the collaborative mechanism to drive progress in this area. Here, the purpose and role of the DTAG are described in the context of the challenges facing NTD programmes.
Risk Factors for Proximal Junctional Kyphosis Following Surgical Deformity Correction in Pediatric Neuromuscular Scoliosis
Authors: Toll Brandon J. , Gandhi Shashank V. , Amanullah Amir , Samdani Amer F. , Janjua M. Burhan , Kong Qingwu , Pahys Joshua M. , Hwang Steven W. 
Published: October 2020

Study Design.
Single-center retrospective cohort analysis.

Objective.
The aim of this study was to evaluate risk factors associated with the development of proximal junctional kyphosis (PJK) in pediatric neuromuscular scoliosis (NMS).

Summary of Background Data.
PJK is a common cause of reoperation in adult deformity but has been less well reported in pediatric NMS.

Methods.
Sixty consecutive pediatric patients underwent spinal fusion for NMS with a minimum 2-year follow-up. PJK was defined as >10° increase between the inferior end plate of the upper instrumented vertebra (UIV) and the superior end plate of the vertebra two segments above. Regression analyses as well as binary correlational models and Student t tests were employed for further statistical analysis assessing variables of primary and compensatory curve magnitudes, thoracic kyphosis, proximal kyphosis, lumbar lordosis, pelvic obliquity, shoulder imbalance, Risser classification, and sagittal profile.

Results.
The present cohort consisted of 29 boys and 31 girls with a mean age at surgery of 14 ± 2.7 years. The most prevalent diagnoses were spinal cord injury (23%) and cerebral palsy (20%). Analysis reflected an overall radiographic PJK rate of 27% (n = 16) and a proximal junctional failure rate of 7% (n = 4). No significant association was identified with previously suggested risk factors such as extent of rostral fixation (P = 0.750), rod metal type (P = 0.776), laminar hooks (P = 0.654), implant density (P = 0.386), nonambulatory functional status (P = 0.254), or pelvic fixation (P = 0.746). Significant risk factors for development of PJK included perioperative use of halo gravity traction (38%, P = 0.029), greater postoperative C2 sagittal translation (P = 0.030), decreased proximal kyphosis preoperatively (P = 0.002), and loss of correction of primary curve magnitude at follow-up (P = 0.047). Increase in lumbar lordosis from post-op to last follow-up trended toward significance (P = 0.055).

Conclusion.
Twenty-seven percent of patients with NMS developed PJK, and 7% had revision surgery. Those treated with halo gravity traction or with greater postoperative C2 sagittal translation, loss of primary curve correction, and smaller preoperative proximal kyphosis had the greatest risk of developing PJK.

Level of Evidence: 4
Neuron-Specific Enolase Levels in Adults Under Venoarterial Extracorporeal Membrane Oxygenation
Authors: Reuter Jean , Peoc’h Katell , Bouadma Lila , Ruckly Stéphane , Chicha-Cattoir Valérie , Faille Dorothée , Bourrienne Marie-Charlotte , Dupuis Claire , Magalhaes Eric , Tanaka Sébastien , Vinclair Camille , de Montmollin Etienne , Mazighi Mikael , Para Marylou , Braham Wael , Pisani Angelo , Ajzenberg Nadine , Timsit Jean-François , Sonneville Romain 
Published: October 2020

Objectives:
We aimed to determine if elevations in serum neuron-specific enolase are associated with brain injury and outcomes in adults who require venoarterial extracorporeal membrane oxygenation.

Design:
Prospective observational study.

Setting:
Two ICUs of a university hospital, Paris, France.

Patients:
Consecutive adult patients treated with venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock or in-hospital refractory cardiac arrest.

Interventions:
None.

Measurements and Main Results:
Serum sampled 1, 3, and 7 days after venoarterial extracorporeal membrane oxygenation cannulation was stored at –80°C and neuron-specific enolase concentrations were measured in batches at the end of the study. The association between neuron-specific enolase concentrations and outcomes (28-d mortality and poor outcome, defined by a score of 4–6 on the modified Rankin scale at 90 d) were explored by multivariable logistic regression, with neuron-specific enolase concentrations dichotomized according to median values. One-hundred three patients were included, of whom 26 (25%) received preextracorporeal membrane oxygenation cardiopulmonary resuscitation. Median (interquartile range) day-1, day-3, and day-7 neuron-specific enolase serum concentrations were 37 μg/L (26–51 μg/L), 25 μg/L (19–37) μg/L, and 22 μg/L (17–31 μg/L). After adjustment for Simplified Acute Physiology Score II, preextracorporeal membrane oxygenation cardiopulmonary resuscitation, and Sepsis Organ Failure Assessment score at time of cannulation, a day-3 neuron-specific enolase greater than 25 μg/L remained independently associated with 28-day mortality (adjusted odds ratio, 4.98; 95% CI, 1.86–13.32) and poor outcome at 90 days (adjusted odds ratio, 4.63; 95% CI, 1.81–11.84). A day-3 neuron-specific enolase threshold greater than 80 μg/L had a 100% specificity for prediction of both mortality (95% CI, 92–100%) and poor functional outcome (95% CI, 89–100%). In a subset of patients who underwent brain CT, neuron-specific enolase concentrations were significantly higher in patients diagnosed with stroke, as compared with those without stroke.

Conclusions:
In adult patients under venoarterial extracorporeal membrane oxygenation, day-3 serum neuron-specific enolase concentrations are independently associated with short-term mortality and poor functional outcomes. These findings deserve validation in a multicenter setting.
Responding to COVID-19: lessons from Kerala on what worked under resource constraint settings and a glimpse into the surgical management of patients
Authors: Rahim Asma A. , Chacko Thomas V. , Rajan Sheeja 
Published: October 2020

Background:
The outbreak of COVID-19 into a pandemic took many countries by surprise and were found wanting for their response and containment measures that they undertook and resulted in unacceptably high mortality in number terms made them search for alternative approaches and models of containment to combat the scourge. In the state of Kerala in India, the response of the government and public response was different compared with rest of the country. Its success with containment to prevent the spillover of the virus into the general public for a long period of time made other states and countries sit up and take notice.

Materials and methods:
Participatory observation in situ by the authors’ personal first hand experience in the public health and surgical practice fields enabled them to use the framework of components measures for outbreak containment following the Nipah outbreak in the state as a lens to capture the factors and measures undertaken for success in COVID-19 containment in Kerala.

Results:
Kerala ensured that a very low proportion of population got infected and a low case fatality rate of 0.94%. What worked was anticipatory preparedness of the political and health systems, systematic contact tracing and quarantine of contacts, transparency in reporting of data and dynamic data-based policy decisions. These measures when combined with social security measures for vulnerable groups, instilled a sense of solidarity with the state government’s harsh “lockdown” measures taken and thereby ensured community wide people’s participation that proved critical for the success in containment.

Conclusion:
By using the consolidated framework of components measures for outbreak containment following the Nipah outbreak in the state as a lens along with participatory observation by the authors, it was possible to capture the factors and measures undertaken for success in COVID-19 containment in Kerala.
Revisiting matrix metalloproteinase 12: its role in pathophysiology of asthma and related pulmonary diseases
Authors: Abd-Elaziz Khalid , Jesenak Milos , Vasakova Martina , Diamant Zuzana 
Published: October 2020

Purpose of review
Matrix metalloproteinases (MMPs) are a family of over 20 zinc-dependent proteases with different biological and pathological activities, and many have been implicated in several diseases. Although nonselective MMP inhibitors are known to induce serious side-effects, targeting individual MMPs may offer a safer therapeutic potential for several diseases. Hence, we provide a concise overview on MMP-12, given its association with pulmonary diseases, including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, and other progressive pulmonary fibrosis (PPF), which may also occur in coronavirus disease 2019.

Recent findings
In asthma, COPD, and PPF, increased MMP-12 levels have been associated with inflammation and/or structural changes within the lungs and negatively correlated with functional parameters. Increased pulmonary MMP-12 levels and MMP-12 gene expression have been related to disease severity in asthma and COPD. Targeting MMP-12 showed potential in animal models of pulmonary diseases but human data are still very scarce.

Summary
Although there may be a potential role of MMP-12 in asthma, COPD and PPF, several pathophysiological aspects await elucidation. Targeting MMP-12 may provide further insights into MMP-12 related mechanisms and how this translates into clinical outcomes; this warrants further research.
Exploring Cancer Treatment Experiences for Patients With Preexisting Mobility Disability
Authors: Agaronnik Nicole D. , El-Jawahri Areej , Kirschner Kristi , Iezzoni Lisa I. 
Published: October 2020

Objective
We explored the process of cancer care for patients with preexisting mobility disability, focusing on treatment decisions and experiences.

Design
We recruited 20 participants with preexisting mobility disability, requiring use of an assistive device or assistance with activities of daily living, subsequently diagnosed with cancer (excluding skin cancers). We conducted open-ended individual interviews, which reached data saturation and were transcribed verbatim for conventional content analysis.

Results
Concerns coalesced around 4 themes: disability-related healthcare experiences affect cancer treatment decisions; concerns about cancer treatment worsening functional impairments; access barriers; and limited provider awareness and biases about treating people with disability. Residual fear from previous medical interventions and concerns about exacerbating functional impairments influenced cancer treatment preferences. Participants also raised concerns that their underlying disability may be used to justify less aggressive treatment. Nevertheless, cancer treatment did exacerbate mobility difficulties for some participants. Inaccessible hospital rooms, lack of accessible medical equipment, and attitudinal barriers complicated treatments.

Conclusions
People with preexisting mobility disability experience barriers to cancer treatment, compromising quality of care and potentially outcomes. Further training and proactive planning for accommodating disability during cancer treatment and rehabilitation are warranted.

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CME Objectives
Upon completion of the article, the reader should be able to: (1) Recognize inadequate accommodations that compromise the diagnosis and treatment of a new cancer in patients with preexisting disability; (2) Recommend involving rehabilitation specialists in the process of care and clinical decision making from the time of cancer diagnosis for patients with preexisting disability newly diagnosed with malignancy; and (3) In the setting of accessibility barriers, facilitate efforts to accommodate patients with preexisting disability to improve quality of care in diagnosing and treating cancer.

Level
Advanced

Accreditation
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