bluuebunny/crossref_metadata_2025_split huggingface dataset:
Designing for adaptation: Static and dynamic robustness in policy‐making
Authors: Howlett Michael , Ramesh M. 
Published: April 2022

AbstractPolicy tools are chosen and deployed in the expectation that they will continue to work effectively over extended periods of time. This is a tall expectation to meet, given that the nature of policy problems and their contexts change constantly. To continue to operate effectively in the face of these changes and respond to policy feedback from policy actors and outputs, policy mixes must be robust. This robustness is of two types: static robustness in which policy means adapt while policy goals remain unchanged, and dynamic robustness in which both goals and tools change. The first equates robustness with resilience—that is, the ability to bounce back to a previous state and attain original goals in altered contexts caused by some change in internal or external conditions. The second, however, is more complex as it can involve changes in aspects of policy goals as well as means in order to allow policies to adapt more broadly by altering their form in response to changing circumstances. This second type of “dynamic robustness” focuses attention on the need for agility and upon the requisites for the creation of policy designs which allow for substantive changes in form as well as state. The article lays out these concepts and their interrelationships and the kinds of procedural and other tools involved in achieving either. It illustrates their features and differences using examples from different sectoral cases.
Comprehensive risk assessments and anesthetic management for children with osteogenesis imperfecta: A retrospective review of 252 orthopedic procedures over 5 years
Authors: Liang Xiyun , Chen Peikai , Chen Chao , Che Wei , Yang Yue , Tan Zhijia , Li Hechun , Zhou Yapeng , Yin Shijie , To Michael Kai‐tsun , Niu Qiang 
Published: April 2022

AbstractBackgroundMajor anesthetic risks arise in orthopedic surgeries for children with osteogenesis imperfecta, a rare genetically inherited condition presenting diverse skeletal issues.AimWe aimed to investigate anesthetic risks, including difficult airway, hypo‐ and hyperthermia, blood loss, and pain, in connection with patient, anesthetic, and surgical factors.MethodsBoth descriptive and inferential statistics were employed to study the anesthetic risks and their predictors. Data of 252 surgeries for 132 Chinese osteogenesis imperfecta patients aged 18 or below were retrieved from the authors' hospital between 2015 and 2019.ResultsTwo thirds of the cohort were Sillence type IV patients, with types I, III, and V accounting for 7.6%, 14.4%, and 11.4%, respectively. Video and direct laryngoscopy were used. No case of difficult airway was identified. Due to a careful management strategy, intraoperative temperature varied on average between −0.38°C and +0.89°C from the initial temperature. Fifty‐two and 18 cases of hyper‐ and hypothermia were encountered, respectively. The use of sevoflurane for maintenance resulted in a mean increase of +0.24°C [95% CI 0.05 ~ 0.42] in the maximum temperature. Massive blood losses (>20% of estimated total blood volume) were observed in 18.3% of the cases. Neither intraoperative temperature changes nor blood loss was found to be related to Sillence classification. Regional anesthesia techniques were applied to 72.6% of the cases. Ultrasound guidance was used per the judgment of anesthesiologists or when in case of difficult landmarks. The incidence of difficult regional anesthesia was low (4 out of 252). For postoperative analgesia, 154 neuraxial blocks (including 77 caudal and 77 lumbar epidural) and 29 peripheral nerve blocks were performed.ConclusionAnesthesia for children with osteogenesis imperfecta undergoing complex orthopedic procedures was challenging. Proper anesthesia planning was essential for both intraoperative management and postoperative analgesia. Age, surgical duration, and use of sevoflurane for maintenance impacted the intraoperative temperature most, and massive blood loss was not uncommon. The risks for airway or regional anesthesia difficulties were low. Pain scores could be controlled to be ≤3 via multiple techniques.
Risk ranking of food categories associated with Salmonella enterica contamination in the central region of Mexico
Authors: Godínez‐Oviedo Angélica , Sampedro Fernando , Bowman John P. , Garcés‐Vega Francisco J. , Hernández‐Iturriaga Montserrat 
Published: April 2022

AbstractTo prevent and control foodborne diseases, there is a fundamental need to identify the foods that are most likely to cause illness. The goal of this study was to rank 25 commonly consumed food products associated with Salmonella enterica contamination in the Central Region of Mexico. A multicriteria decision analysis (MCDA) framework was developed to obtain an S. enterica risk score for each food product based on four criteria: probability of exposure to S. enterica through domestic food consumption (Se); S. enterica growth potential during home storage (Sg); per capita consumption (Pcc); and food attribution of S. enterica outbreak (So). Risk scores were calculated by the equation Se*W1+Sg*W2+Pcc*W3+So*W4, where each criterion was assigned a normalized value (1–5) and the relative weights (W) were defined by 22 experts’ opinion. Se had the largest effect on the risk score being the criterion with the highest weight (35%; IC95% 20%–60%), followed by So (24%; 5%–50%), Sg (23%; 10%–40%), and Pcc (18%; 10%–35%). The results identified chicken (4.4 ± 0.6), pork (4.2 ± 0.6), and beef (4.2 ± 0.5) as the highest risk foods, followed by seed fruits (3.6 ± 0.5), tropical fruits (3.4 ± 0.4), and dried fruits and nuts (3.4 ± 0.5), while the food products with the lowest risk were yogurt (2.1 ± 0.3), chorizo (2.1 ± 0.4), and cream (2.0 ± 0.3). Approaches with expert‐based weighting and equal weighting showed good correlation (R2 = 0.96) and did not show significant differences among the ranking order in the top 20 tier. This study can help risk managers select interventions and develop targeted surveillance programs against S. enterica in high‐risk food products.
Economic integration, industrial structure, and catch‐up growth: Firm‐level evidence from Poland
Authors: Bastos Paulo , Lovo Stefania , Varela Gonzalo , Hagemejer Jan 
Published: April 2022

AbstractWe examine if and how deeper economic integration with high‐income nations impacts industrial performance. We exploit Poland's accession to the EU in 2004 as a source of variation in the degree of market integration with Germany. Using data on Polish manufacturing firms in the period 1995–2013, we find that EU accession was followed by significant within‐firm growth in output and productivity, notably in industries in which Germany was more specialized at the moment of accession. Increased flows of German investment to these sectors played an important role in shaping these effects.
Robust inactivation of Plasmodium falciparum in red blood cell concentrates using amustaline and glutathione pathogen reduction
Authors: Sow Cissé , Bouissou Amélie , Girard Yvette A. , Singh Gurvani B. , Bounaadja Lotfi , Payrat Jean‐Marc , Haas Delphine , Isola Hervé , Lanteri Marion C. , Bringmann Peter , Grellier Philippe 
Published: April 2022

AbstractBackgroundPlasmodium falciparum is the parasite responsible for most malaria cases globally. The risk of transfusion‐transmitted malaria (TTM) is mitigated by donor deferrals and blood screening strategies, which adversely impact blood availability. Previous studies showed robust inactivation of P. falciparum using nucleic acid‐targeting pathogen reduction technologies (PRT) for the treatment of plasma and platelet components or whole blood (WB). The efficacy of the amustaline–glutathione (GSH) PRT to inactivate P. falciparum is here evaluated in red blood cells (RBC), as well the impact of PRT on parasite loads, stages, and strains.Study Design and MethodsRBC units resuspended in AS‐1 or AS‐5 additive solutions were spiked with ring stage‐infected RBC and treated with the amustaline–GSH PRT. Parasite loads and viability were measured in samples at the time of contamination, and after treatment, using serial 10‐fold dilutions of the samples in RBC cultures maintained for up to 4 weeks.ResultsP. falciparum viability assays allow for the detection of very low levels of parasite. Initial parasite titer was >5.2 log10/ml in AS‐1/5 RBC. No infectious parasites were detected in amustaline–GSH‐treated samples after 4 weeks of culture. Amustaline–GSH inactivated high parasite loads regardless of parasite stages and strains. Amustaline readily penetrates the parasite, irreversibly blocks development, and leads to parasite death and expulsion from RBC.DiscussionAmustaline–GSH PRT demonstrated robust efficacy to inactivate malaria parasites in RBC concentrates. This study completes the portfolio of studies demonstrating the efficacy of nucleic acid‐targeting PRTs to mitigate TTM risks as previously reported for platelet concentrates, plasma, and WB.
TNFR2 blockade of regulatory T cells unleashes an antitumor immune response after hematopoietic stem-cell transplantation
Authors: Moatti Audrey , Debesset Anais , Pilon Caroline , Beldi-Ferchiou Asma , Leclerc Mathieu , Redjoul Rabah , Charlotte Frederic , To Nhu Hanh , Bak Adeline , Belkacemi Yazid , Salomon Benoît Laurent , Issa Fadi , Michonneau David , Maury Sebastien , Cohen José Laurent , Thiolat Allan 
Published: April 2022

BackgroundTargeting immune checkpoints that inhibit antitumor immune responses has emerged as a powerful new approach to treat cancer. We recently showed that blocking the tumor necrosis factor receptor-type 2 (TNFR2) pathway induces the complete loss of the protective function of regulatory T cells (Tregs) in a model of graft-versus-host disease (GVHD) prevention that relies on Treg-based cell therapy. Here, we tested the possibility of amplifying the antitumor response by targeting TNFR2 in a model of tumor relapse following hematopoietic stem-cell transplantation, a clinical situation for which the need for efficient therapeutic options is still unmet.MethodWe developed appropriate experimental conditions that mimic patients that relapsed from their initial hematological malignancy after hematopoietic stem-cell transplantation. This consisted of defining in allogeneic bone marrow transplantation models developed in mice, the maximum number of required tumor cells and T cells to infuse into recipient mice to develop a model of tumor relapse without inducing GVHD. We next evaluated whether anti-TNFR2 treatment could trigger alloreactivity and consequently antitumor immune response. In parallel, we also studied the differential expression of TNFR2 on T cells including Treg from patients in post-transplant leukemia relapse and in patients developing GVHD.ResultsUsing experimental conditions in which neither donor T cells nor TNFR2-blocking antibody per se have any effect on tumor relapse, we observed that the coadministration of a suboptimal number of T cells and an anti-TNFR2 treatment can trigger alloreactivity and subsequently induce a significant antitumor effect. This was associated with a reduced percentage of activated CD4+ and CD8+ Tregs. Importantly, human Tregs over-expressed TNFR2 relative to conventional T cells in healthy donors and in patients experiencing leukemia relapse or cortico-resistant GVHD after hematopoietic stem cell transplantation.ConclusionsThese results highlight TNFR2 as a new target molecule for the development of immunotherapies to treat blood malignancy relapse, used either directly in grafted patients or to enhance donor lymphocyte infusion strategies. More widely, they open the door for new perspectives to amplify antitumor responses against solid cancers by directly targeting Tregs through their TNFR2 expression.
Endothelial BACE1 Impairs Cerebral Small Vessels via Tight Junctions and eNOS
Authors: Zhou Haoyue , Gao Feng , Yang Xiaoli , Lin Tingting , Li Zhenxing , Wang Qiong , Yao Yang , Li Lei , Ding Xinxin , Shi Kaibin , Liu Qiang , Bao Hong , Long Zhenyu , Wu Zujun , Vassar Robert , Cheng Xin , Li Rena , Shen Yong 
Published: April 2022

Background:
Cerebral small vessel injury, including loss of endothelial tight junctions, endothelial dysfunction, and blood-brain barrier breakdown, is an early and typical pathology for Alzheimer's disease, cerebral amyloid angiopathy, and hypertension-related cerebral small vessel disease. Whether there is a common mechanism contributing to these cerebrovascular alterations remains unclear. Studies have shown an elevation of BACE1 (β-site amyloid precursor protein cleaving enzyme 1) in cerebral vessels from cerebral amyloid angiopathy or Alzheimer's disease patients, suggesting that vascular BACE1 may involve in cerebral small vessel injury.

Methods:
To understand the contribution of vascular BACE1 to cerebrovascular impairments, we combined cellular and molecular techniques, mass spectrometry, immunostaining approaches, and functional testing to elucidate the potential pathological mechanisms.

Results:
We observe a 3.71-fold increase in BACE1 expression in the cerebral microvessels from patients with hypertension. Importantly, we discover that an endothelial tight junction protein, occludin, is a completely new substrate for endothelial BACE1. BACE1 cleaves occludin with full-length occludin reductions and occludin fragment productions. An excessive cleavage by elevated BACE1 induces membranal accumulation of caveolin-1 and subsequent caveolin-1-mediated endocytosis, resulting in lysosomal degradation of other tight junction proteins. Meanwhile, membranal caveolin-1 increases the binding to eNOS (endothelial nitric oxide synthase), together with raised circulating Aβ (β-amyloid peptides) produced by elevated BACE1, leading to an attenuation of eNOS activity and resultant endothelial dysfunction. Furthermore, the initial endothelial damage provokes chronic reduction of cerebral blood flow, blood-brain barrier leakage, microbleeds, tau hyperphosphorylation, synaptic loss, and cognitive impairment in endothelial-specific BACE1 transgenic mice. Conversely, inhibition of aberrant BACE1 activity ameliorates tight junction loss, endothelial dysfunction, and memory deficits.

Conclusions:
Our findings establish a novel and direct relationship between endothelial BACE1 and cerebral small vessel damage, indicating that abnormal elevation of endothelial BACE1 is a new mechanism for cerebral small vessel disease pathogenesis.
Characterizing Cochlear Implant Magnet-Related MRI Artifact
Authors: Cass Nathan D. , Totten Douglas J. , Ross John D. , O’Malley Matthew R. 
Published: April 2022

Objective: To evaluate cochlear implant (CI) magnet-related MRI artifact shape and size, as well as imaging indications and clinical adequacy of scans. Methods: A retrospective chart review was performed for patients undergoing CI and subsequent MRI head imaging from 2014 to 2020 at a single institution. Indications and adequacy of each scan was recorded, and interpretability compared by indication. Magnet-related artifact size was determined by performing ellipsoid modeling at axial slice of greatest signal loss. Artifact radius in centimeters was calculated for 5 sequence categories, and size compared between sequences, manufacturers, and by time from implantation. Results: Twenty patients underwent 58 head MRI scans. Approximately 76% of MRIs (n = 44) for 70% of patients (n = 14) were performed for indications known of prior to implantation; the remainder were performed during workup of new issues. Desired structures were interpretable in 23 (52%) of known-indication MRIs and 8 (57%) of new-indication MRIs, without significant difference ( P = .751). Magnet-related artifact magnitude, compared to the reference T1-weighted fast spin echo (FSE) (4.47 cm), was similar in T2 FSE (4.57 cm, P = .068) and T1 gradient echo (GRE) sequences (4.79 cm, P = .28), but significantly greater in T2 GRE (6.86, P < .0001) and DWI (7.56 cm, P < .0001) sequences. Conclusions: DWI and T2 GRE sequences are less useful in MRI evaluation of CI patients. With a more favorable artifact profile, T1 FSE, T2 FSE, and T1 GRE sequences more likely yield clinically useful information. The large proportion of scans performed for known pathology represents an opportunity to optimize for magnet location preoperatively.
The Social and Emotional Learning and Orientation Scale - Development and Validation of a Brief Measure in Hindi
Authors: Sharma Mayank , Chheda Sonal , Piramal Reshma , Bhatia Neha , Frazier Tyralynn , Singh Nandini Chatterjee 
Published: April 2022

Accumulating evidence of the impact of social and emotional learning (SEL) on student well-being as well as academic performance has led to an increased interest in understanding and measuring SEL in students. However, most existing measures have been developed in English and there is a paucity of culturally relevant measures in other languages. In this study, we present a short, culturally sensitive 8-item scale in Hindi entitled the Social and Emotional Learning and Orientation Scale (SELOS). Factor structure of SELOS was established through exploratory ( N=2844; Mage=14.65 years) and confirmatory factor analysis ( N=1508; Mage=14.50 years) with responses from 4352 Hindi-speaking students in India. The scale demonstrated a two-factor structure, with good reliability, discriminant validity and partial measurement invariance across gender. These results provide encouraging evidence for conducting culturally sensitive studies of SEL in India and in other Hindi-speaking parts of the world.
Nature Relatedness Is Positively Associated With Dietary Diversity and Fruit and Vegetable Intake in an Urban Population
Authors: Milliron Brandy-Joe , Ward Dane , Granche Janeway , Mensinger Janell , Stott Dahlia , Chenault Claire , Montalto Franco , Ellis Eugenia V. 
Published: April 2022

Purpose: Feeling connected to nature, or nature relatedness (NR), can positively impact physical and psychological well-being. However, the relationship between NR and dietary behaviors has not been studied. This research examined the relationship between NR and dietary behaviors, including dietary diversity and fruit and vegetable intake. Design Cross-sectional online survey study. Setting Philadelphia, Pennsylvania. Subjects Adults (n = 317) over 18 years who resided in Philadelphia, PA. Measures The NR Scale was used to measure participants’ connection to nature. It includes 21 items across three subscales: self, experience, and perspective (total and subscales range from 1 to 5). Dietary Diversity was assessed using the FAO’s standardized tool (scores range from 0 to 9). To calculate dietary diversity, food groups reported were aggregated into nine food categories: starchy staples; dark green leafy vegetables; vitamin A rich fruits/vegetables; other fruits/vegetables; organ meat; meat/fish; eggs; legumes, nuts/seeds; and milk products. The NCI’s 2-item CUP Fruit and Vegetable Screener was used to estimate daily fruit and vegetable intake (cups/day), and socio-demographic questions were asked. Analysis Simple and multivariable regression models were used to examine associations between NR Total and subscale scores with dietary diversity scores and fruit and vegetable intake with NR Total scores and subscale scores. The multivariable models were adjusted for age, race, gender, and income. Results People with higher NR Total ( P < .001), NR Self (P < .001), NR Perspective (P = .002), and NR Experience (P = .002) were more likely to report greater dietary diversity. Those with higher NR Total (P < .001), NR Self (P < .001), and NR Experience (P < .001) reported greater fruit and vegetable intake. Associations remained significant after adjusting for covariates. Conclusion NR was associated with better dietary intake after accounting for socio-demographic indicators. These findings highlight the need for health promotion interventions that enhance NR, such as nature prescription initiatives, urban gardening and greening, and immersion in urban green spaces.
The treatment outcome and predictors of serological response in syphilis in a sexually transmitted infections center, China
Authors: Gong Hui Zi , Li Jun , Zheng He Yi 
Published: April 2022

Serology is the mainstay for syphilis treatment monitoring. Baseline rapid plasma reagin (RPR) titre, HIV status, and syphilis stage have been found to be associated with the time to serological response among syphilis patients. This study mainly aims to evaluate the time to serological response, and to identify factors affecting the serological outcome. Medical records of syphilis cases diagnosed in Peking Union Medical College Hospital (PUMCH) between 2008 and 2018 were retrospectively reviewed. Kaplan–Meier analysis was performed to evaluate the median time to serologic response and cumulative probability of serologic response over time according to different variables. Cox regression model was conducted to find factors associated with serological response. There were 984 patients diagnosed with primary, secondary, or latent syphilis cases and receiving injections of benzathine penicillin G (BPG) as initial treatment at the Peking Union Medical College Hospital (PUMCH) between 2008 and 2018. Finally, data on 571 patients, including 49 (8.6%) primary syphilis, 261 (45.7%) secondary syphilis, and 261 (45.7%) latent syphilis, were used for analysis. It took longer time to achieve serological response for subjects aged ≥45 years than younger individuals (89 days versus 58 days; p=0.008). Males achieved serological response more quickly than females (71 days versus 83 days; p = 0.011). There was a significant difference in the time to serological response according to different syphilis stages ( p < 0.001), with 55 days (95% CI, 43–67 days) for primary, 57 days (95% CI, 51–63 days) for secondary, and 117 days for latent syphilis. In addition, patients with lower baseline RPR titre had longer period to achieve serological response (252 days [95% CI, 129–375 days] for RPR titre ≤1:8, 78 days [95% CI, 63–93 days] for RPR titres from 1:16 to 1:32, and 53 days [95% CI, 49–57 days] for RPR titres ≥1:64, respectively; p<0.001). However, no significant difference in time to serological response to treatment was found according to HIV coinfection status. The result of multivariate Cox regression analysis showed that being older than 45 years with latent syphilis, HIV coinfection, or with baseline RPR titre ≤1:8 was associated with slow response. Among patients followed for at least 1 year or seroreverted, 128 (36.9%) had seroreverted within a year, and 219 (63.1%) still had a positive RPR after 1 year. For multiple logistical regression, being female and HIV coinfection were significantly associated with the failure of seroreversion (OR, 0.42 [95% CI, 0.26–0.68]; p <0.001). This study revealed that younger age, higher initial RPR titre, early syphilis stage, and HIV-negative status were associated with faster serological cure. Female sex, individuals with HIV coinfection, and latent syphilis were significantly associated with the failure of seroreversion.
Refractory antiphospholipid antibody syndrome–induced thrombocytopaenia successfully treated with belimumab
Authors: Yoshizuka Riku , Hasegawa Hisanori , Kamiya Mari , Umezawa Natsuka , Yasuda Shinsuke 
Published: April 2022

Antiphospholipid antibody syndrome (APS) is an autoimmune disease with clinical symptoms such as recurrent arterial/venous thrombosis, pregnancy morbidities and thrombocytopaenia. Antiphospholipid antibodies are suggested to be involved in the pathological condition of APS. Therefore, belimumab (BLM), which reduces autoantibody production from B cells, is expected to be effective in the treatment of APS. We report a case of a 63-years-old woman with APS with refractory thrombocytopaenia. Her thrombocytopaenia did not respond to antithrombotic therapy and immunosuppressive treatment including corticosteroids and rituximab but improved with BLM. This is the first report of an APS-induced thrombocytopaenia treated successfully with BLM. BLM should be an effective treatment for APS-related thrombocytopaenia.