bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of school‐based management on Indian government schools
Authors: Guha Panchali 
Published: June 2022

AbstractIndia institutionalized school‐based management in 2009 by requiring all government schools to constitute school management committees, primarily staffed by parents, that would make decisions on school‐related issues. This article utilizes school‐level panel data from the state of Uttar Pradesh and uses a matched difference‐in‐difference estimation methodology to examine the effect of this policy on the provision of basic school infrastructure and services in government schools. It finds evidence that the policy resulted in improving the provision of libraries and medical checkups for students.
Recent Transformation of Marginal Rural Areas in the Sudetes Mountains in Poland—Drivers and Effects of Changes in Perception of their Inhabitants☆
Authors: Kajdanek Katarzyna , Latocha Agnieszka , Sikorski Dominik , Tomczak Przemysław , Szmytkie Robert , Miodońska Paulina 
Published: June 2022

AbstractThe study aims to analyze inhabitants' perceptions vis‐a‐vis the actual demographic, economic, functional, and land use transformation taking place in the peripheral area of Kłodzko County in the Sudetes Mountains in southwestern Poland. Recently, new socio‐economic processes can be observed in the region, suggesting a revival after a period of stagnation. It employs qualitative data from semi‐structured interviews and observation, and quantitative data from an online survey. Findings on inhabitants' perception are discussed against evidence from diverse statistical databases based on the literature. Results show that changes to physical built environment are most perceived, but tourism is seen as the main positive driver. The most acute negative change is depopulation, which is also considered to have a damaging effect on the transformation. The results show some disparities in perceptions across different socio‐demographic and spatially defined categories of inhabitants, as well as ambiguity of assessment of rural transformations that are interpreted in relation to the socio‐economic context of interviewees. The study contributes to discussion on perceived and actual change in rural areas by pointing to patterns of perception. It provides social feedback on changes and depicts collective attitudes towards rural revival—knowledge that is necessary to formulate policies tailored to site‐specific preconditions.
Intersectionality in pandemic youth suicide attempt trends
Authors: McCoy Katherine , Kohlbeck Sara 
Published: June 2022

AbstractIntroductionThe COVID‐19 pandemic has resulted in increased distress at a societal level, with youth and young people bearing a disproportionate burden. A series of recent Morbidity and Mortality Weekly Reports has highlighted emergency department (ED) visit rates for suicide attempts among youth ages 12–25 during the COVID‐19 pandemic. This study expands those analyses by adding race and ethnicity to the examination of suspected suicide attempts among youth.MethodsThis study uses National Syndromic Surveillance Program (NSSP) data for Wisconsin from hospitals that consistently reported ED visits between the study period of January 1, 2019 and September 30, 2021. Suspected suicide attempt visits were identified using the CDC‐developed suicide attempt query.ResultsDuring the study period, there were 8915 ED visits for suicide attempts by children and youth ages 12–25 in Wisconsin's NSSP system. We confirm gendered patterns of ED visit rates for suspected suicide attempts among youth that were first noted in studies using a non‐representative national dataset. Large and significant 2019 vs. 2021 increases were noted for Black females ages 12–17 (79% increase) and White non‐Hispanic females ages 12–17 (58%), but no significant change for Hispanic females ages 12–17. Black females ages 18–25 had high and relatively stable rates throughout this period.
How voter distributions, issue ownership, and position influence party emphasis
Authors: Williams Christopher J. , Ishiyama John 
Published: June 2022

AbstractBackgroundResearch regarding party behavior has often be understood through one of two models, (1) the Downsian proximity model, which supposes parties will change positions in order to be most competitive, and (2) the issue salience model, which understands parties to emphasize issues on which it is more competitive.ObjectivesThis study produces a theoretical framework explaining why parties, specifically in a two‐party system, emphasize one issue dimension over others. We argue that voter distributions differ across issue dimensions and take one of four general forms: (1) unimodal symmetrical, (2) bimodal symmetrical, (3) unimodal asymmetrical, and (4) bimodal asymmetrical. These distributions determine the nature of an issue dimension as approximating valence or positional. Combined with a party's issue ownership or positional advantage, this determines whether a party emphasizes an issue. An issue owner is expected to emphasize unimodal symmetrical issues, parties with positional advantage are expected to emphasize bimodal asymmetrical issues, and no party should emphasize a bimodal symmetrical issue. The decision to emphasize a unimodal asymmetrical issue is dependent upon whether the issue owner and the party with positional advantage are the same and the long‐versus short‐term electoral strategy of a party.MethodsData to test this theoretical approach do not yet exist. This theoretical framework is designed to apply to a two‐party system. In order to properly test the above expectations, we would need data regarding the distribution of voters along different issue dimensions, as well as the emphases placed on issues by parties. These data must be specific to a two‐party system.ConclusionThis theory attempted to build a synthesized theory of party behavior based on the Downsian proximity model and the issue salience model. This theory helps explain what issues parties will seek to contest, and which issues become politicized. However, this framework can be extended to explain many questions regarding polarization, party behavior, electoral strategy and political contestation.
Electoral incentives make politicians respond to voter preferences: Evidence from a survey experiment with members of Parliament in Belgium
Authors: Soontjens Karolin , Sevenans Julie 
Published: June 2022

AbstractBackgroundResearch shows that there is variation in how responsive individual politicians are to voter preferences. One explanation, it is commonly argued, lies in politicians' varying electoral motivations.MethodsWe test this assumption in a survey‐embedded experiment in which Belgian Members of parliament were asked what position they would take on a policy proposal after a random half of them had been shown real survey data indicating that their party voters were in favor of this policy.ResultsWe find that politicians who feel unsure about their re‐election adapt their behavior more to be in line with the preferences of voters than confident politicians. Moreover, the anticipation of electoral accountability fosters responsiveness; the more politicians anticipate to be held accountable on Election Day for what they do and say, the more they respond to voter preferences.ConclusionThese ideas are not new, yet we are the first to isolate them empirically and demonstrate their individual‐level foundations.
Internet and firms’ exports and imports: Firm level evidence from China
Authors: Li Bing , Li Linyue , Li Rou , Yue Yunsong 
Published: June 2022

AbstractThis study investigates the impact of the Internet on Chinese firms' export and import performance by using China's industrial enterprise and customs data and adopting a propensity score matching difference‐in‐differences method (PSM‐DID). The empirical results show that utilising the Internet has positive effects on firms' exports and imports; however, the effects are mainly concentrated in the first 2–3 years. The positive effect on exports is larger than on domestic sales; thus, the Internet increases export intensity. Further, we investigate the effects of the Internet on the three margins of Chinese exports. First, we borrow the multi‐product multi‐destination firm exporting theory developed by Bernard et al. (The Quarterly Journal of Economics, 126, 2011, 1271) and find that the Internet improves not only the extensive margin between firms, but also the within‐firm extensive margin. We then investigate the effects of the Internet on product quality and find that the Internet has a negative effect since Chinese firms export more products to developing countries than to other countries, where the requirements for product quality are relatively low. Our findings empirically justify the ‘Internet Plus’ strategy proposed by the Chinese government with regard to international trade.
Global REACH 2018: increased adrenergic restraint of blood flow preserves coupling of oxygen delivery and demand during exercise at high‐altitude
Authors: Hansen Alexander B. , Moralez Gilbert , Amin Sachin B. , Hofstätter Florian , Simpson Lydia L. , Gasho Christopher , Tymko Michael M. , Ainslie Philip N. , Lawley Justin S. , Hearon Christopher M. 
Published: June 2022

AbstractChronic exposure to hypoxia (high‐altitude, HA; >4000 m) attenuates the vasodilatory response to exercise and is associated with a persistent increase in basal sympathetic nerve activity (SNA). The mechanism(s) responsible for the reduced vasodilatation and exercise hyperaemia at HA remains unknown. We hypothesized that heightened adrenergic signalling restrains skeletal muscle blood flow during handgrip exercise in lowlanders acclimatizing to HA. We tested nine adult males (n = 9) at sea‐level (SL; 344 m) and following 21–28 days at HA (∼4300 m). Forearm blood flow (FBF; duplex ultrasonography), mean arterial pressure (MAP; brachial artery catheter), forearm vascular conductance (FVC; FBF/MAP), and arterial and venous blood sampling (O2 delivery () and uptake ()) were measured at rest and during graded rhythmic handgrip exercise (5%, 15% and 25% of maximum voluntary isometric contraction; MVC) before and after local α‐ and β‐adrenergic blockade (intra‐arterial phentolamine and propranolol). HA reduced ΔFBF (25% MVC: SL: 138.3 ± 47.6 vs. HA: 113.4 ± 37.1 ml min−1; P = 0.022) and Δ (25% MVC: SL: 20.3 ± 7.5 vs. HA: 14.3 ± 6.2 ml min−1; P = 0.014) during exercise. Local adrenoreceptor blockade at HA restored FBF during exercise (25% MVC: SLα–β blockade: 164.1 ± 71.7 vs. HAα–β blockade: 185.4 ± 66.6 ml min−1; P = 0.947) but resulted in an exaggerated relationship between and (/ slope: SL: 1.32; HA: slope: 1.86; P = 0.037). These results indicate that tonic adrenergic signalling restrains exercise hyperaemia in lowlanders acclimatizing to HA. The increase in adrenergic restraint is necessary to match oxygen delivery to demand and prevent over perfusion of contracting muscle at HA.
imageKey points
In exercising skeletal muscle, local vasodilatory signalling and sympathetic vasoconstriction integrate to match oxygen delivery to demand and maintain arterial blood pressure.
Exposure to chronic hypoxia (altitude, >4000 m) causes a persistent increase in sympathetic nervous system activity that is associated with impaired functional capacity and diminished vasodilatation during exercise.
In healthy male lowlanders exposed to chronic hypoxia (21–28 days; ∼4300 m), local adrenoreceptor blockade (combined α‐ and β‐adrenergic blockade) restored skeletal muscle blood flow during handgrip exercise.
However, removal of tonic adrenergic restraint at high altitude caused an excessive rise in blood flow and subsequently oxygen delivery for any given metabolic demand.
This investigation is the first to identify greater adrenergic restraint of blood flow during acclimatization to high altitude and provides evidence of a functional role for this adaptive response in regulating oxygen delivery and demand.
Genetics of Atavism
Authors: Korzh V. P. , Gasanov E. V. 
Published: June 2022

Abstract
Atavisms have attracted people’s attention for a long time. First, atavisms excited their imagination and created fertile ground for myths and superstitions. With the development of science, atavisms became the subject of investigation, which soon provided evidence to support evolutionary theory. However, at the molecular level, the formation of atavisms remained insufficiently understood. Recent progress in comparative genomics and molecular developmental biology has helped in understanding the processes underlying the formation of one of the human atavisms: the vestigial tail.
Exploring the sustainability of perinatal audit in four district hospitals in the Western Cape, South Africa: a multiple case study approach
Authors: Kinney Mary , Bergh Anne-Marie , Rhoda Natasha , Pattinson Robert , George Asha 
Published: June 2022

IntroductionMaternal and perinatal death surveillance and response (MPDSR) is an intervention process that uses a continuous cycle of identification, notification and review of deaths to determine avoidable causes followed by actions to improve health services and prevent future deaths. This study set out to understand how and why a perinatal audit programme, a form of MPDSR, has sustained practice in South Africa from the perspectives of those engaged in implementation.MethodsA multiple case study design was carried out in four rural subdistricts of the Western Cape with over 10 years of implementing the programme. Data were collected from October 2019 to March 2020 through non-participant observation of seven meetings and key informant interviews with 41 purposively selected health providers and managers. Thematic analysis was conducted inductively and deductively adapting the extended normalisation process theory to examine the capability, contribution, potential and capacity of the users to implement MPDSR.ResultsThe perinatal audit programme has sustained practice due to integration of activities into routine tasks (capability), clear value-add (contribution), individual and collective commitment (potential), and an enabling environment to implement (capacity). The complex interplay of actors, their relationships and context revealed the underlying individual-level and organisational-level factors that support sustainability, such as trust, credibility, facilitation and hierarchies. Local adaption and the broad social and structural resources were required for sustainability.ConclusionThis study applied theory to explore factors that promote sustained practice of perinatal audit from the perspectives of the users. Efforts to promote and sustain MPDSR will benefit from overall good health governance, specific skill development, embedded activities, and valuing social processes related to implementation. More research using health policy and system approaches, including use of implementation theory, will further advance our understanding on how to support sustained MPDSR practice in other settings.
Novel immunoprofiling method for diagnosing SLE and evaluating therapeutic response
Authors: Lee Jan-Mou , Chen Ming-Huang , Chou Kai-Yuan , Chao Yee , Chen Ming-Han , Tsai Chang-Youh 
Published: June 2022

ObjectiveDiagnosis of SLE is based on clinical manifestations but is heterogeneous in early onset. Hence, we aimed to evaluate the feature of the immunoprofiling in patients with SLE and apply it to develop an immune signature algorithm for supporting SLE diagnosis.MethodsWe enrolled 13 newly diagnosed patients with SLE and 9 healthy controls (HCs) followed by analysing their immunoprofilings within their peripheral blood mononuclear cells (PBMCs) through flow cytometry. The immunoprofiling from the patients with SLE and HCs were ranked and formed an immune signature score. Besides, we enrolled four patients with SLE and monitored the changes in their immunoprofilings after immunosuppressant treatment.ResultsAmong 93 immune cell subsets, 29 differed significantly between patients with SLE and HCs, and lower dendritic and natural killer cell percentages and a higher CD8+T-cell percentage were identified in patients with SLE. In an investigation of immune-tolerant-related cell subsets, higher concentrations of CD8+regulatory natural killer T cells, programmed cell death 1 (PD-1)+T cells, and lower concentrations of programmed cell death ligand 1 (PD-L1)+PBMCs were observed in the SLE group. The immune signature score from patients with SLE was significantly different from that from the HCs. After treatment, the disease activity of the four patients were tended to stable and percentages of PD-L1+monocytes, PD-1+CD4 T and CD8 T cells in patients with SLE exhibited positively and negatively correlation with the SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index 2000) score, which might associate with the remission of SLE.ConclusionsThe comparison of immunprofiling between patients with SLE and HCs exhibited a distinct pattern. This difference and its application to immune signature algorithm shed light on the studies of SLE pathogenesis and immune-based diagnostic tool development in the future.
Crystallization of ropivacaine and bupivacaine when mixed with different adjuvants: a semiquantitative light microscopy analysis
Authors: Hoerner Elisabeth , Stundner Ottokar , Putz Guenther , Steinfeldt Thorsten , Mathis Simon , Gasteiger Lukas 
Published: June 2022

IntroductionAmino-amide local anesthetics precipitate when mixed with some commonly used adjuvants, carrying the risk of perineural or vascular crystal deposition. The aim of this study was to evaluate whether crystallization occurs with routinely used local anesthetic–adjuvant combinations and if a relation with the solution’s pH exists.MethodsAll substances used in this trial were first visually investigated undiluted under tenfold magnification. Grade of crystallization was assessed using a 6 point grading system.Ropivacaine (0.2%, 0.75% and 1%) and bupivacaine (0.25% and 0.5%) were mixed in a 1:1 solution with the following adjuvants: dexamethasone, dexmedetomidine, clonidine, fentanyl, sodium bicarbonate 8.4% and sodium chloride 0.9%. Subsequently, ropivacaine (0.2% and 0.75%) and bupivacaine (0.25% and 0.5%) were mixed with adjuvants in concentrations commonly used in clinical practice and then serially assessed at several time points up to 1 hour. pH of all substances/combinations was assessed and correlated with crystallization grade.ResultsAll pure substances—except the reference standards sterile water and triamcinolon—showed crystallization grades ranging from grade 1 to grade 4. Addition of adjuvants lead to variable, unpredictable changes in crystal depositions. Addition of sodium bicarbonate 8.4% produced heavy crystallization in all combinations. Grade of crystallization was weakly positively related to the pH of the solution in 1:1 mixtures and clinically relevant concentrations, but not in pure substances.DiscussionOur study showed that crystallization is present in pure local anesthetics and may be increased or decreased by admixture of adjuvants. Higher pH of mixtures was weakly associated with more crystallization. Further research is necessary to translate these findings into clinical practice.
Risk of malignancy in rheumatoid arthritis patients initiating biologics: an historical propensity score matched cohort study within the French nationwide healthcare database
Authors: Seror Raphaele , Lafourcade Alexandre , De Rycke Yann , Pinto Sandrine , Castaneda Johann , Fautrel Bruno , Mariette Xavier , Tubach Florence 
Published: June 2022

ObjectiveTo compare the risk of malignancy between patients with rheumatoid arthritis (RA) initiating their first biological disease-modifying antirheumatic drug (bDMARD) and those continuing conventional synthetic DMARDs (csDMARDs).MethodsNine-year historical Propensity Score (PS) matched cohort study within the French national healthcare database (87% of the French population; ~57 million people), including adults RA without malignancy. Exposures started with the first use of any systemic treatment (csDMARDs and/or bDMARDs). Incident users of bDMARDs were matched on a dynamic PS to patients continuing csDMARDs. Their risk of malignancy was compared by Cox model.ResultsFrom 1 January 2007 to 31 December 2014, 83 706 patients with RA started their first systemic treatment (63 837 remained on csDMARDs and 19 869 initiated a bDMARD during follow-up). After dynamic PS matching, 19 727 bDMARD initiators were compared with 19 727 RA remaining on csDMARDs. They did not statistically differ in risk of overall malignancies (HR 0.99 (95% CI 0.86 to 1.14)), solid cancer (HR 0.95 (95% CI 0.82 to 1.11)), nor lymphoma (HR 1.35 (95% CI 0.72 to 2.53)). Results were similar when bDMARDs were given as monotherapy or in association with csDMARDs. Analyses restricted to patients starting TNF inhibitor as first bDMARD compared with matched RA remaining on csDMARDs, provided similar results (HR for overall malignancy 1.03 (95% CI 0.88 to 1.21)). Sensitivity analyses, varying carry-over periods (up to 5 years) to define risk periods, provided similar results.ConclusionsIn this historical cohort study within the French nationwide healthcare database, the risk of overall, solid or haematological malignancies did not significantly differ between patients with RA initiating bDMARD and those continuing csDMARDs.
Meaning of patient global assessment when joint counts are low in rheumatoid arthritis
Authors: Felson David , Feathers Vivi , Naik Chinmayi , Solomon Daniel H , Weinblatt Michael E , Shadick Nancy 
Published: June 2022

ObjectiveIn patients with rheumatoid arthritis (RA) with low 28-joint tender and swollen joint counts but who assessed their disease as active, to evaluate whether activity reflected RA symptoms.MethodsWe carried out a cross-sectional study of patients in BRASS, a cohort of patients with established RA who had 28-joint counts assessed, scored their disease activity, identified their painful joints, and answered questions about other sites of pain and fatigue. Patients and their rheumatologists were asked about the presence of fibromyalgia. We examined whether patients reported pain in joints excluded from the 28-joint joint count (feet, ankles, hips, neck) and pain or symptoms probably unrelated to RA including low back pain, headache and fibromyalgia. Fatigue was not classified. Analyses were descriptive.ResultsOf 272 patients, 49 had tender and swollen joint counts <1 and a patient global assessment score of ≥3/10. 48/49 (95%) reported pain in joints excluded from the 28-joint count. Of these 49, 24 (45%) also had other symptoms especially low back pain. Fatigue was present in all patients. No patient had fibromyalgia.ConclusionIf joint counts <=1 are scored in 28 joints, patient global assessments of ≥3/10 often occur when there is pain in uncounted joints, joints that may respond to RA treatment.