Stable Commitment Research Articles

SLAMF7 (CD319) on activated CD8+ T cells transduces environmental cues to initiate cytotoxic effector cell responses.

CD8+ T-cell responses are meticulously orchestrated processes regulated by intercellular receptor:ligand interactions. These interactions critically control the dynamics of CD8+ T-cell populations that is crucial to overcome threats such as viral infections or cancer. Yet, the mechanisms governing these dynamics remain incompletely elucidated. Here, we identified a hitherto unknown T-cell referred function of the self-ligating surface receptor SLAMF7 (CD319) on CD8+ T cells during initiation of cytotoxic T-cell responses. According to its cytotoxicity related expression on T effector cells, we found that CD8+ T cells could utilize SLAMF7 to transduce environmental cues into cellular interactions and information exchange. Indeed, SLAMF7 facilitated a dose-dependent formation of stable homotypic contacts that ultimately resulted in stable cell-contacts, quorum populations and commitment to expansion and differentiation. Using pull-down assays and network analyses, we identified novel SLAMF7-binding intracellular signaling molecules including the CRK, CRKL, and Nck adaptors, which are involved in T-cell contact formation and may mediate SLAMF7 functions in sensing and adhesion. Hence, providing SLAMF7 signals during antigen recognition of CD8+ T cells enhanced their overall magnitude, particularly in responses towards low-affinity antigens, resulting in a significant boost in their proliferation and cytotoxic capacity. Overall, we have identified and characterized a potent initiator of the cytotoxic T lymphocyte response program and revealed advanced mechanisms to improve CD8+ T-cell response decisions against weak viral or tumor-associated antigens, thereby strengthening our defense against such adversaries.

3D printing viscoelastic hydrogel-based scaffolds with a swelling-dependent gate for cartilage injury regeneration

Regeneration of articular cartilage remains a great challenge due to its poor self-healing capacity and weak stability. The microfracture surgery (MF) can provide bone marrow mesenchymal stem cells (BMSCs) and is commonly used in clinical practice, but its therapeutic effect is still limited by the lack of effective adhesion matrix and the uncontrollable tendency to develop fibrosis and even mineralization. In this study, a small molecular drug-loaded viscoelastic hydrogel-based 3D printing bilayer scaffold with a swelling-dependent gate was successfully developed to address these limitations. The scaffold consisted of a lower layer with a smaller pore size and an upper matrix with larger pore size. The former acted as a swelling-dependent gate to switch pore size, which initially was on-state allowing the infiltration of BMSCs, and eventually transformed into off-state serving as a barrier blocking excessive blood support from the bone marrow after swelling-induced closure of pores. This barrier structure cooperated with fatty acid inhibitor-suppressed hypertrophy of neo-cartilage matrix. The latter provided a biocompatible and viscoelastic matrix to guide MSCs toward stable chondrogenic commitment. By integrating structural design with the inhibitor, the bilayer scaffold provides a promising platform for future clinical applications of MF surgery in cartilage regeneration.

Religious Institutions’ Stances towards Autocratization in the Post-Third Wave Period

AbstractWhile scholars have devoted significant attention to religious institutions’ role in democratization, less attention has been given to their role in autocratization. Moreover, religious economy approaches suggest that religious institutions are flexible to offer whatever is of interest to the marketplace, but here the role the institutions played in the third wave of democratization suggests a stable commitment. I test the impact of religious monopoly and the historical pro-democratizing role on 52 dominant religious institutions’ stances towards autocratic practices related to regime survival in the post-third wave period. Logistic regression models reveal that stronger religious monopolies decrease the probability of opposing regime survival, while the historical pro-democratizing role of the dominant religious groups in the third wave increases the probability. Furthermore, when the religious market is highly monopolized, the commitment to a democratic role in the third wave is weak, and it is strengthened when there is intense religious competition.

Corporate social responsibility in the banking sector: a focus on Latin America and the Caribbean

Corporate social responsibility [CSR] represents the need to maintain a stable commitment to the needs of a human group. In this sense, the objective of this research is to analyze the actions of corporate social responsibility implemented in the banking sector in Latin America and the Caribbean, taking Bancolombia, Banco de Crédito e Inversiones, and Banco General as a reference. The methodology used was qualitative, cross-sectional, and non-experimental. This was carried out based on a documentary analysis of the annual reports of the aforementioned companies, ranked in the top CSR positions, according to the Merco Ranking. As a result, it was determined that the companies most predominantly carry out social responsibility actions based on the internal dimension, with 26% regarding the adoption of equitable salaries and 28% regarding the quality of the job. On the other hand, the external dimension shows that 25% of corporate actions emphasize the potential for responsible investment. Finally, it was found that the CSR actions and resources allocated by the aforementioned banks in 2021 were used for business sustainability, seen from the promotion of employee stability and satisfaction in the company, as well as responsible investment, evaluating the social, economic, and environmental impact. In this sense, CSR activities that have an impact on an external context stand out with greater importance despite the percentage differences between dimensions, since their impact is identified from the investment in employee training and development programs; the contributions to local and regional economic development based on job creation, as well as the reduction of polluting gas emissions, conversation and environmental education.

Maneuvering between Baghdad and Tehran: North Korea's Relations with Iraq and Iran during the Cold War

Abstract This article explores how North Korean leaders tried to maneuver between Iran and Iraq to gain greater leverage in the Cold War. Both of these Middle Eastern countries seemed potentially attractive partners for Pyongyang, but they were often on hostile terms with each other. The article considers how the Iraq-Iran rivalry and domestic changes in Iraq and Iran affected North Korean policy. Even when Pyongyang's cooperation with one or the other of the two states reached a high level, the North Koreans also reached out to the other country, regardless of the position of either state and of external actors such as the Soviet Union and China. The North Koreans generally avoided taking a public stand on the Iraq-Iran dispute, but on occasion they became more deeply involved. Mainly, the North Korean government sought to maximize the number of its partners, rather than to make a stable commitment to just one state. In turn, both Iraq and Iran eventually came to perceive North Korea as a state that was mostly out to benefit itself rather than helping either of them.

Public procurement for innovation through supplier firms' sustainability lens: A systematic review and research agenda

AbstractPublic sector purchasing processes are gaining increasing prominence as a demand‐side innovation tool for addressing national sustainability challenges. Accordingly, there has been growing research attention to this topic. Prior studies suggest three key rationales that underlie the use of public sector procurement to drive innovation: (i) the buyer–user rationale (for creating new needs); (ii) the market/system failure rationale (for improving suppliers' capacity to innovate); and (iii) the public services rationale (for improving public services). However, operational activities at the upstream supply chain affecting the sustainable innovation capacities of supplier firms appear to be under‐researched in the public procurement for innovation (PPI) scholarship, despite knowledge about innovation capacity being critical to successfully implementing PPI. This paper adopts a systematic literature review approach to synthesise existing fragmented literature on sustainability‐oriented PPI, focusing on supplier perspectives. Findings from a synthesis of 41 relevant articles suggest, among others conditions, that a procurement framework that maintains a good balance of competition and innovation, builds buyer–supplier relationship and urges strong supply networks, maintains a stable political commitment, offers security for niche markets with effective innovation risk management culture would enhance suppliers' sustainability capacity and propensity to innovate. This paper contributes to the PPI literature and the literature on determinants of sustainable innovation systems from supplier firms' sustainability lens.

Stem cell differentiation with consistent lineage commitment induced by a flash of ultrafast-laser activationin vitroand in vivo.

Recent technological advancements on stem cell differentiation induction have been making great progress in stem cell research, regenerative medicine, and therapeutic applications. However, the risk of off-target differentiation limits the wide application of stem cell therapy strategies. Here, we report a non-invasive all-optical strategy to induce stem cell differentiation invitro and invivo that activates individual target stem cells in situ by delivering a transient 100-ms irradiation of a tightly focused femtosecond laser to a submicron cytoplasmic region of primary adipose-derived stem cells (ADSCs). The ADSCs differentiate to osteoblasts with stable lineage commitment that cannot further transdifferentiate because of simultaneous initiation of multiple signaling pathways through specific Ca2+ kinetic patterns. This method can work invivo to direct mouse cerebellar granule neuron progenitors to granule neurons in intact mouse cerebellums through the skull. Hence, this optical method without any genetic manipulations or exogenous biomaterials holds promising potential in biomedical research and cell-based therapies.

There and back again. Examining the development of employee commitment during a prolonged crisis

To effectively function and adapt in crises, healthcare organizations rely on the skills and commitment of their workforce. Yet, our current understanding of how employees’ workplace commitment is affected by and evolves throughout the course of a crisis remains limited. In this paper, we explore the commitment of hospital staff to an important workplace target, the COVID-19 crisis response, and show how this commitment develops over time. We report on an exploratory case study of hospital staff in a heavily hit region of the Netherlands. We conducted interviews with hospital executives, management, medical and support staff to uncover the issues hospitals faced in recruiting staff to provide COVID-19 care throughout the first and second wave of the crisis. Our findings suggest that while staff initially exhibited high levels of commitment to aiding in the crisis effort, staff were perceived to exhibit lower levels of commitment in the second wave, complicating the provision of COVID-19 care. We unveil three contributing factors to this shift, namely: competing demands, energy depletion and a lack of support and appreciation. Our findings suggest that while staff were initially willing to dedicate themselves and take responsibility for the crisis effort, as their other more stable commitments became more salient in the second wave, their willingness to dedicate limited resources to the crisis effort decreased. In our discussion, we examine the implications of our findings for the literature on workplace commitment, and advance our understanding of employee workplace commitment during crises.

Enhancing China–Africa Health Cooperation for a Healthier and Safer World: A Multilateral Perspective

China has made remarkable contributions to Africa’s health development through building public health facilities and systems, building basic medical service capacity, and improving human resources for medical services. Despite these achievements, China still faces challenges in improving project effectiveness, increasing local engagement, expanding the scope of health cooperation, and enhancing interaction with the larger international aid community. Besides, the differences in culture, communication style, history, and institution limit China and Africa on “soft” issues, as does the absence of a coherent and coordinated approach among Chinese stakeholders in health cooperation. One solution is to increase multilateral engagement in China–Africa health cooperation. Compared with other countries, China’s engagement in Africa’s health development is primarily bilateral, and its roles in the structure, management, and decision-making of the health-related multilateral organizations are also limited. Building on their acknowledged strengths, such as knowledge bases and centers, health and medical expertise, and past best practices, extensive connections with local communities, multilateral organizations should play a more prominent role in strengthening China–Africa health cooperation. To increase engagement with multilateral organizations and improve effectiveness and sustainability of China–Africa health cooperation, Beijing should conduct more field research and analysis to better understand the local development needs, ensure appropriate, targeted, and contextualized health cooperation, and jointly establish a pooled fund to guarantee stable, sustained, and predictable commitments from each side.

What motivates patients to change general practitioners in the Pleven region, Bulgaria?

Abstract Problem The World Health Organization's 2008 World Health Report, entitled ‘Primary care now more than ever,' clearly states the need of knowledge about primary care not as one of the ordinary structures of the national health system, but as its leading priority. Description of the problem Since the start of health reform in Bulgaria, the choice and change of a GP by patients is most often spontaneous, random, and without enough specific information about the qualities of the GP. This reduces the effectiveness of the free choice of a doctor. The purpose of this study was to analyze the patient's motives for changing their GP. A survey was conducted among respondents in the period from September 1st to 30th, 2018 in the Pleven Region, Bulgaria. Patients who visited their GPs during the study period were interviewed. The results were processed using Microsoft Office Excel 2007. Results It was established that 830 (78.8%) of the 1053 respondents in the territory of Pleven Region have changed their personal doctor. The three leading motives were: long waiting times in front of the GP's office - 30.2%, change of residence - 19%, and lack of sufficient referrals from a physician to the specialist - 11.7%. Most of the surveyed patients assessed their GP as having a positive attitude toward them. 132 (12.6%) of the participants rate their personal doctor as rude, always being in a hurry, and nervous or not giving them any answers at all. Lessons When choosing a GP, the patient's prior information about the qualities and competencies of the personal physician of his\her choice is very low. It is necessary to create a system for the informed choice of a personal physician which will have a double effect, 1) a more adequate and more critically justified choice of a GP by the patient, and 2) a clearer, more stable commitment and responsibility of the GPs to the patients who chose them. Key messages It is necessary to improve the overall organization of the work of GPs. Healthcare is a type of interaction between the doctor and the patient during the diagnostic and treatment process.

New approaches to financing the health care system

Main areas of state budget expenditures have been identified in the article. They include financing the staff of the Ministry of Health of Ukraine, the State Service of Ukraine for Medicines and Drug Control, the National Health Service of Ukraine, the Ministry of Health of Ukraine. It has been emphasized that the adoption of the Concept of Health Care Financing Reform at the legislative level was important during the reform of the health care system of Ukraine, according to which the implementation of a large-scale transformation of health care system financing has begun. The initial provisions of the concept of health care financing reform have been studied, namely: the purpose of health care financing reform and its principles. The directions of the health care system's reforming that affected the financial mechanism of public administration have been proposed. One of the key reasons for the successful implementation of the health care financing reform is the stable political commitments and high-quality interdepartmental relations between the Cabinet of Ministers, the Ministry of Health, the National Health Service of Ukraine and the Ministry of Finance. It has been noted that the main problem of imperfection of financial provision of health care in Ukraine is the lack of clear criteria for assessing the effectiveness of the use of budget resources at different levels of government and health care facilities. The transformed system of financing of primary medical care in Ukraine has been presented and characterized, the algorithm of calculation of budgetary financing of the medical sphere has been given. It has been found out that the implementation of the concept of health care financing reform took place together with the development of the legal mechanism, which provided for the adoption of regulations. The main directions of improving the financial mechanism of public administration of the healthcare system have been identified: at the level of public administration of the healthcare system, at the level of reforming the state regulation of healthcare institutions.

Daily Identity Dynamics in Adolescence Shaping Identity in Emerging Adulthood: An 11-Year Longitudinal Study on Continuity in Development

According to identity theory, short-term day-to-day identity exploration and commitment processes are the building blocks for long-term development of stable commitments in emerging adulthood. This key assumption was tested in a longitudinal study including 494 individuals (43% girls, Mage T1 = 13.31 years, range 11.01–14.86 years) who were followed from adolescence into emerging adulthood, covering ages 13 to 24 years. In the first five years, adolescents reported on their daily identity processes (i.e., commitment, reconsideration and in-depth exploration) across 75 assessment days. Subsequently, they reported on their identity across four (bi-) annual waves in emerging adulthood. Findings confirmed the existence of a dual-cycle process model of identity formation and identity maintenance that operated at the within-person level across days during adolescence. Moreover, individual differences in these short-term identity processes in adolescence predicted individual differences in identity development in emerging adulthood. Specifically, those adolescents with low daily commitment levels, and high levels of identity reconsideration were more likely to maintain weak identity commitments and high identity uncertainty in emerging adulthood. Also, those adolescents characterized by stronger daily changes in identity commitments and continuing day-to-day identity uncertainty maintained the highest identity uncertainty in emerging adulthood. These results support the view of continuity in identity development from short-term daily identity dynamics in adolescence to long-term identity development in emerging adulthood.

Cities4ZERO: Overcoming Carbon Lock-in in Municipalities through Smart Urban Transformation Processes

How can local authorities effectively address the decarbonization of urban environments in the long run? How would their interests and expertise be aligned into an integrated approach towards decarbonization? This paper delves into how strategic processes can help to integrate diverse disciplines and stakeholders when facing urban decarbonization and presents Cities4ZERO, a step-by-step methodology for local authorities, able to guide them through the process of developing the most appropriate plans and projects for an effective urban transition; all from an integrated, participatory and cross-cutting planning approach. For the development of the Cities4ZERO methodology, plans, projects, and strategic processes from five European cities that are part of the Smart Cities and Communities European Commission program have been monitored for 4 years, in close collaboration with local authorities, analyzing ad-hoc local strategic approaches to determine key success factors and barriers to be considered from their transitioning experiences. The study indicates that an iterative strategic approach and a project-oriented vision, combined with a stable institutional commitment, are opening a window of opportunity for cities to achieve effective decarbonization.

Pediatric Assent and Treating Children Over Objection.

* Abbreviation: AAP — : American Academy of Pediatrics More than 20 years ago, the pioneering pediatric ethicist William Bartholome1 wrote a fiery letter to the editor of this journal because he thought a recently published statement on pediatric assent, from the Committee on Bioethics of the American Academy of Pediatrics (AAP), showed insufficient respect for children.2 That AAP statement, like its 2016 update, asserts that pediatric assent should be solicited only when a child’s dissent will be honored.3,4 Bartholome1 objected that pediatricians should always solicit children’s assent and that they should acknowledge and apologize when they treat children over their objections even when they must do so to promote children’s best interests. We think Bartholome1 was right. In this brief commentary, we elaborate on his perspective about the moral value of pediatric assent, and we suggest improvements to the corresponding clinical guidance. The AAP grounds the moral value of pediatric assent by noting, “We are obliged to act out of fundamental respect for other persons by virtue of their personal autonomy.” But in drawing on the concept of autonomy, the AAP invokes too narrow a conception of respect. Indeed, the AAP acknowledges that many children “lack the agency required to be truly autonomous agents.”3 If respect is grounded … Address correspondence to Jason Adam Wasserman, PhD, William Beaumont School of Medicine, Oakland University, ODH 412, 586 Pioneer Dr, Rochester, MI 48371. E-mail: wasserman{at}oakland.edu

An analysis of the impacts of wind power penetration in the power system of southern Brazil

This paper analyzes the main impacts of high penetration levels of wind power in the power system of Southern Brazil. For this, an hourly operation of the Brazilian Southern power system is simulated using an Economic Dispatch Model. Two main scenarios are explored: a baseline and a wind penetration case, both for 2030 and 2050. To create these scenarios, results from an Integrated Energy Model are used as inputs for the dispatch model. The economic dispatch modeling led to some expected outcomes, such as a reduction in the system generation cost, a reduction in greenhouse-gas emissions, and a greater need for transmission expansion in the wind-power scenarios. Results also show that, even for a power system as flexible as the one in Southern Brazil, wind power penetration impacts can be observed. Moreover, results show that setting thermal power plants to provide secondary reserve can potentially improve the balancing management in hydropower-based systems. Finally, results from linking the Economic Dispatch Model and the Integrated Energy Model showed the need for better combining energy expansion models with power dispatch models that consider both the operation and the transmission system restrictions, in order to have stable and feasible unit commitment schedules.

Toward a Strategic Design of the CCS Demonstration Projects: A Statistical Approach

This paper reports the key findings of a statistical study that analyze 315 CCS projects worldwide with the most recent database. A worldwide database combining government R&D spending, patent, and demonstration is compiled to get a profound observation on the CCS innovation landscape. The results indicate that the first wave of CCS patent application in 2005 which is driven by private sector. The demonstration project is highly correlated to the patent application. Both demonstration projects and patent application peak in 2009. Our results of demonstration projects suggest that increasing unit cost and larger plant size increase the risk of a project being terminated or on hold. The stable political commitment is crucial to delivering a successful demonstration project. The risk of project failure due to system integration and scale-up of demonstration project might be possibly resolved by smaller facilities demonstrations which is promising in the advancing broad deployment of CCS and reducing political and financial barriers.

Natures in Translation: Romanticism and Colonial Natural History

Natures in Translation: Romanticism and Colonial Natural History

Payment for Targeted Grazing: Integrating Local Shepherds into Wildfire Prevention

Wildfires are one of the most prominent risks for Mediterranean forests, reducing the flow of ecosystem services and representing a hazard for infrastructure and human lives. Several wildfire prevention programs in southern Europe are currently incorporating extensive livestock grazers in fire prevention activities to reduce the high costs of mechanical clearance. Among these the Andalusian network of grazed fuel breaks, the so-called RAPCA program, stands out for its dimension and stability over time. RAPCA currently works with 220 local shepherds who, with their guided flocks maintain low biomass levels in almost 6000 ha of fuel breaks in public forests to meet fire prevention standards. This work analyses the institutional design and performance of the RAPCA payment scheme under a payment for environmental services (PES) framework. Results show effectiveness of the payment scheme while efficiency is achieved through savings relative to the mainstream mechanized biomass removal, as well as through reduced information asymmetry. High-level and stable political commitment has been crucial for the emergence and consolidation of RAPCA. Moreover, key intermediaries and sound monitoring practices increased levels of trust amongst involved actors. Beneficial side-effects include social recognition of shepherds’ activities and reduction of their friction with forest managers.

The Cost of Family Medicine Residency Training: Impacts of Federal and State Funding.

Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. A group of family medicine residency programs have shared their financial data since 2002 through a biennial survey of program revenues, expenses, and staffing. Data sets over 12 years were collected and analyzed, and results compared to analyze trends. Overall expenses increased 70.4% during this period. Centers for Medicare and Medicaid Services (CMS) GME revenue per resident increased by 15.7% for those programs receiving these monies. Overall, total revenue per resident, including clinical revenues, state funding, and any other revenue stream, increased 44.5% from 2006 to 2016. The median cost per resident among these programs, excluding federal GME funds, is currently $179,353; this amount has increased over the 12 years by 93.7%. For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.

Integration as a scientific paradigm

PurposeIntegration is policy, practice as well as object of systematic investigation. What we do not know is whether or not integration can be understood as a science. In his book The Structure of Scientific Revolutions, Thomas Kuhn formulated a notion of (natural) sciences based on the emergence of commitments amongst a community of scientists to a set of logics, model and exemplars. He called this a paradigm. The purpose of this paper is to assess the scientific nature of integration by perceiving it as a paradigm in Kuhn’s sense.Design/methodology/approachThe paper proceeds by conceptual reflection through matching existing components, theories and exemplifications of integration to Kuhn’s model of a scientific paradigm. Integration is understood broadly, either vertical or horizontal, and located within the practical domains of policy formulation, policy implementation and evaluation research. The nature, scope and depth of group commitments amongst students and practitioners of integration receive particular attention in line with Kuhn’s social interactionist approach.FindingsEmploying Kuhn’s notion of paradigm in the context of integration highlights the fundamental tension between integration efforts and integration outcomes. Whilst integration defines itself in contradistinction to professional boundaries and fragmentation, the paper argues that it fails to develop a strong theoretical and empirical foundation for a robust and stable group commitment. The reason is that the key motivational force that may create a stable group commitment amongst those engaged in integration, the patient perspective, remains outside the integration paradigm. This leaves integration as a practice and policy model underdeveloped, mainly paradigmatically illustrated by singular exemplars and rooted in aspirational policy vocabulary, while clustered around a near dogmatic belief that working together between services must lead to improved quality of care. To become a scientific paradigm the group commitment in integration would have to coalesce around a clear ontology (symbolic generalisations), epistemology (models of knowledge) and manifestations in practice (exemplars).Research limitations/implicationsAt present both the ontology and epistemological foundations of integration practice and research are insufficiently clear. This hampers the development of integration practice as well as a better understanding of how to evaluate integration outcomes. Future studies should focus on the depth, nature and subject of group commitments to assess whether integration is a viable candidate for scientific paradigm or an assorted construct of policy aspirations.Originality/valueThe paper questions the rigour and trajectory of integration practice, policy and research. It identifies a tension at the centre of the field between group commitments to scientific exemplars (case studies) and symbolic generalisations, encapsulated in the desire to improve patient care. The notion of a scientific paradigm thus helps to re-frame the discussion about research and practice in integration.