bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive Weight Vector Solving Based on the Summation of Partial Eigenbeams in STAP
Authors: Gong Ziyi , Wang Wanlin , He Yinguang
Published: May 2021

For the side-looking airborne or spaceborne early warning radar, Space-time adaptive processing (STAP) is a well-established technique. The adaptive weight vector can be written in the form of summation that equivalents to the inversion of covariance matrix. In order to reduce the computational complexity of the adaptive weight vector, this paper proposes a modified calculation method based on the weighted sum of partial eigenbeams according to the array model of the radar system. Both the loss of signal-to-interference and noise ratio (LSINR) and adapted patterns are used as performance metrics. Computer simulations verified the effectiveness of the method and its adaptability in traditional full-dimension, fixed-structure reduced dimension STAP.
Electrostatic Signal analysis of rotor UAV
Authors: Xi Chen , Runsheng Wang , Pengfei Li , Wei Wang , Liwei Shao
Published: May 2021

With the rapid growth of unmanned aerial vehicle(UAV) market, incidents of small UAV flying without license or without permission frequently occur, which bring serious hidden dangers to the security of civil airports, sensitive targets and major activities. Rapid and accurate detection and recognition of small UAVs is the basis and premise of countermeasures against small UAVs. However, due to the fact that the production materials of small UAVs are mostly composite materials with good wave-absorbing and wave-penetrating properties and small size, the existing detection technologies such as radar and laser cannot effectively detect the signals of UAVs, so the detection accuracy is very low and the amount of information that can be obtained is small. In this paper, the most typical type of small UAV, rotor UAV, is taken as the research object to study the electrostatic signal of rotor UAV, which provides a theoretical basis for the electrostatic detection of rotor UAV.
Experimental Study on Compressive and Splitting Tensile Strength of Layer Hybrid Steel Fiber Recycled Aggregate Concrete
Authors: Wang Yuying , Tang Jiajun , Hu Jie , An Silong
Published: May 2021

In order to improve the mechanical properties of recycled aggregate concrete, hybrid steel fiber layers were added to recycled aggregate concrete. By changing the number of layers and contents of hybrid steel fibers, compressive and splitting tensile strength tests were carried out on 10 groups of 60 recycled aggregate concrete blocks. The results show that with the increase of the number of layers of hybrid steel fibers, the overall change of compressive strength is not significant, the splitting tensile strength gradually shows an upward trend, and the change of tension-compression ratio is not obvious, but the tension-compression ratio generally increases compared with group RC. With the increase of hybrid steel fiber contents, the compressive strength first increases and then decreases, the splitting tensile strength gradually increases, and the tension-compression ratio first decreases and then increases. After adding hybrid steel fiber layers, the failure of recycled aggregate concrete changes from brittleness to plasticity.
The ‘Pombalino Frontal’ design and its structural efficiency
Authors: Morais António , Fialho Carmo , Santos Lam dos
Published: May 2021

After November 1st, 1755, earthquake which hit and destroyed Lisbon, the Portuguese military architects innovated the constructive techniques and conceived a ‘new construction system’ with anti-seismic characteristics, the so called ‘Pombalino building’, often improperly named ‘pombalino cage’. Inserting in the ‘Pombalino cage’ a vertical ‘frontal’ element, made up of Santo André Crosse’s lattices, impresses the intellectual boldness, at that time, demonstrated by the military architects of the Kingdom, concerning the effectiveness and efficiency of the structural performance of the ‘Pombalino building’. It should be noted that we were in 1755, so the concept of stress and deformation had not yet appeared, and, therefore, mankind did not yet discover the structural calculus theory, so the concepts of bending moment and normal effort were not known at that time. Although they did not know it, the frontal element design suggests their engineers’ designers had an accurate knowledge about the phenomenology involved in their behavior, and, above all, they knew the optimal geometry to achieve structural efficiency to resist rupture of the ‘Pombalino frontal’ when an earthquake occurs. In this article we present structural calculations performed on a ‘frontal pombalino’ standard, used in the ‘Pombalino cage’, which demonstrate that the military architects, who developed the Pombalino system, had not only a perfect understanding of the St. André cross potential, but they also experimented with models to scale, because the ‘pombalino frontal’ geometric dimension is optimized in the plane of structural efficiency.
Impact on patients’ compliance with medication using prepacked blisters for multidrug medical therapy: I-COMPLY Study
Authors: Shah Gautam , Erickson Jessica L , Luxenburg Jennifer , Hu Bo , Reali-Sorrell Michele , Lovelace Rita , Pfoh Elizabeth , Kobaivanova Nana , Brateanu Andrei
Published: May 2021

Purpose

Studies have supported the use of packaging interventions such as pillboxes or blister packs to improve medication adherence but have not evaluated the efficacy of these interventions in a population of low socioeconomic status. The aim of this study was to assess the effect of home-delivered pill packs on medication adherence in a low-income Black American population with Medicaid insurance.

Methods

This study was an open-label, randomized, controlled trial. The patient population studied included 80 patients followed by primary care physicians at the Cleveland Clinic. Patients were randomized to a study group who received delivery of their multidrug medical therapy, defined as a minimum of 4 medications daily, in prepackaged blisters or a control group who obtained their prescriptions from their routine pharmacy.

Results

The primary analysis compared the mean percentage of missed pills between the 2 groups using t-test analysis. The percentage of missed pills in the study group was significantly lower than in the control group (mean [SD]: 3.7% [6.0%] vs 17.4% [16.6%] missed daily pills; P < 0.001). The number of daily missed doses was also significantly lower in the study group (0.3 [0.5] vs 0.7 [0.6]; P = 0.002). Patients were on a mean of 8.1 (SD, 2.3) and 8.1 (SD, 2.6) medications in the study and control groups, respectively (P = 0.96).

Conclusion

Delivery of prepackaged medications in a low-income Black American community was demonstrated to improve medication adherence. The use of prepackaged blisters for medication home delivery is a model that can be utilized on a larger scale for patients on multidrug medical therapy.
Formation and validation of an acute care clinical pharmacist productivity model: Part 2
Authors: Simmons Adrienne , Vest Tyler A , Cicci Jonathan , Clarke Megan , Morbitzer Kathryn A , Valgus John M , Falato Chris , Colmenares Evan W , Vest Mary-Haston , Waldron Kayla M
Published: May 2021

Purpose

The purpose of the project described here was to use the work outputs identified in part 1 of a 2-part research initiative to build and validate an acute care clinical pharmacist productivity model.

Methods

Following the identification of work outputs in part 1 of the project, relative weighting was assigned to all outputs based on the time intensity and complexity of each task. The number of pharmacists verifying an inpatient medication order each day was selected to represent the labor input. A multivariable linear regression was performed to determine the final work outputs for inclusion in the model. Productivity and productivity index values were calculated for each day from July 1, 2018, through June 30, 2019.

Results

Of the 27 work outputs identified via consensus by the clinical pharmacist working team, 17 work outputs were ultimately included in the productivity model. The average productivity during the period July 2018 through June 2019 was derived from the model and will serve as the baseline productivity for acute care clinical pharmacists.

Conclusion

Validated consensus methodology can be useful for engaging clinical pharmacist in decision-making and developing a clinical productivity model. When thoughtfully designed, the model can replace obsolete measures of productivity that do not account for the responsibilities of clinical pharmacists.
A Content Analysis and Population Exposure Estimate Of Guinness Branded Alcohol Marketing During the 2019 Guinness Six Nations
Authors: Barker Alexander B , Bal Jaspreet , Murray Rachael L
Published: May 2021

Aims

To quantify Guinness-related branding in the 2019 Guinness Six Nations Championship.

Methods

Content analysis of Guinness-related branding (‘Guinness’ and the alibi brand ‘Greatness’) was shown during active play throughout all 15 games of the 2019 Guinness Six Nations Championship. The duration of each appearance was timed to the nearest second to provide information on the amount of time that Guinness-related branding was shown on screen. Census data and viewing figures were used to estimate gross and per capita alcohol impressions.

Results

Our coding identified a total of 3719 appearances of two logos of which 3415 (92%) were for ‘Guinness’ and 304 (8%) were for ‘Greatness’. ‘Guinness’ imagery was present for 13,640 s (227.3 min or 3.8 h, 16% of total active play time), ‘Greatness’ was present for 944 s (15.7 min, 1% of total active play time), with a combined total of 14,584 s across all games (243 min or 4.05 h, 17% of active play time). The 15 games delivered an estimated 122.4 billion Guinness-related branded impressions to the UK population, including 758 million to children aged under 16.

Conclusions

Alcohol marketing was highly prevalent during the 2019 Guinness Six Nations Championship and was a significant source of exposure to alcohol marketing and advertising for children, likely influencing youth alcohol experimentation and uptake.
pyconsFold: a fast and easy tool for modeling and docking using distance predictions
Authors: Lamb J , Elofsson A
Published: May 2021

Motivation

Contact predictions within a protein have recently become a viable method for accurate prediction of protein structure. Using predicted distance distributions has been shown in many cases to be superior to only using a binary contact annotation. Using predicted interprotein distances has also been shown to be able to dock some protein dimers.

Results

Here, we present pyconsFold. Using CNS as its underlying folding mechanism and predicted contact distance it outperforms regular contact prediction-based modeling on our dataset of 210 proteins. It performs marginally worse than the state-of-the-art pyRosetta folding pipeline but is on average about 20 times faster per model. More importantly pyconsFold can also be used as a fold-and-dock protocol by using predicted interprotein contacts/distances to simultaneously fold and dock two protein chains.

Availability and implementation

pyconsFold is implemented in Python 3 with a strong focus on using as few dependencies as possible for longevity. It is available both as a pip package in Python 3 and as source code on GitHub and is published under the GPLv3 license. The data underlying this article together with source code are available on github, at https://github.com/johnlamb/pyconsfold.

Supplementary information

Supplementary data are available at Bioinformatics online.
NeuralPolish: a novel Nanopore polishing method based on alignment matrix construction and orthogonal Bi-GRU Networks
Authors: Huang Neng , Nie Fan , Ni Peng , Luo Feng , Gao Xin , Wang Jianxin
Published: May 2021

Motivation

Oxford Nanopore sequencing producing long reads at low cost has made many breakthroughs in genomics studies. However, the large number of errors in Nanopore genome assembly affect the accuracy of genome analysis. Polishing is a procedure to correct the errors in genome assembly and can improve the reliability of the downstream analysis. However, the performances of the existing polishing methods are still not satisfactory.

Results

We developed a novel polishing method, NeuralPolish, to correct the errors in assemblies based on alignment matrix construction and orthogonal Bi-GRU networks. In this method, we designed an alignment feature matrix for representing read-to-assembly alignment. Each row of the matrix represents a read, and each column represents the aligned bases at each position of the contig. In the network architecture, a bi-directional GRU network is used to extract the sequence information inside each read by processing the alignment matrix row by row. After that, the feature matrix is processed by another bi-directional GRU network column by column to calculate the probability distribution. Finally, a CTC decoder generates a polished sequence with a greedy algorithm. We used five real datasets and three assembly tools including Wtdbg2, Flye and Canu for testing, and compared the results of different polishing methods including NeuralPolish, Racon, MarginPolish, HELEN and Medaka. Comprehensive experiments demonstrate that NeuralPolish achieves more accurate assembly with fewer errors than other polishing methods and can improve the accuracy of assembly obtained by different assemblers.

Availability and implementation

https://github.com/huangnengCSU/NeuralPolish.git.

Supplementary information

Supplementary data are available at Bioinformatics online.
Impact of Stress on Job Engagement among Social Workers in Beijing: The Roles of Positive Emotion and Career Resilience
Authors: Zhang Huiping , Zhu Xuanbai , Yu Xiaowen
Published: May 2021

In China, social workers face great at-work stress, job burnout and turnover. Determining how to prevent and alleviate their job burnout and improve their work enthusiasm and engagement has become urgent. Using the affective events theory and challenge stressor-hindrance stressor framework, this study explored the impacts of different types of stressors on job engagement and its associated mechanisms and then examined the protective roles of positive emotion and career resilience. A total of 430 social workers in Beijing were investigated. The unique and combined contribution of the stress components to job engagement has been examined. The results showed that both challenge stressors and hindrance stressors had significantly negative impacts on social workers’ work engagement and positive emotion, and positive emotion had a significant positive influence on work engagement. Positive emotion fully mediated the negative relationship between challenge stressors and work engagement, and partially mediated the negative relationship between hindrance stressors and work engagement. Furthermore, career resilience can buffer the negative influence of challenge stressors on positive emotion.
Disaster Preparedness in Social Work: A Scoping Review of Evidence for Further Research, Theory and Practice
Authors: Boetto Heather , Bell Karen , Ivory Nicola
Published: May 2021

The aim of this study was to understand the extent and nature of social work literature relating to preparedness in the context of natural disasters and to identify the implications for further research, theory and practice. A systematic scoping review explored scholarly databases pertaining to literature about social work and disaster preparedness, between 2000 and 2019; a total of thirty-nine articles met the inclusion criteria. Data were extracted from these articles to map the range and type of literature, and thematic analysis was undertaken to explore aspects of preparedness in greater depth. Analysis revealed a recurring theme regarding the need to foreground preparedness in social work and disaster practice along with recommendations that preparedness be more consistently enacted as an ongoing, localised, dynamic and dialogic process in order to better respond to a diverse range of community needs. Building on these findings, the authors highlight the need to challenge dominant discourses in social work and extend the conceptualisation of the profession in the context of disasters at both the intra- and inter-professional levels. By drawing on transformative, ecosocial approaches, the profession’s contributions to disaster practice, equity and justice in this complex context of global practice can gain visibility.
Biallelic mutations in RNF220 cause laminopathies featuring leukodystrophy, ataxia and deafness
Authors: Sferra Antonella , Fortugno Paola , Motta Marialetizia , Aiello Chiara , Petrini Stefania , Ciolfi Andrea , Cipressa Francesca , Moroni Isabella , Leuzzi Vincenzo , Pieroni Luisa , Marini Federica , Boespflug Tanguy Odile , Eymard-Pierre Eleonore , Danti Federica Rachele , Compagnucci Claudia , Zambruno Giovanna , Brusco Alfredo , Santorelli Filippo M , Chiapparini Luisa , Francalanci Paola , Loizzo Anna Livia , Tartaglia Marco , Cestra Gianluca , Bertini Enrico
Published: May 2021

Leukodystrophies are a heterogeneous group of rare inherited disorders that mostly involve the white matter of the CNS. These conditions are characterized by primary glial cell and myelin sheath pathology of variable aetiology, which causes secondary axonal degeneration, generally emerging with disease progression.

Whole exome sequencing performed in five large consanguineous nuclear families allowed us to identify homozygosity for two recurrent missense variants affecting highly conserved residues of RNF220 as the causative event underlying a novel form of leukodystrophy with ataxia and sensorineural deafness.

We report these two homozygous missense variants (p.R363Q and p.R365Q) in the ubiquitin E3 ligase RNF220 as the underlying cause of this novel form of leukodystrophy with ataxia and sensorineural deafness that includes fibrotic cardiomyopathy and hepatopathy as associated features in seven consanguineous families. Mass spectrometry analysis identified lamin B1 as the RNF220 binding protein and co-immunoprecipitation experiments demonstrated reduced binding of both RNF220 mutants to lamin B1. We demonstrate that RNF220 silencing in Drosophila melanogaster specifically affects proper localization of lamin Dm0, the fly lamin B1 orthologue, promotes its aggregation and causes a neurodegenerative phenotype, strongly supporting the functional link between RNF220 and lamin B1. Finally, we demonstrate that RNF220 plays a crucial role in the maintenance of nuclear morphology; mutations in primary skin fibroblasts determine nuclear abnormalities such as blebs, herniations and invaginations, which are typically observed in cells of patients affected by laminopathies.

Overall, our data identify RNF220 as a gene implicated in leukodystrophy with ataxia and sensorineural deafness and document a critical role of RNF220 in the regulation of nuclear lamina. Our findings provide further evidence on the direct link between nuclear lamina dysfunction and neurodegeneration.
Molecular Epidemiology, Natural History, and Long-Term Outcomes of Multidrug-Resistant Enterobacterales Colonization and Infections Among Solid Organ Transplant Recipients
Authors: Hong Nguyen M , Shields Ryan K , Chen Liang , William Pasculle A , Hao Binghua , Cheng Shaoji , Sun Jonathan , Kline Ellen G , Kreiswirth Barry N , Clancy Cornelius J
Published: May 2021

Background

Multidrug-resistant Enterobacterales (MDR-E), including carbapenem-resistant and third-generation cephalosporin-resistant Enterobacterales (CRE, CefR-E), are major pathogens following solid organ transplantation (SOT).

Methods

We prospectively studied patients who underwent lung, liver, and small bowel transplant from February 2015 through March 2017. Weekly perirectal swabs (up to 100 days post-transplant) were cultured for MDR-E. Whole-genome sequencing (WGS) was performed on gastrointestinal (GI) tract–colonizing and disease-causing isolates.

Results

Twenty-five percent (40 of 162) of patients were MDR-E GI-colonized. Klebsiella pneumoniae was the most common CRE and CefR-E. Klebsiella pneumoniae carbapenemases and CTX-M were leading causes of CR and CefR, respectively. Thirty-five percent of GI colonizers developed MDR-E infection vs 2% of noncolonizers (P < .0001). The attack rate was higher among CRE colonizers than CefR-E colonizers (53% vs 21%, P = .049). GI colonization and high body mass index were independent risk factors for MDR-E infection (P ≤ .004). Thirty-day mortality among infected patients was 6%. However, 44% of survivors developed recurrent infections; 43% of recurrences were late (285 days to 3.9 years after the initial infection). Long-term survival (median, 4.3 years post-transplant) did not differ significantly between MDR-E–infected and MDR-E–noninfected patients (71% vs 77%, P = .56). WGS phylogenetic analyses revealed that infections were caused by GI-colonizing strains and suggested unrecognized transmission of novel clonal group-258 sublineage CR-K. pneumoniae and horizontal transfer of resistance genes.

Conclusions

MDR-E GI colonization was common following SOT and predisposed patients to infections by colonizing strains. MDR-E infections were associated with low short- and long-term mortality, but recurrences were frequent and often occurred years after initial infections. Findings provide support for MDR-E surveillance in our SOT program.
Arginase II protein regulates Parkin-dependent p32 degradation that contributes to Ca2+-dependent eNOS activation in endothelial cells
Authors: Koo Bon-Hyeock , Won Moo-Ho , Kim Young-Myeong , Ryoo Sungwoo
Published: May 2021

Aims

Arginase II (ArgII) plays a key role in the regulation of Ca2+ between the cytosol and mitochondria in a p32-dependent manner. p32 contributes to endothelial nitric oxide synthase (eNOS) activation through the Ca2+/CaMKII/AMPK/p38MAPK/Akt signalling cascade. Therefore, we investigated a novel function of ArgII in the regulation of p32 stability.

Methods and results

mRNA levels were measured by quantitative reverse transcription-PCR, and protein levels and activation were confirmed by western blot analysis. Ca2+ concentrations were measured by FACS analysis and a vascular tension assay was performed. ArgII bound to p32, and ArgII protein knockdown using siArgII facilitated the ubiquitin-dependent proteasomal degradation of p32. β-lactone, a proteasome inhibitor, inhibited the p32 degradation associated with endothelial dysfunction in a Ca2+-dependent manner. The amino acids Lys154, Lys 180, and Lys220 of the p32 protein were identified as putative ubiquitination sites. When these sites were mutated, p32 was resistant to degradation in the presence of siArgII, and endothelial function was impaired. Knockdown of Pink/Parkin as an E3-ubiquitin ligase with siRNAs resulted in increased p32, decreased [Ca2+]c, and attenuated CaMKII-dependent eNOS activation by siArgII. siArgII-dependent Parkin activation was attenuated by KN93, a CaMKII inhibitor. Knockdown of ArgII mRNA and its gene, but not inhibition of its activity, accelerated the interaction between p32 and Parkin and reduced p32 levels. In aortas of ArgII−/− mice, p32 levels were reduced by activated Parkin and inhibition of CaMKII attenuated Parkin-dependent p32 lysis. siParkin blunted the phosphorylation of the activated CaMKII/AMPK/p38MAPK/Akt/eNOS signalling cascade. However, ApoE−/− mice fed a high-cholesterol diet had greater ArgII activity, significantly attenuated phosphorylation of Parkin, and increased p32 levels. Incubation with siArgII augmented p32 ubiquitination through Parkin activation, and induced signalling cascade activation.

Conclusion

The results suggest a novel function for ArgII protein in Parkin-dependent ubiquitination of p32 that is associated with Ca2+-mediated eNOS activation in endothelial cells.
MTDH Promotes Intestinal Inflammation by Positively Regulating TLR Signalling
Authors: Wang Lijuan , Zhang Ning , Han Dianwen , Su Peng , Chen Bing , Zhao Wenjing , Liu Ying , Zhang Hanwen , Hu Guohong , Yang Qifeng
Published: May 2021

Macrophages in the intestinal mucosa can rapidly engage Toll-like receptor [TLR]-mediated inflammatory responses to protect against pathogen invasion, but these same innate immune responses can also drive the induction of colitis. Our previous research revealed that metadherin [MTDH] is overexpressed in multiple cancers and plays vital roles in tumour progression. However, the role of MTDH in intestinal inflammation is largely unknown. In this study, we found the MTDH expression in colonic lamina propria [CLP] macrophages was positively correlated with inflammatory colitis severity. MTDH-/- mice were protected against the symptoms of dextran sodium sulphate [DSS]-induced colitis; however, adoptive transfer of MTDH wild-type [WT] monocytes partially restored the susceptibility of MTDH-/- mice to DSS-induced colitis. TLR stimulation was sufficient to induce the expression of MTDH, whereas the absence of MTDH was sufficient to suppress TLR-induced production of inflammatory cytokines by macrophages. From a mechanistic perspective, MTDH recruited TRAF6 to TAK1, leading to TRAF6-mediated TAK1 K63 ubiquitination and phosphorylation, ultimately facilitating TLR-induced NF-κB and MAPK signalling. Taken together, our results indicate that MTDH contributes to colitis development by promoting TLR-induced pro-inflammatory cytokine production in CLP macrophages and might represent a potential therapeutic approach for intestine inflammation intervention.
Chicago Bees: Urban Areas Support Diverse Bee Communities but With More Non-Native Bee Species Compared to Suburban Areas
Authors: Gruver Andrea , CaraDonna Paul
Published: May 2021

Urbanization is rapidly growing worldwide, yet we still do not fully understand how it affects many organisms. This may be especially true for wild bees that require specific nesting and floral resources and have been threatened by habitat loss. Our study explores the response of wild bee communities to an urbanization gradient in the Chicagoland region of Illinois. Specifically, we explored how both landscape scale impervious surface and local floral diversity across an urbanization gradient influenced 1) the composition of local bee communities, 2) the richness of native and non-native bees, and 3) the composition of bee functional traits. Over the course of our study, we documented 2,331 bees belonging to 83 different species, 13 of which were not native to North America. We found that impervious surface influenced the overall composition of bee communities. In particular, highly urban areas were composed of more non-native bee species and fewer native bee species. Additionally, bee richness and native bee richness responded positively to floral resources. Bee functional trait responses were variable, with floral diverse sites supporting greater richness of ground nesting, eusocial, and generalist bees regardless of landscape-level impervious surface. Importantly, our study provides evidence that urban areas can support diverse bee communities, but urban and suburban bee communities do differ in composition. Thus, bee conservation efforts in urban areas should focus on creating floral diverse habitats to help support more bee species, specifically native bee species, while also considering which bees are best supported by these conservation efforts.
ST-segment elevation myocardial infarction with normal coronary arteries secondary to anterior communicating cerebral artery aneurysmal rupture: a case report
Authors: Lwin Tin Sanda , Mitrakrishnan Rayno Navinan , Farooq Mohisin , Alama Mohamed
Published: May 2021

Background

Myocardial infarction (MI) with non-obstructive coronary arteries presenting with ST-segment elevation can be challenging. Understanding the cardiac and non-cardiac causes aid in identifying the underlying diagnosis and deciding on the management. Neurological insult resulting in a mismatch of oxygen supply or demand to cardiomyocytes can lead to type 2 MI. Acute brain injury, such as intracranial haemorrhage, can induce cardiac dysfunction secondary to brain–heart interaction via hypothalamic–pituitary–adrenal axis and catecholamine surge.

Case summary

A 50-year-old Caucasian male who vaped cannabis presented with epileptic seizures. A Glasgow coma scale of 7/15 necessitated urgent intubation. Electrocardiogram showed ST-segment elevation in inferior leads. Computed tomography of the head suggested intracerebral haemorrhage. He was stabilized in the intensive care unit (ICU). Subsequent imaging confirmed anterior communicating cerebral artery aneurysm and haematoma. Echocardiogram showed severe left ventricular dysfunction and hypokinesia in the left circumflex (LCx) territory. After step down from ICU, cardiac magnetic resonance imaging revealed transmural MI and myocardial oedema at LCx territory. Coronary angiogram was normal. Patient was treated with Levetiracetam and heart failure regimen. A cardiac defibrillator was implanted for secondary prevention and he was scheduled for elective neurosurgical intervention. A follow-up outpatient echocardiogram was normal.

Discussion

Myocardial infarction with non-obstructive coronary arteries is uncommon. Though the majority is due to either plaque disruption or myocarditis, non-cardiac causes, such as acute neurological insults and substance use, should be considered. Scrutinizing the clinical presentation and using a meticulous approach with appropriate investigations are required to reach the correct diagnosis and appropriate management.
Right aortic arch forming a true vascular ring: a clinical review
Authors: Biermann Daniel , Holst Theresa , Hüners Ida , Rickers Carsten , Kehl Torben , Rüffer André , Sachweh Jörg S , Hazekamp Mark G
Published: May 2021

OBJECTIVES

This review aims at presenting and summarizing the current state of literature on the presentation and surgical management of a right-sided aortic arch with a left-sided ligamentum forming a complete vascular ring around the oesophagus and trachea.

METHODS

A systematic database search for appropriate literature was conducted on PubMed/MEDLINE. Articles were considered relevant when providing details on the presentation, diagnosis and surgical treatment of this specific congenital arch anomaly in human beings.

RESULTS

Affected patients present with respiratory and/or oesophageal difficulties due to tracheoesophageal compression. Conservative treatment might be reasonable in asymptomatic or mildly symptomatic cases; however, once moderate-to-severe symptoms develop, surgical intervention is definitely indicated. Surgery is commonly performed through a left thoracotomy or median sternotomy and includes the division of the left ductal ligamentum; if a Kommerell's diverticulum is present that is >1.5 times the diameter of the subclavian artery, then concomitant resection of the large diverticulum and translocation of the aberrant left subclavian artery is also conducted. Postoperative morbidity and mortality are low and are rather related to concomitant intracardiac and extracardiac anomalies than to the procedure itself. In a majority of patients, full resolution of symptoms is seen within months to years from the surgery. Nevertheless, there is also a subset of patients who remain with some tracheobronchial narrowing, sometimes even requiring reintervention during follow-up due to persisting or recurring symptoms.

CONCLUSIONS

Overall, the surgical management of a right aortic arch forming a true vascular ring in infancy, childhood and adulthood seems relatively safe and effective in providing symptomatic relief despite some persistent tracheobronchial and/or oesophageal narrowing in some cases.
Intraoperative transit-time flow measurement and high-frequency ultrasound in coronary artery bypass grafting: impact in off versus on-pump, arterial versus venous grafting and cardiac territory grafted
Authors: Rosenfeld Ethan S , Trachiotis Gregory D , Napolitano Michael A , Sparks Andrew D , Wendt Daniel , Kieser Teresa M , Puskas John D , DiGiammarco Gabriele , Taggart David P
Published: May 2021

OBJECTIVES

Despite society guideline recommendations, intraoperative high-frequency ultrasound (HFUS) and transit-time flow measurement (TTFM) use in coronary artery bypass grafting (CABG) has not been widely adopted worldwide. This retrospective review of the REQUEST (REgistry for QUality assESsmenT with Ultrasound Imaging and TTFM in Cardiac Bypass Surgery) study assesses the impact of protocolled high-frequency ultrasound/TTFM use in specific technical circumstances of CABG.

METHODS

Three REQUEST study sub-analyses were examined: (i) For off-pump (OPCAB) versus on-pump (ONCAB) procedures: strategy changes from preoperative plans for the aorta, conduits, coronary targets and graft revisions; and for all REQUEST patients, revision rates in: (ii) arterial versus venous grafts; and (iii) grafts to different cardiac territories.

RESULTS

Four hundred and two (39.6%) of 1016 patients undergoing elective isolated CABG for multivessel disease underwent OPCAB procedures. Compared to ONCAB, OPCAB patients experienced more strategy changes regarding the aorta [14.7% vs 3.4%; odds ratios (OR) = 4.03; confidence interval (CI) = 2.32–7.20], less regarding conduits (0.2% vs 2.8%; OR = 0.09; CI = 0.01–0.56), with no differences in coronary target changes or graft revisions (4.1% vs 3.5%; OR = 1.19; CI = 0.78–1.81). In all REQUEST patients, revisions were more common for arterial versus venous grafts (4.7% vs 2.4%; OR = 2.05; CI = 1.29–3.37), and inferior versus anterior (5.1% vs 2.9%; OR = 1.77; CI = 1.08–2.89) and lateral (5.1% vs 2.8%; OR = 1.83; CI = 1.04–3.27) territory grafts.

CONCLUSIONS

High-frequency ultrasound/TTFM use differentially impacts strategy changes and graft revision rates in different technical circumstances of CABG. Notably, patients undergoing OPCAB experienced 4 times more changes related to the ascending aorta than ONCAB patients. These findings may indicate where intraoperative assessment is most usefully applied.

Clinical trial registration number

ClinicalTrials.gov: NCT02385344
The impact of guidance on the supply of codeine-containing products on their use in intentional drug overdose
Authors: Birchall Emma , Perry Ivan J , Corcoran Paul , Daly Caroline , Griffin Eve
Published: May 2021

Background

Concerns about the misuse of codeine led to the introduction of guidance restricting the supply of over-the-counter (OTC) codeine-containing products in Ireland in 2010. The aim of this study was to examine the impact of this guidance on the national rate of hospital-presenting self-harm involving codeine-related intentional drug overdose (IDO).

Methods

Presentations involving IDO to Irish general hospitals between 1 January 2007 and 31 December 2013, as recorded by the National Self-Harm Registry Ireland, were analyzed. Event-based rates per 100 000 were calculated using national population data. Poisson regression models were used to assess rate changes between pre- and post-guidance periods and to calculate excess presentations.

Results

Between January 2007 and December 2013, a total of 57 759 IDOs were recorded, with 4789 (8.3%) involving a codeine-containing product. The rate of codeine-related IDOs was 20% lower in the period following implementation of the guidance (incidence rate ratio: 0.80; 95% CI: 0.75 to 0.85), representing a total of 509 (95% CI: −624, −387) fewer codeine-related IDOs in that period. Reductions were observed across all ages and were more pronounced for females (0.76, 0.71 to 0.82) than males (0.87, 0.79 to 0.97). The rate of IDOs involving other drugs decreased by 3% in the same period (0.97, 0.95 to 0.98).

Conclusion

Our findings indicate that the rate of codeine-related IDOs was significantly lower in the period following the implementation of the guidance. There is a large body of evidence supporting the restriction of potentially harmful medication as an effective strategy in suicide prevention.
Effects of patient education to reduce antibiotic prescribing rates for upper respiratory infections in primary care
Authors: McNicholas Michelle , Hooper Gwendolyn
Published: May 2021

Background

Antibiotic stewardship programs in primary care are necessary to reduce the estimated 30% of inappropriately written antibiotic prescriptions and reduce the spread of microbial resistance. Most programs focus on educating prescribers, but this intervention focused on educating patients.

Objectives

To develop and implement an antibiotic stewardship program in a primary care clinic to educate patients with upper respiratory infections (URIs) about antibiotic use and to assess the effectiveness of the program through antibiotic prescribing rates.

Methods

Using materials from the Centers for Disease Control and Prevention (CDC) Be Antibiotics Aware program, posters on antibiotic use were placed in the exam rooms, graphic interchange formats (GIFs) and memes were displayed on exam room monitors, patient–provider discussions on antibiotic use were held, and written information for symptom management of URIs was provided. Retrospective chart reviews were conducted to assess antibiotic prescribing rates by four prescribers in a primary care clinic for September and October 2020 and compared to the same time period for 2019.

Results

The rate of total antibiotic prescriptions decreased by 12.6% (P = 0.044) and the rate of repeat consultation antibiotic prescriptions decreased by 12.2% (P = 0.007), whereas the rate of antibiotics prescribed at the time of the visit remained unchanged (P = 0.937). All providers had decreased rates of antibiotic prescribing after the intervention.

Conclusion

Results of this study indicate that providing education about antibiotics to patients in need of treatment for URIs may reduce the rate of antibiotics prescribed in primary care; however, further research is warranted.
Back to the Future: Reintegrating Biology to Understand How Past Eco-evolutionary Change Can Predict Future Outcomes
Authors: Thompson Cynthia L , Alberti Marina , Barve Sahas , Battistuzzi Fabia U , Drake Jeana L , Goncalves Guilherme Casas , Govaert Lynn , Partridge Charlyn , Yang Ya
Published: May 2021

During the last few decades, biologists have made remarkable progress in understanding the fundamental processes that shape life. But despite the unprecedented level of knowledge now available, large gaps still remain in our understanding of the complex interplay of eco-evolutionary mechanisms across scales of life. Rapidly changing environments on Earth provide a pressing need to understand the potential implications of eco-evolutionary dynamics, which can be achieved by improving existing eco-evolutionary models and fostering convergence among the sub-fields of biology. We propose a new, data-driven approach that harnesses our knowledge of the functioning of biological systems to expand current conceptual frameworks and develop corresponding models that can more accurately represent and predict future eco-evolutionary outcomes. We suggest a roadmap toward achieving this goal. This long-term vision will move biology in a direction that can wield these predictive models for scientific applications that benefit humanity and increase the resilience of natural biological systems. We identify short, medium, and long-term key objectives to connect our current state of knowledge to this long-term vision, iteratively progressing across three stages: (1) utilizing knowledge of biological systems to better inform eco-evolutionary models, (2) generating models with more accurate predictions, and (3) applying predictive models to benefit the biosphere. Within each stage, we outline avenues of investigation and scientific applications related to the timescales over which evolution occurs, the parameter space of eco-evolutionary processes, and the dynamic interactions between these mechanisms. The ability to accurately model, monitor, and anticipate eco-evolutionary changes would be transformational to humanity’s interaction with the global environment, providing novel tools to benefit human health, protect the natural world, and manage our planet’s biosphere.
Tradition and Innovation: The Samādhi of Naraharināth Yogī in Mṛgasthalī (Nepal) in Historical Context
Authors: Bühnemann Gudrun
Published: May 2021

In 2003 Naraharināth Yogī passed away at the Gorakhnāth Maṭha in Mṛgasthalī, a forested hill across from the sacred Paśupatināth temple in Kathmandu. Naraharināth was a prominent figure among the Nāth (sometimes called Kānphaṭā) Yogīs, a predominantly Śaiva ascetic movement in India and Nepal. Three years after his demise a memorial was inaugurated for him above the place where he was interred. The commemorative space, which has been expanding over the years, incorporates traditional features but is innovative in its layout. In this article I will trace the development of this single burial monument (samādhi) and compare it to the structures of other Nāth burials.
Value Factors, Capture Prices and Cannibalism: nightmares for renewable energy decision-makers
Authors: Blume-Werry Eike , Huber Claus , Resch Gustav , Haas Reinhard , Everts Martin
Published: May 2021

Renewable energy sources increasingly seek to compete in electricity markets outside of traditional support schemes. In this context, market values and the cannibalization risks of wind and solar photovoltaic (PV) take on crucial roles for investment decisions and potential investors. Most existing studies analyse the market value of renewables at different penetration levels, looking at the extent to which PV panels and wind turbines cannibalize their own market revenues. This article explores how other market and policy drivers affect wind and PV value factors and capture prices in real-world settings over the next three decades. To this end, we model and analyse a number of scenarios with altered natural gas, coal and carbon prices as well as varied availabilities of wind and PV in Europe. We find that higher natural gas and carbon prices result in lower wind and PV value factors and vice versa, while the influence of coal prices is rather limited. Our results show substantial merit order effects on absolute wind and PV capture prices, following varied availabilities yet no significant cross-cannibalization between the two technologies.
The EDGE–CALIFA survey: central molecular gas depletion in AGN host galaxies – a smoking gun for quenching?
Authors: Ellison Sara L , Wong Tony , Sánchez Sebastian F , Colombo Dario , Bolatto Alberto , Barrera-Ballesteros Jorge , García-Benito Rubén , Kalinova Veselina , Luo Yufeng , Rubio Monica , Vogel Stuart N
Published: May 2021

Feedback from an active galactic nucleus (AGN) is often implicated as a mechanism that leads to the quenching of galactic star formation. However, AGN-driven quenching is challenging to reconcile with observations that AGN hosts tend to harbour equal (or even excess) amounts of gas compared with inactive galaxies of similar stellar mass. In this paper, we investigate whether AGN feedback happens on sub-galactic (kpc) scales, an effect that might be difficult to detect with global gas measurements. Using kpc-scale measurements of molecular gas ($\Sigma _{\rm H_2}$) and stellar mass (Σ⋆) surface densities, taken from the Extragalactic Data base for Galaxy Evolution–Calar Alto Legacy Integral Field Area survey, we show that the gas fractions of central AGN regions are typically a factor of ∼ 2 lower than those in star-forming regions. Based on four galaxies with the best spaxel statistics, the difference between AGN and star-forming gas fractions is seen even within a given galaxy, indicating that AGN feedback is able to deplete the molecular gas reservoir in the central few kpc.
Altering transcription factor binding reveals comprehensive transcriptional kinetics of a basic gene
Authors: Popp Achim P , Hettich Johannes , Gebhardt J Christof M
Published: May 2021

Transcription is a vital process activated by transcription factor (TF) binding. The active gene releases a burst of transcripts before turning inactive again. While the basic course of transcription is well understood, it is unclear how binding of a TF affects the frequency, duration and size of a transcriptional burst. We systematically varied the residence time and concentration of a synthetic TF and characterized the transcription of a synthetic reporter gene by combining single molecule imaging, single molecule RNA-FISH, live transcript visualisation and analysis with a novel algorithm, Burst Inference from mRNA Distributions (BIRD). For this well-defined system, we found that TF binding solely affected burst frequency and variations in TF residence time had a stronger influence than variations in concentration. This enabled us to device a model of gene transcription, in which TF binding triggers multiple successive steps before the gene transits to the active state and actual mRNA synthesis is decoupled from TF presence. We quantified all transition times of the TF and the gene, including the TF search time and the delay between TF binding and the onset of transcription. Our quantitative measurements and analysis revealed detailed kinetic insight, which may serve as basis for a bottom-up understanding of gene regulation.
Fiscal multipliers in a small open economy: the case of Austria
Authors: Čapek Jan , Crespo Cuaresma Jesús , Holler Johannes , Schuster Philip
Published: May 2021

We estimate fiscal multipliers for Austria in a framework of model uncertainty emanating from the choice of a particular econometric model. We present a comprehensive framework that allows to assess the effects of different multiplier definitions and choices related to the data, the model employed, and further technical choices associated with the specification of the model exert on fiscal multiplier estimates. The mean present-value government spending multiplier over all models entertained, based on around 3,000 estimates, is 0.68. Estimates of the peak spending multiplier for Austria tend to be larger than present-value spending multipliers, with a mean value of 0.85. The magnitude of the present-value tax multiplier is relatively high, with an average value across specifications of −1.12 and the mean peak tax multiplier is −0.54 for all specifications used.
Dry season intensity has equivocal effects on the nutritional condition of understory birds in a Neotropical forest
Authors: Nishikawa Elise T , Pollock Henry S , Brawn Jeffrey D
Published: May 2021

Rainfall regime, the amount and timing of annual precipitation, can influence the breeding phenology, individual fitness, and population dynamics of tropical birds. In Neotropical regions with rainfall seasonality (i.e. wet and dry seasons), the warm phase of the El Niño Southern Oscillation (ENSO) can exacerbate seasonal drought and negatively impact avian survival and reproduction. However, the mechanisms underlying associations between seasonal drought conditions and avian demography are largely unexplored. One hypothesis is that nutritional condition mediates demographic responses to seasonal drought: individuals in poor condition may be less capable of balancing their energy budgets and consequently suffer reduced survival, lower reproductive output, or both. We estimated nutritional condition (i.e. scaled mass index, percent hematocrit, plasma lipid metabolites) as a proxy of energy balance in understory forest birds with contrasting population-level responses to dry season length. This study took place across two dry seasons of differing intensity in central Panama: an El Niño dry season (2016, severe drought) and a more typical dry season (2017). Scaled mass index remained relatively constant throughout both dry seasons and across years for 5 common focal species and among 4 foraging guilds (22 additional species, 27 species total). Three of 5 focal species did exhibit reduced nutritional condition (i.e. lower hematocrit and/or higher β-hydroxybutyrate) during the El Niño dry season but not during the more typical dry season. However, foraging guilds did not show consistent nutritional responses to seasonal drought and we found little evidence of the reduced nutritional condition at the guild level, suggesting that many Neotropical forest bird species are capable of tolerating seasonal drought.