bluuebunny/crossref_metadata_2025 huggingface dataset:
Fantasias on a Theme by Walt Disney
Authors: Summers Tim
Published: March 2021

This chapter investigates listening to music in video games by proposing a model of “playful listening” to show how music creates domains of musical play. The chapter uses case studies of three games all based on Walt Disney’s Fantasia (1940/1999) films: Atari 2600 (1983), Sega Mega Drive/Genesis (1991), Microsoft Xbox Kinect (2014). Each Fantasia game highlights these fields of musical play in different ways. Games like the Fantasia titles make obvious how listening to music can be playful (even outside games). When we listen for how music “plays out,” we are engaging with the implied possibilities of the music, its “potential to be otherwise”; the music generates a field of potential sounding forms, only one of which is realized and fulfilled in performance. Games, and these games in particular, encourage us to listen playfully, and to enjoy the dynamic relationships of listening, in-game and outside, on-screen and off.
Music and the Use of the Profits of the Anglo-American Slave Economy (ca. 1610–c. 1810)
Authors: Hunter David
Published: March 2021

During the era of the Anglo-American slave trade ca. 1610–ca. 1810, music itself offered few opportunities for immense financial gain. By contrast, the slave trade (transatlantic, intra-coastal, and local) and the use of slave labor (not just on plantations but also in manufacturing, small businesses, and domestically) provided profits to owners who put some of that surplus into fostering musical activities such as purchasing lessons, instruments, and scores; subscribing to opera and concert seasons; hiring musicians; and even buying a musical prodigy—Muzio Clementi—from his father in Rome. In addition to considering the opportunities afforded individual owners and families by slave-derived wealth, this chapter brings to the fore theories of the commercialization of consumption, capitalism, and the development of empire. It points to the use of slave-related products such as ivory on musical instruments. It demonstrates how significant slavery’s investors were to the establishment of the Royal Academy of Music in London, the first opera company to be chartered as a business. It identifies professional and amateur musicians who were slave owners. These previously unknown or disregarded links between slavery and the musical world of the nascent British empire are laid bare for the first time.
Confucianism and Intergenerational Ethics
Authors: Hourdequin Marion , Wong David B.
Published: March 2021

This chapter explains how early Confucianism can ground a distinctly relational perspective on intergenerational ethics. The Analects of Confucius foregrounds intergenerational relations by rooting ethics in relationships between parents and children and presenting as moral exemplars sage-kings from generations ago. From a Confucian point of view, persons are understood as persons-in-relation, embedded in networks of connection across space and time. Self-cultivation thus involves taking one’s place in a community where one’s own identity and welfare are deeply bound to those of others. In this view, gratitude and reciprocity emerge as central values. A Confucian understanding of gratitude and reciprocity involves not only dyadic relations but broader connections within a temporally extended social web. Thus, Confucian reciprocity might involve honoring one’s parents by nurturing one’s own children in turn or expressing gratitude for what past generations have provided by ensuring that future generations can flourish. Genuine ethical relations between current and future generations reflect care and concern for ongoing human communities; for the triad of heaven, earth, and humanity; and for realization of the Dao in the world.
A History of Biblical Interpretation in China
Authors: Yieh John Y. H.
Published: March 2021

Since its first Protestant translation by Robert Morrison in 1823, the Chinese Bible has been earnestly used for devotional and apologetical purposes by Chinese Christians. This essay discusses why it is necessary to construct a history of biblical interpretation in China now and suggests how best to conceive it and what to include. A history of biblical interpretation has historical and hermeneutical value and it may help clarify three elements of “Chinese biblical interpretation.” It can be divided into four stages of development in correlation to the radical changes in national history and the main challenges in church history, to provide proper socio-historical contexts. For basic content, it should assess major interpreters and influential approaches in four settings, i.e. translation, church, society, and universities and discuss four inquiries regarding its reception, interpretation, appropriation, and consequence in China.
The Bible and Calligraphy in China
Authors: Shuai Jeremiah Zhu
Published: March 2021

In China, calligraphy has become an important element of Christian art and Christian localization in the proclamation of the gospel. This essay surveys the history and characteristics of Nestorian, Catholic, and Protestant use and understanding of calligraphy in relation to Scriptures and textual meaning. Since “holy words” have transcendental characteristics in Christianity, and the Chinese language itself is combined with its visual form, so the holy words in the Bible expressed by Chinese calligraphy have an ontological meaning of “incarnation.” To many Chinese Christians, the Chinese people’s aesthetic pursuit of handwriting means that beautiful writing itself reveals and witnesses to God’s glory.
Sacred Images and Space of the Jesuit Churches in Beijing
Authors: Wang Lianming
Published: March 2021

This essay revisits the Jesuit churches in Beijing in order to address both the spatial engagement of Christian sacred images and the way Christian and biblical themes were narrated and perceived in the church space. It first discusses the availability of Christian iconographies and their hierarchical usage in gendered church spaces. It then demonstrates the ways the altarpieces and the trompe l’oeil murals were arranged into defined iconographic programs in the reevaluation of their architectural contexts. Through a close reading of contemporary travel writings, this essay concludes by presenting a larger picture of various types of Christian sacred images in Chinese perceptions of Christianity.
Biblical Ecclesiology and the Chinese Church
Authors: Liu Evan
Published: March 2021

The challenge of the Chinese Church is to explore an innovative and effective operational model of its own. This essay studies the phenomenon of the Chinese Church in mainland China but does not include those in Taiwan, Hong Kong, and Macau. It discusses the complexity of Chinese churches as they have survived and thrived over the centuries and explores the compatibility of Chinese Christians’ religious experiences with the biblical tradition of the church. It surveys the rise, the struggle, the mission, and the hope of the following churches in China: Chinese Three-Self Patriotic Protestant (TSP), Protestant Family Churches, Catholic Churches, and Russian Orthodox Churches.
Chinese Jingjiao and the Antiochene Exegesis
Authors: Zhu Donghua
Published: March 2021

This essay illustrates how the Antiochene approach has been the most central tradition of Chinese Jingjiao theology and exegetics. The Jingjiao-hermeneutical lens continues the legacy of the Antiochene School, evident in its exegesis toward literary, literal, and historical interpretations of the name “Jingjiao 景教” and of the central christological passages of Philippians 2:5–11, where the expression “nap̄šeh sareq” (emptied Himself) was interpreted in the Antiochene way as 戢隱 nap̄šeh tašši (hid Himself). This study also serves to show the Diatessaron’s profound influence upon the Chinese Dunhuang document, Xuting Mishisuo Jing 序聽迷詩所經 (Jesus Messiah Sūtra), and to show the authenticity of this Chinese Diatessaronic text while highlighting its value to the study of Bible versions.
The Islamic State as a Revolutionary Rebel GroupIS’s Governance and Violence in Historical Context
Authors: Stewart Megan A.
Published: March 2021

What role, if any, does religious ideology play in the Islamic State’s (IS) violence and governance strategies? Given the organization’s name alone, the role of religious ideology in the group’s behavior—from challenging its enemies through a combination of violent tactics to undertaking intensive state-building projects—has seemed paramount. This essay, however, argues that the Islamic State’s governance and warmaking strategies are neither unique to the Islamic State nor are they particularly Islamic, as these behaviors are part of revolutionary warfare strategy that crystallized under, and were predominantly implemented by, leftist rebel groups during the Cold War. The Islamic State’s approach is thus a jihadist interpretation of this revolutionary warfare strategy with origins in leftist rebel groups. This essay describes the nature and origins of revolutionary warfare, as well as its spread from leftist and anticolonial movements across ideological categories to jihadist groups. It then demonstrates the parallels in both violence and governance between the Islamic State and Cold War leftist revolutionaries. The essay concludes with a discussion of the role of a religious ideology in terms of the Islamic State’s strategic approach, as well as the implications for jihadist warfare in the future.
Early Miocene Post-collision Andesite in the Takab Area, NW Iran
Authors: Azizi Hossein , Daneshvar Narges , Mohammadi Asrin , Asahara Yoshihiro , Whattam Scott A , Tsuboi Motohiro , Minami Masayo
Published: March 2021

Miocene magmatic rocks are exposed as lava flows (OKV group), subvolcanic rocks (SRG group), and as lavas interbedded with shallow-basin sedimentary layers (TVN group) in the Takab area, NW Iran. Zircon U–Pb dating yields ages of 18 to 15 Ma. Whole-rock chemistry shows that most of the Early Miocene magmatic rocks are andesite with subordinate dacite. The magmatic rocks have low contents of MgO, Ni, Cr, Ti, Nb and Ta, and high concentrations of Li, large ion lithophile elements such as Rb, K and Ba, and light rare earth elements. The OKV and SRG groups have similar initial 87Sr/86Sr ratios (0·70557–0·70768) and εNd(t) values (+1·0 to +2·2). The TVN group show larger variations of 87Sr/86Sr(i) ratios from 0·70628 to 0·71033 and εNd(t) values from –3·8 to +1·6. This implies a greater role of involvement of supra-crustal domains in the evolution of the TVN group relative to the SRG and OKV groups. Early Miocene magmatic rocks in the Takab area are situated between the Sanandaj–Saqqez Cretaceous calc-alkaline andesite in the SW and the Late Eocene–Oligocene (35–27 Ma) ocean island basalt-like Mianeh–Hashtrood magmatic belt of possible back-arc affinity in the NE. In addition, Late Eocene (40–37 Ma) syn-collision granites in the Baneh–Marivan area along the Zagros suture zone along the west side of the Sanandaj–Saqqez Cretaceous calc-alkaline andesite body indicate that collision of the Arabian Plate and the NW Iran Block occurred in the Late Eocene. These observations support the idea that Early Miocene andesites (18–15 Ma) in the Takab area were generated after collision, which was also associated with doubling of the thickness of the continental crust in the Zagros suture zone, thinning of continental crust far from the Zagros suture zone, and development of shallow-basin sedimentary rocks in NW Iran. Partial melting of mafic calc-alkaline bodies at depth or highly metasomatized fossil mantle owing to thinning of continental crust and asthenospheric upwelling may represent possible sources for the Late Miocene andesite. We conclude that andesitic rocks, even with typical arc signatures, are not always generated in an active margin and that some were probably generated in a post-collision tectonic regime. Misinterpretation of the arc signature can result in erroneous assumptions as to the geodynamic regime, and in the particular case of NW Iran, the timing of collision of the Arabian and Iranian plates.
TheArabidopsismediator complex subunit 8 regulates oxidative stress responses
Authors: He Huaming , Denecker Jordi , Van Der Kelen Katrien , Willems Patrick , Pottie Robin , Phua Su Yin , Hannah Matthew A , Vertommen Didier , Van Breusegem Frank , Mhamdi Amna
Published: March 2021

Signaling events triggered by hydrogen peroxide (H2O2) regulate plant growth and defense by orchestrating a genome-wide transcriptional reprogramming. However, the specific mechanisms that govern H2O2-dependent gene expression are still poorly understood. Here, we identify the Arabidopsis Mediator complex subunit MED8 as a regulator of H2O2 responses. The introduction of the med8 mutation in a constitutive oxidative stress genetic background (catalase-deficient, cat2) was associated with enhanced activation of the salicylic acid pathway and accelerated cell death. Interestingly, med8 seedlings were more tolerant to oxidative stress generated by the herbicide methyl viologen (MV) and exhibited transcriptional hyperactivation of defense signaling, in particular salicylic acid- and jasmonic acid-related pathways. The med8-triggered tolerance to MV was manipulated by the introduction of secondary mutations in salicylic acid and jasmonic acid pathways. In addition, analysis of the Mediator interactome revealed interactions with components involved in mRNA processing and microRNA biogenesis, hence expanding the role of Mediator beyond transcription. Notably, MED8 interacted with the transcriptional regulator NEGATIVE ON TATA-LESS, NOT2, to control the expression of H2O2-inducible genes and stress responses. Our work establishes MED8 as a component regulating oxidative stress responses and demonstrates that it acts as a negative regulator of H2O2-driven activation of defense gene expression.
Global Imbalances and Policy Wars at the Zero Lower Bound
Authors: Caballero Ricardo J , Farhi Emmanuel , Gourinchas Pierre-Olivier
Published: March 2021

This article explores the consequences of extremely low real interest rates in a world with integrated but heterogeneous capital markets, nominal rigidities, and an effective lower bound [a zero lower bound (ZLB) for simplicity]. We establish four main results: (1) At the ZLB, creditor countries export their recession abroad, which we illustrate with a new Metzler diagram in quantities; (2) Beggar-thy-neighbour currency and trade wars provide stimulus to the undertaking country at the expense of other countries; (3) (Safe) public debt issuances and increases in government spending anywhere are expansionary everywhere; and (4) When there is a scarcity of safe assets, net issuers of these assets import the recession from abroad.
Influence of carbon fixation on the mitigation of greenhouse gas emissions from livestock activities in Italy and the achievement of carbon neutrality
Authors: De Vivo Roberto , Zicarelli Luigi
Published: March 2021

Among the greenhouse gas emissions due to livestock activities there is, in addition to rumen methane, that which derives from the fermentation and management of manure from farmed animals. To feed the farmed animals, plants are used that fix carbon and therefore subtract carbon dioxide from the atmosphere. The emissions related to rumen fermentations, those related to manure, management, and spreading of animals of species reared in Italy, as well as manure released by grazing animals were quantified and summed. The emissions due to the respiration of animals were calculated and the carbon dioxide fixed by the main crops of zootechnical interest was calculated and then subtracted from the atmosphere. In addition, the emissions from the cultivation of plant species, attributable to the working of the soil, the production of fertilizers and pesticides, electricity, fuels, and the operation of machines, were also taken into account. The results of this elaboration show that in Italy the CO2 fixed in the vegetation cultivated to feed animals is about 10% higher than the sum of that emitted by the animals reared and by the entire process that is part of it. It could therefore be argued that the influence of carbon fixation should probably be taken into account to calculate the environmental impact in terms of carbon footprint of agricultural and animal products. In this way, carbon neutrality would be demonstrated, which characterizes the production processes of agricultural products and animal productions unlike other production cycles.
The balanced life: evolution of ventral shell weighting in gastropods
Authors: Vermeij Geerat J
Published: March 2021

Exaggerated morphologies present challenges for understanding the factors that enable, prevent or compel lineages to evolve unusual functional traits. Here, I examine the case of gastropods whose adult shells are bottom heavy by virtue of a thick, often broad, convex ventral callus deposit on the inner lip and adapical to the aperture. Data on the spatial, temporal and phylogenetic distribution of callus-bearing gastropods were gleaned from the literature and from personal observations on fossil and living gastropods in collections. An exaggerated ventral callus has evolved in ≥ 72 lineages of gastropods, all in warm, shallow waters, beginning in the Late Ordovician but mostly during and after the Late Cretaceous. The phylogenetic distribution of these gastropods is highly clumped, with multiple acquisitions in some clades (e.g. Stromboidea and Buccinoidea) and none in others (e.g. Conoidea). Functional considerations and comparisons indicate that the enhanced gravitational stability provided by a ventral callus evolved only in conditions of low-cost calcification and when predators capable of dislodging or overturning gastropods or causing them to flee were important agents of selection.
Chromosome-Scale Genome Sequence ofAlternaria alternataCausing Alternaria Brown Spot of Citrus
Authors: Gai Yunpeng , Ma Haijie , Chen Yanan , Li Lei , Cao Yingzi , Wang Mingshuang , Sun Xuepeng , Jiao Chen , Riely Brendan K. , Li Hongye
Published: March 2021

Alternaria brown spot (ABS), caused by Alternaria alternata, is an economically important fungal disease of citrus worldwide. The ABS pathogen A. alternata tangerine pathotype can produce a host-specific ACT toxin, which is regulated by ACT toxin gene cluster located in the conditionally dispensable chromosome (CDC). Previously, we have assembled a draft genome of A. alternata tangerine pathotype strain Z7, which comprises 165 contigs. In this study, we report a chromosome-level genome assembly of A. alternata Z7 through the combination of Oxford Nanopore sequencing and Illumina sequencing technologies. The assembly of A. alternata Z7 had a total size of 34.28 Mb, with a GC content of 51.01% and contig N50of 3.08 Mb. The genome is encompassed 12,067 protein-coding genes, 34 ribosomal RNAs, and 107 transfer RNAs. Interestingly, A. alternata Z7 is composed of 10 essential chromosomes and 2 CDCs, which is consistent with the experimental evidences of pulsed-field gel electrophoresis. To our best knowledge, this is the first chromosome-level genome assembly of A. alternata. In addition, a database for citrus-related Alternaria genomes has been established to provide public resources for the sequences, annotation and comparative genomics data of Alternaria spp. The improved genome sequence and annotation at the chromosome level is a significant step toward a better understanding of the pathogenicity of A. alternata. The database will be updated regularly whenever the genomes of newly isolated Alternaria spp. are available. The citrus-related Alternaria genomes database is open accessible through the Citrus Fungal Disease Database.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Reemergence of Septoria Leaf Spot Caused by Septoria cannabis on Hemp in Kentucky
Authors: Rahnama Mostafa , Szarka Desiree , Li Hua , Dixon Ed , Castlebury Lisa , Ward Gauthier Nicole A.
Published: March 2021

Hemp reemerged in 2014 after being illegal for over 50 years and restricted for 90 years. Today, hemp is primarily grown for production of cannabidiol (CBD), with limited acreage dedicated to fiber. One of the most frequent and destructive leaf spot diseases of hemp cultivars grown for CBD is Septoria leaf spot. Symptoms are mostly observed in lower leaves and inner canopy. Leaf spots begin as small, irregular, brown to gray spots that rapidly expand to about 5.0 to 7.5 mm in diameter. Pycnidia are scattered, round, dark brown to black in color, and measure 38.8 to 145.0 μm in diameter. Conidia are hyaline, curved but occasionally straight, pointed at the apex, and contain 3 to 4 septa. Morphological characteristics were similar to those reported for Septoria cannabis. Gene sequences from seven diagnostic loci (elongation factor, β-tubulin, RNA polymerase II, large subunit, internal transcribed spacer, actin, and calmodulin) did not match any published accessions. There are no published sequences for S. cannabis available for comparison. Phylogenetic analysis of concatenated sequences showed that isolates from hemp grouped separately from other Septoria spp. Similarity of morphological characteristics and lack of sequence data matching other Septoria spp. led to the conclusion that isolates collected from hemp in Kentucky are S. cannabis. This new information will serve as an update for Septoria leaf spot diagnostics, especially as hemp acreage continues to increase across the United States.
Safety and Efficacy: Clinical Experience of Venetoclax in Combination With Hypomethylating Agents in Both Newly Diagnosed and Relapsed/Refractory Advanced Myeloid Malignancies
Authors: Feld Jonathan , Tremblay Douglas , Dougherty Mikaela , Czaplinska Tina , Sanchez Gillian , Brady Claudia , Kremyanskaya Marina , Bar-Natan Michal , Keyzner Alla , Marcellino Bridget K. , Gabrilove Janice , Navada Shyamala C. , Silverman Lewis R. , El Jamal Siraj M. , Mascarenhas John , Shih Alan H.
Published: March 2021

Hypomethylating agents (HMAs) in combination with venetoclax have been widely adopted as the standard of care for patients who cannot tolerate induction chemotherapy and for patients who have relapsed/refractory (R/R) acute myeloid leukemia (AML). This study retrospectively analyzed the outcomes of all patients with AML (n = 65) or myelodysplastic syndrome (n = 7) who received the combination of HMA and venetoclax at our institution. Outcomes measured included complete remission (CR) and CR with incomplete hematologic recovery (CRi) rates, duration of response (DOR), and overall survival (OS). Patient mutational profiles and transfusion requirements were also assessed. Of 26 newly diagnosed AML patients, the CR/CRi rate was 53.8%. The median DOR and OS were 6.9 months and not reached, respectively. Of 39 R/R AML patients, the CR/CRi rate was 38.5%. The median DOR and OS were both 8.1 months. Responders to HMA and venetoclax were enriched for TET2, IDH1, and IDH2 mutations, while nonresponders were associated with FLT3 and RAS mutations. Adaptive resistance was observed through various mechanisms including acquired RAS pathway mutations. Of transfusion-dependent patients, 12.2% and 15.2% achieved red blood cell (RBC) and platelet transfusion independence, respectively, while 44.8% and 35.1% of RBC and platelet transfusion independent patients, respectively, became transfusion dependent. In total 59.1% of patients developed a ≥grade 3 infection and 46.5% neutropenic fever. HMA + venetoclax can lead to impressive response rates with moderately durable remissions and survival. However, the benefits of this combination are diminished by the significant toxicities from infection, persistent cytopenias, and transfusion requirements.
Integration of a Lean Daily Management System into an Antimicrobial Stewardship Program
Authors: Wirtz Ann L. , Monsees Elizabeth A. , Gibbs Kate A. , Myers Angela L. , Burns Alaina N. , Lee Brian R. , El Feghaly Rana E. , Weddle Gina M. , Day James C. , Purandare Amol V. , Goldman Jennifer L.
Published: March 2021

Introduction:

Growing demands and limited guidance on efficient use of resources to advance stewardship initiatives challenge antimicrobial stewardship programs (ASP).

Methods:

The primary aim was to incorporate a Lean Readiness and Metrics Board (RMB) into ASP and assess team member accountability and satisfaction with weekly 15-minute huddle participation within 1 year of implementation. ASP team survey data were analyzed for comments regarding Lean integration, team communication, and productivity. The second aim was to develop 5 shared metrics associated with quality, people, delivery, safety, and stewardship and evaluate ASP team productivity by assessing the impact of projects targeted at each specific metric. Pharmacist-physician ASP scheduling conflicts were addressed through identified rounding times under the “People” metric. The “Quality” metric assessed ASP intervention disagreement rate and collaborations that occurred to reduce disagreement. ASP tracked the number of individuals educated by ASP monthly through the “Delivery” metric.

Results:

Since August 2018, ASP replaced hour-long monthly meetings with weekly huddles at the RMB. On average, 14 members (88%) of the ASP participate weekly. Team members report improvement in communication and satisfaction with Lean integration. Metric utilization enhanced productivity. For the metrics under “People,” “Quality,” and “Delivery,” reduced scheduling conflicts occurred, the ASP intervention disagreement rate decreased (37.0%–25.6%; P < 0.001), and the ASP educated an average of 79 learners per month.

Conclusions:

Weekly huddles at the RMB enhanced communication and team accountability while visually displaying program needs, progress, and achievements. The RMB helps to ensure ongoing institutional commitment, and Lean methods show promise for evaluating and improving ASP productivity.
Decreasing Inappropriate Use of Antireflux Medications by Standardizing Gastroesophageal Reflux Disease Management in NICU
Authors: Shakeel Fauzia M. , Crews Jacquelyn , Jensen Preceous , Ritchey Andrea , Allen Megan , Mateus Jazmine , Machry Joana
Published: March 2021

Introduction:

Gastroesophageal reflux (GER) is a functional self-limiting condition in neonates. When pathologic, it is called GER disease (GERD). There are wide variations in the management of signs, symptoms, and complications associated with GERD in the neonatal intensive care unit (NICU). Evidence does not support an empiric trial of GERD medications as a diagnostic tool or therapy in premature infants.

Methods:

A multidisciplinary team developed evidence-based clinical practice guidelines (CPG) for GERD management. Process improvement included developing a GERD management algorithm, electronic order sets, and education for all providers. Multiple plan-do-study-act cycles done.

Results:

Implementation of standardized GERD management guideline, decreased the overall use of antireflux medications from baseline, 15.1%–6.8% [χ2 (1, N = 1259) = 12.98, P < 0.001]. There was elimination of GERD medication use in preterm from baseline of 19.3% [χ2 (1, N = 220) = 12.18, P < 0.001]. The most frequently used GERD medication was lansoprazole, with an incorrect initial dosing rate of 55.0% that deceased to zero [χ2 (1, N = 33) = 10.73, P = 0.001]. Appropriate testing with PH probe with 24-hour multichannel impedance was observed (17.1%–28.0%) identifying patients with correct GERD diagnosis [χ2 (1, N = 101) = 1.41, P = 0.236]. Length of stay for GERD patient’s improved from a median of 89–53 days.

Conclusion:

Standardizing clinical management leads to best practices for GERD management with appropriate diagnostic testing, eliminating incorrect medication dosing, and improved patient safety with value-based outcomes.
Evidence-based Standardization of Constipation Management in the Emergency Department: A Quality Improvement Study
Authors: Lipshaw Matthew J. , Zamor Ronine L. , Carson Rebecca , Mallon Daniel , Sobolewski Brad , Vukovic Adam A. , Kurowski Eileen Murtagh
Published: March 2021

Introduction:

Constipation is a common problem in pediatric patients. Abdominal radiographs (AXRs) are frequently obtained in the pediatric emergency department for diagnosis despite their poor reliability to rule out underlying pathology or prognostic ability to determine the degree of constipation. The goal of this quality improvement (QI) initiative was to standardize the diagnosis and management of constipation in the pediatric emergency department and urgent care in patients ages 6 months to 21 years and decrease AXR use by 20% and sustain this reduction for 12 months.

Methods:

This prospective QI project involved a multidisciplinary team at a large urban pediatric tertiary care center. The study team constructed a key driver diagram and identified interventions, such as creating a standardized evaluation and management algorithm for constipation, using free open-access medical education platforms, incorporating the electronic medical record interface, and expanding educational conferences to include standardized approach and discharge instructions for patients with constipation across all acuity levels. The primary measure of AXR utilization was tracked overtime on a statistical process control chart to evaluate the impact of interventions.

Results:

The percentage of visits for constipation that included an AXR decreased from a baseline of 49.6%–37.1%, a 25% reduction. Length-of-stay, return visits within 7 days, and inpatient admissions remained unchanged by the interventions.

Conclusions:

QI methodology successfully decreased AXR utilization in the evaluation of constipation across a broad spectrum of acuity levels. Further interventions may help to decrease the length of stay and further decrease AXR utilization.
A Fully Automated Pulsating Support System for Pressure Injury Prevention and Treatment in 10 Belgium Nursing Homes
Authors: Raepsaet Charlotte , Zwaenepoel Elien , Manderlier Bénédicte , Van Damme Nele , Verhaeghe Sofie , Van Hecke Ann , Beeckman Dimitri
Published: March 2021

PURPOSE:

We studied pressure injury (PI) stage II-IV cumulative incidence and the change of PI status in the sacral area of nursing home residents associated with the use of a fully automated pulsating support system air mattress in use for 30 days. We also assessed caregivers', residents', and their family members' experiences and perceptions of mattress comfort and other factors such as pain.

DESIGN:

Multicenter cohort study.

SUBJECT AND SETTING:

A convenience sample of 40 residents residing in 10 Belgian nursing homes was recruited.

METHODS:

Pressure injury classification was confirmed using the European Pressure Ulcer Advisory Panel classification system. The Pressure Ulcer Scale for Healing (PUSH) tool was used to assess and measure PI status change. A comfort assessment was performed at end of the study. Cumulative PI incidence of stages II-IV was calculated, and frequencies and percentages were used to describe the results of the comfort assessments.

RESULTS:

Residents were allocated to the prevention group (n = 22) and to the treatment group (n = 18). The cumulative PI incidence was 4.5% (n = 1/22) in the prevention group. In the treatment group, the mean score on the PUSH tool decreased from 9.36 to 7.70 during the observation period, indicating an overall improvement. Four of the existing PIs healed, 17 PIs remained stable, and 1 PI deteriorated. The comfort questionnaires were completed by 76 nursing home caregivers, 21 family members, and 11 residents in the 10 participating nursing homes; the mattress comfort was perceived as very good, and pain was noted to decrease.

CONCLUSIONS:

Low cumulative PI incidence findings were observed with use of the mattress for the prevention of PIs and resulted in improvements in existing PIs, results which are consistent with several existing studies. The majority of the caregivers, residents, and family members evaluated the mattress as comfortable. Future research is needed to corroborate findings in larger randomized clinical trials.
The Microbiome and Metabolome of Malignant Fungating Wounds
Authors: Tilley Charles P. , Fu Mei R. , Qiu Jeanna M. , Comfort Christopher , Crocilla Brooke L. , Li Zujun , Axelrod Deborah
Published: March 2021

PURPOSE:

Malignant fungating wounds (MFWs) afflict up to 14% of patients with advanced cancer. The bacterial community structures of MFW may influence the development and severity of wound symptoms. The purpose of this systematic review was to evaluate existing evidence regarding the relationship between microbiome and symptoms of MFWs.

METHODS:

A systematic review of the published literature from January 1995 to January 2020 was conducted. An established quality assessment tool was used to assess the quality of the included studies.

SEARCH STRATEGY:

We searched 4 major electronic databases and retrieved 724 articles; 7 met inclusion criteria.

FINDINGS/CONCLUSIONS:

Seven studies were included; the overall quality of the included 7 studies was ranked as adequate. Findings from the studies provided an incomplete characterization of the microbiome and metabolome of MFW; none included modern genomic technologies. Twenty different species of aerobes and 14 species of anaerobes were identified, with inconsistent identification of biofilms and multi-drug-resistant bacteria. Symptom occurrence increased with the number of bacteria species (P = .0003) and the presence of at least 1 anaerobe (P = .0006) in malignant wound beds. Cancer wound-derived odor was associated with dimethyl trisulfide and 4 fatty acid volatiles. Periwound and moisture-associated skin damage were associated with higher putrescine levels in exudates.

IMPLICATIONS:

Understanding the role of microbiota of MFW in developing or amplifying the severity of wound symptoms is the first step toward development of more precise and effective topical interventions.
Sir Rex Edward Richards. 28 October 1922—15 July 2019
Authors: Gadian David G.
Published: March 2021

Rex Richards was renowned for his research in the field of nuclear magnetic resonance (NMR). Very early on, in the late 1940s, when NMR was in the domain of physicists, he foresaw that the technique might play an important role in chemistry. He embarked on a highly successful research career in which he combined the design and development of new NMR spectrometers with novel applications, initially in chemistry and subsequently in the biological sciences. One major outcome was the establishment of the Oxford Enzyme Group's NMR research programme. Another was the development of
31
P NMR spectroscopy as a non-invasive method of probing the biochemistry of intact biological tissue. Rex was an outstanding teacher and mentor. He also had highly impressive administrative skills, as recognized through successive appointments at the University of Oxford as head of the Physical Chemistry Department, then warden of Merton College and finally vice-chancellor. He was subsequently appointed director of the Leverhulme Trust and became widely respected in the arts world, as reflected by his remarkable array of committee memberships at the National and Tate Galleries.
The characteristics of nuclear membrane fluctuations in stem cells
Authors: Ghanbarzadeh Nodehi Sedigheh , Shivashankar G. V. , Prost Jacques , Mohammad-Rafiee Farshid
Published: March 2021

We analyse the stem cell nucleus shape fluctuation spectrum obtained from optical confocal microscopy on an hour time scale with 10 s resolution. In particular, we investigate the angular and time dependencies of these fluctuations, define appropriate correlation functions that reveal the fundamentally out of equilibrium nature of the observed fluctuations as well as their global anisotropy. Langevin equations respecting the symmetry of the system allow us to model the damped oscillatory behaviour of the time correlations.
Evaluating how lethal management affects poaching of Mexican wolves
Authors: Louchouarn Naomi X. , Santiago-Ávila Francisco J. , Parsons David R. , Treves Adrian
Published: March 2021

Despite illegal killing (poaching) being the major cause of death among large carnivores globally, little is known about the effect of implementing lethal management policies on poaching. Two opposing hypotheses have been proposed in the literature: implementing lethal management may decrease poaching incidence (killing for tolerance) or increase it (facilitated illegal killing). Here, we report a test of the two opposed hypotheses that poaching (reported and unreported) of Mexican grey wolves (
Canis lupus baileyi
) in Arizona and New Mexico, USA, responded to changes in policy that reduced protections to allow more wolf-killing. We employ advanced biostatistical survival and competing risk methods to data on individual resightings, mortality and disappearances of collared Mexican wolves, supplemented with Bayes factors to assess the strength of evidence. We find inconclusive evidence for any decreases in reported poaching. We also find strong evidence that Mexican wolves were 121% more likely to disappear during periods of reduced protections than during periods of stricter protections, with only slight changes in legal removals by the agency. Therefore, we find strong support for the ‘facilitated illegal killing’ hypothesis and none for the ‘killing for tolerance’ hypothesis. We provide recommendations for improving the effectiveness of US policy on environmental crimes, endangered species and protections for wild animals. Our results have implications beyond the USA or wolves because the results suggest transformations of decades-old management interventions against human-caused mortality among wild animals subject to high rates of poaching.
New forms of structure in ecosystems revealed with the Kuramoto model
Authors: Vandermeer John , Hajian-Forooshani Zachary , Medina Nicholas , Perfecto Ivette
Published: March 2021

Ecological systems, as is often noted, are complex. Equally notable is the generalization that complex systems tend to be oscillatory, whether Huygens' simple patterns of pendulum entrainment or the twisted chaotic orbits of Lorenz’ convection rolls. The analytics of oscillators may thus provide insight into the structure of ecological systems. One of the most popular analytical tools for such study is the Kuramoto model of coupled oscillators. We apply this model as a stylized vision of the dynamics of a well-studied system of pests and their enemies, to ask whether its actual natural history is reflected in the dynamics of the qualitatively instantiated Kuramoto model. Emerging from the model is a series of synchrony groups generally corresponding to subnetworks of the natural system, with an overlying chimeric structure, depending on the strength of the inter-oscillator coupling. We conclude that the Kuramoto model presents a novel window through which interesting questions about the structure of ecological systems may emerge.
Semi-martingale driven variational principles
Authors: Street O. D. , Crisan D.
Published: March 2021

Spearheaded by the recent efforts to derive stochastic geophysical fluid dynamics models, we present a general framework for introducing stochasticity into variational principles through the concept of a semi-martingale driven variational principle and constraining the component variables to be compatible with the driving semi-martingale. Within this framework and the corresponding choice of constraints, the Euler–Poincaré equation can be easily deduced. We show that the deterministic theory is a special case of this class of stochastic variational principles. Moreover, this is a natural framework that enables us to correctly characterize the pressure term in incompressible stochastic fluid models. Other general constraints can also be incorporated as long as they are compatible with the driving semi-martingale.
Genetic structure in the endosymbiont
Breviolum ‘muscatinei’
is correlated with geographical location, environment and host species
Authors: Cornwell Brendan H. , Hernández Luis
Published: March 2021

Corals and cnidarians form symbioses with dinoflagellates across a wide range of habitats from the tropics to temperate zones. Notably, these partnerships create the foundation of coral reef ecosystems and are at risk of breaking down due to climate change. This symbiosis couples the fitness of the partners, where adaptations in one species can benefit the holobiont. However, the scales over which each partner can match their current—and future—environment are largely unknown. We investigated population genetic patterns of temperate anemones (
Anthopleura
spp.) and their endosymbiont
Breviolum ‘muscatinei’
, across an extensive geographical range to identify the spatial scales over which local adaptation is possible. Similar to previously published results, two solitary host species exhibited isolation by distance across hundreds of kilometres. However, symbionts exhibited genetic structure across multiple spatial scales, from geographical location to depth in the intertidal zone, and host species, suggesting that symbiont populations are more likely than their hosts to adaptively mitigate the impact of increasing temperatures.
Mycoplasma pneumoniae co-infection with SARS-CoV-2: A case report
Authors: Chaudhry Rama , Sreenath K. , Vinayaraj E. V. , Sahoo Biswajeet , Vishnu Narayanan M. R. , Kiran K. V. P. Sai , Batra Priyam , Rathor Nisha , Singh Sheetal , Mohan Anant , Bhatnagar Sushma
Published: March 2021

We report co-infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and

Mycoplasma pneumoniae

in a patient with pneumonia in India. Atypical bacterial pathogens causing community-acquired pneumonia may share similar clinical presentations and radiographic features with SARS-CoV-2 making a thorough differential diagnosis essential. The co-infection of SARS-CoV-2 and

M. pneumoniae

is infrequently reported in the literature. Broader testing for common respiratory pathogens should be performed in severe COVID-19 cases to rule out other concurrent infections. Early identification of co-existing respiratory pathogens could provide pathogen-directed therapy, and can save patient lives during the ongoing COVID-19 outbreak.
Meningitis due to Roseomonas in an immunocompetent adolescent
Authors: Waris Rabbia S. , Ballard Melissa , Hong David , Seddik Talal B.
Published: March 2021

Both bacterial and aseptic meningitis can complicate neurosurgery, but they are often difficult to distinguish clinically or by cerebrospinal fluid (CSF) analysis. We present an adolescent with subacute meningitis after neurosurgery, eventually diagnosed with meningitis caused by

Roseomonas mucosa

via 16S rRNA gene sequencing after two negative CSF cultures. He was treated successfully with intravenous meropenem with full recovery. This case shows that distinguishing bacterial from aseptic meningitis is important to allow directed antibiotic therapy. We recommend considering bacterial meningitis in the differential diagnosis of aseptic meningitis complicating neurosurgery, and to perform molecular diagnostics such as bacterial sequencing if the suspicion of bacterial meningitis is high.
Systemic Tissue and Cellular Disruption from SARS-CoV-2 Infection revealed in COVID-19 Autopsies and Spatial Omics Tissue Maps
Authors: Park Jiwoon , Foox Jonathan , Hether Tyler , Danko David , Warren Sarah , Kim Youngmi , Reeves Jason , Butler Daniel J. , Mozsary Christopher , Rosiene Joel , Shaiber Alon , Afshinnekoo Ebrahim , MacKay Matthew , Bram Yaron , Chandar Vasuretha , Geiger Heather , Craney Arryn , Velu Priya , Melnick Ari M. , Hajirasouliha Iman , Beheshti Afshin , Taylor Deanne , Saravia-Butler Amanda , Singh Urminder , Wurtele Eve Syrkin , Schisler Jonathan , Fennessey Samantha , Corvelo André , Zody Michael C. , Germer Soren , Salvatore Steven , Levy Shawn , Wu Shixiu , Tatonetti Nicholas , Shapira Sagi , Salvatore Mirella , Loda Massimo , Westblade Lars F. , Cushing Melissa , Rennert Hanna , Kriegel Alison J. , Elemento Olivier , Imielinski Marcin , Borczuk Alain C. , Meydan Cem , Schwartz Robert E. , Mason Christopher E.
Published: March 2021

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus has infected over 115 million people and caused over 2.5 million deaths worldwide. Yet, the molecular mechanisms underlying the clinical manifestations of COVID-19, as well as what distinguishes them from common seasonal influenza virus and other lung injury states such as Acute Respiratory Distress Syndrome (ARDS), remains poorly understood. To address these challenges, we combined transcriptional profiling of 646 clinical nasopharyngeal swabs and 39 patient autopsy tissues, matched with spatial protein and expression profiling (GeoMx) across 357 tissue sections. These results define both body-wide and tissue-specific (heart, liver, lung, kidney, and lymph nodes) damage wrought by the SARS-CoV-2 infection, evident as a function of varying viral load (high vs. low) during the course of infection and specific, transcriptional dysregulation in splicing isoforms, T cell receptor expression, and cellular expression states. In particular, cardiac and lung tissues revealed the largest degree of splicing isoform switching and cell expression state loss. Overall, these findings reveal a systemic disruption of cellular and transcriptional pathways from COVID-19 across all tissues, which can inform subsequent studies to combat the mortality of COVID-19, as well to better understand the molecular dynamics of lethal SARS-CoV-2 infection and other viruses.
A multi-phase multi-objective dynamic genome-scale model shows different redox balancing among yeast species in fermentation
Authors: Henriques David , Minebois Romain , Mendoza Sebastian , Macías Laura G. , Pérez-Torrado Roberto , Barrio Eladio , Teusink Bas , Querol Amparo , Balsa-Canto Eva
Published: March 2021

Yeasts constitute over 1500 species with great potential for biotechnology. Still, the yeastSaccharomyces cerevisiaedominates industrial applications and many alternative physiological capabilities of lesser-known yeasts are not being fully exploited. While comparative genomics receives substantial attention, little is known about yeasts’ metabolic specificity in batch cultures. Here we propose a multi-phase multi-objective dynamic genome-scale model of yeast batch cultures that describes the uptake of carbon and nitrogen sources and the production of primary and secondary metabolites. The model integrates a specific metabolic reconstruction, based on the consensus Yeast8, and a kinetic model describing the time-varying culture environment. Besides, we proposed a multi-phase multi-objective flux balance analysis to compute the dynamics of intracellular fluxes. We then compared the metabolism ofS. cerevisiaeandS. uvarumstrains in a rich medium fermentation. The model successfully explained the experimental data and brought novel insights into how cryotolerant strains achieve redox balance. The proposed model (along with the corresponding code) provides a comprehensive picture of the main steps occurring inside the cell during batch cultures and offers a systematic approach to prospect or metabolically engineering novel yeast cell factories.

IMPORTANCE

Non-conventional yeast species hold the promise to provide novel metabolic routes to produce industrially relevant compounds and tolerate specific stressors, such as cold temperatures. This work presented and validated the first multi-phase multi-objective genome-scale dynamic model to describe carbon and nitrogen metabolism throughout batch fermentation. To test and illustrate its performance, we considered the comparative metabolism of three yeast strains of the Saccharomyces genus in rich medium fermentation. The study revealed that cryotolerant Saccharomyces species might use the GABA shunt and the production of reducing equivalents as alternative routes to achieve redox balance, a novel biological insight worth being explored further. The proposed model (along with the provided code) can be applied to a wide range of batch processes started with different yeast species and media, offering a systematic and rational approach to prospect non-conventional yeast species metabolism and engineering novel cell factories.