bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective cohort study of bedroom heating and risk of common cold in children
Authors: Ishimaru Tomohiro , Mine Yuko , Odgerel Chimed‐Ochir , Miyake Fuyu , Kubo Tatsuhiko , Ikaga Toshiharu , Fujino Yoshihisa
Published: April 2021

Background

In countries with mild winter climates and inadequate heating, the relationship between housing conditions and health outcomes in winter have not been well studied. The purpose of the present study was to evaluate the relationship between heater type and temperature factors in the bedroom and incidence of the common cold among children in Japan.

Methods

In this prospective cohort study, we distributed baseline questionnaires and temperature loggers in December 2019 and administered follow‐up questionnaires in March 2020. We recruited children under the age of 15 years. We performed Poisson regression analysis and logistic regression analysis.

Results

Of 297 participants, air conditioners were the most prevalent (n = 105, 35%), followed by gas or kerosene heaters (n = 50, 17%), and floor heaters (n = 31, 10%). Air‐conditioners were associated with higher incidence of all events related to the common cold, especially having a fever (adjusted incidence rate ratio (aIRR) = 1.84, 95% confidence interval (CI): 1.41–2.40). Gas or kerosene and floor heaters showed a lower incidence rate of some events related to the common cold, such as school or nursery school absence (aIRR = 0.55, 95% CI: 0.37–0.82 and aIRR = 0.39, 95% CI: 0.23–0.67, respectively). Bedroom temperature did not show a positive association, but children who always felt cold showed a higher incidence of some events related to the common cold.

Conclusions

Our findings imply that the heating approach and modal thermal comfort, such as location of heating appliances, humidity, airflow, and radiant heat, may be more important for the onset of common cold in children than bedroom temperature itself.
Do Citizens Want Something for Nothing? Mass Attitudes and the Federal Budget
Authors: Tuxhorn Kim‐Lee , D'Attoma John , Steinmo Sven
Published: April 2021

Prior research has shown that citizens demand more public spending for government services but are unwilling to support tax increases to cover the increased costs. Yet the basis for this observed inconsistency in fiscal preferences remains unclear. Some scholars propose that the desire “something for nothing” could be the result of citizens lacking knowledge about taxation, public spending, and the inherent trade‐offs between the two sides of the ledger, while others suggest that citizens sincerely want the benefits without paying the costs. This article contributes to the literature by studying citizens' fiscal priorities under the condition of near‐complete information about the U.S. federal budget. We used an online budget simulation—based on the actual U.S. federal budget—to provide respondents with information about the structure of the federal budget and gather data on their preferred changes in the budget. Further, we conducted a population‐based survey and found that respondents express preferences that are more nuanced—and more coherent—than previously suggested.

Related Articles

Ariely, Gal. 2011. “Why People (Dis)Like the Public Service: Citizen Perception of the Public Service and the NPM Doctrine.” Politics & Policy 39 (6): 997‐1019. https://doi.org/10.1111/j.1747‐1346.2011.00329.x

Fisher, Patrick. 2008. “The Partisan Foundations of Balanced Budget Politics.” Politics & Policy 33 (4): 617‐641. https://doi.org/10.1111/j.1747‐1346.2005.tb00216.x

Smith, Robert W. 2008. “The Courage to Tax: Rational Choice versus State Budgetary Politics in the South.” Politics & Policy 32 (4): 636‐659. https://doi.org/10.1111/j.1747‐1346.2004.tb00199.x
In vivo functional analysis of the structural domains of FLUORESCENT (FLU)
Authors: Hou Zhiwei , Pang Xiaoqing , Hedtke Boris , Grimm Bernhard
Published: April 2021

The control of chlorophyll (Chl) synthesis in angiosperms depends on the light‐operating enzyme protochlorophyllide oxidoreductase (POR). The interruption of Chl synthesis during darkness requires suppression of the synthesis of 5‐aminolevulinic acid (ALA), the first precursor molecule specific for Chl synthesis. The inactivation of glutamyl‐tRNA reductase (GluTR), the first enzyme in tetrapyrrole biosynthesis, accomplished the decreased ALA synthesis by the membrane‐bound protein FLUORESCENT (FLU) and prevents overaccumulation of protochlorophyllide (Pchlide) in the dark. We set out to elucidate the molecular mechanism of FLU‐mediated inhibition of ALA synthesis, and explored the role of each of the three structural domains of mature FLU, the transmembrane, coiled‐coil and tetratricopeptide repeat (TPR) domains, in this process. Efforts to rescue the FLU knock‐out mutant with truncated FLU peptides revealed that, on its own, the TPR domain is insufficient to inactivate GluTR, although tight binding of the TPR domain to GluTR was detected. A truncated FLU peptide consisting of transmembrane and TPR domains also failed to inactivate GluTR in the dark. Similarly, suppression of ALA synthesis could not be achieved by combining the coiled‐coil and TPR domains. Interaction studies revealed that binding of GluTR and POR to FLU is essential for inhibiting ALA synthesis. These results imply that all three FLU domains are required for the repression of ALA synthesis, in order to avoid the overaccumulation of Pchlide in the dark. Only complete FLU ensures the formation of a membrane‐bound ternary complex consisting at least of FLU, GluTR and POR to repress ALA synthesis.
Canine presumed glial brain tumours treated with radiotherapy: Is there an inferior outcome in tumours contacting the subventricular zone?
Authors: Rohrer Bley Carla , Staudinger Chris , Bley Tim , Marconato Laura , Sabattini Silvia , Beckmann Katrin
Published: April 2021

Post‐treatment outcome in canine glial tumours is described with a broad range of survival times between 2 and 28 months. After surgery or radiation therapy, the tumours may progress locally or spread within the central nervous system. It is unknown if tumour‐ or patient‐specific factors influence prognosis. In humans, glioblastoma involving the subventricular zone has been found to recur distantly, with shortened time to progression and overall survival. We included 32 dogs irradiated for a presumptive primary glial brain tumour in this retrospective cohort study. Tumours were grouped relative to subventricular zone contact and overt ventricular invasion assessing pre‐treatment magnetic resonance images. Median time to progression (TTP) for all cases was 534 days (95%CI, 310–758), with a significantly shorter TTP in dogs with lesions at the subventricular zone (median TTP, 260 vs. 687 days; p = .049). Tumours at the subventricular zone progressed more often (p = .001), and more likely as CNS‐metastasis (52.9% vs. 13.3%, p = .028). Median overall survival (OS) was 489 days (95%CI, 147–831) and median tumour‐specific survival 609 days (95%CI, 382–835). Involvement of the subventricular zone was significantly associated with a shorter tumour‐specific survival (median, 306 vs. 719 days; p = .044). Glial tumours contacting the subventricular zone in dogs have a shorter tumour‐specific survival and a higher rate of progression and CNS‐metastasis. Despite local tumour control, metastasis must be considered and should prompt further treatment approaches.
Biofilm Dispersal for Spore Release in Bacillus subtilis
Authors: Kovács Ákos T. , Stanley-Wall Nicola R.
Published: April 2021

The dispersal of bacterial cells from a matured biofilm can be mediated either by active or passive mechanisms. In this issue of the
Journal of Bacteriology
, Nishikawa and Kobayashi demonstrate that the presence of calcium influences the dispersal of spores from the pellicle biofilm of
Bacillus subtilis
(M.
Clinical Evaluation of a Novel Point-of-Care Assay To Detect Mycoplasma pneumoniae and Associated Macrolide-Resistant Mutations
Authors: Kakiuchi Toshihiko , Miyata Ippei , Kimura Reiji , Shimomura Goh , Shimomura Kunihisa , Yamaguchi Satoru , Yokoyama Takato , Ouchi Kazunobu , Matsuo Muneaki
Published: April 2021

The recent increase in macrolide-resistant
Mycoplasma pneumoniae
in Asia has become a continuing problem. A point-of-care testing method that can quickly detect
M. pneumoniae
and macrolide-resistant mutations (MR mutations) is critical for proper antimicrobial use.
Antiviral Resistance and Phage Counter Adaptation to Antibiotic-Resistant Extraintestinal Pathogenic
Escherichia coli
Authors: Salazar Keiko C. , Ma Li , Green Sabrina I. , Zulk Jacob J. , Trautner Barbara W. , Ramig Robert F. , Clark Justin R. , Terwilliger Austen L. , Maresso Anthony W.
Published: April 2021

Extraintestinal pathogenic
Escherichia coli
(ExPEC), often multidrug resistant (MDR), is a leading cause of urinary tract and systemic infections. The crisis of emergent MDR pathogens has led some to propose bacteriophages as a therapeutic.
Accessory Genome Dynamics and Structural Variation of
Shigella
from Persistent Infections
Authors: Bengtsson Rebecca J. , Dallman Timothy J. , Allen Hester , De Silva P. Malaka , Stenhouse George , Pulford Caisey V. , Bennett Rebecca J. , Jenkins Claire , Baker Kate S.
Published: April 2021

Shigella
spp. are Gram-negative bacteria that are the etiological agent of shigellosis, the second most common cause of diarrheal illness among children under the age of five in low-income countries. In high-income countries, shigellosis is also a sexually transmissible disease among men who have sex with men.
Limited and Strain-Specific Transcriptional and Growth Responses to Acquisition of a Multidrug Resistance Plasmid in Genetically Diverse Escherichia coli Lineages
Authors: Dunn Steven , Carrilero Laura , Brockhurst Michael , McNally Alan
Published: April 2021

Plasmids play a key role in bacterial evolution by transferring adaptive functions between lineages that often enable invasion of new niches, including driving the spread of antibiotic resistance genes. Fitness costs of plasmid acquisition arising from the disruption of cellular processes could limit the spread of multidrug resistance plasmids.
Examining the level and inequality in health insurance coverage in 36 sub-Saharan African countries
Authors: Barasa Edwine , Kazungu Jacob , Nguhiu Peter , Ravishankar Nirmala
Published: April 2021

Introduction

Low/middle-income countries (LMICs) in sub-Saharan Africa (SSA) are increasingly turning to public contributory health insurance as a mechanism for removing financial barriers to access and extending financial risk protection to the population. Against this backdrop, we assessed the level and inequality of population coverage of existing health insurance schemes in 36 SSA countries.

Methods

Using secondary data from the most recent Demographic and Health Surveys, we computed mean population coverage for any type of health insurance, and for specific forms of health insurance schemes, by country. We developed concentration curves, computed concentration indices, and rich–poor differences and ratios to examine inequality in health insurance coverage. We decomposed the concentration index using a generalised linear model to examine the contribution of household and individual-level factors to the inequality in health insurance coverage.

Results

Only four countries had coverage levels with any type of health insurance of above 20% (Rwanda—78.7% (95% CI 77.5% to 79.9%), Ghana—58.2% (95% CI 56.2% to 60.1%), Gabon—40.8% (95% CI 38.2% to 43.5%), and Burundi 22.0% (95% CI 20.7% to 23.2%)). Overall, health insurance coverage was low (7.9% (95% CI 7.8% to 7.9%)) and pro-rich; concentration index=0.4 (95% CI 0.3 to 0.4, p<0.001). Exposure to media made the greatest contribution to the pro-rich distribution of health insurance coverage (50.3%), followed by socioeconomic status (44.3%) and the level of education (41.6%).

Conclusion

Coverage of health insurance in SSA is low and pro-rich. The four countries that had health insurance coverage levels greater than 20% were all characterised by substantial funding from tax revenues. The other study countries featured predominantly voluntary mechanisms. In a context of high informality of labour markets, SSA and other LMICs should rethink the role of voluntary contributory health insurance and instead embrace tax funding as a sustainable and feasible mechanism for mobilising resources for the health sector.
Death of a parent during childhood and blood pressure in youth: a population-based cohort study of Swedish men
Authors: Chen Hua , Hemmingsson Tomas , Janszky Imre , Rostila Mikael , Forsell Yvonne , Meng Linghui , Liang Yajun , László Krisztina D.
Published: April 2021

Objective

Compelling evidence suggests that childhood adversities are associated with an increased risk of hypertension in middle age and old age. The link between childhood adversities and blood pressure in youth is less clear. In this cohort study, we examined the association between death of a parent during childhood and blood pressure in early adulthood in men.

Setting

Sweden.

Participants

We studied 48 624 men born in 1949–1951 who participated in the compulsory military conscription in 1969/1970 in Sweden. Information on death of a parent during childhood was obtained from population-based registers. Information on covariates was obtained from the questionnaire and the clinical examination completed at conscription and from population-based registers.

Outcome measures

Blood pressure was measured at conscription according to standard procedures.

Results

The multivariable least square means of systolic and diastolic blood pressure did not differ between bereaved (128.25 (127.04–129.46) and 73.86 (72.89–74.84) mm Hg) and non-bereaved study participants (128.02 (126.86–129.18) and 73.99 (73.06–74.93) mm Hg). Results were similar when considering the cause of the parent’s death, the gender of the deceased parent or the child’s age at loss. Loss of a parent in childhood tended to be associated with an increased hypertension risk (OR and 95% CI: 1.10 (1 to 1.20)); the association was present only in case of natural deaths.

Conclusion

We found no strong support for the hypothesis that stress following the loss of a parent during childhood is associated with blood pressure or hypertension in youth in men.
Phase Space Analysis and Thermodynamics of Interacting Umami Chaplygin Gas in FRW Universe
Authors: Biswas Sujay Kr. , Biswas Atreyee
Published: April 2021

In this work interacting Umami Chaplygin gas has been studied in flat FRW model of universe in context of it’s thermodynamic and dynamical behaviour. In particular, considering Umami fluid as dark energy interacting with dark matter, irreversible thermodynamics has been studied both for apparent and event horizon as bounding horizon in two separate cases. Also the model has been investigated in purview of dynamical systems analysis by converting the cosmological evolution equations to an autonomous system of ordinary differential equations. With some restrictions on model parameter $$\omega $$
ω
and coupling parameter $$\lambda $$
λ
, some cosmologically interesting critical points describing late time accelerated evolution of the universe attracted by cosmological constant and accelerated scaling attractor in quintessence era have been found to alleviate coincidence problem.
A Torelli type theorem for nodal curves
Authors: Basu Suratno , Das Sourav
Published: April 2021

The moduli space of Gieseker vector bundles is a compactification of moduli of vector bundles on a nodal curve. This moduli space has only normal-crossing singularities and it provides flat degeneration of the moduli of vector bundles over a smooth projective curve. We prove a Torelli type theorem for a nodal curve using the moduli space of stable Gieseker vector bundles of fixed rank (strictly greater than [Formula: see text]) and fixed degree such that rank and degree are co-prime.
APPLICATION POTENTIAL OF RESPONSE SURFACE METHOD ON ELECTRO DISCHARGE MACHINING OF AA6061–CENOSPHERE AMCs PREPARED BY COMPOCASTING METHOD
Authors: DEY ABHIJIT , PANDEY KRISHNA MURARI , RAI RAM NARESH , KHAN AKHTAR , DAS ANSHUMAN
Published: April 2021

Cenosphere fly ash particles are incorporated into AA6061 alloys with different concentrations ranging from 0[Formula: see text]wt.% to 10[Formula: see text]wt.% using a modified semi-solid metal processing technique. X-ray diffraction patterns were recorded to analyze the morphology of the aluminum-based metal matrix composites (AMCs). The major diffraction peaks of Al, SiO2, Al2O3 and Fe2O3 are distinctly identified which revealed the presence of cenosphere particles and their integrity within the matrix is preserved. The high-resolution optical micrograph identifies the homogeneous distribution and uniform dispersion of the particles. Machinability of the prepared AMCs was investigated by electro discharge machining (EDM) using response surface methodology (RSM). Face-centered CCD of RSM was considered to design the number of experimental runs required. ANOVA was used to explore the influence of selected process parameters and their interactions on the performance characteristics of the systems by developing a second-order quadratic mathematical model for all the responses. Pulse on-time and pulse current were observed to be the most influencing independent variables of EDM system that affect the selected performance measures during spark erosion process. Finally, desirability function approach was employed to optimize the parameters. The optimal processing condition was identified as follows: pulse current: 6 A, pulse on-time: 1010[Formula: see text][Formula: see text]s, percentage of reinforcement: 2% and flushing pressure: 0.2 MPa. Very small percentages of deviation have been observed while comparing with the experimental results obtained for MRR (8.6%), TWR (10.3%) and SR (2.18%).
Discussion on 'Shape fabrics and superimposed simple shear strain in a Precambrian shear belt, W Greenland' by John Grocott
Authors: Grocott John , Allen P. , Wells M. K.
Published: April 2021

THE PRESIDENT (Professor P. Allen) asked Dr Grocott
if the structural history in his field area reflected
events in the broader context (e.g. jostling of the
Greenland blocks).

DR M. K. WELLS asked the author to comment on
possible variations of fabric which might be related to
lithological contrasts of major rock masses in different
parts of the region. Was there any evidence to suggest
that the development of some form of layered anisotropy
in the rocks was a necessary preliminary to the
development of the second kind of fabric he described?
Reproduction Multitasking: The Male Gametophyte
Authors: Hafidh Said , Honys David
Published: April 2021

The gametophyte represents the sexual phase in the alternation of generations in plants; the other, nonsexual phase is the sporophyte. Here, we review the evolutionary origins of the male gametophyte among land plants and, in particular, its ontogenesis in flowering plants. The highly reduced male gametophyte of angiosperm plants is a two- or three-celled pollen grain. Its task is the production of two male gametes and their transport to the female gametophyte, the embryo sac, where double fertilization takes place. We describe two phases of pollen ontogenesis—a developmental phase leading to the differentiation of the male germline and the formation of a mature pollen grain and a functional phase representing the pollen tube growth, beginning with the landing of the pollen grain on the stigma and ending with double fertilization. We highlight recent advances in the complex regulatory mechanisms involved, including posttranscriptional regulation and transcript storage, intracellular metabolic signaling, pollen cell wall structure and synthesis, protein secretion, and phased cell–cell communication within the reproductive tissues.
Systemic Risk in Financial Networks: A Survey
Authors: Jackson Matthew O. , Pernoud Agathe
Published: April 2021

We provide an overview of the relationship between financial networks and systemic risk. We present a taxonomy of different types of systemic risk, differentiating between direct externalities between financial organizations (e.g., defaults, correlated portfolios, fire sales), and perceptions and feedback effects (e.g., bank runs, credit freezes). We also discuss optimal regulation and bailouts, measurements of systemic risk and financial centrality, choices by banks regarding their portfolios and partnerships, and the changing nature of financial networks.
Influence of Gallic Acid and Thai Culinary Essential Oils on Antibacterial Activity of Nisin against Streptococcus mutans
Authors: Jiamboonsri Pimsumon , Kanchanadumkerng Pimpikar
Published: April 2021

Streptococcus mutans is a well-known oral pathogen commonly associated with a normal dental problem and life-threatening infection. A bacteriocin nisin and the plant-derived compounds including gallic acid (GA) and Thai culinary essential oils (EOs) have been reported to have activity against oral pathogens. However, their synergistic interaction against S. mutans has not been explored. The purposes of this study were primarily to investigate anti-S. mutans properties and the antibiofilm formation of nisin, GA, and five EOs by using the broth microdilution method. Besides, the morphological change, killing rate, and antibacterial synergism were determined by scanning electron microscopy (SEM), time-kill assay, and checkerboard method, respectively. The results demonstrated that kaffir lime leaf (KLL) oil, lemongrass (LG) oil, and GA showed a potent anti-S. mutans activity and inhibited biofilm formation with the possible mechanism targeted on the cell membrane. Additionally, KLL oil revealed anti-S. mutans synergism with GA, LG oil, and chlorhexidine with the fractional inhibitory concentration (FIC) indexes ≤ 0.5. Interestingly, GA displayed a high potential to enhance anti-S. mutans activity of nisin by lowering the minimum inhibitory concentrations (MICs) to at least 8-fold in a bacteriostatic manner. These results suggest that GA and KLL oil may be potentially used as an adjunctive therapy along with nisin and chlorhexidine to control S. mutans infection.
Diagnostic Ability of Magnifying Narrow-Band Imaging for the Extent of Early Gastric Cancer: A Systematic Review and Meta-Analysis
Authors: Hu Yingying , Chen Xueqin , Hendi Maher , Si Jianmin , Chen Shujie , Deng Yanyong
Published: April 2021

Background. Accurate delineation of tumor margin is essential for complete resection of early gastric cancer (EGC). The objective of this study is to assess the performance of magnifying endoscopy with narrow-band imaging (ME-NBI) for the accurate demarcation of EGC margins. Methods. We searched PubMed, EMBASE, Web of Science, and Cochrane Library databases up to March 2020 to identify eligible studies. The diagnostic accuracy of ME-NBI for EGC margins was calculated, and subgroup analyses were performed based on tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, Helicobacter pylori (H. pylori), and endoscopists’ experience. Besides, we also evaluated the negative and positive resection rates of the horizontal margin (HM) of EGC after endoscopic submucosal dissection (ESD) and surgery. Results. Ten studies comprising 1018 lesions were eligible in the databases. The diagnostic accuracy of ME-NBI for the demarcation of EGC margins was 92.4% (95% confidence interval (CI): 86.7%-96.8%). According to ME-NBI subgroup analyses, the rate of accurate evaluation of EGC margins was not associated with H. pylori infection status, tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, and endoscopists’ experience, and no statistical differences were found in subgroup analyses. Moreover, the negative and positive resection rates of HM after ESD and surgery were 97.4% (95% CI: 92.1%-100%) and 2.6% (95% CI: 0.02%-7.9%), respectively. Conclusions. ME-NBI enables a reliable delineation of the extent of EGC.
Excessive Daytime Sleepiness and Its Associated Factors among Emergency Medicine Residents in South Korea: A Nationwide Survey
Authors: Park Song Yi , Cho Kwang Hyun , Kim Ho Jung , Kim In Byung , Seo Bum Suk , Choi Suk Jae , Yoon Yoo Sang , Key Donghune , Park Kyung Hye , Lee Eu Sun , Lee Hyung Min , Kim Jiyoung
Published: April 2021

Objective. Excessive daytime sleepiness (EDS) in emergency medicine (EM) residents is associated with patient safety. However, studies regarding EDS in EM residents are limited. The objective of this study was to identify the prevalence of EDS and its associated factors among EM residents. Methods. Epworth sleepiness scale scores, working hours per week (WHW), night working days per month, working environment, and depression were analyzed using data from the 2019 Korean Emergency Medicine Resident Survey. Results. The survey response rate was 63.8% (384/601). Among 241 respondents, the prevalence rate of EDS was 32.4%. Multivariable logistic regression analysis demonstrated that WHW (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01–1.06) and depression (OR = 3.64, 95% CI = 1.91–6.96) had increased ORs for EDS. Conclusions. Approximately one-third of EM residents had EDS. Depression and WHW were the associated factors.
Real-Time Return Demand Prediction Based on Multisource Data of One-Way Carsharing Systems
Authors: Liu Dongbo , Lu Jian , Ma Wanjing
Published: April 2021

One-way carsharing system has been widely adopted in the carsharing field due to its flexible services. However, as one of the main limitations of the one-way carsharing system, the imbalance between supply and demand needs to be solved. Predicting pick-up demand has been studied to achieve the goal, but using returned vehicles to reduce unnecessary relocation is also one of the important methods. Nowadays, trajectory data and other data are available for real-time prediction for return demand. Based on the return demand prediction, the relocation response can be more reasonable. Thus, the balance of demand and supply can be largely improved. The multisource data include trajectory data, user application log data, order data, station data, and user characteristic data. Based on these data, a return demand prediction model was used to predict whether the user will return the vehicle in 15 min in real time, and a destination station prediction model was applied to forecast which station the user will park at. Finally, a case study using ten stations’ one-week field data was conducted to test the benefit of the dynamic return demand prediction. The results showed that the return demand prediction improves the efficiency of the relocations by mitigating the condition that the station parking space is full or empty. The potential application of this study would effectively reduce unnecessary relocation and further formulate an active operation optimization strategy to reduce the system’s operational cost and improve the service quality of the system.
The Aging GABAergic System and Its Nutritional Support
Authors: Mills Demetra J.
Published: April 2021

Aging is associated with a decline in hormones and an associated decline in GABAergic function and calcium and ion current dysregulation. Neurosteroid hormones act as direct calcium channel blockers, or they can act indirectly on calcium channels through their interaction with GABA receptors. The calcium channel dysfunction associated with hormone loss further leads to an excitatory cell state, which can ultimately lead to cell death. The calcium theory of aging posits that cellular mechanisms, which maintain the homeostasis of cytosol Ca2+ concentration, play a key role in brain aging and that sustained changes in Ca2+ homeostasis provide the final common pathway for age-associated brain changes. There is a link between hormone loss and calcium dysregulation. Loss of calcium regulation associated with aging can lead to an excitatory cell state, primarily in the mitochondria and nerve cells, which can ultimately lead to cell death if not kept in check. A decline in GABAergic function can also be specifically tied to declines in progesterone, allopregnanolone, and DHEA levels associated with aging. This decline in GABAergic function associated with hormone loss ultimately affects GABAergic inhibition or excitement and calcium regulation throughout the body. In addition, declines in GABAergic function can also be tied to vitamin status and to toxic chemicals in the food supply. The decline in GABAergic function associated with aging has an effect on just about every body organ system. Nutritional support of the GABAergic system with supportive foods, vitamins, and GABA or similar GABA receptor ligands may address some of the GABAergic dysfunction associated with aging.
Inactivation of TOPK Caused by Hyperglycemia Blocks Diabetic Heart Sensitivity to Sevoflurane Postconditioning by Impairing the PTEN/PI3K/Akt Signaling
Authors: Gao Sumin , Wang Rong , Dong Siwei , Wu Jing , Perek Bartłomiej , Xia Zhengyuan , Yao Shanglong , Wang Tingting
Published: April 2021

The cardioprotective effect of sevoflurane postconditioning (SPostC) is lost in diabetes that is associated with cardiac phosphatase and tensin homologue on chromosome 10 (PTEN) activation and phosphoinositide 3‐kinase (PI3K)/Akt inactivation. T‐LAK cell‐originated protein kinase (TOPK), a mitogen‐activated protein kinase‐ (MAPKK‐) like serine/threonine kinase, has been shown to inactivate PTEN (phosphorylated status), which in turn activates the PI3K/Akt signaling (phosphorylated status). However, the functions of TOPK and molecular mechanism underlying SPostC cardioprotection in nondiabetes but not in diabetes remain unknown. We presumed that SPostC exerts cardioprotective effects by activating PTEN/PI3K/Akt through TOPK in nondiabetes and that impairment of TOPK/PTEN/Akt blocks diabetic heart sensitivity to SPostC. We found that in the nondiabetic C57BL/6 mice, SPostC significantly attenuated postischemic infarct size, oxidative stress, and myocardial apoptosis that was accompanied with enhanced p‐TOPK, p‐PTEN, and p‐Akt. These beneficial effects of SPostC were abolished by either TOPK kinase inhibitor HI‐TOPK‐032 or PI3K/Akt inhibitor LY294002. Similarly, SPostC remarkably attenuated hypoxia/reoxygenation‐induced cardiomyocyte damage and oxidative stress accompanied with increased p‐TOPK, p‐PTEN, and p‐Akt in H9c2 cells exposed to normal glucose, which were canceled by either TOPK inhibition or Akt inhibition. However, either in streptozotocin‐induced diabetic mice or in H9c2 cells exposed to high glucose, the cardioprotective effect of SPostC was canceled, accompanied by increased oxidative stress, decreased TOPK phosphorylation, and impaired PTEN/PI3K/Akt signaling. In addition, TOPK overexpression restored posthypoxic p‐PTEN and p‐Akt and decreased cell death and oxidative stress in H9c2 cells exposed to high glucose, which was blocked by PI3K/Akt inhibition. In summary, SPostC prevented myocardial ischemia/reperfusion injury possibly through TOPK‐mediated PTEN/PI3K/Akt activation and impaired activation of this signaling pathway may be responsible for the loss of SPostC cardioprotection by SPostC in diabetes.
SRFabric: A Semi-Reconfigurable Rack Scale Topology
Authors: Song Hu , Fang Quan , Jin Yibo , Qian Zhuzhong
Published: April 2021

Rack scale design is a promising trend towards customized hardware design, where high density clusters of SoCs are integrated in the rack. One of the biggest challenges for rack scale computing is the interconnection network. Traditional data center topologies require too many ToR switches to support hundreds of SoCs, while distributed fabrics deliver a considerably high end-to-end latency and network oversubscription. Since no one topology fits all kinds of workloads, a flexible in-rack topology requires a careful redesign to dynamically adapt to diverse data center traffic within tight cost and space constraints in the rack. SRFabric is a semi-reconfigurable rack scale network topology that exploits the high path diversity, the cost-effectiveness of distributed fabrics, and the dynamic reconfigurability of circuit switches. This is accomplished by enabling multiple static ports and dynamic ports for each SoC. Leveraging the partial link reconfigurability, SRFabric is able to optimize its topology to dynamically adapt to various workload patterns. We further propose the design of SRFabric to decide the nearly optimal number of dynamic ports and static ports for expected communication density and performance. Extensive evaluations demonstrate that SRFabric can deliver lower average path length, i.e., 2.21 hops on average, and higher bisection bandwidth, i.e., up to 77% nonblocking bandwidth, and provide comparable performance with state-of-the-art strategy XFabric at a lower cost, i.e., XFabric costs up to 3 times more than that of SRFabric.
The Use of Dornase Alfa in the Management of COVID-19-Associated Adult Respiratory Distress Syndrome
Authors: Toma Andrew , Darwish Christina , Taylor Michele , Harlacher Justin , Darwish Ribal
Published: April 2021

Objective. Currently, management of acute respiratory distress syndrome (ARDS) in COVID-19 infection with invasive mechanical ventilation results in poor prognosis and high mortality rates. Interventions to reduce ventilatory requirements or preclude their needs should be evaluated in order to improve survival rates in critically ill patients. Formation of neutrophil extracellular traps (NETs) during the innate immune response could be a contributing factor to the pulmonary pathology. This study suggests the use of dornase alfa, a recombinant DNAse I that lyses NETs, to reduce ventilatory requirements and improve oxygenation status, as well as outcomes in critically ill patients with ARDS subsequent to confirmed or highly suspected COVID-19 infection. Design. A single-institution cohort study. Setting. Intensive care unit in a tertiary medical center. Patients. Adult patients with acute respiratory distress syndrome (ARDS) admitted to the ICU with confirmed COVID-19 infection. Intervention. Treatment with aerosolized dornase alfa. Measurements and Main Results. Of 39 patients evaluated, most patients had improvement in oxygenation measured by increase in the PaO2/FiO2 ratio, reduction in ventilatory support or other supportive oxygen requirements, and partial resolution of bilateral opacities visible on CXR, as well as improved outcome. Conclusions. Administration of inhalational dornase alfa via a filtered nebulizer medication system or through an adapter in a ventilator circuit should be considered in all COVID-19-positive patients with ARDS as early in the disease course as possible.
Prediction of High-Tech Talents Flow Impact on Labor Income Share: Based on DEA and Fractional Hausdorff Grey Model
Authors: Cui Wei , Wan Anwei , Yang Yongbo
Published: April 2021

The purpose of this paper is to analyze the impact of high-tech talents flow on labor income share and explore the influencing mechanism. It can be proved that high-tech talents flow affects labor income share by production function, with technological progress as a mediator variable. The labor income share is the dependent variable, and the gravity of high-tech talents as the independent variable is the index to measure the high-tech talents flow, constructing the panel data model with the Malmquist index of technological progress as a mediator variable. Furthermore, the Malmquist index of technological progress is decomposed into catching-up of technological progress index and leapfrogging of technological progress index, which, respectively, replaces the Malmquist index of technological progress as a mediator variable in the panel data model. Regression analysis shows that technological progress is a mediator variable for high-tech talents flow to reduce labor income share, and the impact mainly comes from leapfrogging of technological progress. However, although the mediating effect of catching-up technological progress index is not significant at the significance level of 10%, it is a mediator variable for high-tech labor mobility to increase income share at the significance level of 20%. Finally, this paper predicts the change in labor income share from 2018 to 2027 by the fractional Hausdorff grey model, and the results show that it is an increasing trend. However, the Gini coefficient whose change trend is opposite to the labor income share remains high in the past two years, indicating that there are other factors affecting the income gap, such as the urbanization rate and the transportation convenience. The innovation of this paper is mainly to reveal that the leapfrogging of technological progress is the major cause of the high-tech talents flow rising income inequality gap, while the catching-up of technological progress is the source of the former narrowing the latter. The fractional Hausdorff grey model predicts that the key determinants of income inequality gap are more than labor income share.
Innovando en pandemia y en la nueva normalidad
Authors: Geldes Cristian , Heredia Jorge
Published: April 2021

La pandemia de COVID 19 ha obligado a las empresas e instituciones a innovar para enfrentar los cambios que se generaron a nivel económico y social. Este fenómeno ha acelerado procesos que afectarán la sociedad, especialmente en el desarrollo empresarial e institucional. En este marco, nace esta Edición Especial de Gestión y Tendencias que presenta dos casos de innovación desarrollados durante la pandemia y dos análisis que invitan reflexionar sobre cómo abordar la nueva normalidad. Concluimos con una reflexión sobre la necesidad de innovar conjugando lo organizacional con el ecosistema de innovación.
Determinants of Response and Mechanisms of Resistance of CAR T-cell Therapy in Multiple Myeloma
Authors: van de Donk Niels W.C.J. , Themeli Maria , Usmani Saad Z.
Published: April 2021

B-cell maturation antigen (BCMA)–specific chimeric antigen receptor (CAR) T cells have substantial therapeutic potential in multiple myeloma (MM), but most patients eventually relapse. Determinants of response and mechanisms of resistance are most likely multifactorial and include MM-related factors, premanufacturing T-cell characteristics, CAR T-cell–related features, and several components of the immunosuppressive microenvironment. Efforts to improve the potency and safety of CAR T-cell therapy include optimizing CAR design, combinatorial approaches to enhance persistence and activity, treatment of less heavily pretreated patients, and dual-antigen targeting to prevent antigen escape. We expect that these rationally designed strategies will contribute to further improvement in the clinical outcome of patients with MM.

Significance:

Although BCMA-specific CAR T-cell therapies are highly effective in heavily pretreated patients with MM, there has been, until now, no indication of a plateau in the survival curves. In this review, we provide an overview of the determinants of response and the mechanisms that contribute to the development of treatment failure after initial remission (acquired resistance). A better understanding of these mechanisms, underlying lack of disease response, and acquired resistance may lead to further improvements in the effectiveness of CAR T-cell therapy.
Intentional Supernumerary Motor Phantom Limb after Right Cerebral Stroke: A Case Report
Authors: Yamada Mai , Sasahara Yoshimi , Seto Makiko , Satoh Akira , Tsujihata Mitsuhiro
Published: April 2021

A 47-year-old right-handed man was admitted to our hospital for rehabilitation after right basal ganglion hematoma. On day 57, he noticed a supernumerary motor phantom limb (SPL) involving his right arm, originating at the level of the elbow. The most notable finding of his SPL was the motor characteristic. When the subject had the intention to move the upper paralyzed limb simultaneously with the trainer’s facilitating action, he said “there is another arm.” The intention to move the paralyzed arm alone or passive movement of the paralyzed arm did not induce the SPL. He showed a severe left sensorimotor impairment and mild hemineglect, but no neglect syndromes of the body (e.g., asomatognosia, somatoparaphrenia, personification and misoplegia, or anosognosia) were observed. Brain MRI demonstrated a hematoma in the right temporal lobe subcortex, subfrontal cortex, putamen, internal capsule, and thalamus. Single-photon emission computed tomography images showed more widespread hypoperfusion in the right hemisphere in comparison to the lesions on MRI. However, the premotor cortex was preserved. Our case is different from Staub’s case in that SPL was not induced by the intention to move the paralyzed limb alone; rather, it was induced when the patient intended to move the paralyzed limb with a trainer’s simultaneous facilitating action. The SPL may reflect that an abnormal closed-loop function of the thalamocortical system underlies the phantom phenomenon. However, despite the severe motor and sensory impairment, the afferent pathway from the periphery to the premotor cortex may have been partially preserved, and this may have been related to the induction of SPL.
Daphnetin Preconditioning Decreases Cardiac Injury and Susceptibility to Ventricular Arrhythmia following Ischaemia-Reperfusion through the TLR4/MyD88/NF-Κb Signalling Pathway
Authors: Yang Fan , Jiang Xiaobo , Cao Hongyi , Shuai Wei , Zhang Lijun , Wang Guangji , Quan Dajun , Jiang Xuejun
Published: April 2021

Background/Aims: Daphnetin (7,8-dihydroxycoumarin, DAP) exhibits various bioactivities, such as anti-inflammatory and antioxidant activities. However, the role of DAP in myocardial ischaemia/reperfusion (I/R) injury and I/R-related arrhythmia is still uncertain. This study aimed to investigate the mechanisms underlying the effects of DAP on myocardial I/R injury and electrophysiological properties in vivo and in vitro. Methods: Myocardial infarct size was measured by triphenyltetrazolium chloride staining. Cardiac function was assessed by echocardiographic and haemodynamic analyses. The levels of creatine kinase-MB, lactate dehydrogenase, malondialdehyde, superoxide dismutase, interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α) were detected using commercial kits. Apoptosis was measured by terminal deoxynucleotidyl-transferase-mediated dUTP nick-end labelling staining and flow cytometry. The viability of H9c2 cells was determined by the Cell Counting Kit-8 assay. In vitro, the levels of IL-6 and TNF-α were measured by quantitative PCR. The expression levels of proteins associated with apoptosis, inflammation, and the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor kappa B (TLR4/MyD88/NF-κB) signalling pathway were detected by Western blot analysis. The RR, PR, QRS, and QTc intervals were assessed by surface ECG. The 90% action potential duration (APD90), threshold of APD alternans, and ventricular tachycardia inducibility were measured by the Langendorff perfusion technique. Results: DAP preconditioning decreased myocardial I/R injury and hypoxia/reoxygenation (H/R) injury in cells. DAP preconditioning improved cardiac function after myocardial I/R injury. DAP preconditioning also suppressed apoptosis, attenuated oxidative stress, and inhibited inflammatory responses in vivo and in vitro. Furthermore, DAP preconditioning decreased the susceptibility to ventricular arrhythmia after myocardial I/R. Finally, DAP preconditioning inhibited the expression of TLR4, MyD88, and phosphorylated NF-κB (p-NF-κB)/P65 in mice subjected to I/R and cells subjected to H/R. Conclusions: DAP preconditioning protected against myocardial I/R injury and decreased susceptibility to ventricular arrhythmia by inhibiting the TLR4/MyD88/NF-κB signalling pathway.
A Prospective Evaluation of Structures and Processes Associated with the Quality of Mental Health Care in the Kingdom of Saudi Arabia
Authors: Al Mousa Yaqoub , Callaghan Patrick , Michail Maria
Published: April 2021

Introduction: Quality of care is important for improving outcomes of service users in inpatient mental health settings. There is a lack of research investigating the predictors of quality of mental health care and their relationship with service user outcomes, particularly in Saudi Arabia, despite the high priority given to this in the Kingdom of Saudi Arabia (KSA) national health strategy. Objective: This study investigates the factors associated with the quality of mental care and their relationship with service users’ outcomes, disability, disease, discomfort, and dissatisfaction, using Donabedian’s framework. Methods: A questionnaire survey was distributed to 176 nurses and 321 service users in an inpatient psychiatric hospital in Saudi Arabia. Data were gathered on structures (staff and service users’ characteristics) and processes (staff attitudes to mental illness, competency, and level of interaction with service users) linked to service users’ outcomes. Results: Multilevel modelling showed that service users’ characteristics, for example, age, marital status, employment status, educational level, area of residence, and diagnosis, significantly predicted disability. With 1 exception (unemployment), none of the service users’ characteristics was found to be a statistically significant predictor of disease, although educational level was found to be a significant predictor of discomfort and dissatisfaction. Age and years of experience were found to significantly predict service user disability among nurses, and years of experience was a significant predictor of users’ dissatisfaction. Nurses’ competence was found to be a statistically significant predictor of disability, while their attitudes to mental illness and their interactions with users did not significantly predict the latter’s outcomes. Conclusions: These findings suggest that factors other than those studied here have more currency in relation to quality of care in Saudi Arabia, despite these factors have been shown to relate to quality of care outside the KSA. A more detailed qualitative approach to better understand factors relevant to the quality of mental care in Saudi Arabia is reported by the authors in a concomitant article.
The Digital Neurologic Examination
Authors: Cohen Adam B. , Nahed Brain V.
Published: April 2021

Digital health has been rapidly thrust into the forefront of care delivery. Poised to extend the clinician’s reach, a new set of examination tools will redefine neurologic and neurosurgical care, serving as the basis for the digital neurologic examination. We describe its components and review specific technologies, which move beyond traditional video-based telemedicine encounters and include separate digital tools. A future suite of these clinical assessment technologies will blur the lines between history taking, examination, and remote monitoring. Prior to full-scale implementation, however, much more investigation is needed. Because of the nascent state of the technologies, researchers, clinicians, and developers should establish digital neurologic examination requirements in order to maximize its impact.