bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of guidance on the supply of codeine-containing products on their use in intentional drug overdose
Authors: Birchall Emma , Perry Ivan J , Corcoran Paul , Daly Caroline , Griffin Eve 
Published: May 2021

Abstract

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

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

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

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

Abstract

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

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

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

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

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

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

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

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

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

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

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

Abstract
Rainfall regime, the amount and timing of annual precipitation, can influence the breeding phenology, individual fitness, and population dynamics of tropical birds. In Neotropical regions with rainfall seasonality (i.e. wet and dry seasons), the warm phase of the El Niño Southern Oscillation (ENSO) can exacerbate seasonal drought and negatively impact avian survival and reproduction. However, the mechanisms underlying associations between seasonal drought conditions and avian demography are largely unexplored. One hypothesis is that nutritional condition mediates demographic responses to seasonal drought: individuals in poor condition may be less capable of balancing their energy budgets and consequently suffer reduced survival, lower reproductive output, or both. We estimated nutritional condition (i.e. scaled mass index, percent hematocrit, plasma lipid metabolites) as a proxy of energy balance in understory forest birds with contrasting population-level responses to dry season length. This study took place across two dry seasons of differing intensity in central Panama: an El Niño dry season (2016, severe drought) and a more typical dry season (2017). Scaled mass index remained relatively constant throughout both dry seasons and across years for 5 common focal species and among 4 foraging guilds (22 additional species, 27 species total). Three of 5 focal species did exhibit reduced nutritional condition (i.e. lower hematocrit and/or higher β-hydroxybutyrate) during the El Niño dry season but not during the more typical dry season. However, foraging guilds did not show consistent nutritional responses to seasonal drought and we found little evidence of the reduced nutritional condition at the guild level, suggesting that many Neotropical forest bird species are capable of tolerating seasonal drought.
Nest cavity reuse by the cooperatively breeding Acorn Woodpecker
Authors: Koenig Walter D , Hallock Eve M , Weber David J , Walters Eric L 
Published: May 2021

AbstractAlthough primary cavity-nesting species are capable of excavating new cavities, they often reuse old ones. To determine potential factors driving such reuse, we studied nest-cavity reuse in the Acorn Woodpecker (Melanerpes formicivorus), a cooperatively breeding species that reuses old cavities for 57.2% of nests at Hastings Reservation in central coastal California, USA. We found no evidence for significant fitness costs or benefits of cavity reuse compared to using newly constructed cavities. In contrast, several lines of evidence supported a role for constraints on both cavity reuse and on new cavity construction. The main constraint on reuse was cavities failing to survive from one year to the next, usually because the limb fell apart, filled with water, or was usurped by another species. Evidence that constraints on new cavity construction may be important included more frequent cavity reuse when groups renested and use of artificial cavities when they were experimentally provided. Nest-cavity reuse in this population appears to be driven primarily by constraints, including the energetic costs and time required to excavate a new cavity, rather than fitness consequences, even though Acorn Woodpeckers regularly excavate small holes in trees for acorn storage and the energetic costs of new cavity construction are apparently insufficient to significantly depress reproductive success. Constraints play a significant role in cavity reuse and may affect both the intraspecific and interspecific frequency of cavity reuse among facultative excavating species.
Current favourable 10-year outcome of patients with early rheumatoid arthritis: data from the ESPOIR cohort
Authors: Combe Bernard , Rincheval Nathalie , Berenbaum Francis , Boumier Patrick , Cantagrel Alain , Dieude Philippe , Dougados Maxime , Fautrel Bruno , Flipo René-Marc , Goupille Philippe , Mariette Xavier , Saraux Alain , Schaeverbeke Thierry , Sibilia Jean , Vittecoq Olivier , Daurès Jean-Pierre 
Published: May 2021

Abstract

Objective
To report the 10-year outcome of an inception cohort of patients with early rheumatoid arthritis (RA), the ESPOIR cohort, and predictors of outcome.

Methods
From 2003 to 2005, 813 patients were included if they had early arthritis (&lt;6 months) with a high probability of RA and had never been prescribed DMARDs. Multivariate analysis was used to evaluate predictors of outcome.

Results
In total, 521 (64.1%) RA patients were followed up for 10 years; 35 (4.3%) died, which appears to be similar to the French general population. Overall, 480 (92.1%) patients received a DMARD; 174 (33.4%) received at least one biologic DMARD, 13.6% within 2 years. At year 10, 273 (52.4%) patients were in DAS28 remission, 40.1% in sustained remission, 14.1% in drug-free remission, 39.7% in CDAI remission. Half of the patients achieved a health assessment questionnaire-disability index (HAQ-DI) &lt; 0.5. SF-36 physical component and pain were well controlled. Structural progression was weak, with a mean change from baseline in modified Sharp score of 11.0  (17.9). Only 34 (6.5%) patients required major joint surgery. A substantial number of patients showed new comorbidities over 10 years. Positivity for anti-citrullinated peptides antibodies (ACPA) was confirmed as a robust predictor of long-term outcome.

Conclusions
We report a very mild 10-year outcome of a large cohort of patients with early RA diagnosed in the early 2000s, which was much better than results for a previous cohort of patients who were recruited in 1993. This current favourable outcome may be related to more intensive care for real-life patients.
Drug survival of anakinra and canakinumab in monogenic autoinflammatory diseases: observational study from the International AIDA Registry
Authors: Sota Jurgen , Rigante Donato , Cimaz Rolando , Cattalini Marco , Frassi Micol , Manna Raffaele , Sicignano Ludovico Luca , Verrecchia Elena , Aragona Emma , Maggio Maria Cristina , Lopalco Giuseppe , Emmi Giacomo , Parronchi Paola , Cauli Alberto , Wiesik-Szewczyk Ewa , Hernández-Rodríguez José , Gaggiano Carla , Tarsia Maria , Mourabi Mariam , Ragab Gaafar , Vitale Antonio , Fabiani Claudia , Frediani Bruno , Lamacchia Vittoria , Renieri Alessandra , Cantarini Luca 
Published: May 2021

Abstract

Objectives
To investigate survival of IL-1 inhibitors in monogenic autoinflammatory disorders (mAID) through drug retention rate (DRR) and identify potential predictive factors of drug survival from a real-life perspective.

Patients and methods
Multicentre retrospective study analysing patients affected by the most common mAID treated with anakinra or canakinumab. Survival curves were analysed with the Kaplan-Meier method. Statistical analysis included a Cox-proportional hazard model to detect factors responsible for drug discontinuation.

Results
Seventy-eight patients for a total of 102 treatment regimens were enrolled. The mean treatment duration was 29.59 months. The estimated DRR of IL-1 inhibitors at 12, 24 and 48 months of follow-up was 75.8%, 69.7% and 51.1%, respectively. Patients experiencing an adverse event had a significantly lower DRR (P=0.019). In contrast, no significant differences were observed between biologic-naïve patients and those previously treated with biologic drugs (P=0.985). Patients carrying high-penetrance mutations exhibited a significantly higher DRR compared with those with low-penetrance variants (P=0.015). Adverse events were the only variable associated with a higher hazard of treatment withdrawal [hazard ratio (HR) 2.573 (CI: 1.223, 5.411), P=0.013] on regression analysis. A significant glucorticoid-sparing effect was observed (P&lt;0.0001).

Conclusions
IL-1 inhibitors display an excellent long-term effectiveness in terms of DRR, and their survival is not influenced by the biologic line of treatment. They display a favourable safety profile, which deserves, however, a close monitoring given its impact on treatment continuation. Special attention should be paid to molecular diagnosis and mutation penetrance, as patients carrying low-penetrance variants are more likely to interrupt treatment.
Comparison of a traditional bovine respiratory disease control regimen with a targeted program based upon individualized risk predictions generated by the Whisper On Arrival technology
Authors: Nickell Jason S , Hutcheson John P , Renter David G , Amrine David A 
Published: May 2021

AbstractThe study objective was to determine if cattle health and performance comparing a targeted bovine respiratory disease (BRD) control program based on individualized risk prediction generated by a novel technology (Whisper On Arrival) was superior to a negative control (no metaphylaxis) yet no different than a positive control (conventional BRD control; 100% application). Across four study sites, auction market-derived beef calves were randomly allocated to one of four BRD control treatment groups: 1) Negative control (Saline), 2) Positive control (Tildipirosin [TIL] to 100% of the group), 3) Whisper-high (±TIL based on conservative algorithm threshold), and 4) Whisper-low (±TIL based on aggressive algorithm threshold). Within either Whisper On Arrival group, only calves predicted to be above the algorithm threshold by the technology (determined a priori) were administered TIL leaving the remainder untreated. Cattle were followed to either a short-term timepoint (50 or 60 d; health outcomes, all sites; feed performance outcomes, two sites) or to closeout (two sites). Data were analyzed as a completely randomized block design separately at each site. Across all sites, BRD control antibiotic use was reduced by 11% to 43% between the two Whisper On Arrival treatment groups compared to the positive control. The positive control and both Whisper On Arrival groups reduced (P ≤ 0.05) BRD morbidity compared to negative controls at both the short-term timepoint at three of the four sites and at closeout at one of two sites. The positive control and both Whisper-managed groups had improved (P ≤ 0.05) average daily gain (ADG), dry-matter intake (DMI), and feed efficiency compared to negative controls at the short-term timepoint at one of two sites. At closeout, the positive control and both Whisper-managed groups improved (P ≤ 0.05) ADG (deads-in) compared to the negative control at one of the two sites. At one of two sites, the positive control and the Whisper-high group displayed an improvement (P ≤ 0.05) in hot carcass weight compared to the negative control. The Whisper On Arrival technology maintained the benefits of a conventional BRD control program yet reduced BRD control antibiotic use by 11% to 43%. This technology maintained the benefits of a conventional BRD control program while reducing antibiotic costs to the producer and supporting judicious antimicrobial use.