Systems thinking and efficiency under emissions constraints: Addressing rebound effects in digital innovation and policy.

Innovations and efficiencies in digital technology have lately been depicted as paramount in the green transition to enable the reduction of greenhouse gas emissions, both in the information and communication technology (ICT) sector and the wider economy. This, however, fails to adequately account for rebound effects that can offset emission savings and, in the worst case, increase emissions. In this perspective, we draw on a transdisciplinary workshop with 19 experts from carbon accounting, digital sustainability research, ethics, sociology, public policy, and sustainable business to expose the challenges of addressing rebound effects in digital innovation processes and associated policy. We utilize a responsible innovation approach to uncover potential ways forward for incorporating rebound effects in these domains, concluding that addressing ICT-related rebound effects ultimately requires a shift from an ICT efficiency-centered perspective to a "systems thinking" model, which aims to understand efficiency as one solution among others that requires constraints on emissions for ICT environmental savings to be realized.

Erratum: The real climate and transformative impact of ICT: A critique of estimates, trends, and regulations.

[This corrects the article DOI: 10.1016/j.patter.2021.100340.].

Bronchial artery embolization for hemoptysis in a postpartum patient via cesarean section with COVID-19 while on extracorporeal membrane oxygenation.

Although COVID-19 coagulopathy typically manifests with thrombotic complications, hemorrhagic complications also occur and must be considered when making decisions about anticoagulation in these patients. Here, we report a case of massive hemoptysis occurring in a recently post-partum woman via Cesarean section with COVID-19 who was managed via bronchial artery embolization while on extracorporeal membrane oxygenation.

Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis.

OBJECTIVE(S): Subglottic stenosis (SGS) represents a constellation of diverse pathologic processes that ultimately lead to narrowing of the subglottic region and can produce significant morbidity. Existing endoscopic and radiographic assessments may not be consistent in practice. METHODS: Severity of stenosis was evaluated and reported using the Cotton-Myer classification system from 33 endoscopic procedures from 32 unique subjects. Radiographic imaging within the preceding 3 month period was subsequently reviewed and narrowing was measured by a blinded radiologist. Degree of stenosis was reported as a percentage in 30 out of 33 endoscopic evaluations and subsequently compared to radiographically determined percentage of stenosis. Statistical analyzes were conducted to evaluate concordance between endoscopic and radiographic assessments. RESULTS: About 45.5% (15/33) of the evaluations were in agreement using Cotton-Myer scoring, while 27.3% (9/33) were discrepant by 1 grade and 27.3% (9/33) by 2 grades. Correlation of degree of stenosis as a percentage using Spearman (coefficient: 0.233, P-value: .214) and Pearson (coefficient: 0.138, P-value: .466) methods demonstrated very weak relationships. Radiographic scoring did not predict endoscopic classification to a significant degree using mixed effects regression. CONCLUSIONS: Radiographic and endoscopic grading of subglottic stenosis may not be reliably concordant in practice.

The real climate and transformative impact of ICT: A critique of estimates, trends, and regulations.

In this paper, we critique ICT's current and projected climate impacts. Peer-reviewed studies estimate ICT's current share of global greenhouse gas (GHG) emissions at 1.8%-2.8% of global GHG emissions; adjusting for truncation of supply chain pathways, we find that this share could actually be between 2.1% and 3.9%. For ICT's future emissions, we explore assumptions underlying analysts' projections to understand the reasons for their variability. All analysts agree that ICT emissions will not reduce without major concerted efforts involving broad political and industrial action. We provide three reasons to believe ICT emissions are going to increase barring intervention and find that not all carbon pledges in the ICT sector are ambitious enough to meet climate targets. We explore the underdevelopment of policy mechanisms for enforcing sector-wide compliance, and contend that, without a global carbon constraint, a new regulatory framework is required to keep the ICT sector's footprint aligned with the Paris Agreement.

Design of Dielectric Resonator Antenna Using Dielectric Paste.

In this publication, the use of a dielectric paste for dielectric resonator antenna (DRA) design is investigated. The dielectric paste can serve as an alternative approach of manufacturing a dielectric resonator antenna by subsequently filling a mold with the dielectric paste. The dielectric paste is obtained by mixing nanoparticle sized barium strontium titanate (BST) powder with a silicone rubber. The dielectric constant of the paste can be adjusted by varying the BST powder content with respect to the silicone rubber content. The tuning range of the dielectric constant of the paste was found to be from 3.67 to 18.45 with the loss tangent of the mixture being smaller than 0.044. To demonstrate the idea of the dielectric paste approach, a circularly polarized DRA with wide bandwidth, which is based on a fractal geometry, is designed. The antenna is realized by filling a 3D-printed mold with the dielectric paste material, and the prototype was found to have an axial ratio bandwidth of 16.7% with an impedance bandwidth of 21.6% with stable broadside radiation.

The Impact of a Virtual Radiology Medical Student Rotation: Maintaining Engagement During COVID-19 Mitigation.

INTRODUCTION: The purpose of this study is to introduce a virtual radiology rotation curriculum that is being used to safely maintain medical student and intern education and engagement with the Department of Radiology at Walter Reed National Military Medical Center during coronavirus disease 2019 (COVID-19) mitigation. MATERIALS AND METHODS: The curriculum is designed as a 4-week block with each week representing one of the four highest yield radiology subspecialties for medical students; neuroradiology, thoracic radiology, body radiology, and musculoskeletal radiology. A subspecialist radiologist from each section was identified as a primary mentor and tasked with designing a daily schedule for medical students and interns. The first 2 months of virtual rotators were surveyed to assess the effectiveness of the course. RESULTS: Thirty-five of 41 rotators responded to the survey, a response rate of 85%. Thirty-one of 35 (89%) of the rotators gave this virtual elective rotation a positive rating, with 16 trainees scoring the course as 4 out of 5 and 15 trainees selecting 5 out of 5. Four respondents selected 3 out of 5. Five out of 5 respondents who had experienced an in-person radiology elective rotation before this virtual rotation rated the virtual elective as more educational than the in-person rotation. We found the 4-week subspecialist mentor-based structure to be highly versatile, allowing us to simultaneously accommodate multiple groups of full or partial block rotators throughout COVID-19 mitigation. CONCLUSION: A virtual rotation curriculum is a viable method of maintaining medical student and intern education and engagement with the department of radiology during COVID-19 mitigation.

Forecasting Air Quality in Taiwan by Using Machine Learning.

This study proposes a gradient-boosting-based machine learning approach for predicting the PM2.5 concentration in Taiwan. The proposed mechanism is evaluated on a large-scale database built by the Environmental Protection Administration, and Central Weather Bureau, Taiwan, which includes data from 77 air monitoring stations and 580 weather stations performing hourly measurements over 1 year. By learning from past records of PM2.5 and neighboring weather stations' climatic information, the forecasting model works well for 24-h prediction at most air stations. This study also investigates the geographical and meteorological divergence for the forecasting results of seven regional monitoring areas. We also compare the prediction performance between Taiwan, Taipei, and London; analyze the impact of industrial pollution; and propose an enhanced version of the prediction model to improve the prediction accuracy. The results indicate that Taipei and London have similar prediction results because these two cities have similar topography (basin) and are financial centers without domestic pollution sources. The results also suggest that after considering industrial impacts by incorporating additional features from the Taichung and Thong-Siau power plants, the proposed method achieves significant improvement in the coefficient of determination (R2) from 0.58 to 0.71. Moreover, for Taichung City the root-mean-square error decreases from 8.56 for the conventional approach to 7.06 for the proposed method.

Microsampling: considerations for its use in pharmaceutical drug discovery and development.

There is growing interest in the implementation of microsampling approaches for the quantitation of circulating concentrations of analytes in biological samples derived from nonclinical and clinical studies involved in drug development. This interest is partly due to the ethical advantages of taking smaller blood volumes, particularly for studies in rodents, children and the critically ill. In addition, these technologies facilitate sampling to be performed in previously intractable locations and occasions. Further, they enable the collection of samples for additional purposes (extra time points, biomarkers, sampling during a clinical event, etc). This article gives a comprehensive insight to the utilization of these approaches in drug discovery and development, and provides recommendations for best practice for nonclinical, clinical and bioanalytical aspects.

Public Intoxication: Sobering Centers as an Alternative to Incarceration, Houston, 2010-2017.

In 2010, the Houston police department admitted 20 508 publicly intoxicated individuals into its jail. To address jail overcrowding, the city created a jail diversion policy that allowed law enforcement to admit publicly intoxicated individuals into a new sobering center. By 2017, public intoxication jail admissions had decreased by 95%, freeing valuable resources. A promising public health intervention, sobering centers offer an alternative to incarceration and relieve overuse of emergency services while assisting individuals with substance use issues.

The KN-93 Molecule Inhibits Calcium/Calmodulin-Dependent Protein Kinase II (CaMKII) Activity by Binding to Ca2+/CaM.

Calcium/calmodulin-dependent protein kinase II (CaMKII) is a multifunctional serine/threonine protein kinase that transmits calcium signals in various cellular processes. CaMKII is activated by calcium-bound calmodulin (Ca2+/CaM) through a direct binding mechanism involving a regulatory C-terminal α-helix in CaMKII. The Ca2+/CaM binding triggers transphosphorylation of critical threonine residues proximal to the CaM-binding site leading to the autoactivated state of CaMKII. The demonstration of its critical roles in pathophysiological processes has elevated CaMKII to a key target in the management of numerous diseases. The molecule KN-93 is the most widely used inhibitor for studying the cellular and in vivo functions of CaMKII. It is widely believed that KN-93 binds directly to CaMKII, thus preventing kinase activation by competing with Ca2+/CaM. Herein, we employed surface plasmon resonance, NMR, and isothermal titration calorimetry to characterize this presumed interaction. Our results revealed that KN-93 binds directly to Ca2+/CaM and not to CaMKII. This binding would disrupt the ability of Ca2+/CaM to interact with CaMKII, effectively inhibiting CaMKII activation. Our findings also indicated that KN-93 can specifically compete with a CaMKIIδ-derived peptide for binding to Ca2+/CaM. As indicated by the surface plasmon resonance and isothermal titration calorimetry data, apparently at least two KN-93 molecules can bind to Ca2+/CaM. Our findings provide new insight into how in vitro and in vivo data obtained with KN-93 should be interpreted. They further suggest that other Ca2+/CaM-dependent, non-CaMKII activities should be considered in KN-93-based mechanism-of-action studies and drug discovery efforts.

Characterization of murine CEACAM1 in vivo reveals low expression on CD8+ T cells and no tumor growth modulating activity by anti-CEACAM1 mAb CC1.

Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) has been reported to mediate both tumorigenic and anti-tumor effects in vivo. Blockade of the CEACAM1 signaling pathway has recently been implicated as a novel mechanism for cancer immunotherapy. CC1, a mouse anti-CEACAM1 monoclonal antibody (mAb), has been widely used as a pharmacological tool in preclinical studies to inform on CEACAM1 pathway biology although limited data are available on its CEACAM1 blocking characteristics or pharmacodynamic-pharmacokinetic profiles. We sought to investigate CEACAM1 expression on mouse tumor and immune cells, characterize CC1 mAb binding, and evaluate CC1 in syngeneic mouse oncology models as a monotherapy and in combination with an anti-PD-1 mAb. CEACAM1 expression was observed at high levels on neutrophils, NK cells and myeloid-derived suppressor cells (MDSCs), while the expression on tumor-infiltrating CD8+ T cells was low. Unexpectedly, rather than blocking, CC1 facilitated binding of soluble CEACAM1 to CEACAM1 expressing cells. No anti-tumor effects were observed in CT26, MBT2 or A20 models when tested up to 30 mg/kg dose, a dose that was estimated to achieve >90% target engagement in vivo. Taken together, tumor infiltrating CD8+ T cells express low levels of CEACAM1 and CC1 Ab mediates no or minimal anti-tumor effects in vivo, as a monotherapy or in combination with anti-PD-1 treatment.

A microfluidic sub-critical water extraction instrument.

This article discusses a microfluidic subcritical water extraction (SCWE) chip for autonomous extraction of amino acids from astrobiologically interesting samples. The microfluidic instrument is composed of three major components. These include a mixing chamber where the soil sample is mixed and agitated with the solvent (water), a subcritical water extraction chamber where the sample is sealed with a freeze valve at the chip inlet after a vapor bubble is injected into the inlet channels to ensure the pressure in the chip is in equilibrium with the vapor pressure and the slurry is then heated to ≤200 °C in the SCWE chamber, and a filter or settling chamber where the slurry is pumped to after extraction. The extraction yield of the microfluidic SCWE chip process ranged from 50% compared to acid hydrolysis and 80%-100% compared to a benchtop microwave SCWE for low biomass samples.

Clinical and pharmaceutical success from discovery to regulatory approval: biomarkers, modeling and analytical technologies.

The 8th Annual Shanghai Symposium on Clinical and Pharmaceutical Solutions through Analysis (CPSA): Clinical and Pharmaceutical Success from Discovery to Regulatory Approval: Biomarkers, Modeling and Analytical Technologies (CPSA Shanghai 2017); Renaissance Shanghai Pudong Hotel, Shanghai, China, 12-14 April 2017 was held on 12-14 April 2017 in Shanghai, China. The meeting was featured with highly interactive events including diversified symposia, workshops, roundtable discussions, conference awards and poster sessions. There were over 220 participants with 61 oral presentations and 20 posters presented. In addition, the meeting included a preconference workshop with an inaugural session on the evaluation of quality and efficacy for generic drugs in China.

7th Annual Symposium on Clinical and Pharmaceutical Solutions through Analysis.

7th Annual Symposium on Clinical & Pharmaceutical Solutions through Analysis, Renaissance Shanghai Pudong Hotel, Shanghai, China, 20-23 April 2016 The 7th Annual Shanghai Symposium on Innovative Approaches to Reduce Attrition and Predict Clinical Outcomes (CPSA Shanghai 2016) was held on 20-23 April 2016 in Renaissance Shanghai Pudong Hotel, Shanghai, China. The meeting was featured with highly interactive events including diversified symposia, round table discussions, workshops, poster sessions and conference awards. There were over 220 participants from more than ten countries, with 61 oral presentations and 29 posters presented. In addition, the meeting included one preconference workshop and three joint sessions held with bioanalytical experts from local communities.

Patterns of expression of factor VIII and von Willebrand factor by endothelial cell subsets in vivo.

UNLABELLED: Circulating factor VIII (FVIII) is derived from liver and from extrahepatic sources probably of endothelial origin, but the vascular sites of FVIII production remain unclear. Among organs profiled, only liver and lymph nodes (LNs) show abundant expression of F8 messenger RNA (mRNA). Transcriptomic profiling of subsets of stromal cells, including endothelial cells (ECs) from mouse LNs and other tissues, showed that F8 mRNA is expressed by lymphatic ECs (LECs) but not by capillary ECs (capECs), fibroblastic reticular cells, or hematopoietic cells. Among blood ECs profiled, F8 expression was seen only in fenestrated ECs (liver sinusoidal and renal glomerular ECs) and some high endothelial venules. In contrast, von Willebrand factor mRNA was expressed in capECs but not in LECs; it was coexpressed with F8 mRNA in postcapillary high endothelial venules. Purified LECs and liver sinusoidal ECs but not capECs from LNs secrete active FVIII in culture, and human and mouse lymph contained substantial FVIII: C activity. Our results revealed localized vascular expression of FVIII and von Willebrand factor and identified LECs as a major cellular source of FVIII in extrahepatic tissues.

Vascular inflammation and abnormal aortic histomorphometry in patients after pulsatile- and continuous-flow left ventricular assist device placement.

BACKGROUND: Left ventricular assist devices are increasingly being used in patients with advanced heart failure as both destination therapy and bridge to transplant. We aimed to identify histomorphometric, structural and inflammatory changes after pulsatile- and continuous-flow left ventricular assist device placement. METHODS: Clinical and echocardiographic data were collected from medical records. Aortic wall diameter, cellularity and inflammation were assessed by immunohistochemistry on aortic tissue collected at left ventricular assist device placement and at explantation during heart transplantation. Expression of adhesion molecules was quantified by Western blot. RESULTS: Decellularization of the aortic tunica media was observed in patients receiving continuous-flow support. Both device types showed an increased inflammatory response after left ventricular assist device placement with variable T-cell and macrophage accumulations and increased expression of vascular E-selectin, ICAM and VCAM in the aortic wall. CONCLUSIONS: Left ventricular assist device implantation is associated with distinct vascular derangements with development of vascular inflammation. These changes are pronounced in patients on continuous-flow left ventricular assist and associated with aortic media decellularization. The present findings help to explain the progressive aortic root dilation and vascular dysfunction in patients after continuous-flow device placement.