An XMM-Newton View of the Radio Galaxy 3C 411

We present the first high signal-to-noise XMM-Newton observations of the broad-line radio galaxy 3C 411. After fitting various spectral models, an absorbed double power-law continuum and a blurred relativistic disk reflection model (kdblur) are found to be equally plausible descriptions of the data. While the softer power-law component ($\Gamma$=2.11) of the double power-law model is entirely consistent with that found in Seyfert galaxies (and hence likely originates from a disk corona), the additional power law component is very hard ($\Gamma$=1.05); amongst the AGN zoo, only flat-spectrum radio quasars have such hard spectra. Together with the very flat radio-spectrum displayed by this source, we suggest that it should instead be classified as a FSRQ. This leads to potential discrepancies regarding the jet inclination angle, with the radio morphology suggesting a large jet inclination but the FSRQ classification suggesting small inclinations. The kdblur model predicts an inner disk radius of at most 20 r$_g$ and relativistic reflection

Fit for purpose? The patents regime, the Fourth Industrial Revolution, and sustainable development

This article uses data from several publicly available databases to show that the distribution of intellectual property for frontier technologies, including those useful for sustainable development, is very highly skewed in favor of a handful of developed countries. The intellectual property rights (IPR) regime as it exists does not optimize the global flow of technology and know-how for the attainment of the sustainable development goals and is in need of updating. Some features of the Fourth Industrial Revolution imply that the current system of patents is even more in need of reform than before. COVID-19 vaccines and therapies and the vast inequality in access to these has highlighted the costs of inaction. We recommend several policy changes for the international IPR regime. Broadly, these fall into three categories: allowing greater flexibility for developing countries, reassessing the appropriateness of patents for technologies that may be considered public goods, and closing loopholes that allow for unreasonable intellectual property protections

Study protocol for Smartphone Monitoring for Atrial fibrillation in Real-Time in India (SMART-India): a community-based screening and referral programme

INTRODUCTION: Atrial fibrillation (AF), the world\u27s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India, where AF epidemiology is undefined. AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF. This study aims to describe the epidemiology of AF in Anand District, Gujarat, India, characterise the clinical profile of individuals who are diagnosed with AF and determine the performance of two mobile technologies for community-based AF screening. METHODS: This observational study builds on findings from a previous feasibility study and leverages two novel technologies as well as an existing community health programme to perform door-to-door AF screening for 2000 people from 60 villages of Anand District, Gujarat, India using local health workers. A single-lead ECG and a pulse-based application is used to screen each individual for AF three times over a period of 5 days. Participants with suspected arrhythmias are followed up by study cardiologist who makes final diagnoses. Participants diagnosed with AF are initiated on treatment based on current anticoagulation guidelines and clinical reasoning. ANALYTICAL PLAN: Age-stratified and sex-stratified prevalence of AF in the Anand District will be calculated for sample and estimated for Anand distribution using survey design weights. Sociodemographic and clinical factors associated with AF will be evaluated using multivariable regression methods. Performance of each mobile technology in detecting AF will be evaluated using a 12-lead ECG interpretation as the gold standard. ETHICS AND DISSEMINATION: This protocol was approved separately by the Institutional Review Board of University of Massachusetts Medical School and the Human Research Ethics Committee at Charutar Arogya Mandal. The findings of this study will be disseminated through peer-reviewed journals and scientific conferences

High Burden of Unrecognized Atrial Fibrillation in Rural India: An Innovative Community-Based Cross-Sectional Screening Program

BACKGROUND: Atrial fibrillation, the world\u27s most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly. OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor. METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team of trained research coordinators and community health workers enrolled a total of 354 participants aged 50 years and older and screened them at their residences using Alivecor for 2 minutes on 5 consecutive days over a period of 6 weeks beginning June, 2015. RESULTS: Almost two-thirds of study participants were 55 years or older, nearly half were female, one-third did not receive any formal education, and more than one-half were from households earning less than US $2 per day. Twelve participants screened positive for atrial fibrillation yielding a sample prevalence of 5.1% (95% CI 2.7-8.7). Only one participant had persistent atrial fibrillation throughout all of the screenings, and 9 screened positive only once. CONCLUSIONS: Our study suggests a prevalence of atrial fibrillation in this Indian region (5.1%) that is markedly higher than has been previously reported in India and similar to the prevalence estimates reported in studies of persons from North America and Europe. Historically low reported burden of atrial fibrillation among individuals from low and middle-income countries may be due to a lack of routine screening. Mobile technologies may help overcome resource limitations for atrial fibrillation screening in underserved and low-resource settings

RAHI-SATHI Indo-U.S. Collaboration: The Evolution of a Trainee-Led Twinning Model in Global Health Into a Multidisciplinary Collaborative Program

BACKGROUND: In recent years there has been a surge in the number of global health programs operated by academic institutions. However, most of the existing programs describe partnerships that are primarily faculty-driven and supported by extramural funding. PROGRAM DESCRIPTION: Research and Advocacy for Health in India (RAHI, or pathfinder in Hindi) and Support and Action Towards Health-Equity in India (SATHI, or partnership in Hindi) are 2 interconnected, collaborative efforts between the University of Massachusetts Medical School (UMMS) and Charutar Arogya Mandal (CAM), a medical college and a tertiary care center in rural western India. The RAHI-SATHI program is the culmination of a series of student/trainee-led research and capacity strengthening initiatives that received institutional support in the form of faculty mentorship and seed funding. RAHI-SATHI\u27s trainee-led twinning approach overcomes traditional barriers faced by global health programs. Trainees help mitigate geographical barriers by acting as a bridge between members from different institutions, garner cultural insight through their ability to immerse themselves in a community, and overcome expertise limitations through pre-planned structured mentorship from faculty of both institutions. Trainees play a central role in cultivating trust among the team members and, in the process, they acquire personal leadership skills that may benefit them in their future careers. CONCLUSION: This paradigm of trainee-led twinning partnership promotes sustainability in an uncertain funding climate and provides a roadmap for conducting foundational work that is essential for the development of a broad, university-wide global health program

Exile Vol. XLI

39th Year Cover Art by Elisa Gargarelle \u2795 (quote from J.D. Salinger\u27s Catcher in the Rye) untitled by Aileen Jones \u2797 i Girl by Colin Bossen \u2798 1 sun by Alex Blazer \u2796 2 Shifting by Alex Blazer \u2796 2 The Fish by Sarah Ramsey \u2795 3 New Woman by Lisa Stillman \u2795 4 Why by Lelei Jennings \u2795 5 Camel Cafe by Jeremy Aufrance \u2795 5 Jenny by Lizzy Loud \u2795 6 Beautiful Dreamer by Melissa Bostrom \u2796 7 Rising by Lizzy Loud \u2795 12 Pinsetter by Jeremy Aufrance \u2795 13 A Greater Distance by Jeff Boon \u2795 14 Shiho by Jeff Boon \u2795 15 Sub-stance by Alex Blazer \u2796 15 Sisters by Gretchen Hambley \u2796 16 Anne Sexton by Allison Lemieux \u2796 17 The Holy Grail... by Ed Shim \u2795 17 untitled by Liz Bolyard \u2796 18 23 by Keith Chapman \u2795 18 Bang, Zoom! by Victoria Lyall \u2796 19 Gabe and Me by Heather Trabert \u2797 20 Tornado Summer by Liz Bolyard \u2796 21 Nude by Elise Gargarella \u2795 21 Why I can\u27t tell short stories by Colin Bossen \u2798 22 america by Lynn Tramonte \u2798 24 Upon Being Asked... by Matt Makman \u2796 24 Being Azra by Lynn Tramonte \u2798 25 Mystic Truths by Adrienne Binni \u2795 27 King\u27s Court by Elisha Gargarella \u2795 27 Incense by Erin Lott \u2796 28 Sunday Morning... by Lisa Stillman \u2795 33 untitled by Elisa Gargarella \u2795 33 Quien no ha visto... by Adrienne Binni \u2795 34 The Space Between Us by Allison Lemieux \u2795 35 searching for the Bermuda... by Victoria Lyall \u2796 35 untitled by Man Chhoa \u2796 36 The Hunted by J. Murdoch Matheson \u2796 37 Editorial decisions are shared equally among the editorial board. -4

Integrated Risk Assessment for the Blue Economy

With the anticipated boom in the ‘blue economy’ and associated increases in industrialization across the world’s oceans, new and complex risks are being introduced to ocean ecosystems. As a result, conservation and resource management increasingly look to factor in potential interactions among the social, ecological and economic components of these systems. Investigation of these interactions requires interdisciplinary frameworks that incorporate methods and insights from across the social and biophysical sciences. Risk assessment methods, which have been developed across numerous disciplines and applied to various real-world settings and problems, provide a unique connection point for cross-disciplinary engagement. However, research on risk is often conducted in distinct spheres by experts whose focus is on narrow sources or outcomes of risk. Movement toward a more integrated treatment of risk to ensure a balanced approach to developing and managing ocean resources requires cross-disciplinary engagement and understanding. Here, we provide a primer on risk assessment intended to encourage the development and implementation of integrated risk assessment processes in the emerging blue economy. First, we summarize the dominant framework for risk in the ecological/biophysical sciences. Then, we discuss six key insights from the long history of risk research in the social sciences that can inform integrated assessments of risk: (1) consider the subjective nature of risk, (2) understand individual social and cultural influences on risk perceptions, (3) include diverse expertise, (4) consider the social scales of analysis, (5) incorporate quantitative and qualitative approaches, and (6) understand interactions and feedbacks within systems. Finally, we show how these insights can be incorporated into risk assessment and management, and apply them to a case study of whale entanglements in fishing gear off the United States west coast

Bidirectional lipid droplet velocities are controlled by differential binding strengths of HCV Core DII protein

Host cell lipid droplets (LD) are essential in the hepatitis C virus (HCV) life cycle and are targeted by the viral capsid core protein. Core-coated LDs accumulate in the perinuclear region and facilitate viral particle assembly, but it is unclear how mobility of these LDs is directed by core. Herein we used two-photon fluorescence, differential interference contrast imaging, and coherent anti-Stokes Raman scattering microscopies, to reveal novel core-mediated changes to LD dynamics. Expression of core protein’s lipid binding domain II (DII-core) induced slower LD speeds, but did not affect directionality of movement on microtubules. Modulating the LD binding strength of DII-core further impacted LD mobility, revealing the temporal effects of LD-bound DII-core. These results for DII-core coated LDs support a model for core-mediated LD localization that involves core slowing down the rate of movement of LDs until localization at the perinuclear region is accomplished where LD movement ceases. The guided localization of LDs by HCV core protein not only is essential to the viral life cycle but also poses an interesting target for the development of antiviral strategies against HCV

Partial pulmonary embolization disrupts alveolarization in fetal sheep

BACKGROUND: Although bronchopulmonary dysplasia is closely associated with an arrest of alveolar development and pulmonary capillary dysplasia, it is unknown whether these two features are causally related. To investigate the relationship between pulmonary capillaries and alveolar formation, we partially embolized the pulmonary capillary bed. METHODS: Partial pulmonary embolization (PPE) was induced in chronically catheterized fetal sheep by injection of microspheres into the left pulmonary artery for 1 day (1d PPE; 115d gestational age; GA) or 5 days (5d PPE; 110-115d GA). Control fetuses received vehicle injections. Lung morphology, secondary septal crests, elastin, collagen, myofibroblast, PECAM1 and HIF1 alpha abundance and localization were determined histologically. VEGF-A, Flk-1, PDGF-A and PDGF-R alpha mRNA levels were measured using real-time PCR. RESULTS: At 130d GA (term approximately 147d), in embolized regions of the lung the percentage of lung occupied by tissue was increased from 29 +/- 1% in controls to 35 +/- 1% in 1d PPE and 44 +/- 1% in 5d PPE fetuses (p < 0.001). Secondary septal crest density was reduced from 8 +/- 0% in controls to 5 +/- 0% in 1d PPE and 4 +/- 0% in 5d PPE fetuses (p < 0.05), indicating impaired alveolar formation. The deposition of differentiated myofibroblasts (23 +/- 1% vs 28 +/- 1%; p < 0.001) and elastin fibres (3 +/- 0% vs 4 +/- 0%; p < 0.05) were also impaired in embolized lung regions of PPE fetuses compared to controls. PPE did not alter the deposition of collagen or PECAM1. At 116d GA in 5d PPE fetuses, markers of hypoxia indicated that a small and transient hypoxic event had occurred (hypoxia in 6.7 +/- 1.4% of the tissue within embolized regions of 5d PPE fetuses at 116d compared to 0.8 +/- 0.2% of tissue in control regions). There was no change in the proportion of tissue labelled with HIF1 alpha. There was no change in mRNA levels of the angiogenic factors VEGF and Flk-1, although a small increase in PDGF-R alpha expression at 116d GA, from 1.00 +/- 0.12 in control fetuses to 1.61 +/- 0.18 in 5d PPE fetuses may account for impaired differentiation of alveolar myofibroblasts and alveolar development. CONCLUSIONS: PPE impairs alveolarization without adverse systemic effects and is a novel model for investigating the role of pulmonary capillaries and alveolar myofibroblasts in alveolar formation

Developing a Community-Based Screening and Referral Mechanism for Atrial Fibrillation in Low Resource Settings: “Smartphone Monitoring for Atrial Fibrillation in Real-Time – India (SMART-India)”

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF. OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for community-based AF screening. METHODS: We built on findings from our feasibility study and leveraged two novel technologies as well as an existing community health program to screen 2,500 people from 60 villages of Anand District. A single-lead EKG and a pulse-based app was used to screen each individual for AF 3 times over a period of 5 days. Participants with suspected arrhythmias were referred at a local tertiary-care hospital for further evaluation and follow up with a cardiologist. Participants diagnosed with AF were initiated on treatment as deemed appropriate by the cardiologist. ANALYTICAL PLAN: Age- and sex-stratified AF prevalence for AF will be calculated using survey weights to estimate population prevalence. Sociodemographic and clinical factors associated with AF will be evaluated using multivariable regression methods. Performance of each mobile technology in detecting AF will be evaluated by measuring sensitivity, specificity, and discriminative ability while considering a 12-lead EKG interpretation as gold-standard. CONCLUSIONS: Effective approaches for leveraging state-of-the-art technology to develop a screening and referral mechanism for AF in low-resource settings requires active participation with community partners and health workers