bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Viral Load as a Triage Strategy With Primary High-Risk Human Papillomavirus Cervical Cancer Screening
Authors: Luo Hongxue , Belinson Jerome L. , Du Hui , Liu Zhihong , Zhang Lijie , Wang Chun , Qu Xinfeng , Pretorius Robert G. , Wu Ruifang
Published: November 2016

Objective

The aim of the study was to evaluate the human papillomavirus (HPV) viral load combined with cytology as a secondary screening strategy after primary HPV screening.

Materials and Methods

The data referring to direct Hybrid Capture 2 (HC2), cytology, and histology from Shenzhen Cervical Cancer Screening Trial II were re-analyzed to determine the correlation between viral load and cervical lesions. In addition, algorithms using different viral loads as cut points for immediate colposcopy plus cytology triage were compared with several recommended or controversial primary screening methods.

Results

A total of 8,556 women with a mean age of 38.9 years were included in the analysis, of which 13.67% tested high-risk HPV positive with a prevalence of 2.72% for cervical intraepithelial neoplasia 2+ (CIN 2+) and 1.65% for CIN 3+. A significant correlation was observed between increasing relative light units/control (RLU/CO) values and worsening cervical lesions. The mean RLU/CO values for negative, CIN 1, CIN 2, CIN 3, and cancer were 6.86, 119.43, 410.90, 449.39, and 853.26, respectively. A larger proportion of HPV infections with relative high viral load (≥10 RLU/CO) were found in higher-grade lesions. The algorithm using 10 or greater RLU/CO as cut point for immediate colposcopy followed by triage cytology for the other positive (≥1 < 10 RLU/CO) had sensitivity of 93.13%/96.45% and specificity of 92.32%/91.44% for CIN 2+/3+, and the colposcopy referral rate was 10.00%.

Conclusions

Human papillomavirus viral load level is positively associated with cervical lesion grade. Ten relative light units/control or greater is a viable threshold for immediate colposcopy whereas 1 or greater or less than 10 RLU/CO is advised to reflex cytology for optimizing sensitivity and specificity, as well as referral rates.
Postoperative care in endoscopic sinus surgery: a critical review
Authors: Eloy Philippe , Andrews Peter , Poirrier Anne-Lise
Published: November 2016

Purpose of review

Chronic rhinosinusitis with and without nasal polyps is a common disease affecting people all over the world. Functional endoscopic sinus surgery (FESS) has become the gold standard treatment for medically refractive disease. Postoperative care is recommended by international leaders as an important part of the patient's management. This article is a critical review and discussion focusing on postoperative care, which is based on expert opinion, clinical studies, randomized controlled trials and meta-analysis studies.

Recent findings

Postoperative care including nasal rinsing, topical corticosteroids, antibiotics and avoidance of nasal packing are unanimously considered to be the cornerstone of best practice following FESS. However, the effectiveness of in-office nasal debridement is still under debate.

There is a lack of consensus regarding the necessity of performing in-office nasal debridement and the majority of clinicians carry out their postoperative care according to experience and their own preference. This is often determined by the extent of surgery performed, the severity of the postoperative inflammation, as well as being dependent on the patient's discomfort, the time constraints associated with postoperative care and the costs associated with additional appointments. Ideally, nasal debridement should be performed by the operating surgeon under endoscopic control both gently and atraumatically.
Closing the growth plate: a review of indications and surgical options
Authors: Ruzbarsky Joseph J. , Goodbody Christine , Dodwell Emily
Published: November 2016

Purpose of review

The purpose is to review the indications for epiphysiodesis in the treatment of pediatric limb length discrepancies; provide an update on current diagnostic, planning, and surgical techniques; and to introduce possible future alternatives.

Recent findings

Retrospective comparative studies have failed to demonstrate superiority of one epiphysiodesis technique over the others. EOS low-dose biplanar X-ray and smartphone growth prediction applications are improving our ability to diagnose and plan treatment for leg length discrepancy. Arthroscopically guided percutaneous epiphysiodesis and radiofrequency ablation are newer techniques that are still under investigation.

Epiphysiodesis is the treatment of choice for children with predicted leg length discrepancies between 2–5 cm, provided that the physes are open with sufficient growth remaining. The most common epiphysiodesis techniques are performed percutaneously and either ablate the physis with drills/curettes or use metal implants to tether the physis and prevent further growth. Surgical treatment is typically ambulatory in nature, and allows for early return to weight bearing. In modern series, complication rates are less than 10%, with the majority being minor complications. Further high-quality prospective research is needed to determine the optimal epiphysiodesis surgical technique.
Serum Acetaminophen Protein Adduct Concentrations in Pediatric Emergency Department Patients
Authors: Heard Kennon , Anderson Victoria , Dart Richard C. , Kile Deidre , Lavonas Eric J. , Green Jody L.
Published: November 2016

Objectives:

Acetaminophen toxicity is a common cause of pediatric liver failure. The diagnosis may be limited by the short window of detection of acetaminophen in serum. Recently acetaminophen protein adducts (APAP‐CYS) have been used as a biomarker with a longer duration of detection. The objective of this study was to describe the serum concentrations of APAP‐CYS in pediatric patients with and without reported therapeutic acetaminophen exposure.

Methods:

A cross‐sectional study of children age 1 to <12 years presenting to a pediatric emergency department. Subjects were stratified by recent acetaminophen use and had serum APAP‐CYS measured using LC/MS.

Results:

One hundred patients were enrolled. All of the patients whose caregivers denied acetaminophen exposure had nondetectable APAP‐CYS. Fifty‐two percent of subjects who were reported to have taken acetaminophen in the preceding 2 weeks had detectable serum APAP‐CYS. The APAP‐CYS concentrations were positively correlated with higher overall dose and more recent ingestion.

Conclusions:

APAP‐CYS is detectable in the majority of children taking acetaminophen and not detected in the majority of children who are not exposed to acetaminophen.
Prevalence and Patterns of Marijuana Use in Young Adults With Inflammatory Bowel Disease
Authors: Phatak Uma P. , Rojas‐Velasquez Danilo , Porto Anthony , Pashankar Dinesh S.
Published: November 2016

Objectives:

Recent studies in adults report symptom relief with marijuana use in patients with inflammatory bowel disease (IBD). We assessed the prevalence, pattern, effects, and adverse effects of marijuana use in young adults with IBD.

Methods:

We conducted a prospective questionnaire survey study at a pediatric IBD clinic. All patients (18–21 years of age) answered anonymous questionnaires about demographics, IBD, medications, and marijuana use.

Results:

Fifty‐three patients (mean age 18.7 years, 32 boys) were enrolled. Thirty‐seven patients (70%) reported using marijuana currently or in the past. There was no statistically significant difference between the users and nonusers of marijuana regarding demographics, disease activity, or medications. Despite prolonged use of marijuana, 70% of patients did not discuss it with their gastroenterologists. Twenty‐four patients used marijuana medicinally for IBD symptoms in addition to medical therapy. Although majority found marijuana to be moderately/very helpful, complete relief of symptoms such as abdominal pain, poor appetite, nausea, and diarrhea was seen in 29%, 37%, 14%, and 10% of patients, respectively. Only half of patients reported knowledge of possible adverse effects of marijuana and 19% of patients reported mild neuropsychiatric adverse effects. Overall, 98% of patients supported legalization of marijuana and 85% were interested in using medical marijuana if it became legally available.

Conclusions:

We found a high rate of marijuana use in our cohort of young adults with IBD. Majority of users report symptom improvement but do not inform physicians. Future well‐controlled studies are necessary to assess role of marijuana in IBD therapy.
Organizational Readiness for Nurse Residency Accreditation
Authors: Franquiz Renee , Seckman Charlotte
Published: November 2016

Professional development nurses assume a principal role in establishing a state of readiness for accreditation of an organization’s nurse residency program. This quality improvement project engaged a professional development department in self-study of their nurse residency program to determine readiness for accreditation by the Commission on Collegiate Nursing Education. The outcomes demonstrate a favorable state of organizational readiness, with minor program gaps in 19/45 accreditation criteria, requiring corrective action to optimize readiness for success.
Two Paths to Competency Validation
Authors: Morrell Briyana L. , Campbell Nancy
Published: November 2016

To determine nurses’ ability to intervene appropriately in cases of opiate-induced respiratory depression, educators piloted two competency validation options. Nurses could choose to write an exemplar or perform in a simulation. A comparison of how nurses prepared for the methods and how educators validated their competency is described. Although unofficial staff and leadership responses to the competency methods were positive, further exploration is needed to evaluate the effectiveness of the strategies in improving nurses’ care practices and patient outcomes.
The potential role of Wolbachia in controlling the transmission of emerging human arboviral infections
Authors: Kamtchum-Tatuene Joseph , Makepeace Benjamin L. , Benjamin Laura , Baylis Matthew , Solomon Tom
Published: November 2016

Purpose of review

Wolbachia is a genus of Gram-negative intracellular bacteria that is naturally found in more than half of all arthropod species. These bacteria cannot only reduce the fitness and the reproductive capacities of arthropod vectors, but also increase their resistance to arthropod-borne viruses (arboviruses). This article reviews the evidence supporting a Wolbachia-based strategy for controlling the transmission of dengue and other arboviral infections.

Recent findings

Studies conducted 1 year after the field release of Wolbachia-infected mosquitoes in Australia have demonstrated the suppression of dengue virus (DENV) replication in and dissemination by mosquitoes. Recent mathematical models show that this strategy could reduce the transmission of DENV by 70%. Consequently, the WHO is encouraging countries to boost the development and implementation of Wolbachia-based prevention strategies against other arboviral infections. However, the evidence regarding the efficacy of Wolbachia to prevent the transmission of other arboviral infections is still limited to an experimental framework with conflicting results in some cases. There is a need to demonstrate the efficacy of such strategies in the field under various climatic conditions, to select the Wolbachia strain that has the best pathogen interference/spread trade-off, and to continue to build community acceptance.

Wolbachia represents a promising tool for controlling the transmission of arboviral infections that needs to be developed further. Long-term environmental monitoring will be necessary for timely detection of potential changes in Wolbachia/vector/virus interactions.
Efficacy of Endoscopic Submucosal Excavation for Gastrointestinal Stromal Tumors in the Cardia
Authors: Wang Shanshan , Shen Lei
Published: November 2016

Objective:

Our goal was to estimate the feasibility and efficacy of endoscopic submucosal excavation (ESE) for the treatment of gastrointestinal stromal tumors (GISTs) in the cardia.

Materials and Methods:

We analyzed the clinical data of 30 patients who were diagnosed with GISTs after ESE in the cardia at the Endoscopy Center of Renmin Hospital of Wuhan University (China) from June 2009 to 2015. We evaluated the operative and postoperative conditions and long-term follow-up of these patients.

Results:

The success rate and the complete resection rate were both 100%. The maximum diameter of the tumor ranged from 1.0 to 3.5 cm (2.2±0.2 cm). The operation time was 20 to 120 min (50±5 min). During ESE, bleeding occurred in all cases (100%) with a mean blood loss of 50 mL, and perforation in 6 (20%), including 2 full-thickness resections. GIST was confirmed by pathology in all cases. Follow-up included endoscopy at 1, 3, and 6 months, and at 1 year. At 1 month, ulcer was detected in 23 cases (76.67%), titanium clips remained in 17 cases (56.67%), and scar tissues were observed in the remainder. No recurrence was found with gastroscopy.

Conclusions:

The cardia is a unique anatomic location for GISTs, which often requires complex surgeries prone to complications. ESE for GISTs of the cardia is a challenging, but safe and effective procedure.
Laparoscopic Repair of Intrathoracic Stomach: Clinical and Health-related Quality of Life Outcomes
Authors: Karim Muhammad A. , Maloney Jay , Ali AbdulMajid
Published: November 2016

Background:

This study aims to evaluate the clinical and quality of health outcomes in patients undergoing laparoscopic repair of intrathoracic stomach with or without gastric volvulus.

Materials and Methods:

From January 2007 to December 2013, a prospectively maintained data, of patients undergoing surgical repair of intrathoracic stomach, with or without gastric volvulus, was reviewed. Patient demographics, ASA grade, diagnostic technique, semiurgent/emergency status, type of volvulus if present, details of surgery and perioperative complications were recorded. Validated SF-36 questionnaires were completed by patients to record preoperative and postoperative quality of life (QoL) status. Patients managed by nonoperative measures were excluded from the study.

Results:

Thirty patients were identified with intrathoracic stomach. Fourteen patients had gastric volvulus. Twenty-seven patients (10 emergency, 17 semiurgent) underwent laparoscopic repair of intrathoracic stomach and were included in the study. Mean operating time was 156 (SD, 37.5; range, 105 to 230) minutes. All 27 operations were completed by laparoscopic approach. There was no conversion to open procedure or mortality at 30 days. Mean hospital stay was 5.2 (range, 1 to 15) days. There were 3 (11%) early postoperative complications. One (3.7%) patient developed recurrence at 2 years which required reoperation. Mean follow-up was 10.5 (range, 1 to 36) months. ASA grade and operative time determined the postoperative hospital stay (P=0.001, 0.001, respectively), whereas body mass index and age were shown to have no influence. Patient-reported QoL scores improved across all scales of the health questionnaire after surgery especially bodily pain, social functioning, and physical functioning.

Conclusions:

Laparoscopic surgery is a safe and effective treatment option for intrathoracic stomach, with or without gastric volvulus. It is associated with low rates of complications and recurrence. Self-reported patient data shows significant improvement to overall QoL after surgery for intrathoracic stomach.
Decreased Incidence of Postoperative Delirium in Robot-assisted Thoracoscopic Esophagectomy Compared With Open Transthoracic Esophagectomy
Authors: Jeong Dae Myoung , Kim Jie Ae , Ahn Hyun Joo , Yang Mikyung , Heo Burn Young , Lee Soo Hee
Published: November 2016

Background:

Postoperative delirium (POD) is one of messy complications related with increased mortality and hospital costs. Patients undergoing esophagectomy are more in danger of delirium than other kinds of surgeries. We investigated the impact of robot-assisted thoracoscopic esophagectomy on the incidence of POD compared with open transthoracic esophagectomy.

Materials and Methods:

A retrospective review was completed for the patients who underwent esophagectomy from December 2, 2012 and April 15, 2015 (n=529). POD was assessed using Confusion Assessment Method for the Intensive Care Unit. The comparison of group differences between the robotic esophagectomy group (R group) and the open esophagectomy group (O group) was conducted with and without propensity score (PS) matching method. Univariate model was used for 247 PS-matched patients to calculate the odds ratio of potential risk factors of POD.

Results:

The incidence rate of POD was significantly lower among R group patients than O group (30% vs. 42%; P=0.035) after PS matching method. The risk of POD in R group was 0.55-fold lower than that of O group. Operative time and intraoperative blood loss were also significantly lower in R group patients.

Conclusions:

In conclusion, robotic thoracoscopic esophagectomy lowers the incidence of POD 0.55-fold compared with open transthoracic esophagectomy.
Laparoscopic Sleeve Gastrectomy Outcomes of 750 Patients: A 2.5-Year Experience at a Bariatric Center of Excellence
Authors: Altun Hasan , Batman Burcin , Uymaz Salim D. , Serin Rahmi K. , Salman Serpil , Tayyareci Yelda , Ece Ferah , Hurkal Tugce , Dal Didem
Published: November 2016

Laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. This retrospective cohort study evaluated the outcomes of a large cohort of patients with obesity who underwent LSG in a Bariatric Center of Excellence. All consecutive patients who underwent LSG between July 2013 and April 2016 were identified retrospectively. Preoperative and postoperative variables and comorbidities were recorded. The study consisted of 750 patients. Their mean age was 37.4 years; 72% were women, and the mean body mass index was 42.8 kg/m2. The most common preoperative comorbidities were diabetes (23.3%), hyperlipidemia (21.9%), hypertension (21.1%), and obstructive sleep apnea (21.1%). The rates of comorbidity resolution during follow-up were 80.6%, 74.4%, 82.9%, and 94.3%, respectively. The percentage average excess weight loss 1, 3, and 6 months and 1 and 2 years after surgery was 29.4%±11.3%, 54.4%±17.7%, 76.9%±20.9%, 85.5%±23.6%, and 89.7%±27.6%, respectively. There was no mortality. LSG effectively and safely induced weight loss and comorbidity resolution.
Endoscopic Stenting With the Over-The-Scope Technique: Our Experience With 11 Consecutive Patients
Authors: Mutignani Massimiliano , Dokas Stefanos , Forti Edoardo , Pugliese Francesco , Manta Raffaele , Dioscoridi Lorenzo
Published: November 2016

Background:

Endoscopic stenting is widely used to manage benign and malignant strictures, postoperative stenoses, or anastomotic leaks and fistulas.

Materials and Methods:

However, Over the Wire delivery systems are generally short and quite stiff, and therefore, cannot reach distal parts of the gastrointestinal tract or cross severely angulated strictures. In such cases, we used the Over-the-Scope stenting (OTSS) technique to deliver and deploy endoscopically large-bore fully covered stents. We present herein a series of 11 patients treated with the OTSS technique for a variety of indications. To our knowledge, this is the largest series of OTSS cases published.

Results:

The stents were correctly deployed in 10 cases. In one case, the stent was dislocated during scope withdrawal and Through the Scope stenting was performed with a smaller diameter uncovered stent instead. Predilation of the stricture was necessary in 5 patients. Clinical success was achieved in all patients.

Conclusions:

Our results encourage the use of the OTSS technique in cases where standard Over the Wire delivery systems of large-bore stents cannot reach or cross distal or tortuous strictures. The technique can also be used to reinsert migrated stents or misplaced braided-suture release mechanism (Ultraflex) stents.
The World's Youngest Cadaveric Kidney Transplant: Medical, Surgical and Ethical Issues
Authors: Daar Abdallah S. , Al Lawati Nabil Mohsin
Published: November 2016

Background

We report here the first successful transplant from a preterm cadaveric donor. This was performed in November 1994. The donor, who had been born at about 33 weeks of gestation, was diagnosed as having agenesis of the corpus callosum. The transplant was carried out 10 days after the donor's birth. The recipient was a 17-month-old boy with a diagnosis of Denys-Drash syndrome (WT1 mutation).

Method

We describe and analyze the ethical, social, cultural, medical and surgical issues encountered and how these were addressed. The major issue of determining death in a beating heart, very young donor was dealt with in the absence of worldwide experience and guidelines.

Results

The transplanted recipient has lived with the grafted pair of kidneys for more then 22 years. He has led a relatively normal life.

Conclusions

It is possible for immature preterm deceased donor kidneys to be transplanted into a 17-month-old recipient and for the grafted kidneys to grow with the recipient and function for 22 years. There were challenges in ethically determining the death of the donor, in surgical techniques to obviate potential surgical complications, and in postoperative care of the recipient, but these were managed successfully.
Data philanthropy and the design of the infraethics for information societies
Authors: Taddeo Mariarosaria
Published: November 2016

In mature information societies, sharing data is increasingly recognized as a crucial means to foster their development. However, competing tensions on data control and ownership, limited technical understanding, and the lack of an adequate governance framework pose serious challenges to attempts to share data among different actors. Data philanthropy, understood as the donation of data from both individuals and private companies, has been proposed as means to meet these challenges. While at first sight data philanthropy may seem an uncontroversial phenomenon, a closer analysis reveals a bewildering network of problems. In this article, I analyse the role of data philanthropy in contemporary societies and the moral problems that it yields. I argue that the solution to these problems rests on the understanding of the
infraethical
nature of data philanthropy and on the design of an ethical framework encompassing the
right
infraethics and the
right
ethics. This is a framework able to address the changes brought about by the information revolution and to harness the opportunities that these pose for the prosperity of current and future information societies.

This article is part of the themed issue ‘The ethical impact of data science’.
The opportunities and ethics of big data: practical priorities for a national Council of Data Ethics
Authors: Varley-Winter Olivia , Shah Hetan
Published: November 2016

In order to generate the gains that can come from analysing and linking big datasets, data holders need to consider the ethical frameworks, principles and applications that help to maintain public trust. In the USA, the National Science Foundation helped to set up a Council for Big Data, Ethics and Society, of which there is no equivalent in the UK. In November 2015, the Royal Statistical Society convened a workshop of 28 participants from government, academia and the private sector, and discussed the practical priorities that might be assisted by a new Council of Data Ethics in the UK. This article draws together the views from that meeting. Priorities for policy-makers and others include seeking a public mandate and informing the terms of the social contract for use of data; building professional competence and due diligence on data protection; appointment of champions who are competent to address public concerns; and transparency, across all dimensions. For government data, further priorities include improvements to data access, and development of data infrastructure. In conclusion, we support the establishment of a national Data Ethics Council, alongside wider and deeper engagement of the public to address data ethics dilemmas.

This article is part of the themed issue ‘The ethical impact of data science’.
The ethics of data and of data science: an economist's perspective
Authors: Cave Jonathan
Published: November 2016

Data collection and modelling are increasingly important in social science and science-based policy, but threaten to crowd out other ways of thinking. Economists recognize that markets embody and shed light on human sentiments. However, their ethical consequences have been difficult to interpret, let alone manage. Although economic mechanisms are changed by data intensity, they can be redesigned to restore their benefits. We conclude with four cautions: if data are good, more may not be better; scientifically desirable data properties may not help policy; consent is a double-edged tool; and data exist only because someone thought to capture and codify them.

This article is part of the themed issue ‘The ethical impact of data science’.
Privacy is an essentially contested concept: a multi-dimensional analytic for mapping privacy
Authors: Mulligan Deirdre K. , Koopman Colin , Doty Nick
Published: November 2016

The meaning of privacy has been much disputed throughout its history in response to wave after wave of new technological capabilities and social configurations. The current round of disputes over privacy fuelled by data science has been a cause of despair for many commentators and a death knell for privacy itself for others. We argue that privacy’s disputes are neither an accidental feature of the concept nor a lamentable condition of its applicability. Privacy is essentially contested. Because it is, privacy is transformable according to changing technological and social conditions. To make productive use of privacy’s essential contestability, we argue for a new approach to privacy research and practical design, focused on the development of conceptual analytics that facilitate dissecting privacy’s multiple uses across multiple contexts.

This article is part of the themed issue ‘The ethical impact of data science’.
Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems
Authors: Leonelli Sabina
Published: November 2016

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what ‘participation’ means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs.

This article is part of the themed issue ‘The ethical impact of data science’.
Facilitating the ethical use of health data for the benefit of society: electronic health records, consent and the duty of easy rescue
Authors: Porsdam Mann Sebastian , Savulescu Julian , Sahakian Barbara J.
Published: November 2016

Advances in data science allow for sophisticated analysis of increasingly large datasets. In the medical context, large volumes of data collected for healthcare purposes are contained in electronic health records (EHRs). The real-life character and sheer amount of data contained in them make EHRs an attractive resource for public health and biomedical research. However, medical records contain sensitive information that could be misused by third parties. Medical confidentiality and respect for patients' privacy and autonomy protect patient data, barring access to health records unless consent is given by the data subject. This creates a situation in which much of the beneficial records-based research is prevented from being used or is seriously undermined, because the refusal of consent by some patients introduces a systematic deviation, known as selection bias, from a representative sample of the general population, thus distorting research findings. Although research exemptions for the requirement of informed consent exist, they are rarely used in practice due to concerns over liability and a general culture of caution. In this paper, we argue that the problem of research access to sensitive data can be understood as a tension between the medical duties of confidentiality and beneficence. We attempt to show that the requirement of informed consent is not appropriate for all kinds of records-based research by distinguishing studies involving minimal risk from those that feature moderate or greater risks. We argue that the duty of easy rescue—the principle that persons should benefit others when this can be done at no or minimal risk to themselves—grounds the removal of consent requirements for minimally risky records-based research. Drawing on this discussion, we propose a risk-adapted framework for the facilitation of ethical uses of health data for the benefit of society.

This article is part of the themed issue ‘The ethical impact of data science’.
What is data ethics?
Authors: Floridi Luciano , Taddeo Mariarosaria
Published: November 2016

This theme issue has the founding ambition of landscapingdata ethicsas a new branch of ethics that studies and evaluates moral problems related to data (including generation, recording, curation, processing, dissemination, sharing and use), algorithms (including artificial intelligence, artificial agents, machine learning and robots) and corresponding practices (including responsible innovation, programming, hacking and professional codes), in order to formulate and support morally good solutions (e.g. right conducts or right values). Data ethics builds on the foundation provided by computer and information ethics but, at the same time, it refines the approach endorsed so far in this research field, by shifting the level of abstraction of ethical enquiries, from being information-centric to being data-centric. This shift brings into focus the different moral dimensions of all kinds of data, even data that never translate directly into information but can be used to support actions or generate behaviours, for example. It highlights the need for ethical analyses to concentrate on the content and nature of computational operations—the interactions among hardware, software and data—rather than on the variety of digital technologies that enable them. And it emphasizes the complexity of the ethical challenges posed by data science. Because of such complexity, data ethics should be developed from the start as a macroethics, that is, as an overall framework that avoids narrow, ad hoc approaches and addresses the ethical impact and implications of data science and its applications within a consistent, holistic and inclusive framework. Only as a macroethics will data ethics provide solutions that can maximize the value of data science for our societies, for all of us and for our environments.

This article is part of the themed issue ‘The ethical impact of data science’.
Microbiome engineers: Grazers, browsers, and the phytobiome stampede
Authors: Garrett K. A. , Frank E. E. , Dendy S. P. , Leslie J. F. , Saleh A. A.
Published: November 2016

We definemicrobiome engineersas species that modify the microbiome associated with other host species via changes in the physical environment, potentially including the creation of dispersal networks for microbiome consortia across multiple hosts. Grazers such as bison are indirect plant microbiome engineers through alteration of the structure of plant communities in grasslands and forests. They also can directly engineer plant microbiomes if they distribute microbial consortia. Direct engineering may include simpler examples such as the role of truffle-eating animals in structuring forest mycorrhizal communities, as well as more complex roles in structuring the evolution of bacterial, fungal, and viral microbiome networks. Grazers and browsers may have important historic and current roles in engineering microbiomes by (a) stabilizing and homogenizing microbiomes in their preferred plant species, and (b) selecting for microbiomes in their preferred plant species that are differentiated from microbiomes in plant species they rarely consume.
Systematic integration of biomedical knowledge prioritizes drugs for repurposing
Authors: Himmelstein Daniel S. , Lizee Antoine , Hessler Christine , Brueggeman Leo , Chen Sabrina L. , Hadley Dexter , Green Ari , Khankhanian Pouya , Baranzini Sergio E.
Published: November 2016

The ability to computationally predict whether a compound treats a disease would improve the economy and success rate of drug approval. This study describes Project Rephetio to systematically model drug efficacy based on 755 existing treatments. First, we constructed Hetionet (neo4j.het.io), an integrative network encoding knowledge from millions of biomedical studies. Hetionet v1.0 consists of 47,031 nodes of 11 types and 2,250,197 relationships of 24 types. Data was integrated from 29 public resources to connect compounds, diseases, genes, anatomies, pathways, biological processes, molecular functions, cellular components, pharmacologic classes, side effects, and symptoms. Next, we identified network patterns that distinguish treatments from non-treatments. Then we predicted the probability of treatment for 209,168 compound–disease pairs (het.io/repurpose). Our predictions validated on two external sets of treatment and provided pharmacological insights on epilepsy, suggesting they will help prioritize drug repurposing candidates. This study was entirely open and received realtime feedback from 40 community members.
Drosophilapoised enhancers are generated during tissue patterning with the help of repression
Authors: Koenecke Nina , Johnston Jeff , He Qiye , Meier Samuel , Zeitlinger Julia
Published: November 2016

Histone modifications are frequently used as markers for enhancer states, but how to interpret enhancer states in the context of embryonic development is not clear. The poised enhancer signature, involving H3K4me1 and low levels of H3K27ac, has been reported to mark inactive enhancers that are poised for future activation. However, future activation is not always observed, and alternative reasons for the widespread occurrence of this enhancer signature have not been investigated. By analyzing enhancers during dorsal-ventral (DV) axis formation in theDrosophilaembryo, we find that the poised enhancer signature is specifically generated during patterning in the tissue where the enhancers are not induced, including at enhancers that are known to be repressed by a transcriptional repressor. These results suggest that, rather than serving exclusively as an intermediate step before future activation, the poised enhancer state may be a mark for spatial regulation during tissue patterning. We discuss the possibility that the poised enhancer state is more generally the result of repression by transcriptional repressors.
Crystal structure of a compact three-dimensional metal–organic framework based on Cs+and (4,5-dicyano-1,2-phenylene)bis(phosphonic acid)
Authors: Mendes Ricardo F. , Venkatramaiah Nutalapati , Tomé João P. C. , Almeida Paz Filipe A.
Published: November 2016

A new metal–organic framework compound, poly[[μ7-dihydrogen (4,5-dicyano-1,2-phenylene)diphosphonato](oxonium)caesium], [Cs(C8H4N2O6P2)(H3O)]n(I), based on Cs+and the organic linker 4,5-dicyano-1,2-phenylene)bis(phosphonic acid, (H4cpp), containing two distinct coordinating functional groups, has been prepared by a simple diffusion method and its crystal structure is reported. The coordination polymeric structure is based on a CsO8N2complex unit comprising a monodentate hydronium cation, seven O-atom donors from two phosphonium groups of the (H2cpp)2−ligand, and two N-atom donors from bridging cyano groups. The high level of connectivity from both the metal cation and the organic linker allow the formation of a compact and dense three-dimensional network without any crystallization solvent. Topologically (I) is a seven-connected uninodal network with an overall Schäfli symbol of {417.64}. Metal cations form an undulating inorganic layer, which is linked by strong and highly directional O—H...O hydrogen-bonding interactions. These metallic layers are, in turn, connected by the organic ligands along the [010] direction to form the overall three-dimensional framework structure.
Crystal and molecular structures of two silver(I) amidinates, including an unexpected co-crystal with a lithium amidinate
Authors: Wang Sida , Harmgarth Nicole , Liebing Phil , Edelmann Frank T.
Published: November 2016

The silver(I) amidinates bis[μ-N1,N2-bis(propan-2-yl)benzamidinato-κ2N1:N2]disilver(I), [Ag2(C13H19N2)2] or [Ag{PhC(NiPr)2}]2(1), and bis(μ-N1,N2-dicyclohexyl-3-cyclopropylpropynamidinato-κ2N1:N2)disilver(I), [Ag2(C18H27N2)2] or [Ag{cyclo-C3H5–C[triple-bond]C–C(NCy)2}]2(2a), exist as centrosymmetric dimers with a planar Ag2N4C2ring and a common linear coordination of the metal atoms in the crystalline state. Moiety2aforms a co-crystal with the related lithium amidinate, namely bis(μ-N1,N2-dicyclohexyl-3-cyclopropylpropynamidinato-κ2N1:N2)disilver(I) bis(μ-N1,N2-dicyclohexyl-3-cyclopropylpropynamidinato-κ3N1,N2:N1)bis(tetrahydrofuran-κO)lithium(I) toluene monosolvate, [Ag2(C18H27N2)2][Li2(C18H27N2)2(C4H8O)2]·C7H8or [Ag{cyclo-C3H5–C[triple-bond]C–C(NCy)2}]2[Li{cyclo-C3H5–C[triple-bond]C–C(NCy)2}(THF)]2·C7H8, composed as2a×2b× toluene. The lithium moiety2bfeatures a typical ladder-type dimeric structure with a distorted tetrahedral coordination of the metal atoms. In the silver(I) derivatives1and2a, the amidinate ligand adopts a μ-κN:κN′ coordination, while it is a μ-κN:κN:κN′-coordination in the case of lithium derivative2b.
[N,N-Bis(2-hydroxyethyl)dithiocarbamato-κ2S,S′]bis(triphenylphosphane-κP)copper(I) chloroform monosolvate: crystal structure, Hirshfeld surface analysis and solution NMR measurements
Authors: Tan Sang Loon , Yeo Chien Ing , Heard Peter J. , Akien Geoffrey R. , Halcovitch Nathan R. , Tiekink Edward R. T.
Published: November 2016

The title compound, [Cu(C5H5NO2S2)(C18H15P)2]·CHCl3, features a tetrahedrally coordinated CuIatom within a P2S2donor set defined by two phosphane P atoms and by two S atoms derived from a symmetrically coordinating dithiocarbamate ligand. Both intra- and intermolecular hydroxy-O—H...O(hydroxy) hydrogen bonding is observed: the former closes an eight-membered {...HOC2NC2O} ring, whereas the latter connects centrosymmetrically related molecules into dimeric aggregatesviaeight-membered {...H—O...H—O}2synthons. The complex molecules are arranged to form channels along thecaxis in which reside the chloroform molecules, being connected by Cl...π(arene) and short S...Cl [3.3488 (9) Å] interactions. The intermolecular interactions have been investigated further by Hirshfeld surface analysis, which shows the conventional hydrogen bonding to be very localized with the main contributors to the surface, at nearly 60%, being H...H contacts. Solution NMR studies indicate that whilst the same basic molecular structure is retained in solution, the triphenylphosphane ligands are highly labile, exchanging rapidly with free Ph3P at room temperature.
3-Methyl-5-(4-methylpiperazin-1-yl)-1-phenyl-1H-pyrazole-4-carbaldehyde
Authors: Sunitha V. M. , Manju N. , Naveen S. , Kalluraya B. , Lokanath N. K. , Manjunath H. R.
Published: November 2016

In the title compound, C16H20N4O, the dihedral angle between the pyrazole and phenyl rings is 53.86 (12)°. The piperazine ring adopts a chair conformation with the exocyclic N—C bonds in equatorial orientations. In the crystal, molecules are linked by very weak C—H...O hydrogen bonds to generate [010]C(8) chains, with adjacent molecules related by translation.
Methyl 5-(4-hydroxyphenyl)-6-oxo-1,6-dihydropyrazine-2-carboxylate monohydrate
Authors: Eltayeb Naser Eltaher
Published: November 2016

In the title hydrate, C12H10N2O4·H2O, the dihedral angle between the benzene and pyrazine rings is 37.70 (10)°. In the crystal, molecules are connected by hydrogen bonds (N—H...O, O—H...O and O—H...O) to generate (1-10) sheets. Aromatic π–π stacking [centroid–centroid separation = 3.7070 (13) Å] links the sheets into a three-dimensional network.
9H-Carbazole-9-carbaldehyde
Authors: Wang Cong , Wang An-Ran , Li Sheng-Li
Published: November 2016

The title carbazole derivative, C13H9NO, crystallizes with two independent molecules (AandB) in the asymmetric unit. The dihedral angle between the planar carbazole ring system and the aldehyde group (HC=O) is 3.3 (2)° inAand 7.5 (2)° inB, indicating that the molecules are both nearly planar. In the crystal, theAandBmolecules are linked by a C—H...O hydrogen bond and stack along theb-axis direction. The structure was refined as a two component twin with a refined BASF value of 0.102 (2).
4-Methylpyridinium 2-carboxy-6-nitrobenzoate
Authors: Devi S. Reena , Kalaiyarasi S. , Akilan R. , Kumar R. Mohan , Chakkaravarthi G.
Published: November 2016

In the title molecular salt, C6H8N+·C8H4NO6−, the anion is deprotonated at the carboxylic acid group adjacent to the nitro group. In the crystal, the anions are linked into an [001] chain by O—H...O hydrogen bonds. The cations are linked to these chains by N—H...O hydrogen bonds and weak C—H...O contacts, generating a three-dimensional network.
4-Amino-5-tetradecylamino-4H-1,2,4-triazol-1-ium chloride
Authors: El Bakri Youness , Harmaoui Abdallah , Sebhaoui Jihad , Ramli Youssef , Essassi El Mokhtar , Mague Joel T.
Published: November 2016

In the crystal of the title molecular salt, C16H34N5+·Cl−, (100) bilayers arise in which the tetradecylamino `tails' (which adopt extended conformations) interdigitate and the triazolium `heads' associate with the chloride anions through N—H...Cl hydrogen bonds.
Detecting copper toxicity in sediments: from the subindividual level to the population level
Authors: Jeppe Katherine J. , Yang Jianghua , Long Sara M. , Carew Melissa E. , Zhang Xiaowei , Pettigrove Vincent , Hoffmann Ary A.
Published: November 2016

Sediments accumulate chemicals that can be toxic to biota and often contribute to aquatic ecosystem decline. Measuring mortality in laboratory‐bred organisms is a common way to assess sediment toxicity. However, mortality‐based responses of resilient laboratory organisms may not reflect indigenous macroinvertebrate responses, which can be relatively more sensitive to sediment toxicants. A possible solution is to also measure responses at the subindividual level.

Several organism responses to sediment copper toxicity were assessed in a field‐based microcosm. Responses of laboratory‐bred chironomids and snails deployed in microcosms were compared at subindividual (metabolomic and gene expression), individual (survival and dry weight) and population (reproduction) levels, and contrasted to the abundance of colonizing macroinvertebrates in the microcosms.

Colonizing macroinvertebrate abundance showed a range of sensitivities based on EC50 (effect dose 50% change). Chironomidae made up 94·5% of the microcosm macroinvertebrates, with Paratanytarsus the most sensitive genus (EC50: 89 mg kg−1 copper) and Procladius the least sensitive (EC50: 681 mg kg−1).

Survival of laboratory‐bred organisms was the least sensitive response, comparable to decreased abundance of the least sensitive macroinvertebrate. Juvenile production in the snail, Potamopyrgus antipodarum, was the most sensitive population‐level response (EC50: 121 mg kg−1), in contrast the snail Physella acuta was relatively more tolerant (EC50: 298 mg kg−1).

Changes in subindividual responses (gene expression and metabolite abundance) in laboratory‐bred chironomid, Chironomus tepperi, were evident at 60 mg kg−1. These changes likely reflect the direct effects of copper exposure and represent metal‐specific responses.

Synthesis and applications. We showed that copper toxicity in sediments could be readily detected through changes in gene expression and metabolites in laboratory‐bred chironomids exposed in field‐based microcosms. These responses were more sensitive than mortality, and detected copper levels that caused microcosm chironomid populations to decline. These novel approaches will provide managers with new tools to better assess sediment toxicity.
Comparison of Rehydration Techniques for Fingerprinting the Deceased after Mummification
Authors: Chen Chun‐Chieh , Yang Chao‐Kai , Chen Chun‐Yu , Lee Henry C. , Wang Sheng‐Meng
Published: November 2016

Postmortem decay causes fingertip decomposition, desiccation, shriveling, and rigidity, reducing the possibility of obtaining sufficiently clear fingerprints for identification. In this study, five rehydration solutions (ammonium hydroxide, sodium carbonate, potassium hydroxide, urea, and warm water) followed by three fingerprint recording methods (photograph, inking roll, and dusting tape) were investigated to process mummified fingertips from an unidentified cadaver. The results show that sodium carbonate treatment is the most effective for minutiae restoration, followed by ammonium hydroxide treatment. This study also demonstrates that even those fingertips that previously failed in urea solution, 1% potassium hydroxide solution, and warm water treatment could be further improved with sodium carbonate solution to obtain qualified minutiae for fingerprint matching. The optimal procedure is rehydrating the desiccated fingertips with sodium carbonate solution for 24 h followed by dusting the finger and transferring the print to adhesive tape.
CD48 on blood leukocytes and in serum of asthma patients varies with severity
Authors: Gangwar R. S. , Minai‐Fleminger Y. , Seaf M. , Gutgold A. , Shikotra A. , Barber C. , Chauhan A. , Holgate S. , Bradding P. , Howarth P. , Eliashar R. , Berkman N. , Levi‐Schaffer F.
Published: November 2016

Background

CD48 is a membrane receptor (mCD48) on eosinophils and mast cells and exists in a soluble form (sCD48). CD48 has a pivotal role in murine asthma and in the proinflammatory interactions of mast cells with eosinophils via its ligand CD244. Thus, CD48 might be important in human asthma.

Methods

Therefore, two separate cohorts (IL and UK) comprising mild, moderate, and severe asthma and healthy volunteers were evaluated for blood leukocyte mCD48 expression and sCD48 in serum. Asthmatic bronchial biopsies were immunostained for CD48. sCD48 effect on CD244‐dependent eosinophil activation was evaluated.

Results

Eosinophil mCD48 expression was significantly elevated in moderate while downregulated in severe asthma. mCD48 expression on B, T, and NK cells and monocytes in severe asthma was significantly increased. sCD48 levels were significantly higher in mild while reduced in severe asthma. sCD48 optimal cutoff values for differentiating asthma from health were identified as >1482 pg/ml (IL) and >1619 pg/ml (UK). In asthmatic bronchial biopsies, mCD48 was expressed predominantly by eosinophils. sCD48 inhibited anti‐CD244‐induced eosinophil activation.

Conclusions

mCD48 and sCD48 are differentially expressed in the peripheral blood of asthma patients of varying severity. sCD48 inhibits CD244‐mediated eosinophil activation. These findings suggest that CD48 may play an important role in human asthma.