bluuebunny/crossref_metadata_2025 huggingface dataset:
INCOME INEQUALITY IN THE PEOPLE'S REPUBLIC OF CHINA: TRENDS, DETERMINANTS, AND PROPOSED REMEDIES
Authors: Wang Chen , Wan Guanghua , Yang Dan
Published: July 2014

The issue of income inequality in the People's Republic of China (PRC) has attracted world‐wide attention, leading to a sizable literature. This paper attempts to provide a nonexhaustive literature review of the PRC's inequality trends and determinants, and suggested government interventions. It discusses profiles of income inequality along three dimensions: interhousehold disparity, regional divides, and urban–rural gaps. This is followed by an exploration of the driving forces behind rising inequality, including the notorious hukou system, policy biases, location or geographic factors, globalization, and education. Finally, the paper summarizes and proposes government interventions for containing or reducing income inequality in the PRC. Important areas for future research are also suggested in the final section of the paper.
Stroke Echoscan Protocol: A Fast and Accurate Pathway to Diagnose Embolic Strokes
Authors: Pagola Jorge , González‐Alujas Teresa , Muchada Marian , Teixidó Gisela , Flores Alan , De Blauwe Sophie , Seró Laia , Luna David Rodríguez , Rubiera Marta , Ribó Marc , Boned Sandra , Álvarez‐Sabin José , Evangelista Arturo , Molina Carlos A.
Published: July 2014

BACKGROUND AND PURPOSE

Cardiac Echoscan is the simplified transthoracic echocardiogram focused on the main source of emboli detection in the acute stroke diagnosis (Stroke Echoscan). We describe the clinical impact related to the Stroke Echoscan protocol in our Center.

METHODS

Acute stroke patients who underwent the Stroke Echoscan by a trained stroke neurologist were included (Echoscan group). All examinations were reviewed by cardiologists. The main embolic stroke etiologies were: ventricular akinesia (VA), severe aortic atheroma (AA) plaque and cardiac shunt (SHUNT). The rate of the embolic stroke etiologies and the median length of stay (LOS) were compared with a cohort of patients studied by cardiologist (Echo group).

RESULTS

Eighty acute stroke patients were included. The sensitivity (S) and specificity (E) were: VA (S 98.6%, E 66.7%, k = .7), AA (S 93.3%, E 96.9%, k = .88) and SHUNT (S 100%, E 100%, k = 1), respectively. The rate of AA diagnosis was significantly higher in Echoscan group (18.8% vs. 8.9%; P = .05). Echoscan protocol significantly reduced the LOS: 6 days (IQR 3‐10) versus Echo group 9 days (IQR 6‐13; P < .001).

CONCLUSION

The Echoscan protocol was an accurate quick test, which reduced the length of stay and increased the percentage of severe AA plaque diagnosis.
Clinical application of autologous fibroblast cell culture in gingival recession treatment
Authors: Milinkovic I. , Aleksic Z. , Jankovic S. , Popovic O. , Bajic M. , Cakic S. , Lekovic V.
Published: July 2014

Background and Objective

Gingival recession is defined as soft and hard tissue displacement resulting in root surface exposure. The optimal outcome of gingival recession treatment is complete, predictable and long‐lasting root coverage with a significant level of tissue regeneration. Tissue engineering, which applies active regeneration principles, presents the contemporary treatment approach in the restitution and regeneration of lost tissues. The objective of the present study was to evaluate and compare the clinical results of application of an autologous fibroblast cell culture (AFCC) on a collagen matrix and a connective tissue graft (CTG) placed under a coronally advanced flap (CAF), in the treatment of single and multiple gingival recessions.

Material and Methods

Eighteen patients from the Department of Periodontology, School of Dentistry, University of Belgrade, were randomly enrolled in this study. Inclusion criteria were the bilateral presence of Miller Class I or II single or multiple maxillary gingival recessions. A split‐mouth design was used in the study. The experimental group was treated with AFCC on a collagen scaffold, which was placed under a CAF. The control group received a combination of CTG and CAF. Clinical parameters such as gingival recession coverage, keratinized tissue width, clinical attachment level and gingival index were recorded at baseline and at 12 mo postoperatively. The oral hygiene level was assessed by plaque index evaluation. Postoperative healing was evaluated through the healing index, recorded 1, 2 and 3 wk postoperatively. The final esthetic outcome was assessed using the mean root coverage esthetic score (RES).

Results

Statistically significant improvement of all parameters assessed was found compared with baseline. A statistically significant difference between groups was observed only in keratinized tissue width. Greater keratinized tissue width is still obtained with the use of CTG. Regarding the tissue‐healing results, no statistically significant difference was achieved. The RES results were similar for both groups.

Conclusions

Within the limitations of the present study, both procedures proved to be efficient in gingival recession treatment. AFCC, as a novel tissue‐engineering concept and living cell‐based therapy, proved to be a reliable and successful treatment concept.
Urinary Corticoid Concentrations Measured by 5 Different Immunoassays and Gas Chromatography‐Mass Spectrometry in Healthy Dogs and Dogs with Hypercortisolism at Home and in the Hospital
Authors: Galeandro L. , Sieber‐Ruckstuhl N.S. , Riond B. , Hartnack S. , Hofmann‐Lehmann R. , Reusch C.E. , Boretti F.S.
Published: July 2014

Background

Determination of the urinary corticoid‐to‐creatinine ratio (UCCR) is an important screening test in the diagnosis of hypercortisolism (HC). However, urinary cortisol metabolites interfere with cortisol measurement in immunoassays, leading to decreased specificity. Gas chromatography‐mass spectrometry (GC‐MS) is considered the gold standard for steroid hormone analysis, because it provides a high level of selectivity and accuracy.

Objectives

To prospectively compare theUCCRof healthy dogs and dogs withHCdetermined by 5 different immunoassays and byGC‐MSand to evaluate the influence of veterinary care onUCCR.

Animals

Twenty healthy dogs; 18 dogs withHC.

Methods

Urine was collected in the hospital and again after 6 days at home. Three chemiluminescence immunoassays (Access 2, Beckmann; Immulite 2000,DPCSiemens, with and without trichloromethane extraction) and 2RIAs (Utrecht in house; Access Beckmann) were used.GC‐MSanalyses were performed with Agilent 6890N/5973N. Urinary corticoid concentrations were related to urinary creatinine concentrations.

Results

Immunoassay results were significantly higher compared toGC‐MSresults. Evaluation of bias plots and clinical assessment made on the basis of the assay results of each dog indicated substantial disagreement among the assays. Sensitivity varied from 37.5 to 75% and with selected assays was lower in samples from day 6 compared to day 0.GC‐MSwas not superior to the immunoassays in discriminating healthy fromHCdogs.

Conclusions and Clinical Importance

Considerable variation must be anticipated comparing different urinary cortisol assays. Establishing an assay‐ and laboratory‐specific reference range is critical when usingUCCR.
Winter breeding and high tadpole densities may benefit the growth and development of tadpoles in a subtropical lowland treefrog
Authors: Chang Y.‐M. , Tseng W.‐H. , Chen C.‐C. , Huang C.‐H. , Chen Y.‐F. , Hatch K. A.
Published: July 2014

Unlike high‐altitude Rhacophorus moltrechti breeding in spring and summer and middle‐altitude populations breeding throughout the year, one possible mechanism causing lowland populations to breed in winter may be that high summer temperatures at low altitudes are stressful for tadpoles and lowland populations so they breed in winter to avoid this stress. However, breeding in the winter, which is the dry season in Taiwan, causes high densities as the water bodies they breed in are smaller and more isolated. We tested whether high summer water temperatures impose a cost and high tadpole densities lead to a benefit in growth, development and survival of lowland tadpoles by rearing tadpoles at three temperatures (17 and 22°C are two typical winter water temperatures and 27°C is a representative summer water temperature) and four different densities (5, 10, 20 and 30 tadpoles per box). We found that tadpoles metamorphosed earlier and at smaller sizes at 22°C (the higher winter water temperature) than tadpoles raised at either 17 or 27°C. Tadpoles raised at 27°C exhibited a longer larval period and a smaller metamorphic size than those raised at 22°C. Likewise, under the two winter water temperatures, but not the summer water temperature, increased tadpole density enhanced larval growth, translating into greater metamorphic mass without changing time to metamorphosis or decreasing survival rates. Nevertheless, tadpoles survived to metamorphosis at 27°C and at rates equal to those at 17 and 22°C. Our study suggests that lowland tadpoles are better adapted to maturing at cooler, winter water temperatures and that the summer water temperatures may be stressful to their growth and development. This leads to winter breeding for lowland populations. It also suggests that lowland populations breed at high tadpole densities because high densities benefit the larval growth and development.
Genetic mapping of horizontal stripes in Lake Victoria cichlid fishes: benefits and pitfalls of using RAD markers for dense linkage mapping
Authors: Henning Frederico , Lee Hyuk Je , Franchini Paolo , Meyer Axel
Published: July 2014

The genetic dissection of naturally occurring phenotypes sheds light on many fundamental and longstanding questions in speciation and adaptation and is a central research topic in evolutionary biology. Until recently, forward‐genetic approaches were virtually impossible to apply to nonmodel organisms, but the development of next‐generation sequencing techniques eases this difficulty. Here, we use the ddRAD‐seq method to map a colour trait with a known adaptive function in cichlid fishes, well‐known textbook examples for rapid rates of speciation and astonishing phenotypic diversification. A suite of phenotypic key innovations is related to speciation and adaptation in cichlids, among which body coloration features prominently. The focal trait of this study, horizontal stripes, evolved in parallel in several cichlid radiations and is associated with piscivorous foraging behaviour. We conducted interspecific crosses between Haplochromis sauvagei and H. nyererei and constructed a linkage map with 867 SNP markers distributed on 22 linkage groups and total size of 1130.63 cM. Lateral stripes are inherited as a Mendelian trait and map to a single genomic interval that harbours a paralog of a gene with known function in stripe patterning. Dorsolateral and mid‐lateral stripes were always coinherited and are thus under the same genetic control. Additionally, we directly quantify the genotyping error rates in RAD markers and offer guidelines for identifying and dealing with errors. Uncritical marker selection was found to severely impact linkage map construction. Fortunately, by applying appropriate quality control steps, a genotyping accuracy of >99.9% can be reached, thus allowing for efficient linkage mapping of evolutionarily relevant traits.
EspI regulates the ESX‐1 secretion system in response to ATP levels in Mycobacterium tuberculosis
Authors: Zhang Ming , Chen Jeffrey M. , Sala Claudia , Rybniker Jan , Dhar Neeraj , Cole Stewart T.
Published: July 2014

The function of EspI, a 70 kDa protein in Mycobacterium tuberculosis, has remained unclear. Although EspI is encoded by a gene within the esx‐1 locus, in this study we clarify previous conflicting results and show that EspI is not essential for ESX‐1‐mediated secretion or virulence in M. tuberculosis. We also provide evidence that reduction of cellular ATP levels in wild‐type M. tuberculosis using the drug bedaquiline completely blocks ESX‐1‐mediated secretion. Remarkably, M. tuberculosis lacking EspI fails to exhibit this phenotype. Furthermore, mutagenesis of a highly conserved ATP‐binding motif in EspI renders M. tuberculosis incapable of shutting down ESX‐1‐mediated secretion during ATP depletion. Collectively these results show that M. tuberculosis EspI negatively regulates the ESX‐1 secretion system in response to low cellular ATP levels and this function requires the ATP‐binding motif. In light of our results the potential significance of EspI in ESX‐1 function during latent tuberculosis infection and reactivation is also discussed.
A glimpse into the past and predictions for the future: the molecular evolution of the tuberculosis agent
Authors: Boritsch Eva C. , Supply Philip , Honoré Nadine , Seeman Torsten , Stinear Timothy P. , Brosch Roland
Published: July 2014

Recent advances in genomics and molecular biology are providing an excellent opportunity to get a glimpse into the past, to examine the present, and to predict the future evolution of pathogenic mycobacteria, and in particular that of Mycobacterium tuberculosis, the agent of human tuberculosis. The recent availability of genome sequences of several Mycobacterium canettii strains, representing evolutionary early‐branching tubercle bacilli, has allowed the genomic and molecular features of the putative ancestor of the M. tuberculosis complex (MTBC) to be reconstituted. Analyses have identified extensive lateral gene transfer and recombination events in M. canettii and/or the MTBC, leading to suggestions of a past environmental reservoir where the ancestor(s) of the tubercle bacilli might have adapted to an intracellular lifestyle. The daily increases in M. tuberculosis genome data and the remaining urgent Public Health problem of tuberculosis make it more important than ever to try and understand the origins and the future evolution of the MTBC. Here we critically discuss a series of questions on gene‐loss, acquisition, recombination, mutation and conservation that have recently arisen and which are key to better understand the outstanding evolutionary success of one of the most widespread and most deadly bacterial pathogens in the history of humankind.
Amino acid substitution in P3 of Soybean mosaic virus to convert avirulence to virulence on Rsv4‐genotype soybean is influenced by the genetic composition of P3
Authors: Wang Y. , Khatabi B. , Hajimorad M. R.
Published: July 2014

The modification of avirulence factors of plant viruses by one or more amino acid substitutions converts avirulence to virulence on hosts containing resistance genes. Limited experimental studies have been conducted on avirulence/virulence factors of plant viruses, in particular those of potyviruses, to determine whether avirulence/virulence sites are conserved among strains. In this study, the Soybean mosaic virus (SMV)–Rsv4 pathosystem was exploited to determine whether: (i) avirulence/virulence determinants of SMV reside exclusively on P3 regardless of virus strain; and (ii) the sites residing on P3 and crucial for avirulence/virulence of isolates belonging to strain G2 are also involved in virulence of avirulent isolates belonging to strain G7. The results confirm that avirulence/virulence determinants of SMV on Rsv4‐genotype soybean reside exclusively on P3. Furthermore, the data show that sites involved in the virulence of SMV on Rsv4‐genotype soybean vary among strains, with the genetic composition of P3 playing a crucial role.
Chronic rhinocerebral mucormycosis: a rare case report and review of the literature
Authors: Dimaka Konstantina , Mallis Antonios , Naxakis Stefanos S. , Marangos Markos , Papadas Theodoros A. , Stathas Theodoros , Mastronikolis Nicholas S.
Published: July 2014

Rhinocerebral mucormycosis is an invasive infection caused by filamentous fungi of the Mucoraceae family. The rhinocerebral form of the disease represents the most common form and has two distinct clinical entities. The common presentation consists of a rapidly progressive infection with high mortality rate, while the other presentation is that of a chronic infection with lower mortality. In the present paper we report a rare case of chronic rhinocerebral mucormycosis. An 85‐year‐old male with a 6‐month history of purulent and odorous nasal discharge, and sporadic episodes of epistaxis and anosmia, presented to the outpatient department of our clinic. Initial cultures were positive only for Pseudomonas aeruginosa. The patient was unresponsive to ciprofloxacin treatment, developing necrotic areas of the nasal septum suspicious for rhinocerebral mucormycosis. Admission to the ENT clinic followed, with histopathologic evaluation of the vomer bone confirming the diagnosis. The patient was treated with amphotericin B and was discharged 3 weeks later on oral posaconazole therapy. Chronic rhinocerebral mucormycosis may present with atypical symptoms or coinfection with another agent. A high degree of clinical suspicion is required for correct diagnosis and prompt initiation of appropriate treatment.
Cryoablation of Septal Accessory Pathways in Children: Midterm Results
Authors: KARADENIZ CEM , AKDENIZ CELAL , TURAN OZLEM , TUZCU VOLKAN
Published: July 2014

Background

Radiofrequency (RF) catheter ablation in the septal arrhythmia substrates has an increased risk of irreversible atrioventricular block. Despite its safety profile, several studies reported a lower acute success rate and a higher recurrence rate with cryoablation of septal accessory pathways (APs) when compared to RF ablation. The aim of this study was to assess the efficacy and safety of cryoablation of right septal APs using an electroanatomical mapping system guidance.

Methods and Results

A total of 43 consecutive patients (13.2 ± 5.5 years) underwent cryoablation for right septal APs. The EnSite system (St. Jude Medical, St. Paul, MN, USA) was used in all procedures. No fluoroscopy was used in 90% of patients (39/43). The mean fluoroscopy time in the remaining four patients was 3.7 ± 0.7 minutes. An electrophysiology catheter with 2‐mm distal spacing was used to determine the precise AP location. The majority of the patients (20/43) had anteroseptal, and remaining of the patients had posteroseptal (15/43) and midseptal (8/43) APs. A 6‐mm‐tip catheter was used in 33 patients and 8‐mm‐tip catheter was used in nine patients (both catheters were used in one patient). The mean procedure duration and number of complete cryoablation lesions were 181.5 ± 60.6 minutes and 6.1 ± 3.1 minutes, respectively. Acute success was achieved in 40 of 43 patients (93%). No complications were noted. During a mean follow‐up of 8.8 ± 4.8 months, five patients (12.5%) experienced recurrence.

Conclusions

Our data suggest that cryoablation of septal APs can be performed safely with comparable efficacy to the reported RF ablation results using a limited fluoroscopy approach.
Atrial Fibrillation: An Observational Study with Outpatients
Authors: ALBINA GASTÓN , DE LUCA JULIÁN , CONDE DIEGO , GINIGER ALBERTO
Published: July 2014

Background

Atrial fibrillation (AF) is the most common sustained arrhythmia with serious clinical consequences in the absence of treatment. However, there are limited data on the treatment of these patients in Argentina. The objective was to describe the therapeutic management of patients with nonacute AF by Argentinean cardiologists and to determine the incidence of clinical events after 12 months follow‐up.

Methods

The Atrial Fibrillation study in Argentina (FARAON) was an observational, descriptive, prospective, national, and multicentric study that included outpatients with AF, followed for 12 months. The study included 38 sites in Argentina. Each researcher included the first 10 patients who met the inclusion criteria of being over 21 and also being an AF carrier documented by electrocardiogram or Holter within 12 months prior to or at the time of enrollment.

Results

A total of 373 patients were included, mean age 70 ± 11.5 years, 40% women; 65% had AF rhythm at the time of inclusion, 57% had permanent AF, and 56% were asymptomatic. At the time of enrollment, 40% of physicians opted for rhythm control strategy. β‐blockers and amiodarone were the most used drugs. Patients with rhythm control drugs had higher success rate than those with frequency control drug therapy (80% vs 57%).

Conclusion

Cardiologists in Argentina receive patients with AF that are mostly permanent AF. More than half of the patients are asymptomatic. They opt primarily by controlling the pace. When choosing antiarrhythmic drugs, nearly half of them indicated amiodarone.
The interplay between semantic and phonological constraints during spoken‐word comprehension
Authors: Brunellière Angèle , Soto‐faraco Salvador
Published: July 2014

This study addresses how top‐down predictions driven by phonological and semantic information interact on spoken‐word comprehension. To do so, we measured event‐related potentials to words embedded in sentences that varied in the degree of semantic constraint (high or low) and in regional accent (congruent or incongruent) with respect to the target word pronunciation. The data showed a negative amplitude shift following phonological mismatch (target pronunciation incongruent with respect to sentence regional accent). Here, we show that this shift is modulated by sentence‐level semantic constraints over latencies encompassing auditory (N100) and lexical (N400) components. These findings suggest a fast influence of top‐down predictions and the interplay with bottom‐up processes at sublexical and lexical levels of analysis.
Temporary connectivity: the relative benefits of large river floodplain inundation in the lower Mississippi River
Authors: Phelps Quinton E. , Tripp Sara J. , Herzog David P. , Garvey James E.
Published: July 2014

Studies have demonstrated the importance of the synergistic relationship between large rivers and adjacent floodplain connectivity. The majority of large rivers and their associated floodplain have been isolated through a series of expansive levee systems. Thus, evaluations of the relative importance of floodplain connectivity are limited due to the aforementioned anthropogenic perturbations. However, persistent elevated river levels during spring 2011 at the confluence of the Mississippi River and Ohio River prompted the U.S. Army Corps of Engineers to create large gaps in the levee system producing an expansive floodplain (i.e. the New Madrid Floodway). Specifically, the New Madrid Floodway (approximately 475 km2) in southeast Missouri was created to divert part of the Mississippi River flow during catastrophic floods and thus alleviate flood risk on nearby population centers. Given the historic flooding of 2011, the floodway was opened and provided an unprecedented opportunity to evaluate the influence of floodplain inundation on fish species diversity, relative abundance, and growth. We sampled the floodplain and the adjacent river at three stratified random locations with replication biweekly from the commencement of inundation (late May) through early October. Overall, we found that species diversity, relative abundance, and growth were higher in the floodplain than the main river. Our data support previous examinations, including those outside North America, that suggest floodplain inundation may be important for riverine fishes. Given these apparent advantages of floodplain inundation, restoration efforts should balance benefits of floodplain inundation while safeguarding priority needs of humans.
Assessing the quality of four inshore habitats used by post yolk‐sac Alosa sapidissima (Wilson 1811) in the Hudson River: a prelude to restoration
Authors: Nack Christopher C. , Limburg Karin E. , Miller Daniel
Published: July 2014

Habitat restoration within large rivers to enhance early life stages of fish is an emerging field. Prior to restoration, assessment of what constitutes “good” habitat is needed. We exemplify this with a study of larval Alosa sapidissima (American shad) in the Hudson River estuary in New York State, United States, which examines the quality of four main shallow water habitat types that have been reduced greatly by dredging activities. The larval stage has been identified as a sensitive period in need of mortality reduction. Habitats were examined as nursery habitat by comparing ambient conditions to known suitability indexes and by comparing relative abundance, loss rate, daily growth, and relative condition among habitats. Areas of lower velocity had greater abundances of shad ≤15.0 mm in length and shad growth was significantly higher. As shad became larger, those in areas of higher velocity had significantly higher relative condition, suggesting a shift in habitat use as larvae metamorphose into the juvenile stage. Contiguous backwater and secondary channel habitats had reduced loss rates during 2011 when there was high river discharge. No single habitat type examined in this study was found to be overall poor quality, and it is recommended that restoration sites be examined on an individual basis. More broadly, habitat diversity appears needed both for within‐year ontogeny as well as for longer‐term resiliency in the face of disturbance, such as storm‐driven high flows.
Path Dependence and Paradigm Shift: How Cetacean Scientists Learned to Develop Management Procedures that Survived the Controversial Whaling Regime
Authors: Ishii Atsushi , Okubo Ayako
Published: July 2014

The transformation of the International Whaling Commission (IWC) into a preservationist regime met with extremely fierce opposition from the prowhaling countries and created an unprecedented and famous polarization of the IWC parties into pro and antiwhaling camps, which can be observed even today. In such a bipolar and harsh process, it would be typically argued that scientific advice would be powerless because it would become subject to heightened scrutiny from both camps resulting in endless technical debate. Our case shows that, on the contrary, the advisory scientists learned to successfully develop a scientific management procedure that was accepted by both the pro and antiwhaling camps. The objective of this paper is to explain this process and examine to what extent collective learning in the assessment process affected the political effectiveness of the management procedure and, more broadly thereby, to contribute to the groundwork of analyzing how the scientists participating in the scientific assessments collectively learn. With a view to cross‐fertilization between institutionalism and science and technology study (STS) approaches, we develop an analytical framework and apply it to the international whaling regime to examine the usefulness of it and provide some general lessons to be learned for making learning assessments more effective. The framework was capable of showing that path dependency and paradigm shift were among the key factors of the scientific assessment's increased effectiveness. Overall, the cross‐fertilization between institutionalism and STS appears to be a fruitful way forward for the next generation of scientific assessment studies.
Big Data for Policy Analysis: The Good, The Bad, and The Ugly
Authors: Schintler Laurie A. , Kulkarni Rajendra
Published: July 2014

Big data holds tremendous potential for public policy analysis. At the same time, its use prompts a number of issues related to statistical bias, privacy, equity, and governance, among others. Accordingly, there is a need to formulate, evaluate, and implement policies that not only mitigate the risks, but also maximize the benefits of using big data for policy analysis. This poses a number of challenges, which are highlighted in this essay.
The Promise and Potential of Big Data: A Case for Discovery Informatics
Authors: Honavar Vasant G.
Published: July 2014

The emergence of “big data” offers unprecedented opportunities for not only accelerating scientific advances, but also enabling new modes of discovery. While we understand how to automate routine aspects of data management and analytics, most elements of the scientific process currently require considerable human expertise and effort. We argue that realizing the full potential of data to accelerate discovery calls for a concerted effort in advancing Discovery Informatics: (i) understanding, formalization, and information processing descriptions of the entire scientific process; (ii) design, development, and evaluation of the computational artifacts (representations and processes) that embody such understanding; and (iii) application of the resulting artifacts and systems to advance science (by augmenting individual or collective human efforts, or by fully automating science).
The Big (Data) Bang: Policy, Prospects, and Challenges
Authors: McNeely Connie L. , Hahm Jong‐on
Published: July 2014

Big data is increasingly the cornerstone on which policy making is based. However, with potential benefits and applications come challenges and dilemmas. In this set of symposium articles, authors examine the promise and problems of big data, exploring associated prospects, risks, parameters, and payoffs from a variety of perspectives. The articles address myriad challenges in the handling of big data sets, such as collection, validation, integrity, and security; ontological issues attending data analytics and conceptual transformations; the foundations of big data collection for social science research; the gap between the acquisition of data and its use to advance discovery and innovation; the costs and benefits of using big data in decision making and analysis; and, finally, related problems of privacy, security, and ethics. Issues such as these will continue to arise with increased use of big data as fundamental to policy making and governance in today's growing information society.
Clinical and oral findings in an Afro‐Brazilian family with Gorlin‐Goltz syndrome: case series and literature review
Authors: Pierro Viviane Santos da Silva , Marins Marcello Roter , Borges de Oliveira Renata Cabral , Cortezzi Wladimir , Janini Maria Elisa , Maia Lucianne Cople
Published: July 2014

Gorlin‐Goltz syndrome (GGS) seems to be unusual in black persons. The authors present an Afro‐Brazilian family case report of GGS. The main complaint of the index case was a painless swelling of the left mandible, which was diagnosed as an odontogenic keratocyst. Further classical features of the Syndrome were present in this patient. Other two family members were diagnosed as cases of GGS and one of them presented 11 clinical findings characteristic of the syndrome. From the three cases reported, two of them presented five major diagnostic criteria for the GGS, and the diagnosis was only made because of an oral complaint. This case series emphasizes the importance of carefully examining the patient and close relatives for signs of GGS, even if they belong to an ethnic group in which this diagnosis is unusual.
Caesarean section at full dilatation: incidence, impact and current management
Authors: Vousden Nicola , Cargill Zillah , Briley Annette , Tydeman Graham , Shennan Andrew H
Published: July 2014

Key content

The incidence of caesarean sections performed at full dilatation is increasing, and may now represent around 8000 deliveries in the UK each year.

Delivery can be technically challenging due to fetal impaction into the pelvis, and may be associated with greater maternal and fetal morbidity even without failed attempt at vaginal delivery.

Guidelines are needed to define optimal management, including the use of new devices to teach or assist safe delivery.

Best practice should be incorporated into structured training programmes such as Managing Obstetric Emergencies and Trauma (MOET).

Learning objectives

Assess the reasons for the increasing incidence of full dilatation caesarean section at full dilatation.

Describe the associated maternal and neonatal risks compared with operative vaginal delivery.

Describe the current evidence for optimal management and define areas for research.

Ethical issues

Further research is needed to define long‐term morbidity and address the risk/benefit of second‐stage caesarean section at full dilatation versus attempted vaginal delivery.
PIKfyve Inhibition Interferes with Phagosome and Endosome Maturation in Macrophages
Authors: Kim Grace H.E. , Dayam Roya M. , Prashar Akriti , Terebiznik Mauricio , Botelho Roberto J.
Published: July 2014

Macrophages eliminate pathogens and cell debris through phagocytosis, a process by which particulate matter is engulfed and sequestered into a phagosome. Nascent phagosomes are innocuous organelles resembling the plasma membrane. However, through a maturation process, phagosomes are quickly remodeled by fusion with endosomes and lysosomes to form the phagolysosome. Phagolysosomes are highly acidic and degradative leading to particle decomposition. Phagosome maturation is intimately dependent on the endosomal pathway, during which diverse cargoes are sorted for recycling to the plasma membrane or for degradation in lysosomes. Not surprisingly, various regulators of the endosomal pathway are also required for phagosome maturation, including phosphatidylinositol‐3‐phosphate, an early endosomal regulator. However, phosphatidylinositol‐3‐phosphate can be modified by the lipid kinase PIKfyve into phosphatidylinositol‐3,5‐bisphosphate, which controls late endosome/lysosome functions. The role of phosphatidylinositol‐3,5‐bisphosphate in macrophages and phagosome maturation remains basically unexplored. Using Fcγ receptor‐mediated phagocytosis as a model, we describe our research showing that inhibition of PIKfyve hindered certain steps of phagosome maturation. In particular, PIKfyve antagonists delayed removal of phosphatidylinositol‐3‐phosphate and reduced acquisition of LAMP1 and cathepsin D, both common lysosomal proteins. Consistent with this, the degradative capacity of phagosomes was reduced but phagosomes appeared to still acidify. We also showed that trafficking to lysosomes and their degradative capacity was reduced by PIKfyve inhibition. Overall, we provide evidence that PIKfyve, likely through phosphatidylinositol‐3,5‐bisphosphate synthesis, plays a significant role in endolysosomal and phagosome maturation in macrophages.
Microchimerism in the transfused obstetric population
Authors: Bloch E. M. , Busch M. P. , Lee T.‐H. , Montalvo L. , Matthews Y. , Bird A. , Bruhn R. , Stefan V.
Published: July 2014

Microchimerism (MC), the coexistence of allogeneic populations of cells within a host, is well described in pregnancy and blood transfusion. To date, transfusion‐associated MC (TA‐MC) appears unique to patients transfused after severe traumatic injury. We sought to determine whether transfusion in the peripartum period results in enduring, high‐level TA‐MC. We conducted a prospective cohort study of 22 women who were newly transfused within 48 h of delivery. Two subjects showed evidence of transient TA‐MC; however, MC was not detected at 6 weeks and 6 months. The negative findings suggest that enduring TA‐MC does not occur in this population.
CT substitutes derived from MR images reconstructed with parallel imaging
Authors: Johansson Adam , Garpebring Anders , Asklund Thomas , Nyholm Tufve
Published: July 2014

Purpose:

Computed tomography (CT) substitute images can be generated from ultrashort echo time (UTE) MRI sequences with radial k‐space sampling. These CT substitutes can be used as ordinary CT images for PET attenuation correction and radiotherapy dose calculations. Parallel imaging allows faster acquisition of magnetic resonance (MR) images by exploiting differences in receiver coil element sensitivities. This study investigates whether non‐Cartesian parallel imaging reconstruction can be used to improve CT substitutes generated from shorter examination times.

Methods:

The authors used gridding as well as two non‐Cartesian parallel imaging reconstruction methods, SPIRiT and CG‐SENSE, to reconstruct radial UTE and gradient echo (GE) data into images of the head for 23 patients. For each patient, images were reconstructed from the full dataset and from a number of subsampled datasets. The subsampled datasets simulated shorter acquisition times by containing fewer radial k‐space spokes (1000, 2000, 3000, 5000, and 10 000 spokes) than the full dataset (30 000 spokes). For each combination of patient, reconstruction method, and number of spokes, the reconstructed UTE and GE images were used to generate a CT substitute. Each CT substitute image was compared to a real CT image of the same patient.

Results:

The mean absolute deviation between the CT number in CT substitute and CT decreased when using SPIRiT as compared to gridding reconstruction. However, the reduction was small and the CT substitute algorithm was insensitive to moderate subsampling (≥5000 spokes) regardless of reconstruction method. For more severe subsampling (≤3000 spokes), corresponding to acquisition times less than a minute long, the CT substitute quality was deteriorated for all reconstruction methods but SPIRiT gave a reduction in the mean absolute deviation of down to 25 Hounsfield units compared to gridding.

Conclusions:

SPIRiT marginally improved the CT substitute quality for a given number of radial spokes as compared to gridding. However, the increased reconstruction time of non‐Cartesian parallel imaging reconstruction is difficult to motivate from this improvement. Because the CT substitute algorithm was insensitive to moderate subsampling, data for a CT substitute could be collected in as little as minute and reconstructed with gridding without deteriorating the CT substitute quality.
A normalized wave number variation parameter for acoustic black hole design
Authors: Feurtado Philip A. , Conlon Stephen C. , Semperlotti Fabio
Published: July 2014

In recent years, the concept of the Acoustic Black Hole has been developed as an efficient passive, lightweight absorber of bending waves in plates and beams. Theory predicts greater absorption for a higher thickness taper power. However, a higher taper power also increases the violation of an underlying theory smoothness assumption. This paper explores the effects of high taper power on the reflection coefficient and spatial change in wave number and discusses the normalized wave number variation as a spatial design parameter for performance, assessment, and optimization.
Ultrahigh dose-rate FLASH irradiation increases the differential response between normal and tumor tissue in mice
Authors: Favaudon Vincent , Caplier Laura , Monceau Virginie , Pouzoulet Frédéric , Sayarath Mano , Fouillade Charles , Poupon Marie-France , Brito Isabel , Hupé Philippe , Bourhis Jean , Hall Janet , Fontaine Jean-Jacques , Vozenin Marie-Catherine
Published: July 2014

Pulsed, ultrahigh dose-rate irradiation is safer than standard radiotherapy for the treatment of lung cancer and selectively spares normal tissue.
A Mycobacterium tuberculosis Cytochrome
bd
Oxidase Mutant Is Hypersensitive to Bedaquiline
Authors: Berney Michael , Hartman Travis E. , Jacobs William R.
Published: July 2014

The new medicinal compound bedaquiline (BDQ) kills
Mycobacterium tuberculosis
by inhibiting F
1
F
o
-ATP synthase. BDQ is bacteriostatic for 4 to 7 days and kills relatively slowly compared to other frontline tuberculosis (TB) drugs. Here we show that killing with BDQ can be improved significantly by inhibiting cytochrome
bd
oxidase, a non-proton-pumping terminal oxidase. BDQ was instantly bactericidal against a cytochrome
bd
oxidase null mutant of
M. tuberculosis
, and the rate of killing was increased by more than 50%. We propose that this exclusively bacterial enzyme should be a high-priority target for new drug discovery.

IMPORTANCE
A major drawback of current TB chemotherapy is its long duration. New drug regimens with rapid killing kinetics are desperately needed. Our study demonstrates that inhibition of a nonessential bacterial enzyme greatly improves the efficacy of the latest TB drug bedaquiline and emphasizes that screening for compounds with synergistic killing mechanisms is a promising strategy.
Recovery of a Medieval Brucella melitensis Genome Using Shotgun Metagenomics
Authors: Kay Gemma L. , Sergeant Martin J. , Giuffra Valentina , Bandiera Pasquale , Milanese Marco , Bramanti Barbara , Bianucci Raffaella , Pallen Mark J.
Published: July 2014

Shotgun metagenomics provides a powerful assumption-free approach to the recovery of pathogen genomes from contemporary and historical material. We sequenced the metagenome of a calcified nodule from the skeleton of a 14th-century middle-aged male excavated from the medieval Sardinian settlement of Geridu. We obtained 6.5-fold coverage of a
Brucella melitensis
genome. Sequence reads from this genome showed signatures typical of ancient or aged DNA. Despite the relatively low coverage, we were able to use information from single-nucleotide polymorphisms to place the medieval pathogen genome within a clade of
B. melitensis
strains that included the well-studied Ether strain and two other recent Italian isolates. We confirmed this placement using information from deletions and IS
711
insertions. We conclude that metagenomics stands ready to document past and present infections, shedding light on the emergence, evolution, and spread of microbial pathogens.

IMPORTANCE
Infectious diseases have shaped human populations and societies throughout history. The recovery of pathogen DNA sequences from human remains provides an opportunity to identify and characterize the causes of individual and epidemic infections. By sequencing DNA extracted from medieval human remains through shotgun metagenomics, without target-specific capture or amplification, we have obtained a draft genome sequence of an ~700-year-old
Brucella melitensis
strain. Using a variety of bioinformatic approaches, we have shown that this historical strain is most closely related to recent strains isolated from Italy, confirming the continuity of this zoonotic infection, and even a specific lineage, in the Mediterranean region over the centuries.
Comparison of endovascular treatment approaches for acute ischemic stroke: cost effectiveness, technical success, and clinical outcomes
Authors: Turk Aquilla S , Turner Raymond , Spiotta Alejandro , Vargas Jan , Holmstedt Christine , Ozark Shelly , Chalela Julio , Turan Tanya , Adams Robert , Jauch Edward C , Battenhouse Holly , Whitsitt Brian , Wain Matt , Chaudry M Imran
Published: July 2014

Introduction

The use of mechanical thrombectomy for the treatment of acute ischemic stroke has significantly advanced over the last 5 years. Few data are available comparing the cost and clinical and angiographic outcomes associated with available techniques. The aim of this study is to compare the cost and efficacy of current endovascular stroke therapies.

Methods

A single-center retrospective review was performed of the medical record and hospital financial database of all ischemic stroke cases admitted from 2009 to 2013. Three discrete treatment methodologies used during this time were compared: traditional Penumbra System (PS), stent retriever with local aspiration (SRLA) and A Direct Aspiration first Pass Technique (ADAPT). Statistical analyses of clinical and angiographic outcomes and costs for each group were performed.

Results

222 patients (45% men) underwent mechanical thrombectomy. Successful revascularization was defined as Thrombolysis In Cerebral Infarction (TICI) 2b/3 flow, which was achieved in 79% of cases with PS, 83% of cases with SRLA, and 95% of cases with ADAPT. The average total cost of hospitalization for patients was $51 599 with PS, $54 700 with SRLA, and $33 611 with ADAPT (p<0.0001). Average times to recanalization were 88 min with PS, 47 min with SRLA, and 37 min with ADAPT (p<0.0001). Similar rates of good functional outcomes were seen in the three groups (PS 36% vs SRLA 43% vs ADAPT 47%; p=0.4).

Conclusions

The ADAPT technique represents the most technically successful yet cost-effective approach to revascularization of large vessel intracranial occlusions.
Veterinarians' attitudes to chronic pain in dogs
Authors: Bell A. , Helm J. , Reid J.
Published: July 2014

Veterinary surgeons in the UK were invited to complete an internet survey concerning their attitudes to chronic pain in dogs. UK veterinary surgeons numbering 215 completed surveys in full along with 48 worldwide specialists in anaesthesia and 37 worldwide specialists in oncology. Osteoarthritis, dental and aural disease, vertebral and spinal cord conditions, neoplasia and skin conditions were considered important causes of chronic pain in dogs. UK practitioners used significantly fewer classes of analgesic drugs regularly than either category of specialist. The major barriers to adequate treatment of chronic pain were reported as difficulties with pain assessment, expense of drugs, and difficulties with owner compliance. Illustrations of six common neoplastic conditions were used and scored for pain according to prior experience by practitioners. All six conditions were consistently described as involving some degree of pain with primary bone tumour and oral tumour, causing severe pain and moderate to severe pain, respectively. Years since graduation and specialist status affected the pain scores attributed to the conditions. There was a significant correlation between the pain score attributed to the illustrated condition, and the tendency to administer analgesia.
Feline hyperthyroidism reported in primary‐care veterinary practices in England: prevalence, associated factors and spatial distribution
Authors: Stephens M. J. , Neill D. G. O' , Church D. B. , McGreevy P. D. , Thomson P. C. , Brodbelt D. C.
Published: July 2014

Feline hyperthyroidism is a commonly diagnosed endocrinopathy that can have a substantial deleterious impact on the welfare of affected cats. This study aimed to estimate the prevalence, associated factors and geographical distribution for feline hyperthyroidism in England, using primary‐care veterinary practice clinical data from the VetCompass Animal Surveillance Project. Prevalence was estimated from the overall cat cohort. Associated factor analysis used an age‐matched, nested, case‐control design with multivariable logistic regression. There were 2,276 cases of feline hyperthyroidism identified from 95,629 cats attending 84 practices from September 2009 to December 2011. Cases were aged 6–25 years. 3.7 per cent of cases and 9.9 per cent of controls were purebred, 56.4 per cent of cases and 56.5 per cent of controls were female, and 88.1 per cent of cases and 86.0 per cent of controls were neutered. The apparent prevalence was 2.4 per cent (95% CI 2.3 to 2.5 per cent) overall, and 8.7 per cent (95% CI 8.3 to 9.0 per cent) in cats aged 10 years or above. Burmese (OR 0.15, 95% CI 0.07 to 0.32, P<0.0001), Persian (OR 0.17, 95% CI 0.08 to 0.33, P<0.0001), Siamese (OR 0.4, 95% CI 0.21 to 0.75, P=0.004) and purebred cats overall (OR 0.33, 95% CI 0.25 to 0.42, P< 0.0001) had lower odds of feline hyperthyroidism than non‐purebred cats. Insured cats had increased odds (OR 1.78, 95% CI 1.56 to 2.03, P< 0.001). There was little evidence of spatial variation. This study highlights feline hyperthyroidism as a high‐prevalence disease in England, and reports reduced odds of diagnosis in certain breeds and purebred cats overall.