bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Brain Stimulation for Epilepsy
Authors: Graber Kevin D. , Fisher Robert S.
Published: May 2013

Studies of deep brain stimulation in laboratory models of seizures and epilepsy are invaluable for understanding the mechanisms of stimulation and for identifying the best targets and parameters of stimulation. Unfortunately, existing laboratory studies of brain stimulation in epilepsy models present an incomplete and often contradictory picture (Table 79–1). Some efficacy for deep brain stimulation has been documented in labora tory models involving the cerebellar cortex, caudate, hypothalamus, subthalamus, centromedian and midline thalamus, anterior thalamus, hippocampus, and neocortex. However, many studies are empiric in nature and mechanisms, and our understanding of the optimal parameters remains incomplete. Pivotal clinical trials with the ANT and responsive neural stimulation of the hippocampus and neocortex have been effective in reducing seizures. These recent successes in clinical studies may give more impetus to laboratory investigations, which in turn will potentially further our clinical practice.
Strategies for Antiepileptogenesis
Authors: Löscher Wolfgang
Published: May 2013

Epileptogenesis, that is, the process leading to epilepsy, is a common sequel of brain insults such as head trauma, cerebrovascular disease, brain tumors, neurosurgical procedures, neurodegenerative conditions, status epilepticus (SE), and complex febrile seizures.1–3 Following such brain insults, there is a cascade of morphological and functional changes in the injured area over months to years before the occurrence of spontaneous recurrent seizures, that is, the hallmark of epilepsy (Fig. 81–1). This latent (“silent”) period may offer a therapeutic window for the prevention of epileptogenesis and the subsequent development of unprovoked seizures and epilepsy.2
Neural Stem Cell Therapy for Temporal Lobe Epilepsy
Authors: Shetty Ashok K.
Published: May 2013

The major objective of this chapter is to evaluate the contemporary knowledge and to put forward perspectives concerning the NSC grafting therapy for TLE. Since the efficiency of grafting of neural progenitors obtained from the fetal brain or ES cells are covered in other chapters in this book, this chapter is deliberately confined to studies on the efficacy of NSC grafts in TLE prototypes. The first section will focus on the prospects for preventing or minimizing SRS using NSC grafting procedures that are performed shortly after the initial precipitating injury (IPI), such as SE or a direct excitotoxic lesion. The second section will consider the promise of NSC grafting therapy for restraining seizures and easing cognitive dysfunction when applied shortly after or at prolonged periods after the onset of SE- or kindling- induced TLE. Several critical issues that need to be resolved before initiating the clinical application of NSC grafting therapy for TLE are also discussed.
Embryonic Stem Cell Therapy for Intractable Epilepsy
Authors: Naegele Janice R. , Vemuri Mohan C. , Studer Lorenz
Published: May 2013

Envisioning a world in which humans are able to regenerate severed limbs, rewire neural pathways, and enhance sensory perception has been a mainstay of science fiction novels and movies for decades. While human limb regeneration is still not possible, remarkable developments in the fields of stem cell biology and neuroscience are leading the way for stem cell-based therapies to amend brain and spinal cord damage and repair sensory organs. In this chapter, we discuss recent efforts to derive neural stem cells from embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) and their applications to treating conditions such as temporal lobe epilepsy (TLE) and neurodegenerative diseases.
Cell Therapy Using GABAergic Neural Progenitors
Authors: Anderson Stewart A. , Baraban Scott C.
Published: May 2013

This chapter covers cell therapy using GABAergic neural progenitors, including embryonic origin of cortical interneurons, transplantation of MGE precursor cells, cell therapy using transplanted MGE precursor cells, and potential sources of MGE-like interneuron precursors.
Gene Therapy of Focal-Onset Epilepsy Using Adeno-Associated Virus Vector-Mediated Overexpression of Neuropeptide Y
Authors: Noè Francesco M. , Sørensen Andreas T. , Kokaia Merab , Vezzani Annamaria
Published: May 2013

Although various new antiepileptic drugs (AEDs) with diverse mechanisms of action have been developed in the last 15 years with improved tolerability and pharmacokinetic properties,1,2 there has been relatively little improvement in their ability to control pharmacoresistant epilepsies compared to traditional AEDs. Thus, about 30% of patients with epilepsy still have seizures that are resistant to available AEDs. Drug-resistant epileptic patients are considered for surgical resection of the epileptic focus: this invasive procedure, however, is suitable only for a minority of them and results in complete control of epilepsy (seizure freedom without AEDs) in about 30% to 50% of cases, according to a 5- to 10-year follow-up study.3 Additionally, most AEDs provide symptomatic suppression of seizures without apparently interfering with the mechanisms involved in the epileptic process.4,5 Currently, AEDs mainly target neurotransmitter receptors, mechanisms of neurotransmitter release or reuptake, or ion channels.1 There is therefore an urgent need to find novel treatment strategies, particularly for the most refractory forms, such as temporal lobe epilepsy (TLE). 4,6 As an alternative approach to pharmacotherapy, preclinical studies in models of seizures and epilepsy are addressing the possibility of suppressing seizures by inducing the overexpression of neuromodulatory molecules in the area(s) of seizure origin or propagation. This may be achieved using gene therapy that has been developed, and clinically applied, in other neurological disorders.7–12 The intent of experimental studies is to establish the proof-of-concept evidence that gene therapy may be envisioned as a novel therapeutic approach to control drug-resistant seizures in focal-onset epilepsies.
Brain Death
Authors: Wijdicks Eelco F.M.
Published: May 2013

This resource discusses a neurologic condition that medically and legally defines death, the clinical criteria for brain death, and compresses an amazing amount of scholarship, opinions, and clinical research into one small volume. It aims to present a practical book that can be used at the bedside. It expands on the current criteria used in countries throughout the world and highlights the often inexplicable differences among them. There is also a comprehensive discussion of the new 2010 American Academy of Neurology guidelines on determining brain death.
The Social Determinants of Depression in Older Adulthood
Authors: Gilman Stephen E. , Carliner Hannah , Cohen Alex
Published: May 2013

There is longstanding evidence of the impact of social and environmental factors on the development of persistence of depression. This chapter reviews the current evidence on the social determinants of depression in older adulthood. In addition, evidence is reviewed on the social determinants of the receipt and effectiveness of treatments for late-life depression. The social determinants of late-life depression onset and treatment outcomes include socioeconomic and demographic factors (socioeconomic status, gender, race/ethnicity), and factors related to social integration (social networks and social support). Future work in this area is needed to understand the etiological pathways underlying these associations, and modifiable points of intervention to reduce the disproportionate burden of late-life depression among population subgroups at highest risk.
Structural Brain Abnormalities in Bipolar Disorder
Authors: Matsuo Koji , Sanches Marsal , Brambilla Paolo , Soares Jair C.
Published: May 2013

Structural brain imaging, particularly using fMRI, provides a means to identify the neuroanatomic substrate for psychiatric conditions, including bipolar disorder. Regional brain volumetric studies suggest enlargement in several key structures that subsume emotional and cognitive control, including striatum (particularly putamen) and possibly amygdala in adult bipolar subjects. Decreased volumes have been observed in prefrontal areas, the cerebellar vermis and white matter structures. Unlike findings in adults, bipolar youth exhibit decreased amygdala volumes, suggestion developmental specificity of abnormalities within this structure. The functional meaning of these abnormalities has been difficult to ascertain, as correlations with clinical data are often inconsistent. Nonetheless, some changes seem to reflect progression related to the number of affective episodes as well as potentially from treatment exposure. In particular, lithium may increase gray matter volumes in some structures (e.g., amygdala) over time. White matter abnormalities have also been relatively consistently demonstrated using various structural imaging techniques in bipolar disorder. These findings support a neuroanatomic model of bipolar disorder involving abnormalities within ventral brain networks that modulate mood.
Neuroimaging in Bipolar Disorder and Schizophrenia
Authors: Whalley Heather C. , Sussmann Jessika E. , McIntosh Andrew M.
Published: May 2013

Bipolar disorder and schizophrenia are overlapping syndromes that show evidence of shared risk factors, treatments and disease outcomes. Magnetic resonance imaging has been used to address the question of whether these are separate diseases or whether a single category or dimension better explains clinical observations. Evidence from brain imaging has yielded a complex answer. Studies of grey and white matter imaging suggest a degree of overlap, but investigations to date have been too small and infrequent to come to any confident conclusion. Studies using functional MRI on the other hand, suggest that there may be significant differences in task related activation of frontotemporal and limbic brain regions, possibly mirroring the relatively common and distinct clinical phenotypes seen in practice. These findings suggest that imaging may yet prove to have predictive diagnostic value and utility in defining syndromes more closely related to their underlying etiology.
Characterization of an unusual transmissible spongiform encephalopathy in goat by transmission in knock-in transgenic mice
Authors: Wilson Rona , King Declan , Hunter Nora , Goldmann Wilfred , Barron Rona M.
Published: May 2013

Bovine spongiform encephalopathy (BSE) is a fatal neurodegenerative disorder of cattle, and its transmission to humans through contaminated food is thought to be the cause of the variant form of Creutzfeldt–Jakob disease. BSE is believed to have spread from the recycling in cattle of ruminant tissue in meat and bone meal (MBM). However, during this time, sheep and goats were also exposed to BSE-contaminated MBM. Both sheep and goats are experimentally susceptible to BSE, and while there have been no reported natural BSE cases in sheep, two goat BSE field cases have been documented. While cases of BSE are rare in small ruminants, the existence of scrapie in both sheep and goats is well established. In the UK, during 2006–2007, a serious outbreak of clinical scrapie was detected in a large dairy goat herd. Subsequently, 200 goats were selected for post-mortem examination, one of which showed biochemical and immunohistochemical features of the disease-associated prion protein (PrPTSE) which differed from all other infected goats. In the present study, we investigated this unusual case by performing transmission bioassays into a panel of mouse lines. Following characterization, we found that strain properties such as the ability to transmit to different mouse lines, lesion profile pattern, degree of PrP deposition in the brain and biochemical features of this unusual goat case were neither consistent with goat BSE nor with a goat scrapie herdmate control. However, our results suggest that this unusual case has BSE-like properties and highlights the need for continued surveillance.
A recombinant begomovirus resulting from exchange of the C4 gene
Authors: Xie Yan , Zhao Liling , Jiao Xiaoyang , Jiang Tong , Gong Huanran , Wang Bi , Briddon Rob W. , Zhou Xueping
Published: May 2013

A begomovirus isolated fromMalvastrum coromandelianumand tomato originating from Yunnan province (China) was shown to be representative of a new begomovirus species, for which the name tomato leaf curl Yunnan virus (TLCYnV) is proposed. TLCYnV has high levels of sequence identity to tomato yellow leaf curl China virus (TYLCCNV) across the whole genome, except for sequences encompassing theC4gene.Agrobacterium-mediated inoculation showed TLCYnV to be highly infectious to a range of plant species but poorly infectious toM. coromandelianum. In contrast to TYLCCNV, TLCYnV was shown to infect tomato in the absence of a betasatellite. In field-collected samples, TLCYnV was identified most frequently in tomato in which it was not associated with a betasatellite. Transgenic expression inNicotiana benthamianashowed that the C4 protein of TYLCCNV did not induce developmental abnormalities, whereas the C4 of TLCYnV induced severe developmental abnormalities, reminiscent of virus symptoms. The genome of TLCYnV was shown to be significantly less methylated in plants than that of TYLCCNV and the C4 protein of TLCYnV was shown to suppress post-transcriptional gene silencing and transcriptional gene silencing more effectively than the C4 of TYLCCNV. The results indicate that TLCYnV evolved from TYLCCNV by recombination, acquiring a more virulent C4, allowing it to dispense with the requirement for a betasatellite. The implications of these findings in relation to the evolution of monopartite begomoviruses are discussed.
Possibility of X-ray pulse compression using an asymmetric or inclined double-crystal monochromator
Authors: Hrdý Jaromir , Oberta Peter
Published: May 2013

It is shown theoretically that the asymmetric or inclined double-crystal X-ray monochromator may be used for X-ray pulse compression if the pulse is properly chirped. By adjusting the mutual distance of the two asymmetric or inclined crystals it should be possible to achieve even a sub-femtosecond compression of a chirped free-electron laser pulse. The smalld-spacing of the crystal enables a more compact scheme compared with the currently used grating compression scheme. The asymmetric cut of the crystal enables the acceptance of a larger bandwidth. The inclined cut has larger tunability.
A cohort study of chest pain patients discharged from the emergency department for early outpatient treadmill exercise stress testing
Authors: Paoloni Richard , Ibuowo Razaq
Published: May 2013

Objective

Guidelines on intermediate‐risk chest pain, based on consensus alone, recommend inpatient provocative testing after infarct exclusion. Inpatient testing exceeds capacity in many hospitals, so guidelines concede outpatient testing within 72 h is acceptable. We performed a cohort study of chest pain patients having early outpatient treadmill exercise stress testing (EST).

Methods

All chest pain patients discharged from our emergency with booked outpatient treadmill EST during the 2008 to 2010 calendar years were included. There were no exclusions. The primary outcome was diagnosis of major coronary artery disease among stress test attendees. Secondary outcomes were time to stress test booking, representations with chest pain or death within 30 days.

Results

The cohort consisted of 657 patients: 59% men, mean age 53.2 years. Time from discharge to stress test averaged 10.6 days and 73% of patients attended. Of patients who attended, 14% had a positive test and 13% an inconclusive result. These patients were older than those with negative results (P < 0.001). Four patients (0.8% of attendees) were diagnosed with major coronary artery disease. There were no representations with acute myocardial infarction and no deaths identified.

Conclusions

Outpatient treadmill EST an average of 10 days post‐discharge from emergency with chest pain did not result in adverse events despite reasonably high positive stress test rates. Consensus‐based recommendations for inpatient testing or outpatient testing within 72 h of discharge should be reviewed in light of these data.
The Big 5 and conservation
Authors: Caro Tim , Riggio Jason
Published: May 2013

Read the Feature Paper: Understanding heterogeneous preference of tourists for big game species: implications for conservation and management

Other Commentaries on this paper: To use tourism as a conservation tool, first study tourists

Response from the authors: Conservation marketing and education for less charismatic biodiversity and conservation businesses for sustainable development
Cranofacial osteosarcoma: Single institutional experience in Korea
Authors: Lim Seungtaek , Lee Soohyeon , Rha Sun Young , Rho Jae Kyung
Published: May 2013

Introduction

Craniofacial osteosarcoma is a rare disease accounting for only 1% of all head and neck malignancies. Its clinical features and optimal treatments are not yet clearly established.

Methods

We retrospectively analyzed the clinical course of 15 patients with craniofacial osteosarcoma treated in a single institute.

Results

Out of 13 patients who initially underwent primary mass resection, disease recurrence was found in five (36%). Patients with positive surgical margins showed higher recurrence and shorter median recurrence‐free and overall survival. Of three patients who had secondary operation after local recurrence, two survived for 44.6 and 64.2 months, respectively. One patient who underwent repeated lung metastasectomy had a disease‐free survival of 18.4 months from the first recurrence.

Conclusion

The current study demonstrates that positive surgical margins are important predictive factors for recurrence and overall survival. Salvage surgery for local recurrence and metastasectomy for systemic recurrence might have a positive impact on survival.
Why are there delays in seeking treatment for childhood diarrhoea in India?
Authors: Malhotra Nisha , Upadhyay Ravi Prakash
Published: May 2013

Aim

To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.

Methods

Data from Indian Demographic and Health survey 2005–06 (NFHS‐III) were used. Mothers were asked whether their children (<5‐years) had suffered from diarrhoea during the 2 weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the ‘delay’ in seeking advice/treatment.

Results

Of a sample of 41 287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percentage of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08–2.54), richest (OR 1.76; 95% CI, 1.24–2.48) wealth index, and possession of a health card by the mother (OR 1.35; 95% CI, 1.12–1.62) increased the odds of seeking treatment. There was a strong gender bias; a male child had lower odds of experiencing a ‘delay’ in seeking treatment, compared with a female child (OR 0.71; 95% CI, 0.55–0.92). Access to a health facility still remains a major issue: treatment seeking was delayed when distance to a health facility was reported as a ‘major problem’ (OR 1.33; 95% CI, 1.01–1.76).

Conclusion(s)

Improved care seeking for childhood diarrhoea in India is still constrained by access to a health facility and requires expansion and strengthening of the public health system. The caregivers, especially the mothers need to be educated about the importance of seeking timely treatment and the benefits of oral rehydration solution.
Diagnostic methods used to monitor an outbreak of babesiosis (Babesia bovis) in a herd of feral cattle in New Caledonia
Authors: Hüe T , Graille M , Mortelecque A , Desoutter D , Delathière JM , Marchal C , Teurlai M , Barré N
Published: May 2013

Background

In December 2007, Babesia bovis was introduced to New Caledonia through the importation of cattle vaccinated with a live tick fever (babesiosis and anaplasmosis) vaccine. Medical measures, acaricide and antiprotozoal treatments, and quarantine restrictions were implemented with success on all the farms involved, but the disease spread to one of the neighbouring properties where feral cattle were present. To circumscribe and eliminate this outbreak, the authorities decided to slaughter all animals on the neighbouring property.

Objectives

To monitor the spread of babesiosis in naïve cattle and to compare the usefulness of PCR, ELISA and brain smear for disease detection in monitoring this outbreak.

Methods

Blood and brain samples of slaughtered animals were analysed over time throughout the eradication campaign using serology, PCR and brain smears. In addition, field numbers of Rhipicephalus microplus tick larvae were assessed and Babesia infection of the larvae analysed using PCR.

Results

This study showed the natural spread of babesiosis in a naïve herd without pharmacological control measures. Prevalence reached 80% within a year of introduction. ELISA and PCR tests performed similarly in detecting disease in cattle and both were superior to brain smears. Nevertheless, specific tests or combinations of tests may be preferable, depending on the specific requirements of any future disease situation.

Conclusions

In cattle, ELISA and PCR appear to be suitable tools for monitoring the evolution of a babesiosis outbreak, with brain smears as a useful adjunct. PCR was not suitable for detecting infection in tick larvae.
Methicillin‐resistant Staphylococcus aureus: an issue for veterinary hospitals
Authors: Allen JL , Abraham LA , Thompson K , Browning GF
Published: May 2013

Objective

To investigate the spread of methicillin‐resistant Staphylococcus aureus (MRSA) isolated from a cluster of clinical cases at a veterinary hospital by molecular epidemiological techniques.

Methods

Antimicrobial susceptibility testing, spa typing, multilocus sequence typing and pulsed‐field gel electrophoresis were used to compare 16 isolates of MRSA. Four isolates were cultured from clinical cases thought to be involved in the cluster. A single isolate that was unrelated to the cluster and the remaining 10 isolates were obtained from nasal swabs submitted by staff and students during a subsequent survey of MRSA carriage.

Results

Isolates from four clinical cases and an isolate obtained from a staff member were the same strain of MRSA. Some key risk factors associated with transmission of MRSA within veterinary hospitals were identified.

Conclusion

The information provided by these techniques was invaluable in developing procedures and identifying risk factors to help reduce the effect of future outbreaks within veterinary hospitals.
Indications, durations and outcomes of mechanical ventilation in dogs and cats with tick paralysis caused byIxodes holocyclus: 61 cases (2008–2011)
Authors: Webster RA , Mills PC , Morton JM
Published: May 2013

Objectives

The primary objectives of this research were to describe the indications for mechanical ventilation, the duration of mechanical ventilation and probability of survival in dogs and cats with respiratory failure induced by the Australian paralysis tick (Ixodes holocyclus).

Methods

A retrospective case series and a retrospective single cohort study were conducted using dogs and cats with tick paralysis requiring mechanical ventilation. An index of oxygenating performance of the lung (PFratio of partial pressure of oxygen in arterial blood to fraction of inspired oxygen) was derived from arterial blood gas analysis; patients euthanased because of veterinary costs were identified andKaplan‐Meier survival analyses performed.

Results

In total, 36.6% of patients were ventilated because of hypoxaemia refractory to oxygen therapy, 38.3% because of hypoventilation, 18.3% because of unsustainable respiratory effort and 6.6% because of respiratory arrest. Median duration of mechanical ventilation was 23 h, median time hospitalised was 84 h and 63.9% of all patients requiring mechanical ventilation survived to discharge from the hospital. Survival probability increased to 75% when cases of cost‐based euthanasia were right‐censored rather than treated as deaths. The survival probability of patients ventilated because of hypoxaemia (52.6%) was significantly less than for those ventilated because of hypoventilation (90.5%). The first measuredPFratio after commencing mechanical ventilation was not significantly associated with survival probability.

Conclusions

Dogs and cats with tick paralysis requiring mechanical ventilation to manage respiratory failure have reasonable survival probability. Dogs and cats requiring mechanical ventilation because of hypoventilation have a higher survival probability than those with oxygenation failure.
Retrospective analysis of complications and outcomes inBoxers andStaffordshireBullTerriers undergoing cranial cruciate ligament surgery
Authors: Levien AS , Brodbelt DC , Arthurs GI
Published: May 2013

Objective

The aim of this study was to determine whetherBoxers andStaffordshireBullTerriers (SBT) have a higher incidence of complications or a worse outcome after cranial cruciate ligament (CCL) surgery compared with control breeds.

Design

The design was a retrospective cohort study with data reviewed from medical records and outcome assessed by owner questionnaire.

Results

The cohort included 210 canine stifles comprising 33Boxers, 47SBTsand 130 controls. ForBoxers, the overall complication rate (39.4%), major complication rate (30.3%) and revision surgery rates (18.2%) were significantly higher than those of the control groups (14.6%, 10.8% and 4.6%, respectively). Overall,SBTswere no more likely to suffer complications or repeat surgery than the control group. Considering only lateral fabello‐tibial suture (LFS) stabilisation, bothBoxers (32.0%) andSBTs(23.3%) had higher complication rates than the control group (6.3%). There were no significant differences in outcome among theBoxer,SBTand control groups; median follow‐up time was 2 years (range 0.5–7 years).

Conclusions

The overall complication rate forBoxers undergoingCCLsurgery was higher compared with other breeds of dog. When surgical techniques were analysed separately, theLFSwas associated with a higher complication rate inBoxers andSBTs. Further investigation into breed‐specific surgical techniques is indicated.
Toward a Critical Ethical Reflexivity: Phenomenology and Language in Maurice Merleau‐Ponty
Authors: Murray Stuart J. , Holmes Dave
Published: May 2013

Working within the tradition of continental philosophy, this article argues in favour of a phenomenological understanding of language as a crucial component of bioethical inquiry. The authors challenge the ‘commonsense’ view of language, in which thinking appears as prior to speaking, and speech the straightforward vehicle of pre‐existing thoughts. Drawing on Maurice Merleau‐Ponty's (1908–1961) phenomenology of language, the authors claim that thinking takes place in and through the spoken word, in and through embodied language. This view resituates bioethics as a matter of bodies that speak. It also refigures the meaning of ethical self‐reflexion, and in so doing offers an alternative view on reflexivity and critique. Referring to the Kantian critical tradition and its reception by Hannah Arendt and Michel Foucault, we advance a position we call ‘critical ethical reflexivity’. We contend that Merleau‐Ponty's phenomenology of language offers valuable insight into ethical reflexivity and subject formation. Moreover, his understanding of language may foster new qualitative empirical research in bioethics, lead to more nuanced methods for interpreting personal narratives, and promote critical self‐reflexion as necessary for bioethical inquiry.
Global Health and Justice: Re‐examining our Values
Authors: Benatar Solomon R.
Published: May 2013

Widening disparities in health within and between nations reflect a trajectory of ‘progress’ that has ‘run its course’ and needs to be significantly modified if progress is to be sustainable. Values and a value system that have enabled progress are now being distorted to the point where they undermine the future of global health by generating multiple crises that perpetuate injustice. Reliance on philanthropy for rectification, while necessary in the short and medium terms, is insufficient to address the challenge of economic and other systems spinning out of control. Innovative approaches are required and it is suggested that these could best emerge from in‐depth multidisciplinary research supported by endeavours to promote a ‘global mind‐set.’
Not the Usual Suspects: Addressing Layers of Vulnerability
Authors: Luna Florencia , Vanderpoel Sheryl
Published: May 2013

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of ‘usual suspects’, focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle‐class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking.

In the first section, two different approaches to ‘vulnerability’ are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle‐class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle‐class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities.
Improved risk stratification in myeloma using a microRNA‐based classifier
Authors: Wu Ping , Agnelli Luca , Walker Brian A. , Todoerti Katia , Lionetti Marta , Johnson David C. , Kaiser Martin , Mirabella Fabio , Wardell Christopher , Gregory Walter M. , Davies Faith E. , Brewer Daniel , Neri Antonino , Morgan Gareth J.
Published: May 2013

Multiple myeloma (MM) is a heterogeneous disease. International Staging System/fluorescence hybridization (ISS/FISH)‐based model and gene expression profiles (GEP) are effective approaches to define clinical outcome, although yet to be improved. The discovery of a class of small non‐coding RNAs (micro RNAs, miRNAs) has revealed a new level of biological complexity underlying the regulation of gene expression. In this work, 163 presenting samples from MM patients were analysed by global miRNA profiling, and distinct miRNA expression characteristics in molecular subgroups with prognostic relevance (4p16, MAF and 11q13 translocations) were identified. Furthermore we developed an “outcome classifier”, based on the expression of two miRNAs (MIR17 and MIR886‐5p), which is able to stratify patients into three risk groups (median OS 19·4, 40·6 and 65·3 months, P = 0·001). The miRNA‐based classifier significantly improved the predictive power of the ISS/FISH approach (P = 0·0004), and was independent of GEP‐derived prognostic signatures (P < 0·002). Through integrative genomics analysis, we outlined the potential biological relevance of the miRNAs included in the classifier and their putative roles in regulating a large number of genes involved in MM biology. This is the first report showing that miRNAs can be built into molecular diagnostic strategies for risk stratification in MM.
From Racial Mixture to Black Nation: Racialising Discourses inBrazil's African Affairs
Authors: CICALO ANDRÉ
Published: May 2013

The article links reflections aboutBrazilian race relations with institutional transnational dialogues betweenBrazil and ‘Africa’. I point out that although racial/cultural mixture and the ‘brown’ census category have traditionally reflected much of national identity inBrazil,Brazil today is increasingly spelling out its blackness, both on the national and international scenes. I highlight that, not by coincidence, this fact is happening at a historical moment when programmes of ‘black’ affirmative action and other differential politics in favour ofAfro‐descendants are taking off in the country, and also at a time whenBrazil is expanding its geopolitical and economic interests inAfrica.
Infants and Toddlers in Foster Care
Authors: Dozier Mary , Zeanah Charles H. , Bernard Kristin
Published: May 2013

Young children involved in the child welfare system are susceptible to behavioral and physiological dysregulation. These children need nurturing care to develop organized attachments to caregivers, they need synchronous care to support their physiological and behavioral regulation, and they need stable caregivers who can commit to them, supporting their sense of self and behavioral regulation. Without intervention at the level of the parent and the system, most children involved with the child welfare system are unlikely to have these needs met. We present two models of intervention designed to enhance parents’ synchrony and nurturance, and highlight aspects of the system that can enhance the stability and commitment of caregivers.
Is previous hyperthyroidism associated with long‐term cognitive dysfunction? A twin study
Authors: Lillevang‐Johansen Mads , Petersen Inge , Christensen Kaare , Hegedüs Laszlo , Brix Thomas Heiberg
Published: May 2013

Objective

Hyperthyroidism has been suggested to adversely affect cognitive function. However, this association could also be caused by genetic and environmental factors affecting both the development of hyperthyroidism and cognitive functioning. By investigating twin pairs discordant for hyperthyroidism, this potential confounding can be minimized. The aim of the study was to examine whether hyperthyroidism is associated with long‐term cognitive dysfunction.

Design

Twin case–control study.

Patients

Twin pairs discordant for hyperthyroidism were identified by record linkage between The Danish National Patient Registry and 3036 twin pairs from The Danish Twin Registry, who had participated in nationwide surveys on health conditions.

Measurements

Among other investigations, survey participants had carried out cognitive tests including a Mini–mental state examination (MMSE) and six separate cognitive tests. Based on five of the tests, a composite cognitive score was calculated.

Results

Fifty‐five of 3036 twin pairs were discordant for hyperthyroidism. The mean time from diagnosis until survey participation was 7·3 years (range: 0–24·1 years). In both the intrapair and individual‐level analyses, the hyperthyroid twin scored significantly better in the MMSE than did the healthy co‐twin (P = 0·023 and P = 0·038, respectively). The same tendency was found in the other cognitive tests, and after analysing twins diagnosed with hyperthyroidism more than 2 years before participating, although none were statistically significant.

Conclusion

Utilizing discordant twin pairs to control for genetic as well as early environmental factors, we could not demonstrate any clinically relevant negative impact of previous hyperthyroidism on long‐term cognitive function.
An Extensive Evaluation of Decision Tree–Based Hierarchical Multilabel Classification Methods and Performance Measures
Authors: Cerri Ricardo , Pappa Gisele L. , Carvalho André Carlos P.L.F. , Freitas Alex A.
Published: May 2013

Hierarchical multilabel classification is a complex classification problem where an instance can be assigned to more than one class simultaneously, and these classes are hierarchically organized with superclasses and subclasses, that is, an instance can be classified as belonging to more than one path in the hierarchical structure. This article experimentally analyses the behavior of different decision tree–based hierarchical multilabel classification methods based on the local and global classification approaches. The approaches are compared using distinct hierarchy‐based and distance‐based evaluation measures, when they are applied to a variation of real multilabel and hierarchical datasets' characteristics. Also, the different evaluation measures investigated are compared according to their degrees of consistency, discriminancy, and indifferency. As a result of the experimental analysis, we recommend the use of the global classification approach and suggest the use of the Hierarchical Precision and Hierarchical Recall evaluation measures.
(Re‐)Interpreting Fiduciary Duty to Justify Socially Responsible Investment for Pension Funds?
Authors: Sandberg Joakim
Published: May 2013

Manuscript Type

Conceptual

Research Issue

A critical issue for the future growth of socially responsible investment (SRI) is to what extent institutional investors such as pension funds can be persuaded to engage in it. This paper considers attempts at justifying such engagement stemming from a range of (re‐)interpretations of the fiduciary duties owed by pension funds to their beneficiaries, and thereby develops a hypothesis concerning the most effective political or legal remedy.

Research Findings

Previous commentary suggests that fiduciary duty either already mandates SRI for pension funds, or at least can be made to do so rather easily. In contrast with this, however, this paper finds that none of the considered interpretations is able to justify engagement on social and environmental issues across the board. Indeed, the problem to some extent seems rooted in the very concept of fiduciary duty.

Theoretical Implications

The paper is relevant to current attempts at justifying SRI through reinterpretations of fiduciary duty, provided mainly by legal scholars and practitioners. By addressing the more philosophical issue of how far the concept of fiduciary duty can be “stretched” to accommodate SRI (a project of conceptual rather than legal clarification), it provides an evaluation of the contemporary debate which is independent of squabbles about existing law.

Policy Implications

The paper shows that there are conceptual limits to attempts at redefining fiduciary duty. But this does not mean that pension funds' engagement in SRI is unjustified or unjustifiable more generally. A more promising way to legally mandate SRI may be through what is dubbed independent social and environmental obligations.
Complementary thinking: future perspectives on the assessment of general movements
Authors: Einspieler Christa , Marschik Peter B
Published: May 2013

This commentary is on the original article by Kanemaru et al. on pages 713–721 of this issue.
Phenotypic characterization of cryptic Diplodia species by MALDI‐TOF MS and the bias of mycelium age
Authors: Mancini V. , Dapporto L. , Baracchi D. , Luchi N. , Turillazzi S. , Capretti P.
Published: May 2013

Detection and identification of fungal cryptic species has been facilitated by DNA sequencing. However, the examination of some phenotypic traits is fundamental for the confirmation of genetic results. MALDI‐TOF mass spectrometry has shown remarkable reliability in the recognition of species‐specific phenotypic markers and has already been tested in several species of fungi. However, even though there is no direct evidence, the age of the mycelium appears to influence the composition of the metabolites detected. In this study, we demonstrate that MALDI‐TOF is a reliable technique to identify suitable metabolites to distinguish three monophyletic species of Diplodia (D. pinea, D. seriata and D. scrobiculata), thus supporting recent DNA results. Nevertheless, different collections of samples over a period of 3 months after inoculation also revealed that the MALDI‐TOF spectra are highly dependent on mycelial age. More importantly, the species‐specific markers emerge only after 1 month of mycelial growth. The methodological and biological implications of these findings are discussed.
Fungi in foliage and shoots of Fraxinus excelsior in eastern Ukraine: a first report on Hymenoscyphus pseudoalbidus
Authors: Davydenko K. , Vasaitis R. , Stenlid J. , Menkis A.
Published: May 2013

In eastern Ukraine, the first symptoms of dieback on common ash (Fraxinus excelsior) were observed in 2010, as sparse flushing of leaves, bark necrosis and wood discoloration of shoots. The aim of this study was to assess possible causal agents of the damage by studying fungal communities in both symptomatic and healthy‐looking shoots, and leaf petioles. Field sampling was carried out in 2010 in Kharkiv and Sumy regions in eastern Ukraine and included 68 segments of symptomatic shoots, 68 segments of healthy‐looking shoots and 240 segments of petioles. DNA isolation from individual segments and direct sequencing of fungal ITS rRNA resulted in 430 fungal sequences representing 29 distinct taxa. Results showed that Hymenoscyphus pseudoalbidus – the primary causal agent of ash dieback in Europe – was present at low proportion (5.6%) in symptomatic shoots. Other more frequently detected fungi were Epicoccum nigrum, Venturia fraxini, Colletotrichum truncatum, Aureobasidium pullulans, Alternaria alternata, Alternaria sp. and Lophiostoma corticola. In conclusion, the study reports on the first incidence of ash decline in the Ukraine and other possible causal agents of damage which may help to evaluate and forecast the future situation with F. excelsior stands in the region.
Phase coding by grid cells in unconstrained environments: two‐dimensional phase precession
Authors: Climer Jason R. , Newman Ehren L. , Hasselmo Michael E.
Published: May 2013

Action potential timing is thought to play a critical role in neural representation. For example, theta phase precession is a robust phenomenon exhibited by spatial cells of the rat entorhinal–hippocampal circuit. In phase precession, the time a neuron fires relative to the phase of theta rhythm (6–10 Hz) oscillations in the local field potential reduces uncertainty about the position of the animal. This relationship between neural firing and behavior has made precession an important constraint for hypothetical mechanisms of temporal coding. However, challenges exist in identifying what regulates the spike timing of these cells. We have developed novel analytical techniques for mapping between behavior and neural firing that provide sufficient sensitivity to examine features of grid cell phase coding in open environments. Here, we show robust, omnidirectional phase precession by entorhinal grid cells in openfield enclosures. We present evidence that full phase precession persists regardless of how close the animal comes to the center of a firing field. Many conjunctive grid cells, previously thought to be phase locked, also exhibited phase coding. However, we were unable to detect directional‐ or field‐specific phase coding predicted by some variants of models. Finally, we present data that suggest bursting of layer II grid cells contributes to the bimodality of phase precession. We discuss implications of these observations for models of temporal coding and propose the utility of these techniques in other domains where behavior is aligned to neural spiking.
Ameloblasts require active RhoA to generate normal dental enamel
Authors: Xue Hui , Li Yong , Everett Eric T. , Ryan Kathleen , Peng Li , Porecha Rakhee , Yan Yan , Lucchese Anna M. , Kuehl Melissa A. , Pugach Megan K. , Bouchard Jessica , Gibson Carolyn W.
Published: May 2013

RhoA plays a fundamental role in regulation of the actin cytoskeleton, intercellular attachment, and cell proliferation. During amelogenesis, ameloblasts (which produce the enamel proteins) undergo dramatic cytoskeletal changes and the RhoA protein level is up‐regulated. Transgenic mice were generated that express a dominant‐negative RhoA transgene in ameloblasts using amelogenin gene‐regulatory sequences. Transgenic and wild‐type (WT) molar tooth germs were incubated with sodium fluoride (NaF) or sodium chloride (NaCl) in organ culture. Filamentous actin (F‐actin) stained with phalloidin was elevated significantly in WT ameloblasts treated with NaF compared with WT ameloblasts treated with NaCl or with transgenic ameloblasts treated with NaF, thereby confirming a block in the RhoA/Rho‐associated protein kinase (ROCK) pathway in the transgenic mice. Little difference in quantitative fluorescence (an estimation of fluorosis) was observed between WT and transgenic incisors from mice provided with drinking water containing NaF. We subsequently found reduced transgene expression in incisors compared with molars. Transgenic molar teeth had reduced amelogenin, E‐cadherin, and Ki67 compared with WT molar teeth. Hypoplastic enamel in transgenic mice correlates with reduced expression of the enamel protein, amelogenin, and E‐cadherin and cell proliferation are regulated by RhoA in other tissues. Together these findings reveal deficits in molar ameloblast function when RhoA activity is inhibited.
Women Use Red in Order to Attract Mates
Authors: Prokop Pavol , Hromada Martin
Published: May 2013

Among certain non‐human primates, the red‐colored genitalia of females are a sexual ornament and attract males. The preference for red clothes among women is at times explained as being a parallel. We used here a within‐individual design to investigate the signaling role of the color red with a sample of Slovak participants. As expected, women preferred red clothing both in real‐life and would‐be situations more than men. The preference for red (but not for other colors) in mating game scenarios was only significant for women, but not for men. A preference for the color red was shown in particular for clothes on the upper parts of the participants' bodies, irrespective of gender. Women who were actually involved in a romantic sexual relationship had a preference for red in would‐be situations more than single women, although the menstrual cycle, the total number of lifetime sexual partners, and self‐perceived attractiveness were not associated with the preference for the color red. Our results support the sexual signaling hypothesis which suggests that women use the color red to attract potential mates in a similar way as non‐human primates.
Turning acne on/off via mTORC1
Authors: Danby F. William
Published: May 2013

Over the past 10 years, the increase in comprehension of the mechanisms behind acne has been truly exponential. Starting with the ethnological work of Cordain, accelerated by the epidemiological work of Adebamowo, supported by the clinical trials of Smith and Mann, Kwon, DiLandro and others, the interface of diet and acne is coming into focus. Melnik now presents an exceptional pair of papers that illustrate for dermatologists what translational research is all about. The Western diet, the role of dairy, FoxO1 and mTORC1, the interplay of agonists and antagonists, therapeutics present and future – the jigsaw puzzle is coming together.