bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case-control study of risk factors for human infection with avian influenza A(H7N9) virus in Shanghai, China, 2013
Authors: LI J. , CHEN J. , YANG G. , ZHENG Y. X. , MAO S. H. , ZHU W. P. , YU X. L. , GAO Y. , PAN Q. C. , YUAN Z. A. 
Published: December 2014

SUMMARYThe first human infection with avian influenza A(H7N9) virus was reported in Shanghai, China in March 2013. An additional 32 cases of human H7N9 infection were identified in the following months from March to April 2013 in Shanghai. Here we conducted a case-control study of the patients with H7N9 infection (n= 25) using controls matched by age, sex, and residence to determine risk factors for H7N9 infection. Our findings suggest that chronic disease and frequency of visiting a live poultry market (>10 times, or 1–9 times during the 2 weeks before illness onset) were likely to be significantly associated with H7N9 infection, with the odds ratios being 4·07 [95% confidence interval (CI) 1·32–12·56], 10·61 (95% CI 1·85–60·74), and 3·76 (95% CI 1·31–10·79), respectively. Effective strategies for live poultry market control should be reinforced and ongoing education of the public is warranted to promote behavioural changes that can help to eliminate direct or indirect contact with influenza A(H7N9) virus.
Moral Bioenhancement and the Utilitarian Catastrophe
Authors: AGAR NICHOLAS 
Published: December 2014

Abstract:This article challenges recent calls for moral bioenhancement—the use of biomedical means, including pharmacological and genetic methods, to increase the moral value of our actions or characters. It responds to those who take a practical interest in moral bioenhancement. I argue that moral bioenhancement is unlikely to be a good response to the extinction threats of climate change and weapons of mass destruction. Rather than alleviating those problems, it is likely to aggravate them. We should expect biomedical means to generate piecemeal enhancements of human morality. These predictably strengthen some contributors to moral judgment while leaving others comparatively unaffected. This unbalanced enhancement differs from the manner of improvement that typically results from sustained reflection. It is likely to make its subjects worse rather than better at moral reasoning.
Cognitive Diversity and Moral Enhancement
Authors: GYNGELL CHRIS , EASTEAL SIMON 
Published: December 2014

Abstract:One debate in contemporary bioethics centers on whether the development of cognitive enhancement technologies (CETs) will hasten the need for moral enhancement. In this article we provide a new argument in favor of pursuing these enhancement technologies together. The widespread availability of CETs will likely increase population-level cognitive diversity. Different people will choose to enhance different aspects of their cognition, and some won’t enhance themselves at all. Although this has the potential to be beneficial for society, it could also result in harms as people become more different from one another. Aspects of our moral psychology make it difficult for people to cooperate and coordinate actions with those who are very different from themselves. These moral failings could be targeted by moral enhancement technologies, which may improve cooperation among individuals. Moral enhancement technologies will therefore help society maximize the benefits, and reduce the costs, associated with widespread access to cognitive enhancements.
Moral Enhancement Requires Multiple Virtues
Authors: HUGHES JAMES J. 
Published: December 2014

Abstract:Some of the debates around the concept of moral enhancement have focused on whether the improvement of a single trait, such as empathy or intelligence, would be a good in general, or in all circumstances. All virtue theories, however, both secular and religious, have articulated multiple virtues that temper and inform one another in the development of a mature moral character. The project of moral enhancement requires a reengagement with virtue ethics and contemporary moral psychology to develop an empirically grounded model of the virtues and a fuller model of character development. Each of these virtues may be manipulable with electronic, psychopharmaceutical, and genetic interventions. A set of interdependent virtues is proposed, along with some of the research pointing to ways such virtues could be enhanced.
Narrative Ethics, Authentic Integrity, and an Intrapersonal Medical Encounter in David Foster Wallace’s “Luckily the Account Representative Knew CPR”
Authors: NASH WOODS 
Published: December 2014

Abstract:In Wallace’s short story “Luckily the Account Representative Knew CPR,” a vice president (VP) suffers cardiac arrest. As an account representative (AR) administers CPR, he discovers his own impersonality mirrored back to him by the VP—a disturbing vision of himself that the AR wishes to escape. Because modern moral theories would have the AR respond impersonally to the VP, those theories would only exacerbate his existential predicament. In contrast, by regarding the AR’s act as one that he, in particular, should perform, narrative ethics can discern a resolution for his predicament: because the AR still values his diminished capacities for care and spontaneity, this situation offers him an opportunity to revive those former traits. Doing so would give him greater authentic integrity, or narrative continuity with the most important aspects of his past. Authentic integrity can serve narrative ethics as a helpful starting point for understanding how the life stories of patients, clinicians, and others might appropriately unfold.
Structural and functional consequences of removing the N-terminal domain from the magnesium chelatase ChlH subunit of Thermosynechococcus elongatus
Authors: Adams Nathan B. P. , Marklew Christopher J. , Qian Pu , Brindley Amanda A. , Davison Paul A. , Bullough Per A. , Hunter C. Neil 
Published: December 2014

Magnesium chelatase (MgCH) initiates chlorophyll biosynthesis by catalysing the ATP-dependent insertion of Mg2+ into protoporphyrin. This large enzyme complex comprises ChlH, I and D subunits, with I and D involved in ATP hydrolysis, and H the protein that handles the substrate and product. The 148 kDa ChlH subunit has a globular N-terminal domain attached by a narrow linker to a hollow cage-like structure. Following deletion of this ~18 kDa domain from the Thermosynechoccus elongatus ChlH, we used single particle reconstruction to show that the apo- and porphyrin-bound forms of the mutant subunit consist of a hollow globular protein with three connected lobes; superposition of the mutant and native ChlH structures shows that, despite the clear absence of the N-terminal ‘head’ region, the rest of the protein appears to be correctly folded. Analyses of dissociation constants shows that the ΔN159ChlH mutant retains the ability to bind protoporphyrin and the Gun4 enhancer protein, although the addition of I and D subunits yields an extremely impaired active enzyme complex. Addition of the Gun4 enhancer protein, which stimulates MgCH activity significantly especially at low Mg2+ concentrations, partially reactivates the ΔN159ChlH–I–D mutant enzyme complex, suggesting that the binding site or sites for Gun4 on H do not wholly depend on the N-terminal domain.
Population-based structural variation discovery with Hydra-Multi
Authors: Lindberg Michael R. , Hall Ira M. , Quinlan Aaron R. 
Published: December 2014

Abstract
Summary: Current strategies for SNP and INDEL discovery incorporate sequence alignments from multiple individuals to maximize sensitivity and specificity. It is widely accepted that this approach also improves structural variant (SV) detection. However, multisample SV analysis has been stymied by the fundamental difficulties of SV calling, e.g. library insert size variability, SV alignment signal integration and detecting long-range genomic rearrangements involving disjoint loci. Extant tools suffer from poor scalability, which limits the number of genomes that can be co-analyzed and complicates analysis workflows. We have developed an approach that enables multisample SV analysis in hundreds to thousands of human genomes using commodity hardware. Here, we describe Hydra-Multi and measure its accuracy, speed and scalability using publicly available datasets provided by The 1000 Genomes Project and by The Cancer Genome Atlas (TCGA).
Availability and implementation: Hydra-Multi is written in C++ and is freely available at https://github.com/arq5x/Hydra.
Contact: aaronquinlan@gmail.com or ihall@genome.wustl.edu
Supplementary information: Supplementary data are available at Bioinformatics online.
Safety and clinical outcomes of carbapenem de-escalation as part of an antimicrobial stewardship programme in an ESBL-endemic setting
Authors: Lew Kaung Yuan , Ng Tat Ming , Tan Michelle , Tan Sock Hoon , Lew Ee Ling , Ling Li Min , Ang Brenda , Lye David , Teng Christine B. 
Published: December 2014

AbstractObjectivesTo evaluate the safety and clinical outcomes of patients who received carbapenem de-escalation as guided by an antimicrobial stewardship programme (ASP) in a setting where ESBL-producing Enterobacteriaceae are endemic.MethodsPatients receiving meropenem or imipenem underwent a prospective ASP review for eligibility for de-escalation according to defined institutional guidelines. Patients in whom carbapenem was de-escalated or not de-escalated, representing the acceptance and rejection of the ASP recommendation, respectively, were compared. The primary outcome was the clinical success rate; secondary outcomes included the 30 day readmission and mortality rates, the duration of carbapenem therapy, the incidence of adverse drug reactions due to antimicrobials, the acquisition of carbapenem-resistant Gram-negative bacteria and the occurrence of Clostridium difficile-associated diarrhoea (CDAD).ResultsThe de-escalation recommendations for 300 patients were evaluated; 204 (68.0%) were accepted. The patient demographics and disease severity were similar. The clinical success rates were similar [de-escalated versus not de-escalated, 183/204 (89.7%) versus 85/96 (88.5%), P = 0.84], as was the survival at hospital discharge [173/204 (84.8%) versus 79/96 (82.3%), P = 0.58]. In the de-escalated group, the duration of carbapenem therapy was shorter (6 versus 8 days, P &lt; 0.001), the rate of adverse drug reactions was lower [11/204 (5.4%) versus 12/96 (12.5%), P = 0.037], there was less diarrhoea [9/204 (4.4%) versus 12/96 (12.5%), P = 0.015], there was a lower incidence of carbapenem-resistant Acinetobacter baumannii acquisition [4/204 (2.0%) versus 7/96 (7.3%), P = 0.042] and there was a lower incidence of CDAD [2/204 (1.0%) versus 4/96 (4.2%), P = 0.081].ConclusionsThis study suggests that the ASP-guided de-escalation of carbapenems led to comparable clinical success, fewer adverse effects and a lower incidence of the development of resistance. This approach is safe and practicable, and should be a key component of an ASP.
Let Us Use LET
Authors: Sherman Joshua M. , Sheppard Patrick , Hoppa Eric , Krief William , Avarello Jahn 
Published: December 2014

Background
Well-managed pain is associated with faster recovery, fewer complications, and decreased use of resources. In children, pain relief is also associated with higher patient and parent satisfaction. Studies have shown that there are deficiencies in pediatric pain management. LET gel (lidocaine 4%, epinephrine 0.1%, and tetracaine 0.5%) is a topical anesthetic that is routinely used before laceration repair.

Objective
The aim of this study was to determine if educational initiatives as part of a quality improvement initiative lead to increased rates of early topical anesthetic usage in a large urban pediatric emergency department.

Methods
The initiative consisted of an educational session and a triage booth poster. We then reviewed the charts of patients with facial and scalp lacerations for the month before the initiative, the month after the initiative, and 1 year after the initiative. We assessed if LET gel usage and time to administration improved and were sustainable.

Results
We reviewed 138 charts. Before the initiative, only 57.4% received LET gel before facial laceration repair with a mean time to application of 58.3 minutes. One month after the initiative, there was an increase in LET gel application by 20.1% with a reduction in time to application by 35.9 minutes (P < 0.05). In addition, these improvements were significantly sustainable. One year after the interventions, 82.4% received LET before facial laceration repair, and the time to LET application was 27.8 minutes.

Conclusions
Simple educational initiatives can improve the use of topical anesthetics. By using educational tools as part of a quality improvement initiative, we were able to significantly improve the rates of LET gel application for facial lacerations in children and decrease the time to administration.
Detecting the anomaly zone in species trees and evidence for a misleading signal in higher-level skink phylogeny (Squamata: Scincidae)
Authors: Linkem Charles W. , Minin Vladimir , Leaché Adam D. 
Published: December 2014

AbstractThe anomaly zone presents a major challenge to the accurate resolution of many parts of the Tree of Life. The anomaly zone is defined by the presence of a gene tree topology that is more probable than the true species tree. This discrepancy can result from consecutive rapid speciation events in the species tree. Similar to the problem of long-branch attraction, including more data (loci) will only reinforce the support for the incorrect species tree. Empirical phylogenetic studies often implement coalescent based species tree methods to avoid the anomaly zone, but to this point these studies have not had a method for providing any direct evidence that the species tree is actually in the anomaly zone. In this study, we use 16 species of lizards in the family Scincidae to investigate whether nodes that are difficult to resolve are located within the anomaly zone. We analyze new phylogenomic data (429 loci), using both concatenation and coalescent based species tree estimation, to locate conflicting topological signal. We then use the unifying principle of the anomaly zone, together with estimates of ancestral population sizes and species persistence times, to determine whether the observed phylogenetic conflict is a result of the anomaly zone. We identify at least three regions of the Scindidae phylogeny that provide demographic signatures consistent with the anomaly zone, and this new information helps reconcile the phylogenetic conflict in previously published studies on these lizards. The anomaly zone presents a real problem in phylogenetics, and our new framework for identifying anomalous relationships will help empiricists leverage their resources appropriately for overcoming this challenge.
Prevalence, Genetic Diversity, and Antibiotic Resistance of Bacillus cereus Isolated from Korean Fermented Soybean Products
Authors: Kim Cheol‐Woo , Cho Seung‐Hak , Kang Suk‐Ho , Park Yong‐Bae , Yoon Mi‐Hye , Lee Jong‐Bok , No Wan‐Seob , Kim Jung‐Beom 
Published: December 2014

AbstractBacillus cereus contamination is a major food safety problem for Korean fermented soybean products, but few studies have assessed its potential to cause foodborne illness. The objectives of this study were to investigate the prevalence and characteristics of B. cereus isolated from Korean fermented soybean products. B. cereus was detected in 110 of 162 (67.9%) samples. The highest B. cereus frequency was observed in deonjang (68 of 93 samples, 73.1%) and cheonggukjang (18 of 25, 72.0%); however, nonhemolytic enterotoxin was detected only in 22 of 162 samples (13.6%). Although the tested B. cereus isolates showed diverse pulsotypes according to repetitive sequence‐PCR banding patterns, they displayed similar antibiotic sensitivity spectra. The low frequency of enterotoxin detection suggests that the potential risk of B. cereus foodborne illness associated with Korean fermented soybean products is lower than generally presumed. However, considering the prevalence of B. cereus and the high content of fermented soybean products in the Korean diet, it is necessary to constantly monitor the level of contamination with B. cereus and its toxins in such Korean food products.
Methicillin‐Resistant Staphylococcus aureus in Raw Meats and Prepared Foods in Public Hospitals in Salvador, Bahia, Brazil
Authors: Costa Wellington Luis Reis , Ferreira Jeane dos Santos , Carvalho Joelza Silva , Cerqueira Ellayne Souza , Oliveira Lucimara Cardoso , Almeida Rogeria Comastri de Castro 
Published: December 2014

AbstractThis study investigated the presence of methicillin‐resistant Staphylococcus aureus (MRSA) in raw meat and fish and foods prepared from them for patient consumption in public hospitals in Salvador, Bahia, in northeastern Brazil. A total of 114 samples of raw meat and fish (chicken, n = 30; beef, n = 30; pork, n = 24; and fish, n = 30) and 63 samples of prepared foods (made with chicken, n = 15; beef, n = 15; pork, n = 15; and fish, n = 18) were collected from the kitchens of 10 different hospitals. Of the 114 investigated raw meat and fish samples, 28.1% were positive for MRSA, which comprised 23.3% beef, 23.3% chicken, 37.5% pork, and 30% fish samples. Of the prepared foods, 9.5% were positive for MRSA, which comprised 5.6% chicken products, 6.7% pork products, and 22.2% fish products. MRSA contamination was not detected in prepared beef dishes. A statistical analysis showed no association between the presence of MRSA and the type of raw food (P > 0.05). The high prevalence of MRSA among the raw foods tested and the presence of the microorganism in prepared foods emphasizes the necessity of enforcing hygienic practices within hospital kitchens.
A WebGIS‐based teaching assistant system for geography field practice (TASGFP)
Authors: Wang Jiechen , Ni Haochen , Rui Yikang , Cui Can , Cheng Liang 
Published: December 2014

AbstractField practice is an important part of training geography research talents. However, traditional teaching methods may not adequately manage, share and implement instruction resources and thus may limit the instructor's ability to conduct field instruction. A possible answer is found in the rapid development of computer‐assisted instruction (CAI), a new teaching mode for the Information Age. A “virtual field trip” is an amalgam of Internet and multimedia techniques with great potential for geography field instruction, as it can arouse students' enthusiasm and immerse them in learning. However, limited by available technology, virtual field trips have disadvantages in terms of content presentation, data organisation, and loss or inadequate representation of spatial information. To overcome the above shortcomings, a map‐based, spatially correlated design method was proposed for a CAI system in geography. By integrating spatial information technology (Geographic Information System, Global Positioning System, remote sensing, etc) and information delivery methods (web services, databases, etc), a WebGIS‐based teaching assistant system for geography field practice (TASGFP) was established, realising an effective spatial management scheme and forming a shared platform for instruction material. Its efficiency was verified through the actual application, although there remains room for improvement. Nevertheless, the TASGFP stands as an effective CAI tool in geography instruction.
Is there an Appalachian disparity in dental caries in Pennsylvania schoolchildren?
Authors: Polk Deborah E. , Kim Sunghee , Manz Michael , Weyant Robert J. 
Published: December 2014

AbstractObjectivesTo determine whether there is an Appalachian disparity in caries prevalence or extent in children living in Pennsylvania.MethodsWe conducted a cross‐sectional clinical assessment of caries in a sample representing 1st, 3rd, 9th, and 11th grade students across Pennsylvania. We used logistic regression and zero‐inflated negative binomial regression controlling for age to examine the association of residence in an Appalachian county with caries prevalence and extent in the primary and permanent dentitions.ResultsCompared with children living outside Appalachia, more children living in Appalachia had a dft >0 (OR = 1.37, 95% CI = 1.07–1.76) and more had a DMFT >0 (OR = 1.32, 95% CI = 1.06–1.64). In addition, compared with children living outside Appalachia, children living in Appalachia had a greater primary but not permanent caries extent (IRR = 1.10, 95% CI = 1.01–1.19).ConclusionsWe found Appalachian disparities in caries prevalence in both the primary and permanent dentitions and an Appalachian disparity in caries extent in the primary dentition. None of the disparities was moderated by age. This suggests that the search for the mechanism or mechanisms for the Appalachian disparities should focus on differential exposures to risk factors occurring prior to and at the start of elementary school.
Prevalence, Determinants, and Prognostic Significance of Pulmonary Hypertension in Elderly Patients Admitted with Acute Decompensated Heart Failure: A Report from the BIO‐HF Registry
Authors: Vanhercke Daniel , Pardaens Sofie , Weytjens Caroline , Vande Kerckhove Barbara , De Laet Nancy , Janssens Emilie , Van Camp Guy , De Sutter Johan 
Published: December 2014

PurposePulmonary hypertension (PHT) is a predictor of mortality and morbidity in patients with chronic heart failure (HF). However, the prevalence, determinants, and prognostic significance of PHT in elderly patients admitted with acute decompensated HF are unclear.MethodsWe prospectively evaluated 401 patients aged ≥75 years (mean age 83 ± 5 years, 50% women) with acute HF, who were discharged alive, and whose tricuspid regurgitation (TR) gradient was measured by echocardiography during hospitalization. PHT was defined as a TR gradient ≥30 mmHg. The endpoint was all‐cause mortality.ResultsPHT was found in 280/401 patients (69%), including in 67% of patients with HF with reduced ejection fraction (HFrEF) and 73% of patients with HF with preserved ejection fraction (HFpEF) (P = 0.19). Clinical characteristics and comorbidities were similar between patients with and without PHT. The prevalence of PHT increased with increasing severity of mitral regurgitation (MR) (mild: 65%; moderate: 67%; severe: 85%; P < 0.01). After a mean follow‐up of 405 ± 399 days, 118 patients (30%) had died. In a multivariate Cox regression analysis, that included age, sex, serum creatinine, TR gradient, comorbidities, and medications at discharge, age (hazard ratio [HR] 1.07, 95% confidence interval [CI] 1.03–1.11, P < 0.001), serum creatinine (HR 1.41, 95% CI 1.15–1.73, P < 0.01), and PHT (HR 1.60, 95% CI 1.03–2.49, P < 0.01) were independent predictors of all‐cause mortality.ConclusionIn elderly patients admitted with acute HF, PHT is common, mainly associated with the severity of MR and associated with a worse outcome after discharge.