The potential for bias in reporting of industry-sponsored clinical trials

Concerns about potentially misleading reporting of pharmaceutical industry research have surfaced many times. The potential for duality (and thereby conflict) of interest is only too clear when you consider the sums of money required for the discovery, development and commercialization of new medicines. As the ability of major, mid-size and small pharmaceutical companies to innovate has waned, as evidenced by the seemingly relentless decline in the numbers of new medicines approved by Food and Drug Administration and European Medicines Agency year-on-year, not only has the cost per new approved medicine risen: so too has the public and media concern about the extent to which the pharmaceutical industry is open and honest about the efficacy, safety and quality of the drugs we manufacture and sell. In 2005 an Editorial in Journal of the American Medical Association made clear that, so great was their concern about misleading reporting of industry-sponsored studies, henceforth no article would be published that was not also guaranteed by independent statistical analysis. We examine the precursors to this Editorial, as well as its immediate and lasting effects for statisticians, for the manner in which statistical analysis is carried out, and for the industry more generally.

Replication enhancer elements within the open reading frame of tick-borne encephalitis virus and their evolution within the Flavivirus genus

We provide experimental evidence of a replication enhancer element (REE) within the capsid gene of tick-borne encephalitis virus (TBEV, genus Flavivirus). Thermodynamic and phylogenetic analyses predicted that the REE folds as a long stable stem–loop (designated SL6), conserved among all tick-borne flaviviruses (TBFV). Homologous sequences and potential base pairing were found in the corresponding regions of mosquito-borne flaviviruses, but not in more genetically distant flaviviruses. To investigate the role of SL6, nucleotide substitutions were introduced which changed a conserved hexanucleotide motif, the conformation of the terminal loop and the base-paired dsRNA stacking. Substitutions were made within a TBEV reverse genetic system and recovered mutants were compared for plaque morphology, single-step replication kinetics and cytopathic effect. The greatest phenotypic changes were observed in mutants with a destabilized stem. Point mutations in the conserved hexanucleotide motif of the terminal loop caused moderate virus attenuation. However, all mutants eventually reached the titre of wild-type virus late post-infection. Thus, although not essential for growth in tissue culture, the SL6 REE acts to up-regulate virus replication. We hypothesize that this modulatory role may be important for TBEV survival in nature, where the virus circulates by non-viraemic transmission between infected and non-infected ticks, during co-feeding on local rodents.

Electromagnetic atmosphere-plasma coupling: the global atmospheric electric circuit

A description is given of the global atmospheric electric circuit operating between the Earth’s surface and the ionosphere. Attention is drawn to the huge range of horizontal and vertical spatial scales, ranging from 10−9 m to 1012 m, concerned with the many important processes at work. A similarly enormous range of time scales is involved from 10−6 s to 109 s, in the physical effects and different phenomena that need to be considered. The current flowing in the global circuit is generated by disturbed weather such as thunderstorms and electrified rain/shower clouds, mostly occurring over the Earth’s land surface. The profile of electrical conductivity up through the atmosphere, determined mainly by galactic cosmic ray ionization, is a crucial parameter of the circuit. Model simulation results on the variation of the ionospheric potential, ∼250 kV positive with respect to the Earth’s potential, following lightning discharges and sprites are summarized. Experimental results comparing global circuit variations with the neutron rate recorded at Climax, Colorado, are then discussed. Within the return (load) part of the circuit in the fair weather regions remote from the generators, charge layers exist on the upper and lower edges of extensive layer clouds; new experimental evidence for these charge layers is also reviewed. Finally, some directions for future research in the subject are suggested.

Pediastrum species as potential indicators of lake-level change in tropical South America

We explored the potential for using Pediastrum (Meyen), a genus of green alga commonly found in palaeoecological studies, as a proxy for lake-level change in tropical South America. The study site, Laguna La Gaiba (LLG) (17°45′S, 57°40′W), is a broad, shallow lake located along the course of the Paraguay River in the Pantanal, a 135,000-km2 tropical wetland located mostly in western Brazil, but extending into eastern Bolivia. Fourteen surface sediment samples were taken from LLG across a range of lake depths (2-5.2 m) and analyzed for Pediastrum. We found seven species, of which P. musteri (Tell et Mataloni), P. argentiniense (Bourr. et Tell), and P. cf. angulosum (Ehrenb.) ex Menegh. were identified as potential indicators of lake level. Results of the modern dataset were applied to 31 fossil Pediastrum assemblages spanning the early Holocene (12.0 kyr BP) to present to infer past lake level changes qualitatively. Early Holocene (12.0-9.8 kyr BP) assemblages do not show a clear signal, though abundance of P. simplex (Meyen) suggests relatively high lake levels. Absence of P. musteri, characteristic of deep, open water, and abundance of macrophyte-associated taxa indicate lake levels were lowest from 9.8 to 3.0 kyr BP. A shift to wetter conditions began at 4.4 kyr BP, indicated by the appearance of P. musteri, though inferred lake levels did not reach modern values until 1.4 kyr BP. The Pediastrum-inferred mid-Holocene lowstand is consistent with lower precipitation, previously inferred using pollen from this site, and is also in agreement with evidence for widespread drought in the South American tropics during the middle Holocene. An inference for steadily increasing lake level from 4.4 kyr BP to present is consistent with diatom-inferred water level rise at Lake Titicaca, and demonstrates coherence with the broad pattern of increasing monsoon strength from the late Holocene until present in tropical South America.

The processing of number and gender agreement in Spanish: an event related potential investigation of the effects of structural distance

Previous research suggests that the processing of agreement is affected by the distance between the agreeing elements. However, the unique contribution of structural distance (number of intervening syntactic phrases) to the processing of agreement remains an open question, since previous investigations do not tease apart structural and linear distance (number of intervening words). We used event related potentials (ERPs) to examine the extent to which structural distance impacts the processing of Spanish number and gender agreement. Violations were realized both within the phrase and across the phrase. Across both levels of structural distance, linear distance was kept constant, as was the syntactic category of the agreeing elements. Number and gender agreement violations elicited a robust P600 between 400 and 900ms, a component associated with morphosyntactic processing. No amplitude differences were observed between number and gender violations, suggesting that the two features are processed similarly at the brain level. Within-phrase agreement yielded more positive waveforms than across-phrase agreement, both for agreement violations and for grammatical sentences (no agreement by distance interaction). These effects can be interpreted as evidence that structural distance impacts the establishment of agreement overall, consistent with sentence processing models which predict that hierarchical structure impacts the processing of syntactic dependencies. However, due to the lack of an agreement by distance interaction, the possibility cannot be ruled out that these effects are driven by differences in syntactic predictability between the within-phrase and across-phrase configurations, notably the fact that the syntactic category of the critical word was more predictable in the within-phrase conditions.

Massive Open Online Courses on health and medicine: review

Background: Massive Open Online Courses (MOOCs) have become immensely popular in a short span of time. However, there is very little research exploring MOOCs in the discipline of Health and Medicine. This paper is aimed to fill this void by providing a review of Health and Medicine related MOOCs. Objective: Provide a review of Health and Medicine related MOOCs offered by various MOOC platforms within the year 2013. Analyze and compare the various offerings, their target audience, typical length of a course and credentials offered. Discuss opportunities and challenges presented by MOOCs in the discipline of Health and Medicine. Methods: Health and Medicine related MOOCs were gathered using several methods to ensure the richness and completeness of data. Identified MOOC platform websites were used to gather the lists of offerings. In parallel, these MOOC platforms were contacted to access official data on their offerings. Two MOOC aggregator sites (Class Central and MOOC List) were also consulted to gather data on MOOC offerings. Eligibility criteria were defined to concentrate on the courses that were offered in 2013 and primarily on the subject ‘Health and Medicine’. All language translations in this paper were achieved using Google Translate. Results: The search identified 225 courses out of which 98 were eligible for the review (n = 98). 58% (57) of the MOOCs considered were offered on the Coursera platform and 94% (92) of all the MOOCs were offered in English. 90 MOOCs were offered by universities and the John Hopkins University offered the largest number of MOOCs (12). Only three MOOCs were offered by developing countries (China, West Indies, and Saudi Arabia). The duration of MOOCs varied from three weeks to 20 weeks with an average length of 6.7 weeks. On average MOOCs expected a participant to work on the material for 4.2 hours a week. Verified Certificates were offered by 14 MOOCs while three others offered other professional recognition. Conclusions: The review presents evidence to suggest that MOOCs can be used as a way to provide continuous medical education. It also shows the potential of MOOCs as a means of increasing health literacy among the public.

Twenty-three cycles of changing open solar magnetic flux

This paper presents a comparison of various estimates of the open solar flux, deduced from measurements of the interplanetary magnetic field, from the aa geomagnetic index and from photospheric magnetic field observations. The first two of these estimates are made using the Ulysses discovery that the radial heliospheric field is approximately independent of heliographic latitude, the third makes use of the potential-field source surface method to map the total flux through the photosphere to the open flux at the top of the corona. The uncertainties associated with using the Ulysses result are 5%, but the effects of the assumptions of the potential field source surface method are harder to evaluate. Nevertheless, the three methods give similar results for the last three solar cycles when the data sets overlap. In 11-year running means, all three methods reveal that 1987 marked a significant peak in the long-term variation of the open solar flux. This peak is close to the solar minimum between sunspot cycles 21 and 22, and consequently the mean open flux (averaged from minimum to minimum) is similar for these two cycles. However, this similarity between cycles 21 and 22 in no way implies that the open flux is constant. The long-term variation shows that these cycles are fundamentally different in that the average open flux was rising during cycle 21 (from consistently lower values in cycle 20 and toward the peak in 1987) but was falling during cycle 22 (toward consistently lower values in cycle 23). The estimates from the geomagnetic aa index are unique as they extend from 1842 onwards (using the Helsinki extension). This variation gives strong anticorrelations, with very high statistical significance levels, with cosmic ray fluxes and with the abundances of the cosmogenic isotopes that they produce. Thus observations of photospheric magnetic fields, of cosmic ray fluxes, and of cosmogenic isotope abundances all support the long-term drifts in open solar flux reported by Lockwood et al. [1999a, 1999b].

The evolution of the sun’s open magnetic flux: II. full solar cycle simulations

In this paper the origin and evolution of the Sun’s open magnetic flux is considered by conducting magnetic flux transport simulations over many solar cycles. The simulations include the effects of differential rotation, meridional flow and supergranular diffusion on the radial magnetic field at the surface of the Sun as new magnetic bipoles emerge and are transported poleward. In each cycle the emergence of roughly 2100 bipoles is considered. The net open flux produced by the surface distribution is calculated by constructing potential coronal fields with a source surface from the surface distribution at regular intervals. In the simulations the net open magnetic flux closely follows the total dipole component at the source surface and evolves independently from the surface flux. The behaviour of the open flux is highly dependent on meridional flow and many observed features are reproduced by the model. However, when meridional flow is present at observed values the maximum value of the open flux occurs at cycle minimum when the polar caps it helps produce are the strongest. This is inconsistent with observations by Lockwood, Stamper and Wild (1999) and Wang, Sheeley, and Lean (2000) who find the open flux peaking 1–2 years after cycle maximum. Only in unrealistic simulations where meridional flow is much smaller than diffusion does a maximum in open flux consistent with observations occur. It is therefore deduced that there is no realistic parameter range of the flux transport variables that can produce the correct magnitude variation in open flux under the present approximations. As a result the present standard model does not contain the correct physics to describe the evolution of the Sun’s open magnetic flux over an entire solar cycle. Future possible improvements in modeling are suggested.

The evolution of the Sun's open magnetic flux: I. a single bipole

In this paper the origin and evolution of the Sun’s open magnetic flux are considered for single magnetic bipoles as they are transported across the Sun. The effects of magnetic flux transport on the radial field at the surface of the Sun are modeled numerically by developing earlier work by Wang, Sheeley, and Lean (2000). The paper considers how the initial tilt of the bipole axis (α) and its latitude of emergence affect the variation and magnitude of the surface and open magnetic flux. The amount of open magnetic flux is estimated by constructing potential coronal fields. It is found that the open flux may evolve independently from the surface field for certain ranges of the tilt angle. For a given tilt angle, the lower the latitude of emergence, the higher the magnitude of the surface and open flux at the end of the simulation. In addition, three types of behavior are found for the open flux depending on the initial tilt angle of the bipole axis. When the tilt is such that α ≥ 2◦ the open flux is independent of the surface flux and initially increases before decaying away. In contrast, for tilt angles in the range −16◦ < α < 2◦ the open flux follows the surface flux and continually decays. Finally, for α ≤ −16◦ the open flux first decays and then increases in magnitude towards a second maximum before decaying away. This behavior of the open flux can be explained in terms of two competing effects produced by differential rotation. Firstly, differential rotation may increase or decrease the open flux by rotating the centers of each polarity of the bipole at different rates when the axis has tilt. Secondly, it decreases the open flux by increasing the length of the polarity inversion line where flux cancellation occurs. The results suggest that, in order to reproduce a realistic model of the Sun’s open magnetic flux over a solar cycle, it is important to have accurate input data on the latitude of emergence of bipoles along with the variation of their tilt angles as the cycle progresses.

Plasma structure within poleward-moving cusp/cleft auroral transients: EISCAT Svalbard radar observations and an explanation in terms of large local time extent of events

We report high-resolution observations of the southward-IMF cusp/cleft ionosphere made on December 16th 1998 by the EISCAT (European incoherent scatter) Svalbard radar (ESR), and compare them with observations of dayside auroral luminosity, as seen at a wavelength of 630 nm by a meridian scanning photometer at Ny Alesund, and of plasma flows, as seen by the CUTLASS (co-operative UK twin location auroral sounding system) Finland HF radar. The optical data reveal a series of poleward-moving transient red-line (630 nm) enhancements, events that have been associated with bursts in the rate of magnetopause reconnection generating new open flux. The combined observations at this time have strong similarities to predictions of the effects of soft electron precipitation modulated by pulsed reconnection, as made by Davis and Lockwood (1996); however, the effects of rapid zonal flow in the ionosphere, caused by the magnetic curvature force on the newly opened field lines, are found to be a significant additional factor. In particular, it is shown how enhanced plasma loss rates induced by the rapid convection can explain two outstanding anomalies of the 630 nm transients, namely how minima in luminosity form between the poleward-moving events and how events can re-brighten as they move poleward. The observations show how cusp/cleft aurora and transient poleward-moving auroral forms appear in the ESR data and the conditions which cause enhanced 630 nm emission in the transients: they are an important first step in enabling the ESR to identify these features away from the winter solstice when supporting auroral observations are not available.

Dayside moving auroral transients related to LLBL dynamics

The NOAA-12 satellite skimmed through a region of dayside auroral activity over Svalbard on January 12, 1992. A sequence of auroral forms from two separated onset sites in the postnoon sector drifted westward towards magnetic noon. The auroral forms were associated with a population of injected magnetosheath plasma mixed with a secondary component of magnetospheric ions (>30 keV) that is a key signature of the low-latitude boundary layer (LLBL). The direction of motion of the cleft auroral forms and the basic features of the NOAA particle spectrograms indicate that the transients are related to LLBL on open field lines. The auroral transients are consistent with footprints of reconnection at the dayside magnetopause which is both patchy in space and sporadic in time.

Ion populations on open field lines within the dayside low-latitude boundary layer: theory and observations during a transient event

We analyze of ion populations observed by the NOAA-12 satellite within dayside auroral transients. The data are matched with an open magnetopause model which allows for the transmission of magnetosheath ions across one or both of the two Alfvén waves which emanate from the magnetopause reconnection site. It also allows for reflection and acceleration of ions of magnetospheric origin by these waves. From the good agreement found between the model and the observations, we propose that the events and the low-latitude boundary precipitation are both on open field lines.

Variability of dayside high latitude convection associated with a sequence of auroral transients

10 second resolution ionospheric convection data covering the invariant latitude range from 71° to 76°, obtained by using the EISCAT UHF and VHF radars, are combined with optical data from Ny Ålesund during a sequence of auroral transients in the post-noon sector (∼ 15 MLT). Satellite observations of polar cap convection patterns suggest negative BZ and BY components of the interplanetary magnetic field. Burst-like enhancements of westward (sunward) post-noon convection were accompanied by eastward moving auroral forms at higher latitudes, above the convection reversal boundary. In this case the background convection was weak, whereas the integrated potential drop across the radar field-of-view associated with the westward flow bursts was typically ∼ 20-35 kV. The auroral phenomenon consists of a series of similar events with a mean repetition period of 8 min. A close correlation between the auroral activity and convection enhancements in the cleft ionosphere is demonstrated.

Auroral and plasma flow transients at magnetic noon

We present observations of a transient event in the dayside auroral ionosphere at magnetic noon. F-region plasma convection measurements were made by the EISCAT radar, operating in the beamswinging “Polar” experiment mode, and simultaneous observations of the dayside auroral emissions were made by optical meridian-scanning photometers and all-sky TV cameras at Ny Ålesund, Spitzbergen. The data were recorded on 9 January 1989, and a sequence of bursts of flow, with associated transient aurora, were observed between 08:45 and 11:00 U.T. In this paper we concentrate on an event around 09:05 U.T. because that is very close to local magnetic noon. The optical data show a transient intensification and widening (in latitude) of the cusp/cleft region, as seen in red line auroral emissions. Over an interval of about 10 min, the band of 630 nm aurora widened from about 1.5° of invariant latitude to over 5° and returned to its original width. Embedded within the widening band of 630 nm emissions were two intense, active 557.7 nm arc fragments with rays which persisted for about 2 min each. The flow data before and after the optical transient show eastward flows, with speeds increasing markedly with latitude across the band of 630 nm aurora. Strong, apparently westward, flows appeared inside the band while it was widening, but these rotated round to eastward, through northward, as the band shrunk to its original width. The observed ion temperatures verify that the flow speeds during the transient were, to a large extent, as derived using the beamswinging technique; but they also show that the flow increase initially occurred in the western azimuth only. This spatial gradient in the flow introduces ambiguity in the direction of these initial flows and they could have been north-eastward rather than westward. However, the westward direction derived by the beamswinging is consistent with the motion of the colocated and coincident active 557.7 nm arc fragment, A more stable transient 557.7 nm aurora was found close to the shear between the inferred westward flows and the persisting eastward flows to the North. Throughout the transient, northward flow was observed across the equatorward boundary of the 630 nm aurora. Interpretation of the data is made difficult by lack of IMF data, problems in distinguishing the cusp and cleft aurora and uncertainty over which field lines are open and which are closed. However, at magnetic noon there is a 50% probability that we were observing the cusp, in which case from its southerly location we infer that the IMF was southward and many features are suggestive of time-varying reconnection at a single X-line on the dayside magnetopause. This IMF orientation is also consistent with the polar rain precipitation observed simultaneously by the DMSP-F9 satellite in the southern polar cap. There is also a 25% chance that we were observing the cleft (or the mantle poleward of the cleft). In this case we infer that the IMF was northward and the transient is well explained by reconnection which is not only transient in time but occurs at various sites located randomly on the dayside magnetopause (i.e. patchy in space). Lastly, there is a 25% chance that we were observing the cusp poleward of the cleft, in which case we infer that IMF Bz was near zero and the transient is explained by a mixture of the previous two interpretations.

Local spaces: open minds - inspirational ideas for managing lowland commons and other green spaces

The Chiltern commons are typical of those in the south east of England: small and numerous, but with the potential to provide important natural green space whilst contributing to environmental sustainability. In order to keep commons in good heart, they need to be managed. However, as activities such as grazing and coppicing become unviable on the commons, owners need to find sustainable roles beyond traditional agricultural and silvicultural practices. This paper examines ways of making management pay. It begins by exploring the economic, social and environmental challenges of sustainable management within the context of contemporary life. Section 2 identifies the different ways in which revenue contributions might be made towards the management of commons. Section 3 examines the relevant legal and other restrictions and Section 4 offers insights into where management proposals might offer multiple positive benefits, but also where there is the potential to cause conflict with environmental and social interests. Section 5 explores alternative funding streams for commons. Finally, Section 6 concludes with practical tips for the owners and managers of commons in the Chilterns and identifies areas for further research. Full references, links and resources are provided in the footnotes and appendix.