bluuebunny/crossref_metadata_2025 huggingface dataset:
The ability of synthetic sex pheromone traps to forecast Plutella xylostella infestations depends on survival of immature stages
Authors: Nofemela Robert S.
Published: October 2015

The potential for using synthetic sex pheromone traps as a simple and practical method of monitoring population densities of insect pests has been investigated in many crop systems. Yet, factors enabling the forecast of infestations based on pheromone trap catches are not fully understood. This study tested the prediction that high survival of immature stages of the target pest is a pre‐requisite for trap catches to correlate well with future infestations on the crop. The influence of parasitoids, as an important natural mortality factor of diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae), larvae and pupae in South Africa, on the ability of pheromone traps to forecast infestations was investigated continuously at weekly intervals over 6 years on unsprayed cabbage. During late October–May, when parasitism levels were high (≥50%), infestations and trap catches were significantly lower than during low parasitism (<50%) observed during June–early October. Because infestations were negatively related to parasitism level, trap catches correlated with infestations better when observations were made in the same week during periods of high parasitism. Conversely, when survival of P. xylostella immature stages was high due to low parasitism levels, trap catches correlated with future infestations well for up to 2 weeks. Thus, trap catches can be used to forecast infestations during September–October, a period that coincides with high P. xylostella infestations as a consequence of low natural control by parasitoids. This is the first study to show that the ability of pheromone trap catches to forecast infestations depends on survival of the immature stages of the target pest.
The evolution of mathematical immunology
Authors: Louzoun Yoram
Published: October 2015

Summary:  The types of mathematical models used in immunology and their scope have changed drastically in the past 10 years. Classical models were based on ordinary differential equations (ODEs), difference equations, and cellular automata. These models focused on the ‘simple’ dynamics obtained between a small number of reagent types (e.g. one type of receptor and one type of antigen or two T‐cell populations). With the advent of high‐throughput methods, genomic data, and unlimited computing power, immunological modeling shifted toward the informatics side. Many current applications of mathematical models in immunology are now focused around the concepts of high‐throughput measurements and system immunology (immunomics), as well as the bioinformatics analysis of molecular immunology. The types of models have shifted from mainly ODEs of simple systems to the extensive use of Monte Carlo simulations. The transition to a more molecular and more computer‐based attitude is similar to the one occurring over all the fields of complex systems analysis. An interesting additional aspect in theoretical immunology is the transition from an extreme focus on the adaptive immune system (that was considered more interesting from a theoretical point of view) to a more balanced focus taking into account the innate immune system also. We here review the origin and evolution of mathematical modeling in immunology and the contribution of such models to many important immunological concepts.
Bioactive effects of a calcium/sodium phosphosilicate on the resin–dentine interface: a microtensile bond strength, scanning electron microscopy, and confocal microscopy study
Authors: Profeta Andrea C. , Mannocci Francesco , Foxton Richard M. , Thompson Ian , Watson Timothy F. , Sauro Salvatore
Published: October 2015

This study evaluated, through microtensile bond strength (μTBS) testing, the bioactive effects of a calcium/sodium phosphosilicate (BAG) at the resin–dentine interface after 6 months of storage in phosphate buffer solution (PBS). Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were also performed. Three bonding protocols were evaluated: (i) RES‐Ctr (no use of BAG), (ii) BAG containing adhesive (BAG‐AD), and (iii) BAG/H
3
PO
4 before adhesive (BAG‐PR). The dentin‐bonded specimens were prepared for μTBS testing, which was carried out after 24 h or 6 months of storage in PBS. Scanning electron microscopy ultramorphology analysis was performed after debonding. Confocal laser scanning microscopy was used to evaluate the morphological and nanoleakage changes induced by PBS storage. High μTBS values were achieved in all groups after 24 h of storage in PBS. Subsequent to 6 months of storage in PBS the specimens created using the BAG‐AD bonding approach still showed no significant reduction in μTBS. Moreover, specimens created using the BAG‐AD or the BAG‐PR approach showed an evident reduction of nanoleakage after prolonged storage in PBS. The use of BAG‐containing adhesive may enhance the durability of the resin–dentine bonds through therapeutic/protective effects associated with mineral deposition within the bonding interface and a possible interference with collagenolytic enzyme activity (matrix metalloproteinases) responsible for the degradation of the hybrid layer.
Initial responses of osteoblasts derived from human alveolar bone to various compressive forces
Authors: Tripuwabhrut Polbhat , Mustafa Kamal , Brudvik Pongsri , Mustafa Manal
Published: October 2015

Mechanical stress generated by orthodontic force is recognized as a major factor in the modulation of alveolar bone remodeling. During this process, osteoblasts play a crucial role, not only by participating in bone formation but also by promoting osteoclastogenesis. The aim of this study was to investigate how continuous compressive force (CF) affects human primary osteoblasts (HOBs) in terms of cell proliferation, apoptosis, and expression of interleukin‐6 (IL‐6) and chemokine CXC ligand 8 (CXCL8). Human primary osteoblasts, isolated from human mandibular bone pieces, were cultured with or without CF (1–4 g cm−2) for up to 72 h. Cell viability and proliferation were evaluated using the MTT assay. RT‐PCR was used to determine the levels of expression of KI67 (a proliferation marker), BAX (a pro‐apoptotic marker), BCL2 (an apoptotic inhibitor), IL6, and CXCL8 mRNAs, while a multiplexed bead immunoassay was used to measure the release of IL‐6 and CXCL8. The results revealed that CF decreased cell viability and proliferation in a time‐ and force‐dependent manner. After applying CF for 24 h, the mRNA expression of KI67 was markedly inhibited, whereas the mRNA expression of BAX and BCL2 was unaltered. In addition, CF enhanced the levels of IL6 and CXCL8 mRNAs in a force‐dependent manner, whereas the levels of the corresponding proteins were reduced in the compressed HOBs.
Quantitative skin color measurements in acanthosis nigricans patients: colorimetry and diffuse reflectance spectroscopy
Authors: Pattamadilok Bensachee , Devpura Suneetha , Syed Zain U. , Agbai Oma N. , Vemulapalli Pranita , Henderson Marsha , Rehse Steven J. , Mahmoud Bassel H. , Lim Henry W. , Naik Ratna , Hamzavi Iltefat H.
Published: October 2015

Tristimulus colorimetry and diffuse reflectance spectroscopy (DRS) are white‐light skin reflectance techniques used to measure the intensity of skin pigmentation. The tristimulus colorimeter is an instrument that measures a perceived color and the DRS instrument measures biological chromophores of the skin, including oxy‐ and deoxyhemoglobin, melanin and scattering. Data gathered from these tools can be used to understand morphological changes induced in skin chromophores due to conditions of the skin or their treatments. The purpose of this study was to evaluate the use of these two instruments in color measurements of acanthosis nigricans (AN) lesions. Eight patients with hyperinsulinemia and clinically diagnosable AN were seen monthly. Skin pigmentation was measured at three sites: the inner forearm, the medial aspect of the posterior neck, and anterior neck unaffected by AN. Of the three, measured tristimulus L*a*b* color parameters, the luminosity parameter L* was found to most reliably distinguish lesion from normally pigmented skin. The DRS instrument was able to characterize a lesion on the basis of the calculated melanin concentration, though melanin is a weak indicator of skin change and not a reliable measure to be used independently. Calculated oxyhemoglobin and deoxyhemoglobin concentrations were not found to be reliable indicators of AN. Tristimulus colorimetry may provide reliable methods for respectively quantifying and characterizing the objective color change in AN, while DRS may be useful in characterizing changes in skin melanin content associated with this skin condition.
Pediatric photosensitivity
Authors: Grossberg Anna L.
Published: October 2015

Photosensitivity is a rarely encountered problem in the pediatric population. It may be caused by a diverse group of primary, idiopathic photosensitivity conditions, or may reflect photoexacerbation of an existing dermatosis. In addition, there are several genodermatoses, metabolic disorders, and connective tissue disorders that can present with photosensitivity, usually in addition to other extracutaneous clinical and laboratory findings. It is important that both dermatologic and pediatric practitioners be able to recognize the various causes of photosensitivity, as well as be familiar with the associated stigmata and necessary workup, if needed, of each particular disorder. This review offers an approach to the pediatric patient who presents with photosensitivity, with emphasis on arriving at the proper diagnosis, necessary evaluations, and management strategies.
Peripheral blood monocyte responses in periodontitis
Authors: Fokkema SJ
Published: October 2015

Periodontitis results from the interaction of bacteria on the tooth surfaces and the host immune response. Although periodontal pathogens are essential for the initiation and progression of the disease, the tissue damage in periodontitis is primarily mediated by the host immune response. Differences in the susceptibility to the disease and in the clinal outcome of the therapy seem to be less dependent on genetics but more on lifestyle factors, like smoking, overweight, stress and nutrition. It has been shown that these lifestyle factors may modulate the immune response and therefore influence the initiation and progression of the disease. To study the host immune response, whole blood cell cultures (WBCC) stimulated with lipopolysaccharide (LPS) have been widely used and they specifically reflect the behaviour of monocytes. It has been shown that peripheral blood monocytes in LPS‐stimulated WBCC from non‐smoking periodontitis patients display a T‐helper 2 (Th2)‐promoting phenotype in comparison with controls. After periodontal therapy, this phenotype reversed and was comparable with controls. However, in smoking but treated patients, the Th2‐promoting phenotype of monocytes still remained. Therefore, the aberrant phenotype of monocytes in the peripheral blood from periodontitis patients is likely to be a systemic response to exogenous and endogenous danger molecules released or induced by the periodontal infection or by smoking. It can be concluded that periodontal therapy in non‐smoking periodontitis patients has beneficial health effects and that smoking cessation should be an integral part of the therapy as well for general health reasons as for the clinical outcome.
Breaking down broken Britain: Targeted solutions for the hardest to reach
Authors: Cavanagh Matt
Published: October 2015

As England's riots bring ‘broken Britain’ back to headlines and policy papers, former special advisor Matt Cavanagh calls for progressive politicians to think creatively about targeted, long‐term cross‐departmental solutions that can overcome political point‐scoring and bureaucratic limitations to address Britain's most complex and deeply rooted social problems.
INTRAORGANIZATIONAL EMPLOYEE NAVIGATION AND SOCIALLY DERIVED OUTCOMES: CONCEPTUALIZATION, VALIDATION, AND EFFECTS ON OVERALL PERFORMANCE
Authors: PLOUFFE CHRISTOPHER R. , GRÉGOIRE YANY
Published: October 2015

Intraorganizational employee navigation (IEN) is conceptualized as a means of better understanding how the organizational actor proactively works across their firm's internal environment in the execution of their jobs. Navigation is argued to be a precursor to the employee's overall performance through a class of mediating variables labeled “socially derived outcomes,” which are variables inside the organization that are bestowed upon the employee as a result of them first engaging in proactive behavior (e.g., IEN). Two studies are reported. Study I sees IEN psychometrically validated versus a range of existing proactive behaviors and individual traits (discriminant, nomological, and criterion‐related validity) with a heterogeneous sample of 704 employees. Study II then tests a model relating IEN to performance through six mediating “socially derived outcomes” by leveraging data from 2 Fortune 500 firms. The results of Study II show that IEN significantly impacts multiple measures of the employee's overall performance through mediating effects brought about by key socially derived outcomes, such as the employee's “manager alignment.” The contributions, broader implications, and limitations of the research are then put into context.
Angiopoietin Balance in Septic Shock Patients With Acute Lung Injury: Effect of Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber
Authors: Ebihara Itaru , Hirayama Kouichi , Nagai Miho , Kakita Tomoko , Sakai Kentaro , Tajima Reiko , Sato Chihiro , Kurosawa Hiromi , Togashi Amane , Okada Akiko , Usui Joichi , Yamagata Kunihiro , Kobayashi Masaki
Published: October 2015

Acute lung injury (ALI) in sepsis is characterized by an increase in microvascular permeability, resulting in pulmonary edema. Several studies have suggested that angiopoietin‐1 and ‐2 play a contributory role in the pathogenesis of ALI. Polymyxin B‐immobilized fiber column hemoperfusion is effective for sepsis‐induced ALI. We investigated the angiopoietin levels before and after direct hemoperfusion with polymyxin B‐immobilized fiber column (PMX) therapy. Enzyme‐linked immunoassay was used to measure the serum angiopoietin‐1 and ‐2 levels in 25 patients with septic shock treated with PMX. Eleven of the 25 patients were diagnosed with ALI. There was a significant positive correlation between the angiopoietin‐1 level and the PaO2/FiO2 ratio, but there was a significant inverse correlation between the angiopoietin‐2 level and the PaO2/FiO2 ratio. The mean angiopoietin‐1 level before PMX therapy in the ALI group was significantly lower and the mean angiopoietin‐2 level was significantly higher than in the non‐ALI group. The mean angiopoietin‐1 level of the ALI patients in response to PMX therapy was increased during PMX therapy, but that of the non‐ALI patients with newly occurring ALI showed a decreased angiopoietin‐1 level. On the other hand, the mean angiopoietin‐2 level of the responders was decreased during PMX therapy, but that of patients with newly occurring ALI showed an increased angiopoietin‐2 level. This result suggested that each angiopoietin‐1 and ‐2 level may play a role in the pathogenesis of ALI and that PMX therapy ameliorates the angiopoietin balance in patients with ALI in sepsis.
Evaluation of the Effect of Ulinastatin on the Production of Macrophage Colony‐Stimulating Factor In Vitro for Potential Combination Therapy with Leukocyte Adsorption
Authors: Nishise Shoichi , Takeda Hiroaki , Orii Tomohiko , Sato Takeshi , Sasaki Yu , Nishise Yuko , Kawata Sumio
Published: October 2015

Macrophage colony‐stimulating factor (M‐CSF) induces normal intestinal macrophages that have anti‐inflammatory effects. Thus, M‐CSF‐rich conditions in colonic tissues seem to contribute to the improvement of pathological conditions in patients with inflammatory bowel diseases (IBD). However, it has not been clarified whether current therapies for IBD, including granulocyte/monocyte adsorptive apheresis using an Adacolumn, and ulinastatin, a serine protease inhibitor, affect the production of M‐CSF. To clarify the effects of these therapies on M‐CSF production, we investigated whether monocyte adsorption to cellulose acetate (CA) beads (carriers for Adacolumn therapy) and ulinastatin augmented M‐CSF production in in vitro experiments. Peripheral blood was incubated with and without CA beads, and then M‐CSF production was measured. Additionally, peripheral blood containing serial dilutions of ulinastatin was incubated with CA beads followed by measurement of M‐CSF production. Monocyte adsorption to CA beads did not affect M‐CSF production. A high concentration of ulinastatin augmented M‐CSF production without inhibiting monocyte adsorption to CA beads, although a low concentration of ulinastatin conversely suppressed M‐CSF production. The present study found that a high concentration of ulinastatin, which was administrated with CA beads, increased the production of M‐CSF. Our results suggest that a combination of ulinastatin and Adacolumn therapy may provide more clinical efficacy for the treatment of IBD in terms of the production of M‐CSF.
Relevance of the Processed Blood Volume per Granulocyte and Monocyte Apheresis Session to its Clinical Efficacy in Patients With Ulcerative Colitis
Authors: Kikuyama Risa , Fukunaga Ken , Kawai Mikio , Yokoyama Yoko , Kamikozuru Koji , Hida Nobuyuki , Ohda Yoshio , Takeda Naohisa , Yoshida Koji , Iimuro Masaki , Kato Kyoichi , Kono Tomoaki , Nogami Koji , Nagase Kazuko , Nakamura Shiro , Takei Yoshiyuki , Miwa Hiroto , Matsumoto Takayuki
Published: October 2015

Granulocyte/monocyte adsorption (GMA) has been introduced as an adjunct intervention for active ulcerative colitis (UC) patients. The processed blood volume (PV) per GMA session is an important factor for its efficacy because depletion of elevated/activated myeloid leukocytes is its main action. Hitherto, this aspect of GMA has been largely ignored. Thirty‐three patients were enrolled for remission induction therapy with five weekly GMA sessions at a standard PV of 1800 mL, regardless of patients' bodyweight (BW). The patients were divided into three groups: high (H)BW (≥65 kg, n = 11), 50 kg ≤ medium (M)BW < 65 kg (n = 12), and low (L)BW (≤50 kg, n = 10). UC clinical activity index (CAI) was according to Lichtiger, and the clinical efficacies were evaluated at both one week post 3rd GMA (Week 4) and one week post 5th GMA (Week 6). The average BW was 70.9 ± 6.2 kg in HBW, 55.8 ± 4.5 kg in MBW, and 46.8 ± 1.2 kg in LBW, indicating the mean PV/BW in the three groups being 25.6 ± 2.12, 32.5 ± 2.50, and 38.7 ± 1.0 (mL/kg, P < 0.05), respectively. The LBW group consisted of female patients only. Significant improvements of CAI were seen before treatment at either Week 4 or Week 6 in all groups. A significantly higher remission rate was achieved in the LBW (80.0%) vs. MBW (33.3%) or HBW (27.3%) at Week 6 (P < 0.03). According to this GMA evaluation, the lower‐limit of optimum PV/kg should be higher than 38.7 mL/kg for its potential clinical efficacy to be significantly greater than the routine GMA method. Additional BW‐oriented GMA studies in larger and gender controlled cohorts of patients should strengthen our findings.
Plasma Diafiltration Therapy in Patients With Postoperative Liver Failure
Authors: Nakae Hajime , Eguchi Yutaka , Yoshioka Toyokazu , Yoshimura Noriko , Isono Motohide
Published: October 2015

Plasma diafiltration (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. A prospective, multicenter study was undertaken to evaluate the changes in biochemical examination of blood and the 28‐day and 90‐day survival rates of patients with postoperative liver failure (PLF). Eleven patients with PLF were studied with the therapy performed 98 times. The Model for End‐Stage Liver Disease (MELD) score was categorized into three grades: 20–29, 30–39, and 40 or higher. The survival rate was assessed by the severity of MELD score. The 28‐day survival rate was 45.5% and that at 90 days was 27.3%. The levels of total bilirubin, BUN, and creatinine decreased significantly after treatment. On the other hand, the levels of total protein increased after treatment and those of albumin did not change significantly. PDF may be the useful blood purification therapies for use in cases of PLF in terms of medical economics and the removal of water‐soluble and albumin‐bound toxins.
In Vitro Evaluation of High Mobility Group Box 1 Protein Removal with Various Membranes for Continuous Hemofiltration
Authors: Yumoto Miho , Nishida Osamu , Moriyama Kazuhiro , Shimomura Yasuyo , Nakamura Tomoyuki , Kuriyama Naohide , Hara Yoshitaka , Yamada Shingo
Published: October 2015

The high mobility group box 1 protein (HMGB1) is an alarmin that plays an important role in sepsis and has been recognized as a promising target with a wide therapeutic window; however, no drugs and devices are currently in practical use. We hypothesized that hemofilters composed of porous membranes or cytokine‐adsorbing membranes could remove HMGB1 from the blood. We performed experimental hemofiltration in vitro using four types of hemofilters composed of different membranes specifically designed for continuous hemofiltration. The test solution was a 1000‐mL substitution fluid containing 100 µg of HMGB1 and 35 g of bovine serum albumin. Experimental hemofiltration was conducted for 360 min in a closed loop circulation system. Among the four membranes, surface‐treated polyacrylonitrile (AN69ST) showed the highest capacity to adsorb HMGB1; it adsorbed nearly 100 µg of HMGB1 in the initial 60 min and showed a markedly high clearance rate (60.8 ± 5.0 mL/min) at 15 min. The polymethylmethacrylate membrane had half of the adsorption capacity of the AN69ST membrane. Although the highest sieving coefficient for HMGB1 was obtained with the high cut‐off polyarylethersulfone membrane, which correlated with a constant filtrate clearance rate, albumin loss was observed. However, no such removal of both HMGB1 and albumin was observed with the polysulfone membrane and tubing. We conclude that continuous hemofiltration using the AN69ST membrane is a promising approach for HMGB1‐related sepsis.
A Tangled Web of Principals and Agents: Examining the Deepwater Horizon Oil Spill through a Principal–Agent Lens
Authors: Neill Katharine A. , Morris John C.
Published: October 2015

The explosion on the Deepwater Horizon oil rig in April 2010 resulted in the largest oil spill in U.S. waters. In the aftermath of the explosion, many sought answers to what appeared to be a lack of effective oversight of the well's owner, British Petroleum (BP). Using multi‐actor principal–agent theory as our framework, we examine the relationships between citizens, the Minerals Management Service (MMS), BP, and BP's partners in the drilling operation. We find that principal–agent theory provides important insights into the case, and that a lack of monitoring, coupled with the willingness of MMS to align its goals with the oil industry rather than the public interest, resulted in a lax regulatory environment that allowed BP to operate largely without public oversight.

Related Articles:

Pautz, Michelle. 2009. “.” Politics & Policy 37 (): 1047‐1072. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2009.00210.x/abstract

Ash, John. 2010. “.” Politics & Policy 38 (): 255‐284. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2010.00237.x/abstract

Elliott‐Teague, Ginger. 2011. “.” Politics & Policy 39 (): 835‐861. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2011.00318.x/abstract

Related Media:

Maps/Photo Gallery: . 2012. http://ngm.nationalgeographic.com/2010/10/gulf‐oil‐spill/gulf‐spill‐photography

La explosión de la plataforma petrolífera Deepwater Horizon en Abril del 2010 resultó en el derrame petrolero más grande en aguas estadounidenses. Luego de la explosión, muchos buscaron respuestas a lo que pareció ser una falta de planeación efectiva por parte del dueño del yacimiento, British Petroleum (BP). Usando una la teoría del agente‐principal con múltiples actores como marco teórico, examinamos la relación entre ciudadanos, el Servicio de Manejo de Minerales (SMM), BP, y los socios de BP en la perforación de los pozos petrolíferos. Encontramos que la teoría del agente‐principal provee importantes perspectivas sobre el caso; y que la falta de monitoreo, junto con la intención de el MMS de alinear sus intereses con los de la industria petrolera en lugar del interés público, resultó en un ambiente regulatorio laxo que permitió a BP continuar con sus operaciones en gran parte sin una vigilancia regulatoria.
Collateral Perfusion: Time for Novel Paradigms in Cerebral Ischemia
Authors: Liebeskind David S.
Published: October 2015

Collateral circulation and associated potential compensation in downstream perfusion have been recognized long before arterial occlusions were known to cause ischemic stroke. Arterial aspects and the venous capacity of collaterals to offset potentially devastating effects of blocking a cerebral artery have been studied in various animal species and even human populations with stroke, providing a framework for translational research. The time has come for collaterals to move from the periphery to a central position in stroke therapeutics, propelled by the momentum of imaging data and culminating in novel paradigms with respect to time, imaging approaches and treatment strategies. It is time for a concerted focus on collateral perfusion to harness potential therapeutic advances from acute stroke to chronic cerebrovascular disorders.
PPACA and Public Health: Creating a Framework to Focus on Prevention and Wellness and Improve the Public's Health
Authors: Majette Gwendolyn Roberts
Published: October 2015

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA), a major piece of health care reform legislation. This comprehensive legislation includes provisions that focus on prevention, wellness, and public health. Some, including authors in this symposium, question whether Congress considered public health, prevention, and wellness issues as mere afterthoughts in the creation of PPACA. As this article amply demonstrates, they did not.

This article documents the extent of congressional consideration on public health issues based on personal experience working on the framework for health care reform — specifically, my experience as a Fellow for a member of the Health Subcommittee of the Senate Finance Committee from 2008-2009. I also include a review of congressional activity in the United States House of Representatives. Analysis of the congressional meetings and hearings reveals that Congress had a deep understanding about the critical need to reform the U.S. public health and prevention system.
Congress, Courts, and Commerce: Upholding the Individual Mandate to Protect the Public's Health
Authors: Hodge James G. , Brown Erin C. Fuse , Orenstein Daniel G. , O'Keefe Sarah
Published: October 2015

Despite historic efforts to enact the Patient Protection and Affordable Care Act (PPACA) in 2010, national health reform is threatened by multiple legal challenges grounded in constitutional law. Premier among these claims is the premise that PPACA’s “individual mandate” (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is constitutionally infirm. Attorneys General in Virginia and Florida (joined by 25 other states) allege that Congress’ interstate commerce powers do not authorize federal imposition of the individual mandate because Congress lacks the power to regulate commercial “inactivity.” Stated simply, Congress cannot regulate individuals who choose not to obtain health insurance because they are not engaged in a commercial venture. Several courts initially considering this argument have rejected it, but two federal district courts in Virginia and Florida have concurred, leading to numerous appeals and the near promise of United States Supreme Court review.
Conscripted Physician Services and the Public's Health
Authors: Kapp Marshall B.
Published: October 2015

The Patient Protection and Affordable Care Act of 2010 (PPACA) purportedly assures almost all Americans of the right to health insurance coverage. The long-term success of this legislation in improving the public’s health in the United States will likely hinge in no small part on the degree to which statutorily establishing a right to health insurance coverage translates into actual timely, meaningful access to health services, particularly physician services, for specific individuals.
Improve Medical Malpractice Law by Letting Health Care Insurers Take Charge
Authors: Reinker Kenneth S. , Rosenberg David
Published: October 2015

The general consensus is that reform of medical malpractice law should be part of the health care system's overhaul. Medical malpractice litigation results in the expenditure of tens of billions annually, largely paid out of health care insurance funds and mostly (roughly two-thirds) paid to defendants' and plaintiffs' lawyers. By all accounts, this tort law regime ill serves the basic deterrence and compensation goals of civil liability. The causes and magnitude of these failings are disputed, and many typical reform proposals sidestep the basic problems and may do more harm than good. In contrast, we advance a straightforward way to improve both deterrence and compensation. Essentially, the proposal is to remove current legal limitations on the scope of insurance subrogation that bar private and public health care insurers from “buying” the whole of their insureds' potential medical malpractice claims in exchange for lower premiums and taxes and expanded insurance coverage. Our proposal’s benefits accrue regardless of the cause and magnitude of the failings of malpractice law or the further reforms that might be adopted.
Currents in Contemporary Bioethics
Authors: Drabiak-Syed Katherine
Published: October 2015

Recently, an agonizing twist intersecting predictive genetic tests and surrogacy contracts made news headlines in Canada. The intended parents, a couple from British Columbia, instructed the surrogate mother with whom they were working to undergo First Trimester Screening and Chorionic Villi Sampling (CVS), which revealed the fetus likely had Down syndrome. The parents directed the surrogate to terminate the fetus or they would abdicate their parental claim upon birth. This story raised numerous legal and ethical questions relating to the transferability of decision making for prenatal screening, diagnostic tests, and the connected decision of termination when additional interested parties – the intended parents – are involved in the medical decision-making relationship. First, although the surrogate is the patient, what are the implications when the intended parents' wishes influence or even dictate the relationship between her and her obstetrician and genetic counselor? Second, if the intended parents' level of authority reaches explicit demands, may the intended parents ethically and legally require the surrogate to waive her right to informed consent for prenatal screening and diagnosis?
Why are Generic Drugs Being Held up in Transit? Intellectual Property Rights, International Trade, and the Right to Health in Brazil and beyond
Authors: Rosina Mônica Steffen Guise , Shaver Lea
Published: October 2015

Most new drugs are protected by pharmaceutical patents, which give the patent holder exclusive control over that drug’s supply for 20 years. When the patent term expires, the drug becomes available for generic production by any company. The resulting competition typically leads to dramatic reductions in price. In Brazil, generic drugs are on average 40% cheaper than reference or brand-name drugs. In the United States, the Federal Drug Administration reports up to 85% price differences. Consumers in India have witnessed more than 100-fold price reduction for antiretroviral (ARV) drugs due to generic production. Generics thus play a key role in broadening access to health care, mostly by driving costs down, both in the developing and developed world.
Pharmaceutical Companies and Global Lack of Access to Medicines: Strengthening Accountability under the Right to Health
Authors: Grover Anand , Citro Brian , Mankad Mihir , Lander Fiona
Published: October 2015

Approximately two billion people lack access to medicines globally. People living with HIV, cancer patients, those suffering from tuberculosis or malaria, and other populations in desperate need of life-saving medicines are increasingly unable to access existing preventative, curative, and life-prolonging treatments. In many cases, treatment may be unavailable or inaccessible for even some of the most common and readily treatable health concerns, such as hypertension. In the developing world, many of the factors that contribute to making the world’s most vulnerable and marginalized populations particularly susceptible to illness also operate to restrict their access to medicines. As a result of dramatic economic inequities and widespread poverty, it is not profitable for most originator pharmaceutical companies to develop new medicines for sale in developing markets or to lower the cost of existing drugs so that they are affordable for the majority of these populations.
Teaching Law in Medical Schools: First, Reflect
Authors: Campbell Amy T.
Published: October 2015

[T]each the law to empower physicians individually and collectively to use the law and law colleagues to serve patients and promote public welfare; in short to better foster the goals of the medical profession.

And yet:

[A]ntipathy appears to be deeper and more pervasive than ever before, making it hard to imagine that relations between attorneys and physicians can get much worse.

It has long been recognized that an understanding of at least some core legal rules and concepts is an important piece of medical training. To address this, law is now typically part of the core medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework — whether as part of a distinct course or series of courses or threaded through the curriculum (or both). While often this education focuses on rules, some have recommended that it also include fundamentals of legal reasoning, and go beyond knowledge to include skills, attitudes, and behaviors vis-à-vis the law.
Personalized Disclosure by Information-on-Demand: Attending to Patients' Needs in the Informed Consent Process
Authors: Siegal Gil , Bonnie Richard J. , Appelbaum Paul S.
Published: October 2015

In an explicit attempt to reduce physician paternalism and encourage patient participation in making health care decisions, the informed consent doctrine has become a foundational precept in medical ethics and health law. The underlying ethical principle on which informed consent rests — autonomy — embodies the idea that as rational moral agents, patients should be in command of decisions that relate to their bodies and lives. The corollary obligation of physicians to respect and facilitate patient autonomy is reflected in the rules that have been created to implement consent procedures, especially those requiring disclosure of relevant information.

However, there are many practical impediments to patient self-determination in health care decisionmaking. Well-meaning physicians often lack the time to live up to the ideal of facilitating genuine, informed deliberation with and by their patients, and many lack the motivation or skill to do so successfully.
Medical Journals and Conflicts of Interest
Authors: Steinbrook Robert , Lo Bernard
Published: October 2015

Physicians and patients rely on medical journals as trusted sources of medical information. Unfortunately, in multiple instances conflicts of interest have undermined the credibility of the medical literature.

The primary sources of conflict of interest at medical journals are authors, reviewers, editors (a category that includes editorial staff, editorial boards, and other advisory groups), and journals (a category that includes owners and publishers). Consider these examples.
Medical Responsibility
Authors: Hamowy Ronald
Published: October 2015

These comments seek to take issue with the contention that society has a responsibility to provide its members with any needed health care. In order to deal with this claim, we must first make clear exactly what it meant by the proposition. I take it that those who embrace this view mean considerably more than that each of us has a moral obligation to contribute to those in need of medical attention who are unable, for one reason or another, to afford the necessary care. This is a moral proposition and is traditionally dealt with under the heading of charity. But the contention, as here used, means considerably more since its main implications are not moral but primarily political.
Government Intervention in Health Care Markets is Practical, Necessary, and Morally Sound
Authors: Nichols Len M.
Published: October 2015

The intensity of the opposition to health reform in the United States continues to shock and perplex proponents of the Patient Protection and Affordable Care Act (PPACA). The emotion (“Abort Obama”) and the apocalyptic rhetoric (“Save our Country, Protect our Liberty, Repeal Obamacare”), render civil and evidence-based debate over the implications and alternatives to specific provisions in the law difficult if not problematic. The public debate has largely barreled down two non-parallel yet non-intersecting paths: opponents focus on their fear of government expansion in the future if PPACA is implemented now, while proponents focus on the urgency and specifics of our health care market problems and the limited number of tools we have to address them. Frustration on both sides has led opponents to deny the seriousness of our health system’s problems and proponents to ignore the risk of governmental overreach. These non-intersecting lines of argument are not moving us closer to a desired and necessary resolution.
The Challenge of Providing the Public with Actionable Information during a Pandemic
Authors: Gerwin Leslie E.
Published: October 2015

Can a country with a free press and a robust political debate provide its citizens with actionable information so that they can protect themselves from a threat to their health or safety? By actionable information, I mean accurate facts and reasonable interpretations of those facts upon which an individual should rely in making reason-based decisions. In the context of public health, this includes information that allows an individual to weigh the risk to one’s self, family, and community before deciding to act in an uncertain environment under threatening conditions. The recent H1N1 pandemic, and in particular the government’s campaign for public acceptance of the vaccine, highlights the challenges in ensuring that individuals receive accurate information and perceive that such information should be the basis on which to make potential life-saving decisions.
Building an Ethical Foundation for First-in-Human Nanotrials
Authors: Dresser Rebecca
Published: October 2015

The biomedical literature and popular media are full of upbeat reports about the health benefits we can expect from medical innovations using nanotechnology. Some particularly enthusiastic reports portray nanotechnology as one of the innovations that will lead to a significantly extended human life span. Extreme enthusiasts predict that nanotechnology “will ultimately enable us to redesign and rebuild, molecule by molecule, our bodies and brains….”

Nanomaterials have special characteristics that could contribute to improved patient care. But the same characteristics that make nanotechnology promising also present risks to humans exposed to nanomaterials. A failure to appreciate these risks could jeopardize the research effort. As others have pointed out, if nanomedical interventions produce unexpected human harm, a loss of public and government support for nanomedicine is likely to follow.

Like other forms of medical innovation, novel nanomedical interventions require human testing to evaluate their safety and effectiveness.
Nanomedicine First-in-Human Research: Challenges for Informed Consent
Authors: King Nancy M. P.
Published: October 2015

First-in-human (FIH) research has several characteristics that require special attention with respect to ethics and human subjects protections. At least some nanomedical technologies may also have characteristics that merit special attention in clinical research, as other papers in this symposium show. This paper considers how to address these characteristics in the consent form and process for FIH nanomedicine research, focusing principally on experimental nanotherapeutic interventions but also considering nanodiagnostic interventions.

It is essential, as a starting point, to recognize that the consent form and process are by no means the primary protectors of human subjects (although they are sometimes so regarded). Instead, consideration of the form and content of informed consent becomes relevant only after a clinical trial has been reviewed and deemed scientifically and ethically acceptable.

Two convergent types of challenges to informed consent are posed by nanomedicine FIH research. First, some issues appear generally applicable to FIH research, but have specific nanomedicine implications.
A Non-Paternalistic Model of Research Ethics and Oversight: Assessing the Benefits of Prospective Review
Authors: London Alex John
Published: October 2015

To judge from the rash of recent law review articles, it is a miracle that research with human subjects in the U.S. continues to draw breath under the asphyxiating heel of the rent-seeking, creativity-stifling, jack-booted bureaucrethics that is the current system of research ethics oversight and review. Institutional Review Boards (IRBs), sometimes called Research Ethics Committees (RECs), have been accused of perpetrating “probably the most widespread violation of the First Amendment in our nation's history,” resulting in a “disaster, not only for academics, but for the whole nation.” One member of the President's Council on Bioethics went so far as to assert, “There has been no greater damage to academic freedom in the United States in my lifetime. And my lifetime encompasses McCarthy and it encompasses political correctness, both.” Locked in the bureaucratic “iron cage” of IRB oversight, critics charge that researchers have been transformed into a vulnerable, exposed population, subject to domination, that has been likened in one case to a kind of “Tuskegee in reverse.”
Human Development in the Context of Social Change: Introduction
Authors: Chen Xinyin
Published: October 2015

Two prominent perspectives have guided most research on social change and human development: Vygotsky's cultural–historical perspective and Elder's life‐course perspective. Whereas Vygotsky's perspective focuses on the largely unidirectional influence of enduring societal transformation on human development, Elder's focuses more on individual experiences in circumstances related to dramatic and often unexpected historical events. In addition to the two traditional perspectives, a pluralist–constructivist perspective has emerged in the study of social change that is occurring in most parts of the world primarily because of globalization and technological development. This perspective emphasizes the coexistence and integration of diverse values and lifestyles and their significance for developing comprehensive competencies that help children function in various settings. This introduction provides an overview of research from each of these perspectives and discusses some major issues in the articles in this special section.
Environmental stress and disease in pearl oysters, focusing on the Akoya pearl oyster (Pinctada fucata Gould 1850)
Authors: Kuchel Rhiannon P. , O’Connor Wayne A. , Raftos David A.
Published: October 2015

Pinctada fucata Gould 1850 was first commercially cultivated in Japan in the early 1920s. Japan dominated this market until the proliferation of Akoya viral disease (AVD) in 1996. Since that time the Japanese industry has struggled. In 2000, Japanese production of Akoya pearls represented only 13% of the total world market value. A number of investigations into this downturn have concluded that the proliferation of AVD was a result of stress associated with increasing urbanization and industrialization. This relationship between environmental stress and altered immunological activity is well documented in a number of oyster species. The decline in Japanese pearl production has led to interest in Akoya cultivation in Australia. Commercial Akoya pearl oyster ventures are now in operation in the Australian states of New South Wales, Queensland and Western Australia. The development of a robust and lucrative Akoya pearl industry in Australia will rely on the cultivation and maintenance of healthy oysters. Oyster health is associated with immunological status, which can be jeopardized by both stress and disease. This review details the relationship between the oyster immune system, environmental stress and disease outbreaks in the genus Pinctada, with implications for P. fucata and the fledgling Australian industry.
Explanatory Exclusion and the Intensionality of Explanation
Authors: CAMPBELL NEIL
Published: October 2015

Ausonio Marras has argued that Jaegwon Kim's principle of explanatory exclusion depends on an implausibly strong interpretation of explanatory realism that should be rejected because it leads to an extensional criterion of individuation for explanations. I examine the role explanatory realism plays in Kim's justification for the exclusion principle and explore two ways in which Kim can respond to Marras's criticism. The first involves separating criteria for explanatory truth from questions of explanatory adequacy, while the second appeals to Kim's fine‐grained theory of events. I argue that the first response is unconvincing on its own but when coupled with the second might provide a viable way for Kim to avoid Marras's criticism. However, I show that the second strategy is weak from a polemical point of view because Kim's theory of events already assumes what the principle of explanatory exclusion was introduced to establish: the falsity of nonreductive physicalism.
The Real and Illusory after September 11, 2001, in Elfriede Jelinek's Bambiland and Babel
Authors: Shahan Cyrus
Published: October 2015

Elfriede Jelinek's play with media and violence is particularly relevant after the events of September 11, 2001. Her 2003 drama Bambiland and the accompanying triad of monologues in Babel (2004) exist in the medial and reality rubble of the twin towers and the “war on terror.” Jelinek mimes the transformation of war into television by the twenty‐four hour news cycle and the transmission of “live” events that compose the natural outgrowth of the September attacks. A media war in Iraq—a counter‐reaction that must be understood as a reaction to television images —sought to create a new illusory system out of the twin towers' collapse; Bambiland and Babel attempt to hack this replacement system. Through this hack the dramas test whether overwhelming media with its own violence can politicize the virtual against the virtualization of politics and violence.
Stand der Auslandsgermanistik: Ein Blick auf Kanada, Lateinamerika und die USA
Authors: Andress Reinhard
Published: October 2015

This introductory statement contextualizes the subsequent four presentations by Anette Guse, Lynne Tatlock, Karolin Moser, and John A. McCarthy. In the first three, the state of German Studies in the USA, Canada, and Latin America is examined, concluding with a summary article that provides an assessment and suggestions for how the profession might appropriately respond to changing demographics and intellectual shifts.