bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunization Milestones: A More Comprehensive Picture of Age-Appropriate Vaccination
Authors: Robison Steve G. , Kurosky Samantha K. , Young Collette M. , Gallia Charles A. , Arbor Susan A.
Published: May 2010

A challenge facing immunization registries is developing measures of childhood immunization coverage that contain more information for setting policy than present vaccine series up-to-date (UTD) rates. This study combined milestone analysis with provider encounter data to determine when children either do not receive indicated immunizations during medical encounters or fail to visit providers. Milestone analysis measures immunization status at key times between birth and age 2, when recommended immunizations first become late. The immunization status of a large population of children in the Oregon ALERT immunization registry and in the Oregon Health Plan was tracked across milestone ages. Findings indicate that the majority of children went back and forth with regard to having complete age-appropriate immunizations over time. We also found that immunization UTD rates when used alone are biased towards relating non-UTD status to a lack of visits to providers, instead of to provider visits on which recommended immunizations are not given.
Constructing a Computer Model of the Human Eye Based on Tissue Slice Images
Authors: Dai Peishan , Wang Boliang , Bao Chunbo , Ju Ying
Published: May 2010

Computer simulation of the biomechanical and biological heat transfer in ophthalmology greatly relies on having a reliable computer model of the human eye. This paper proposes a novel method on the construction of a geometric model of the human eye based on tissue slice images. Slice images were obtained from an in vitro Chinese human eye through an embryo specimen processing methods. A level set algorithm was used to extract contour points of eye tissues while a principle component analysis was used to detect the central axis of the image. The two‐dimensional contour was rotated around the central axis to obtain a three‐dimensional model of the human eye. Refined geometric models of the cornea, sclera, iris, lens, vitreous, and other eye tissues were then constructed with their position and ratio relationships kept intact. A preliminary study of eye tissue deformation in eye virtual surgery was simulated by a mass‐spring model based on the computer models developed.
Bimatoprost Effects on Aqueous Humor Dynamics in Monkeys
Authors: Woodward David F. , Krauss Achim H.-P. , Nilsson Siv F. E.
Published: May 2010

The effects of bimatoprost on aqueous humor dynamics were quantified in monkey eyes. Uveoscleral outflow was measured by the anterior chamber perfusion method, using FITC-dextran. Total outflow facility was determined by the two-level constant pressure method. Aqueous flow was measured with a scanning ocular fluorophotometer. Uveoscleral outflow was  L in vehicle-treated eyes and  L (; ) in eyes that received bimatoprost 0.01% b.i.d. × 5 days. Bimatoprost had no effect on total outflow facility, which was  L at baseline and  L after bimatoprost treatment. Bimatoprost had no significant effect on aqueous humor flow. This study demonstrates that bimatoprost increases uveoscleral outflow but not total outflow facility or aqueous humor flow, indicating that it lowers intraocular pressure in ocular normotensive monkeys by a mechanism that exclusively involves uveoscleral outflow.
Mass Spectrometric Analysis of Multiple Pertussis Toxins and Toxoids
Authors: Williamson Yulanda M. , Moura Hercules , Schieltz David , Rees Jon , Woolfitt Adrian R. , Pirkle James L. , Sampson Jacquelyn S. , Tondella Maria L. , Ades Edwin , Carlone George , Barr John R.
Published: May 2010

Bordetella pertussis(Bp) is the causative agent of pertussis, a vaccine preventable disease occurring primarily in children. In recent years, there has been increased reporting of pertussis. Current pertussis vaccines are acellular and consist of Bp proteins including the major virulence factor pertussis toxin (Ptx), a 5-subunit exotoxin. Variation in Ptx subunit amino acid (AA) sequence could possibly affect the immune response. A blind comparative mass spectrometric (MS) analysis of commercially available Ptx as well as the chemically modified toxoid (Ptxd) from licensed vaccines was performed to assess peptide sequence and AA coverage variability as well as relative amounts of Ptx subunits. Qualitatively, there are similarities among the various sources based on AA percent coverages and MS/MS fragmentation profiles. Additionally, based on a label-free mass spectrometry-based quantification method there is differential relative abundance of the subunits among the sources.
Functional regulation of vascular and platelet activity during thrombosis by nitric oxide and endothelial nitric oxide synthase
Authors: Moore Christopher , Tymvios Charalambos , Michael Emerson
Published: May 2010

Nitric oxide (NO) regulates both vascular tone and platelet function. Since thrombotic diseases and their animal models consist of both vascular and platelet components, the functional mechanisms by which NO and endothelial nitric oxide synthase (eNOS) regulate thrombotic events are unclear. Experiments were conducted by measuring collagen-induced aggregation of freely circulating radio-labelled platelets in the pulmonary vasculature of anaesthetised mice via external detection probes. In addition, cardiac haemodynamic function was assessed by invasive catheterisation during thrombotic stimulation. Platelet aggregation responses were shown to occur independently of changes in vessel tone induced by pharmacological vasoconstriction or vasodilatation. Acute NOS inhibition significantly potentiated the amplitude and duration of platelet aggregation and an NO donor had an inhibitory effect. In contrast, in eNOS−/− mice, the amplitude of platelet aggregation was not affected although the response was protracted following moderate thrombotic stimulation. Thrombosis induced changes in haemodynamic performance were sensitive to vasomodulation and were potentiated by both NOS inhibition and in eNOS−/− mice. In conclusion, endogenous NO and exogenously applied NO donors exert an antithrombotic effect in vivo through a direct suppression of platelet aggregation. In contrast, eNOS exerts a powerful antithrombotic effect upon the vascular components of thrombosis but has a more subtle effect on the duration of thrombotic responses that are platelet-mediated. Our data demonstrate the differential roles of eNOS and general NO bioavailability in regulating vascular and platelet activity during thrombosis.
Multi-Reanalysis Climatology of Intermountain Cyclones
Authors: Jeglum Matthew E. , Steenburgh W. James , Lee Tiros P. , Bosart Lance F.
Published: May 2010

The topography in and around the Intermountain West strongly affects the genesis, migration, and lysis of extratropical cyclones. Here intermountain (i.e., Nevada or Great Basin) cyclone (IC) activity and evolution are examined using the ECMWF Re-Analysis Interim (ERA-Interim) the North American Regional Reanalysis (NARR), and the NCEP–NCAR reanalysis from 1989 to 2008, the period during which all three are available. The ICs are defined and tracked objectively as 850-hPa geopotential height depressions of ≥40 m that persist for ≥12 h.

The monthly distribution of IC center and genesis frequency in all three reanalyses is bimodal with spring (absolute) and fall (secondary) maxima. Although the results are sensitive to differences in resolution, topographic representation, and reanalysis methodology, both the ERA-Interim and NARR produce frequent IC centers and genesis in the Great Basin cyclone region, which extends from the southern “high” Sierra to northwest Utah, and the Canyonlands cyclone region, which lies over the upper Colorado River basin of southeast Utah. The NCEP–NCAR reanalysis fails to resolve these two distinct cyclone regions and produces less frequent IC centers and genesis than the ERA-Interim and NARR.

An ERA-Interim-based composite of strong ICs generated in cross-Sierra (210°–300°) 500-hPa flow shows that cyclogenesis is preceded by the development of the Great Basin confluence zone (GBCZ), a regional airstream boundary that extends downstream from the Sierra Nevada across the Intermountain West. Cyclogenesis occurs along the GBCZ as large-scale ascent develops over the Intermountain West in advance of an approaching upper-level trough. Flow splitting around the high Sierra and the presence of low-level baroclinicity along the GBCZ suggest that IC evolution may be better conceptualized from a potential vorticity perspective than from traditional quasigeostrophic models of lee cyclogenesis. Although these results provide new insights into IC activity and evolution, analysis uncertainty and the cyclone identification criteria are important sources of ambiguity that cannot be fully eliminated.
Population Decline in Polish and Czech Cities during Post-socialism? Looking Behind the Official Statistics
Authors: Steinführer Annett , Bierzynski Adam , Großmann Katrin , Haase Annegret , Kabisch Sigrun , Klusácek Petr
Published: May 2010

The evolving debate on ‘urban shrinkage’ mirrors an increasing interest in demographic phenomena on the part of urban scholars. This paper discusses ambiguous evidence about recent population decline in the large cities of Poland and the Czech Republic, with a particular focus on Łódz and Brno in general and their inner cities more specifically. By applying a mixed-method approach, the paper identifies indications of inner-city repopulation and socio-demographic diversification which are not yet apparent in register or census data. It is argued that there are indications of a silent transformation of traditional residential patterns and neighbourhoods in east central Europe. In the inner cities, this is reflected, amongst other things, by the presence of new households that may be called ‘transitory urbanites’.
South Africa in the African Economy
Authors: Arora Vivek , Vamvakidis Athanasios
Published: May 2010

A key feature of the world economy in recent decades has been growing economic integration among groups of countries. This pattern is also evident in Africa, and, since 1994, in the integration between South Africa and the rest of the continent across many economic dimensions. A question that naturally arises as countries grow more closely integrated is what influence they might have on each other. In particular, does a country’s economic growth have “spillover effects” on its partner countries? Are these spillovers generally beneficial, and what is their size? And what might be some of the future implications of regional integration? This article updates what was, to our knowledge, one of the first empirical assessments of the spillover from South African growth to other African countries.1 It also discusses some implications of the updated results in the context of more recent research on African regional integration.
Quality control of inclusion bodies in Escherichia coli
Authors: Jürgen Britta , Breitenstein Antje , Urlacher Vlada , Büttner Knut , Lin Hongying , Hecker Michael , Schweder Thomas , Neubauer Peter
Published: May 2010

Background

Bacterial inclusion bodies (IBs) are key intermediates for protein production. Their quality affects the refolding yield and further purification. Recent functional and structural studies have revealed that IBs are not dead-end aggregates but undergo dynamic changes, including aggregation, refunctionalization of the protein and proteolysis. Both, aggregation of the folding intermediates and turnover of IBs are influenced by the cellular situation and a number of well-studied chaperones and proteases are included. IBs mostly contain only minor impurities and are relatively homogenous.

Results

IBs of α-glucosidase ofSaccharomyces cerevisiaeafter overproduction inEscherichia colicontain a large amount of (at least 12 different) major product fragments, as revealed by two-dimensional polyacrylamide gel electrophoresis (2D PAGE). Matrix-Assisted-Laser-Desorption/Ionization-Time-Of-Flight Mass-Spectrometry (MALDI-ToF MS) identification showed that these fragments contain either the N- or the C-terminus of the protein, therefore indicate that these IBs are at least partially created by proteolytic action. Expression of α-glucosidase in single knockout mutants for the major proteases ClpP, Lon, OmpT and FtsH which are known to be involved in the heat shock like response to production of recombinant proteins or to the degradation of IB proteins,clpP,lon,ompT, andftsHdid not influence the fragment pattern or the composition of the IBs. The quality of the IBs was also not influenced by the sampling time, cultivation medium (complex and mineral salt medium), production strategy (shake flask, fed-batch fermentation process), production strength (T5-lac or T7 promoter), strain background (K-12 or BL21), or addition of different protease inhibitors during IB preparation.

Conclusions

α-glucosidase is fragmented before aggregation, but neither by proteolytic action on the IBs by the common major proteases, nor during downstream IB preparation. Different fragments co-aggregate in the process of IB formation together with the full-length product. Other intracellular proteases than ClpP or Lon must be responsible for fragmentation. Reaggregation of protease-stable α-glucosidase fragments duringin situdisintegration of the existing IBs does not seem to occur.
Update on Allergy Immunotherapy
Authors: Davidson William , Lucas Sean , Borish Larry
Published: May 2010

This article summarizes and provides commentary regarding guidelines on the administration of immunotherapy (IT) for allergic airway disease. Recent investigations have provided important insights into the immunologic mechanism of IT and the prominent role of interleukin-10-producing regulatory T lymphocytes. The most important aspect of successful IT is the administration of an appropriate dose of an extract containing a sufficient concentration of the relevant allergen. This is largely possible now only with standardized extracts. When the major allergen content of successful IT extracts was quantified, efficacy was demonstrated across a surprisingly narrow concentration range (approximately 5-24 μg per injection), irrespective of the extract. This presumably reflects the concentration of an antigen that drives an immune response toward tolerance. It may be predicted that as major allergen content is quantified in currently nonstandardized extracts, effective IT will also be achieved by administering a dose in this range, in contrast to current practices involving fairly arbitrary dosing decisions. With the availability of nonsedating antihistamines, intranasal corticosteroids, and the leukotriene modifiers, inadequate pharmacologic response or intolerable side effects are less commonly the major indications for starting IT for allergic rhinitis (AR). However, with the recognition that a relatively short course (3-5 years) of IT can provide long-term immunomodulation and clinical benefit, a desire to avoid long-term pharmacotherapy and the associated high costs may be the primary indication for IT in AR cases. While evidence overwhelmingly supports the beneficial influences of IT in asthma cases, the positioning of IT for this disorder is not established. The observed prevention of asthma in children who have AR is intriguing, but further studies are required to assess the extent to which the prevalence and severity of chronic asthma will be reduced when these children reach adulthood. Similarly, safety issues overwhelmingly suggest that uncontrolled asthma is the greatest risk factor for mortality associated with IT and that IT therefore may be contraindicated for most patients who have inadequate pharmacologic responses or are unable to tolerate useful pharmacologic agents. Paradoxically, these are the patients for whom a response to IT may be most desirable.
Duodenal perforation due to a kink in a nasojejunal feeding tube in a patient with severe acute pancreatitis: a case report
Authors: Tong Zhihui , Li Weiqin , Wang Xinying , Ye Xianghong , Li Ning , Li Jieshou
Published: May 2010

Introduction

Nasojejunal feeding tube placement can be achieved by fluoroscopic or endoscopic techniques. Significant complications due to nasojejunal feeding tube placement, such as hydrothorax, duodenal perforation and retroperitoneal emphysema, are very rare. We present a case of massive retroperitoneal emphysema and abscess because of duodenal perforation caused by a kink in a nasojejunal feeding tube.

Case presentation

A 34-year-old Chinese woman was admitted to our intensive care unit due to hypertriglyceridemia and severe acute pancreatitis. As she suffered from acute respiratory distress syndrome and required mechanical ventilation, a nasojejunal feeding tube was placed by transnasal endoscopic technique. The procedure took place at her bedside. Half a month later, she had a high fever and abdominal distension. An abdominal radiography was performed and showed that the nasojejunal feeding tube was kinking on the third portion of the duodenum and the tip of the nasojejunal feeding tube was inserted into the right retroperitoneum on the second portion of the duodenum.

Conclusion

When a nasojejunal feeding tube is placed through the transnasal endoscopic technique, an abdominal radiography should be used to confirm the tube's position and indicate if it is kinking or beyond the ligament of Treitz.
Association of gamma-glutamyltransferase with incidence of type 2 diabetes in Japan
Authors: Fujita Misuzu , Ueno Koichi , Hata Akira
Published: May 2010

The aim of this research was to examine the association of gamma-glutamyltransferase (GGT) and its interactions with alcohol consumption (alcohol), body mass index (BMI) and/or alanine aminotransferase (ALT) on the incidence of type 2 diabetes (DM) in Japan. Data from annual health examinations obtained from 1995 to 2005 were analyzed. The total number of subjects in this cohort was 39,563. Hazard ratios (HRs) were calculated by Cox regression analysis. GGT levels were positively associated with the incidence of DM in both men and women, after adjustment for several variables, including alcohol, BMI and ALT. Among women, the association was stronger in non-drinkers than in drinkers due to a significant interaction of GGT and alcohol. In non-drinkers, the HRs of the third and fourth GGT quartiles in women and the fourth GGT quartile in men were significantly higher than those of the first GGT quartile. The association between BMI and the incidence of DM was enhanced by increased GGT levels in women. When GGT levels were in the second to fourth quartiles, the HRs of obese subjects were significantly higher than those of underweight subjects. Conversely, obesity was no longer a significant risk factor for DM when GGT level was in the first quartile. Increased GGT levels were associated with the development of DM after adjustment for several possible confounding factors. The association between GGT and DM in non-drinkers was significantly stronger than that in drinkers. Furthermore, in women, obesity is no longer a risk factor for DM when GGT level is low.
Dynamic Allocation of Pharmaceutical Detailing and Sampling for Long-Term Profitability
Authors: Montoya Ricardo , Netzer Oded , Jedidi Kamel
Published: May 2010

The U.S. pharmaceutical industry spent upwards of $18 billion on marketing drugs in 2005; detailing and drug sampling activities accounted for the bulk of this spending. To stay competitive, pharmaceutical managers need to maximize the return on these marketing investments by determining which physicians to target as well as when and how to target them.

In this paper, we present a two-stage approach for dynamically allocating detailing and sampling activities across physicians to maximize long-run profitability. In the first stage, we estimate a hierarchical Bayesian, nonhomogeneous hidden Markov model to assess the short- and long-term effects of pharmaceutical marketing activities. The model captures physicians' heterogeneity and dynamics in prescription behavior. In the second stage, we formulate a partially observable Markov decision process that integrates over the posterior distribution of the hidden Markov model parameters to derive a dynamic marketing resource allocation policy across physicians.

We apply the proposed approach in the context of a new drug introduction by a major pharmaceutical firm. We identify three prescription-behavior states, a high degree of physicians' dynamics, and substantial long-term effects for detailing and sampling. We find that detailing is most effective as an acquisition tool, whereas sampling is most effective as a retention tool. The optimization results suggest that the firm could increase its profits substantially while decreasing its marketing spending. Our suggested framework provides important implications for dynamically managing customers and maximizing long-run profitability.
Electrochemical dissolution behavior of conductive TiCxO1–x solid solutions
Authors: Jiao Shuqiang , Ning Xiaohui , Huang Kai , Zhu Hongmin
Published: May 2010

Conductive TiCxO1–x solid solutions were prepared by carbothermic reduction of titanium dioxide. Studies were focused on the possibility of electrochemically dissolving TiCxO1–x in NaCl–KCl molten salt. The tail-gas from the anode was monitored during the electrolysis. It was discovered that carbon monoxide (CO) or carbon dioxide (CO2) gases were generated, with the process being dependent upon the consumption of the TiCxO1–x solid solution anode materials. Furthermore, a series of electrochemical methods was used to investigate the valence state of titanium ions dissolved into molten salt when electrolyzing TiCxO1–x solid solutions. A significant result was that titanium ion species dissolved from the TiCxO1–x solid solutions, and this is changed between Ti2+ and Ti3+ depending on the electrochemically dissolving potentials. The significant result discovered in this paper will be potentially beneficial in the preparation of high-purity titanium by electrorefining TiCxO1–x solid solutions.
What More in the Name of God?: Theologies and Theodicies of Faith Healing
Authors: Campbell Courtney S.
Published: May 2010

The recent deaths of two children from parental decisions to rely on faith healing rather than medical treatment raises fundamental questions about the extent and limits of religious liberty in a liberal democratic society. This essay seeks to identify and critically examine three central issues internal to the ethics of religious communities that engage in faith healing regarding children: (1) the various forms of religious and nonreligious justification for faith healing; (2) the moral, institutional, or metaphysical wrong of medical practice from the perspectives of faith-healing communities; (3) the explanation or "theodicy" articulated by the religious community when faith healing does not occur and a child dies. The essay finds that the holding in Prince v. Massachusetts that parents with religious convictions cannot enforce martyrdom on their children presents a guiding principle for medicine and public policy.
International Stem Cell Tourism and the Need for Effective Regulation: Part I: Stem Cell Tourism in Russia and India: Clinical Research, Innovative Treatment, or Unproven Hype?
Authors: Cohen Cynthia B. , Cohen Peter J.
Published: May 2010

Persons with serious and disabling medical conditions have traveled abroad in search of stem cell treatments in recent years. However, weak or nonexistent oversight systems in some countries provide insufficient patient protections against unproven stem cell treatments, raising concerns about exposure to harm and exploitation. The present article, the first of two, describes and analyzes stem cell tourism in Russia and India and addresses several scientific/medical, ethical, and policy issues raised by the provision of unproven stem cell-based treatments within them. The distinction between treatment based on proven clinical research and "innovative treatment" is addressed and the authors conclude that the innovations at issue constitute neither. Regulatory measures need to be developed or strengthened in accord with internationally accepted standards in such countries to protect those seeking stem cell treatments.
Intellectual Property, State Sovereignty, and Biotechnology
Authors: Brody Baruch A.
Published: May 2010

The issue of biopiracy has attracted considerable attention in recent years. The Convention on Biological Diversity adopted a principle of state sovereignty over biological resources and the genetic information contained within those resources to address this issue. It is argued that this principle has not been adequately justified and that there are other solutions to the issue of biopiracy, based on different theories of justice, that deserve greater consideration. These alternatives include the common heritage of mankind principle and the global commons principle.
Extending Clinical Equipoise to Phase 1 Trials Involving Patients: Unresolved Problems
Authors: Anderson James A. , Kimmelman Jonathan
Published: May 2010

Notwithstanding requirements for scientific/social value and risk/benefit proportionality in major research ethics policies, there are no widely accepted standards for these judgments in Phase 1 trials. This paper examines whether the principle of clinical equipoise can be used as a standard for assessing the ratio of risk to direct-benefit presented by drugs administered in one category of Phase 1 study—first-in-human trials involving patients. On the basis of the supporting evidence for, and architecture of, Phase 1 studies, the articles offers two provisional conclusions: (1) the risks of drug administration in such trials cannot generally be justified on therapeutic grounds but by appeal to the social value of the research; and (2) a framework for adjudicating the ratio of risk/social-value must be developed.
Reframing Developmental Biology and Building Evolutionary Theory's New Synthesis
Authors: Tauber Alfred I.
Published: May 2010

Gilbert and Epel present a new approach to developmental biology: embryogenesis must be understood within the full context of the organism's environment. Instead of an insular embryo following a genetic blueprint, this revised program maintains that embryogenesis is subject to inputs from the environment that generate novel genetic variation with dynamic consequences for development. Beyond allelic variation of structural genes and of regulatory loci, plasticity-derived epigenetic variation completes the triad of the major types of variation required for evolution. Developmental biology and ecology, disciplines that have previously been regarded as distinct, are presented here as fully integrated under the rubric of "eco-devo," and from this perspective, which highlights how the environment not only selects variation, it helps construct it, another synthesis with evolutionary biology must also be made, "eco-evo-devo." This second integration has enormous implications for expanding evolution theory, inasmuch as the Modern Synthesis (Provine 1971), which combined classical genetics and Darwinism in the mid-20th century, did not account for the role of development in evolution. The eco-evo-devo synthesis thus portends a major theoretical inflection in evolutionary biology. Following a description of these scientific developments, comment is offered as to how this new integrated approach might be understood within the larger shifts in contemporary biology.
Ethics of Responsibility in a Multicultural Context
Authors: Turoldo Fabrizio
Published: May 2010

Caring for patients from different cultural or religious backgrounds may create difficult ethical dilemmas for physicians. The article reviews four case histories, involving patients from the Navajo culture or the Christian Science Church, that highlight some of these ethical problems. It then discusses an "ethics of responsibility," which is based on and encompasses a variety of meanings of responsibility, including responsibility as recognition, as taking charge, as the ability to assess the consequences of one's actions, and as making a commitment. An ethics of responsibility provides a novel perspective for resolving ethical problems in medicine.
Embodiments of Will
Authors: Nutton Vivian
Published: May 2010

From the fifth century BCE onwards, Greek doctors and philosophers debated the ways in which the will could be translated into physical action. Aristotle and his followers believed that the heart was the controlling organ, working through sinews. Later anatomists, first in Alexandria in Egypt and later in the Roman world, continued to speculate for several centuries. Galen (129-ca. 216) established a new medical paradigm, insisting on the primacy of the brain mediating largely through nerves. The Aristotelian and Galenic theories continued to be debated in the Greek and Islamic worlds, and, in new Latin translations, in the later Western medieval universities. These debates were largely conducted without recourse to experiment. Even after Mondino de' Liuzzi had introduced the dissection of a corpse in his teaching at Bologna around 1318, the battle of the texts continued into the 17th century. Although Michael Frampton ranges widely in Embodiments of Will , he has left out much, including a recently (re)discovered treatise by Galen that considers in detail the relationship between the brain, the nerves, and bodily movements.
Like Grandfather, Like Grandson: Erasmus and Charles Darwin on evolution
Authors: Smith C. U. M.
Published: May 2010

Last year (2009) marked the bicentenary of Charles Darwin's birth and the sesquicentenary of The Origin of Species . This article examines the influence of Erasmus Darwin on Charles's evolutionary thought and shows how, in many ways, Erasmus anticipated his much better-known grandson. It discusses the similarity in the mindsets of the two Darwins, asks how far the younger Darwin was exposed to the elder's evolutionary thought, examines the similarities and differences in their theories of evolution, and ends by showing the surprising similarity between their theories of inheritance. Erasmus's influence on Charles is greater than customarily acknowledged, and now is an opportune time to bring the grandfather out from behind the glare of his stellar grandson.
A Spectre Haunts Evolution: Haeckel, Heidegger, and the All-Too-Human History of Biology
Authors: Day Matthew
Published: May 2010

Since The Meaning of Evolution (1992), Robert J. Richards has argued that modern evolutionary theory is rooted in late 18th-century Romantic science. The publication of The Tragic Sense of Life (2009) provides a fitting occasion to evaluate how this perspective revises the standard history of biological thought. This essay focuses on three aspects of Richards's attempt to rehabilitate the reputation of German Naturphilosophie : (1) the identification of Romantic strains in Charles Darwin's portrait of evolutionary history; (2) the demonstration that any attempt to treat Ernst Haeckel as a "pseudo-Darwinian" inevitably renders Darwin himself a "pseudo-Darwinian"; and (3) the denial of Haeckel's alleged responsibility for the rise of Nazi racial hygiene. This article examines Richards's case for clearing Haeckel's name, as well as the subsequent (slanderous) charge from Daniel Gasman that Richards is guilty of whitewashing the Haeckelian roots of the Holocaust.
Contemplating Cognitive Enhancement in Medical Students and Residents
Authors: Webb Jadon R. , Thomas John W. , Valasek Mark A.
Published: May 2010

Medical school and residency can be stressful times, involving years of intensive academic study and pressure to earn high grades. Students and residents must learn to care for the sick, a task requiring long work hours and sleep deprivation. In such an environment, it is important to monitor the mental health of trainees and the factors that influence it. This essay examines a relatively unexplored facet of physician mental health: the use of pharmacological stimulants by students and residents to study better, earn higher grades, stay awake longer, and take better care of patients. Practical and ethical considerations of stimulant use in the medical profession, along with future directions for medical student mental health, are discussed.
On First Looking into Kutcher's "Contested Medicine": Ethical Tensions in Clinical Research
Authors: Hellman Samuel
Published: May 2010

Contested Medicine examines the experiments done at the University of Cincinnati by Eugene Saenger and his colleagues during the 1960s, a time of great fear that the Cold War between the United States and the Soviet Union would become a hot war using nuclear weapons. These studies were to provide the Department of Defense information relevant to the consequences of exposure of military personnel to ionizing radiation in such circumstances. Kutcher, a radiation physicist turned historian of science, is especially well prepared to put these studies into the context of the evolving bioethics of the time. He reviews the essential ethical reviews, beginning with the Nuremberg Code and extending to those of the Advisory Committee on Human Radiation Experiments appointed by President Clinton. These evolving ethical standards provide a cautionary note to today's methods of clinical experimentation in search of proper evidence-based medicine. There has been an ascendance of the priority of patient rights over societal good except in increasingly limited special circumstances. Some of what was considered good and necessary science in the 1960s and 1970s is no longer considered proper. Similarly, future ethical norms may well find current trial methodology to be flawed.
Bless Me Reader for I Have Sinned: Physicians and Confessional Writing
Authors: Wear Delese , Jones Therese
Published: May 2010

From the poetry of William Carlos Williams, the novels of Walker Percy, and the short stories of Anton Chekov to the contemporary essays of Atul Gawande, physicians' contributions to literary genres have been significant. This article explores the specific form of confessional writing offered by physicians during the past half century, writing that often exposes medical error or negative feelings towards patients. A history of confessional practices as a legal tool, as religious practice, and as literary genre is offered, followed by analyses of selected confessional writings by physicians, many of them found in clinical journals such as Journal of the American Medical Association, Annals of Internal Medicine , and the Lancet . The authors of the narratives described here are engaged in several or all elements of the confessional sequence, which may offer them some resolution through the exposure and acknowledgment of their shared humanity with their patients and their expression of regret for any harm done.
Interpreting the Implications of DNA Ancestry Tests
Authors: Wagner Jennifer K.
Published: May 2010

Shopping for genetic information has become popular, but consumers may not understand what exactly they are buying. The retail DNA industry is forcing laypersons, academics, and medical and legal professionals alike to face the crossroads of genetics, law, and society. How will we decipher the meanings of the tests, determine the value of the information provided, or appropriately encourage or discourage various applications of that genetic information? When it comes to understanding the signs at the crossroads of disciplines, something is always potentially lost in translation. This article provides an overview of the retail DNA industry, addressing a few questions ripe for misinterpretation and confusion. It argues that the challenges posed by the retail DNA industry are both intelligible and manageable; optimally, multidisciplinary individuals would guide the way, steering the courts, legislature, laboratories, and clinics toward an adequate balance of consumer protection, autonomy, and understanding.
School Meals: A Nutritional and Environmental Perspective
Authors: Demas Antonia , Kindermann Dana , Pimentel David
Published: May 2010

In light of the rise in childhood obesity rates and the influence of the food system on fossil fuel use, this article analyzes current school meals in Baltimore and makes suggestions for school meal reform based on both childhood nutrition and environmental resource use. The nutrient content and estimated energy costs of a typical school lunch are compared with a proposed alternate meal. The study indicates that healthier meals can significantly limit fossil fuel energy inputs for harvesting, production, processing, packaging, and transportation. The authors also provide strategies for developing menus that are both more nutritious and more energy efficient.
Pragmatic Problems with Clinical Equipoise
Authors: Kowalski Charles J.
Published: May 2010

It is widely accepted that if one is to follow the ethical tenets of clinical equipoise, phase III controlled clinical trials must be designed pragmatically, to measure effectiveness rather than efficacy. This choice of a pragmatic rather than an explanatory approach to phase III clinical trial design has a number of consequences, some of which may be considered problematic. These include changes in what the trial is expected to accomplish, the way treatments are defined, the selection of subjects, the ways in which treatments are compared, and the assessment of the results. One also may end up challenging the real-world expectation that scientific results will be replicated before they are considered valid. This article discusses the connection between clinical equipoise and pragmatic trials, contrasts explanatory with pragmatic trials, points to the differences in the ways in which trial data are analyzed and interpreted, and discusses the power of replication, one of the defining hallmarks of the scientific method. Viewing clinical equipoise through a consequentialist lens reveals a number of problems, many of which are attributable to equipoise's insistence on a pragmatic approach to trial architecture.
Treatment Adherence in the Absence of Insight: A Puzzle and a Proposed Solution
Authors: Reimer Marga
Published: May 2010

Abstract: Patients with psychosis often have poor insight into their illness. Poor insight into illness is, at least among patients with psychosis, a good predictor of treatment non-adherence. This is no mystery, for as Xavier Amador asks, "Who would want to take medicine for an illness they did not believe they had?" What is curious is that some patients with psychosis do adhere to treatment despite a lack of insight. Why do these patients adhere to treatment, given that they do not believe they are ill to begin with? In this paper, I attempt to answer this question. I do so by first considering cases of non-psychotic patients who adhere to treatment despite a lack of insight. I point out that these sorts of cases are commonplace, and attempt to explain why they arise. The explanation is given in terms of anticipated treatment benefits. However, these benefits are not conceptualized by the patient in terms of pathology. The patient does not, in other words, think of such benefits in terms of illness, symptoms, treatment , and so forth. I then argue that the proposed explanation can be extended to account for why psychotic patients without insight sometimes adhere to treatment. I conclude by drawing out some of the practical implications of the proposed view. I first argue, on practical as well as ethical grounds, that improving insight for purposes of treatment adherence is misguided. I then suggest that such adherence might be increased simply by explaining treatment benefits in language that does not presuppose that the patient is, in any sense, "ill," "diseased," "sick," "unwell," and so on.
Husserlian Self-Awareness and Selective Serotonin Reuptake Inhibitors
Authors: Hadreas Peter
Published: May 2010

Abstract: The goal of the paper is to offer a model of self-awareness that fits the testimony of both good and bad responders to selective serotonin reuptake inhibitors (SSRIs), of which fluoxetine (Prozac; Lilly, Indianapolis, IN) is probably the most well known. After a review of troubling current uncertainties concerning how and for whom SSRIs are therapeutic, it is argued that SSRIs, as a rule, lessen the emotionality of SSRI subjects in favor of an increased cognitive and volitional orientation. Traditional empiricist and rationalist accounts self-awareness fail to provide models that adequately explain how such a shift from an active emotional response to an increased cognitive/volitional orientation is possible. Instead, notions of self-awareness, as understood by founding phenomenologist, Edmund Husserl, fit the testimony of SSRI subjects.
A Liberal Account of Addiction
Authors: Foddy Bennett , Savulescu Julian
Published: May 2010

Abstract: Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person's self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic errors in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view.
Political Malaise and the New Arabic Noir
Authors: Smolin Jonathan
Published: May 2010

Morocco's experience of political transition and liberalization in the mid-1990s spawned new types of fiction in the country. The most important of these from a political standpoint was the Arabic police novel, the first of its kind in the Middle East or North Africa. At first, this genre expressed optimism and enthusiasm for a new era in Morocco, presenting a highly sympathetic detective who symbolized respect for the rule of law and human rights. By 2002, however, exuberance for the new era turned to despair, as the old forms of brutality and corruption returned. This article examines how a recent Arabic police novel, Abdelilah Hamdouchi's Bled Dry , breaks with the previous novels in the genre by adopting a hard-boiled noir style to express the profound sense of hopelessness and disillusionment felt across the country. In particular, this article traces how the novel boldly depicts graphic prostitution, filthy shantytowns, radical Islam, and corrupt cops, linking the desperation of current-day Casablanca to the exploitation and malaise of the new era.
Petra Delicado: A Hard-Boiled Police Investigator
Authors: Oxford Jeffrey
Published: May 2010

Petra Delicado, the female, hard-boiled detective and police inspector made famous by the Spanish writer Alicia Giménez Bartlett, views her professional role as one of breaking "the glass ceiling"—both for herself and her suspects—and she will use whatever means, physical or otherwise, both to discover the true perpetrator of the crime and obtain a confession from that individual. Her ability to move in the world of the criminals and corrupt government officials—including the police force itself—reveals that the patriarchal, machista society of traditional Spain has certainly changed since the death of Franco and that women are now not solely relegated to the work of the hearth. It is my contention that Alicia Giménez Bartlett crosses the heretofore critical chasm between the violence-laden, bad-mouthing hard boiled genre and the law and order-abiding/promoting police procedural. That is, Alicia Giménez Bartlett leads the reader on a narrative journey in which the long-held dichotomy between the police procedural and the hard boiled is, in fact, beginning to fade if not be outright erased, and a detailed examination of the eight novels shows that Petra Delicado embodies a new type of hard-boiled detective on the force in Spanish literature. She may be a police officer, but she is hard boiled both in spirit and action.
Hard-boiled Rhetoric: The "Fearless Speech" of Philip Marlowe
Authors: Garrison Kristen
Published: May 2010

Existing scholarship on the detective novel has established the genre's tendency and capacity to represent Enlightenment privileging of the rational mind, and the hard-boiled version has garnered attention for the ways in which it challenges and interrogates such assumptions. The hard-boiled detective novelist creates a dark and unpredictable world in order to dramatize the traps and false leads inherent to the so-called scientific method; within this world, the detective comes to recognize that the demands of his job endanger not only his life, but his moral code—the abstract "truths" by which he lives. Consequently, truth itself becomes the mystery. Drawing upon Michel Foucault's Fearless Speech , which traces the concept of parrhesia (frank truth-telling) through classical texts, this article extends the notion of fearless speech to modern times in order to illuminate the rhetorical power of Raymond Chandler's detective novels. In particular, the concept of parrhesia reveals Chandler's particular response to the 20 th century problem of truth and illuminates the significance of Philip Marlowe as a modern day parrhesiastes . Interpreting Marlowe's rhetoric through Foucault's lens not only deepens our appreciation for Chandler's art, but also reveals early 20 th century attitudes toward free speech and skepticism regarding the capacity of anyone to speak—or recognize—the truth.
Forgotten Crimes?: Representing Jewish Experience of the Second World War in French Crime Fiction
Authors: Gorrara Claire
Published: May 2010

This article explores the relationship between French crime fiction and memories of the Second World War. It focuses on the late 1950s and early 1960s and representations of Jewish persecution and deportation in the work of Léo Malet and Hubert Monteilhet. For whilst these early post-war years are commonly supposed to have been given over to the repression of troubling wartime memories, selected French crime fiction offers an intriguing set of counter-narratives with which to challenge such notions of French historical amnesia. By examining Léo Malet's Du rébecca rue des Rosiers (1957) and Des kilomètres de linceuls (1955) and Hubert Monteilhet's Le Retour des cendres (1961), this article will show how representations of Jewish persecution and deportation in these fictions activate complex patterns of disclosure, displacement and disavowal of French wartime guilt and complicity. In so doing, these popular novels provide rich material for speculating on broader configurations of French wartime memories at a time of apparent forgetting.
Lew Archer, House Whisperer
Authors: Kreyling Michael
Published: May 2010

Southern California is both the literary site for Ross Macdonald's (1915-1983) "Lew Archer" series of detective novels and the architectural site for Richard Neutra's (1892-1970) "empathic" houses, domestic dwellings the architect (trained also in psychotherapy by Sigmund Freud) thought of as structured therapies. The paths of Macdonald and Neutra crossed because they were both influenced, if not obsessed, with Freud as the teller of the master-plot of modern consciousness. "Lew Archer, House Whisperer" traces Macdonald's use of houses (usually the houses of Archer's clients, but sometimes the detective's own spaces) as telling sources of information about Archer's cases that his human characters are often unwilling or unable to disclose. Whether they occupy foreground or background in Macdonald's Archer novels, they always show up on Lew's "empathic" radar.