bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of the burrowing mud shrimp, Upogebia yokoyai, on carbon flow and microbial activity on a tidal flat
Authors: Sasaki Akiko , Nakao Hiroki , Yoshitake Shinpei , Nakatsubo Takayuki
Published: April 2014

Mud shrimps, Upogebia spp., are major constituents of macrobenthic communities in tidal flats in Japan. The impact of Upogebia yokoyai on carbon flow on tidal flats was examined by comparing CO2 emission rates from plots with and without burrows in the Kurose River estuary, Japan. In situ CO2 emission rates from plots with burrows were significantly higher than from those without. Laboratory measurements using sediment core samples that excluded respiration of macrobenthic organisms showed similar trends. Although there were no significant differences in grain size distribution, water content, or ignition loss between the sediment cores with and without burrows, oxidation–reduction potential was significantly higher in sediment cores with burrows. Analysis of phospholipid fatty acids (PLFA) indicated that microbial biomass and community structure did not differ significantly between cores with and without burrows. However, microbial respiration activity, as indicated by CO2 emission rates per total PLFA content, was significantly higher in sediment cores with burrows than in those without. Our results indicate that burrows of U. yokoyai change the physicochemical conditions and increase microbial activity in the sediment, significantly affecting carbon flow in the tidal flat.
Daily physical activity and physical function in adult maintenance hemodialysis patients
Authors: Kim J. C. , Shapiro B. B. , Zhang M. , Li Y. , Porszasz J. , Bross R. , Feroze U. , Upreti R. , Kalantar-Zadeh K. , Kopple J. D.
Published: April 2014

Background

Maintenance hemodialysis (MHD) patients reportedly display reduced daily physical activity (DPA) and physical performance. Low daily physical activity and decreased physical performance are each associated with worse outcomes in chronic kidney disease patients. Although daily physical activity and physical performance might be expected to be related, few studies have examined such relationships in MHD patients, and methods for examining daily physical activity often utilized questionnaires rather than activity monitors. We hypothesized that daily physical activity and physical performance are reduced and correlated with each other even in relatively healthier MHD patients.

Methods

Daily physical activity, 6‐min walk distance (6‐MWT), sit‐to‐stand, and stair‐climbing tests were measured in 72 MHD patients (32 % diabetics) with limited comorbidities and 39 normal adults of similar age and gender mix. Daily physical activity was examined by a physical activity monitor. The human activity profile was also employed.

Results

Daily physical activity with the activity monitor, time‐averaged over 7 days, and all three physical performance tests were impaired in MHD patients, to about 60–70 % of normal values (p < 0.0001 for each measurement). Human activity profile scores were also impaired (p < 0.0001). MHD patients spent more time sleeping or in marked physical inactivity (p < 0.0001) and less time in ≥ moderate activity (p < 0.0001). These findings persisted when comparisons to normals were restricted to men or women separately. After adjustment, daily physical activity correlated with 6‐MWT but not the two other physical performance tests. Human activity profile scores correlated more closely with all three performance tests than did DPA.

Conclusions

Even in relatively healthy MHD patients, daily physical activity and physical performance are substantially impaired and correlated. Whether training that increases daily physical activity or physical performance will improve clinical outcome in MHD patients needs to be examined.
Three-dimensional instabilities over a rectangular open cavity: from linear stability analysis to experimentation
Authors: de Vicente J. , Basley J. , Meseguer-Garrido F. , Soria J. , Theofilis V.
Published: April 2014

Three-dimensional instabilities arising in open cavity flows are responsible for complex broad-banded dynamics. Existing studies either focus on theoretical properties of ideal simplified flows or observe the final state of experimental flows. This paper aims to establish a connection between the onset of the centrifugal instabilities and their final expression within the fully saturated flow. To that end, a linear three-dimensional modal instability analysis of steady two-dimensional states developing in an open cavity of aspect ratio $L/D=2$ (length over depth) is conducted. This analysis is performed together with an experimental study in the same geometry adding spanwise endwalls. Two different Reynolds numbers are investigated through spectral analyses and modal decomposition. The physics of the flow is thoroughly described exploiting the strengths of each methodology. The main flow structures are identified and salient space and time scales are characterised. Results indicate that the structures obtained from linear analysis are mainly consistent with the fully saturated experimental flow. The analysis also brings to light the selection and alteration of certain wave properties, which could be caused by nonlinearities or the change of spanwise boundary conditions.
Nonlinear and dispersive free surface waves propagating over fluids with weak vertical and horizontal density variation
Authors: Son Sangyoung , Lynett Patrick J.
Published: April 2014

We consider the change in fluid density in a depth-integrated long-wave model. By allowing horizontal and vertical variation of fluid density, a depth-integrated model for long gravity waves over a variable-density fluid has been developed, where density change effects are included as correction terms. In particular, a two-layer fluid system is chosen to represent vertical density variations, where interfacial wave effects on the free surface are accounted for through direct inclusion of the velocity component of the interfacial wave. For the numerical implementation of the model, a finite-volume scheme coupled with an approximate Riemann solver is adopted for leading-order terms while cell-centred finite-volume methods are utilized for others. Numerical tests in which the density field is configured to vary either horizontally or vertically have been performed to verify the model. For horizontal variation of fluid density, a pneumatic breakwater system is simulated and fair agreement is observed between computed and measured data, indicating that the current induced by the upward bubble flux is responsible for wave attenuation to some degree. To investigate the effects of internal motion on the free surface, a two-layer fluid system with monochromatic internal wave motion is tested numerically. Simulated results agree well with the measured and analytical data. Lastly, nonlinear interactions between external- and internal-mode surface waves are studied numerically and analytically, and the model is shown to have nonlinear accuracy limitations similar to existing Boussinesq-type models.
Drag kings: characterizing large-scale flows in cycling aerodynamics
Authors: Hosoi A. E.
Published: April 2014

In their recent publication Crouch et al. (J. Fluid Mech., this issue, vol. 748, 2014, pp. 5–35) use wind tunnel experiments to quantify the large-scale vortical structures that develop as a cyclist progresses through a full rotation of the pedals. The authors identify asymmetries in the trailing vortex wake, which intensify as one leg straightens, as the primary source of drag variation over one pedal cycle. These new data suggest that targeted approaches to mitigate asymmetries in the trailing wake present an intriguing opportunity to reduce drag in cycling strategies and technologies.
Turbulent mixing driven by spherical implosions. Part 1. Flow description and mixing-layer growth
Authors: Lombardini M. , Pullin D. I. , Meiron D. I.
Published: April 2014

We present large-eddy simulations (LES) of turbulent mixing at a perturbed, spherical interface separating two fluids of differing densities and subsequently impacted by a spherically imploding shock wave. This paper focuses on the differences between two fundamental configurations, keeping fixed the initial shock Mach number ${\approx }1.2$, the density ratio (precisely $|A_0|\approx 0.67$) and the perturbation shape (dominant spherical wavenumber $\ell _0=40$ and amplitude-to-initial radius of $3\, \%$): the incident shock travels from the lighter fluid to the heavy fluid or, inversely, from the heavy to the light fluid. After describing the computational problem we present results on the radially symmetric flow, the mean flow, and the growth of the mixing layer. Turbulent statistics are developed in Part 2 (Lombardini, M., Pullin, D. I. & Meiron, D. I. J. Fluid Mech., vol. 748, 2014, pp. 113–142). A wave-diagram analysis of the radially symmetric flow highlights that the light–heavy mixing layer is processed by consecutive reshocks, and not by reverberating rarefaction waves as is usually observed in planar geometry. Less surprisingly, reshocks process the heavy–light mixing layer as in the planar case. In both configurations, the incident imploding shock and the reshocks induce Richtmyer–Meshkov (RM) instabilities at the density layer. However, we observe differences in the mixing-layer growth because the RM instability occurrences, Rayleigh–Taylor (RT) unstable scenarios (due to the radially accelerated motion of the layer) and phase inversion events are different. A small-amplitude stability analysis along the lines of Bell (Los Alamos Scientific Laboratory Report, LA-1321, 1951) and Plesset (J. Appl. Phys., vol. 25, 1954, pp. 96–98) helps quantify the effects of the mean flow on the mixing-layer growth by decoupling the effects of RT/RM instabilities from Bell–Plesset effects associated with geometric convergence and compressibility for arbitrary convergence ratios. The analysis indicates that baroclinic instabilities are the dominant effect, considering the low convergence ratio (${\approx } 2$) and rather high ($\ell >10$) mode numbers considered.
Reduced-order representation of near-wall structures in the late transitional boundary layer
Authors: Sayadi Taraneh , Schmid Peter J. , Nichols Joseph W. , Moin Parviz
Published: April 2014

Direct numerical simulations (DNS) of controlled H- and K-type transitions to turbulence in an $M = 0.2$ (where $M$ is the Mach number) nominally zero-pressure-gradient and spatially developing flat-plate boundary layer are considered. Sayadi, Hamman & Moin (J. Fluid Mech., vol. 724, 2013, pp. 480–509) showed that with the start of the transition process, the skin-friction profiles of these controlled transitions diverge abruptly from the laminar value and overshoot the turbulent estimation. The objective of this work is to identify the structures of dynamical importance throughout the transitional region. Dynamic mode decomposition (DMD) (Schmid, J. Fluid Mech., vol. 656, 2010, pp. 5–28) as an optimal phase-averaging process, together with triple decomposition (Reynolds & Hussain, J. Fluid Mech., vol. 54 (02), 1972, pp. 263–288), is employed to assess the contribution of each coherent structure to the total Reynolds shear stress. This analysis shows that low-frequency modes, corresponding to the legs of hairpin vortices, contribute most to the total Reynolds shear stress. The use of composite DMD of the vortical structures together with the skin-friction coefficient allows the assessment of the coupling between near-wall structures captured by the low-frequency modes and their contribution to the total skin-friction coefficient. We are able to show that the low-frequency modes provide an accurate estimate of the skin-friction coefficient through the transition process. This is of interest since large-eddy simulation (LES) of the same configuration fails to provide a good prediction of the rise to this overshoot. The reduced-order representation of the flow is used to compare the LES and the DNS results within this region. Application of this methodology to the LES of the H-type transition illustrates the effect of the grid resolution and the subgrid-scale model on the estimated shear stress of these low-frequency modes. The analysis shows that although the shapes and frequencies of the low-frequency modes are independent of the resolution, the amplitudes are underpredicted in the LES, resulting in underprediction of the Reynolds shear stress.
‘The Trial the World is Watching’: The 1972 Prosecution of Derk Crichton and James Watts, Abortion, and the Regulation of the Medical Profession in Apartheid South Africa
Authors: Klausen Susanne M.
Published: April 2014

After its formation in 1910 as a self-governing dominion within the British empire, the Union of South Africa followed a combination of English and Roman-Dutch common laws on abortion that decreed the procedure permissible only when necessary to save a woman’s life. The government continued doing so after South Africa withdrew from the Commonwealth and became a republic in 1961. In 1972 a sensational trial took place in the South African Supreme Court that for weeks placed clandestine abortion on the front pages of the country’s newspapers. Two men, one an eminent doctor and the other a self-taught abortionist, were charged with conspiring to perform illegal abortions on twenty-six white teenagers and young unmarried women. The prosecution of Dr Derk Crichton and James Watts occurred while the National Party government was in the process of drafting abortion legislation and was perceived by legal experts as another test of the judiciary’s stance on the common law on abortion. The trial was mainly intended to regulate the medical profession and ensure doctors ceased helping young white women evade their ‘duty’ to procreate within marriage. Ultimately, the event encapsulated a great deal about elites’ attempt to buttress apartheid culture and is significant for, among other reasons, contributing to the production of South Africa’s extremely restrictive Abortion and Sterilisation Act (1975).
Reconstructing Harry: A Genealogical Study of a Colonial Family ‘Inside’ and ‘Outside’ the Grahamstown Asylum, 1888–1918
Authors: Wilbraham Lindy
Published: April 2014

Recent scholarship has explored the dynamics between families and colonial lunatic asylums in the late nineteenth century, where families actively participated in the processes of custodial care, committal, treatment and release of their relatives. This paper works in this historical field, but with some methodological and theoretical differences. The Foucauldian study is anchored to a single case and family as an illness narrative that moves cross-referentially between bureaucratic state archival material, psychiatric case records, and intergenerational family-storytelling and family photographs. Following headaches and seizures, Harry Walter Wilbraham was medically boarded from his position as Postmaster in the Cape of Good Hope Colony of South Africa with a ‘permanent disease of the brain’, and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. In contrast to writings about colonial asylums that usually describe several patient cases and thematic patterns in archival material over time and place, this study’s genealogical lens examines one white settler male patient’s experiences within mental health care in South Africa between 1908 and 1911. The construction of Harry’s ‘case’ interweaves archival sources and reminiscences inside and outside the asylum, and places it within psychiatric discourse of the time, and family dynamics in the years that followed. Thus, this case study maps the constitution of ‘patient’ and ‘family’ in colonial life,c.1888–1918, and considers the calamity, uncertainty, stigma and silences of mental illness.
Effects of dietary microencapsulated sodium butyrate on growth, intestinal mucosal morphology, immune response and adhesive bacteria in juvenile common carp (Cyprinus carpio) pre-fed with or without oxidised oil
Authors: Liu Wenshu , Yang Yanou , Zhang Jianli , Gatlin Delbert M. , Ringø Einar , Zhou Zhigang
Published: April 2014

The aim of the present study was to investigate the effects of different dietary sustained-release microencapsulated sodium butyrate (MSB) products (0 (non-supplement), 1·5 and 3·0 h) for a control or oxidised soyabean oil (SBO) diet on fish production, intestinal mucosal condition, immunity and intestinal bacteria in juvenile common carp (Cyprinus carpio). Dietary MSB increased weight gain and reduced the feed conversion ratio within the control and oxidised SBO groups. Gut mucosa was damaged in the oxidised SBO group fed without MSB, in contrast to a normal appearance found in fish fed the MSB1·5 and MSB3·0 diets in the oxidised SBO group. Microvillus density increased in fish fed the MSB1·5 and MSB3·0 diets in the oxidised SBO group (P< 0·001); however, microvillus density was affected by the different pre-fed diets in the midgut (P< 0·001) and by the different sustained-release times of MSB in the distal gut (DG) (P= 0·003). The interaction between the pre-fed diets and the sustained-release times of dietary MSB was significant for the relative gene expression levels of gut heat shock protein-70 (HSP70), pro-inflammatory cytokines (IL-1β and TNF-α) and anti-inflammatory cytokines (transforming growth factor-β) within each gut segment, except for HSP70 in the DG and IL-1β in the foregut. Modulation of adherent bacterial communities within each gut segment investigated was not obvious when the common carp were fed the diets with MSB, as similarity coefficients of >0·79 were observed. These results indicated that MSB can be used as a dietary supplement to repair or prevent intestinal damage in carp fed oxidised SBO.
Intravenous lipopolysaccharide challenge alters ruminal bacterial microbiota and disrupts ruminal metabolism in dairy cattle
Authors: Jing Longhui , Zhang Ruiyang , Liu Yujie , Zhu Weiyun , Mao Shengyong
Published: April 2014

In the present study, three primiparous lactating Holstein cows (260–285 d in lactation) were used in a 3 × 3 Latin square design to assess the effects of three doses (0·0, 0·4 and 0·8 μg/kg body weight) of lipopolysaccharide (LPS, Escherichia coli 0111:B4) on changes in ruminal microbiota and ruminal fermentation. Ruminal pH was linearly decreased (P< 0·001) by LPS challenge, and the concentrations of acetate, propionate, butyrate, total volatile fatty acids and amino N increased linearly (P< 0·001) according to the LPS dose. LPS infusion linearly decreased (P< 0·001) the organic matter degradability of alfalfa hay and soyabean meal in the rumen, but did not affect (P>0·10) the gene expression of Na+/K+-ATPase and monocarboxylic acid transporter-1, -2 and -4. A plot of principal coordinate analysis based on unweighted UniFrac values and analysis of molecular variance revealed that the structure of ruminal bacterial communities in the control was distinct from that of the ruminal microbiota in the cattle exposed to LPS. At the phylum level, when compared with the control group, LPS infusion in the tested cows linearly increased (P< 0·05) the abundance of Firmicutes, and linearly decreased (P< 0·05) the percentage of Bacteroidetes, Tenericutes, Spirochaetes, Chlorobi and Lentisphaerae. To our knowledge, this is the first study to report that intravenously LPS challenge altered the ruminal bacterial microbiota and fermentation profiles. The present data suggest that systemic LPS could alter ruminal environment and ruminal microbiota composition, leading to a general decrease in fermentative activity.
Red meat consumption is associated with an increased overall cancer risk: a prospective cohort study in Korea
Authors: Wie Gyung-Ah , Cho Yeong-Ah , Kang Hyun-hee , Ryu Kyoung-A , Yoo Min-Kyoung , Kim Young-A , Jung Kyu-Won , Kim Jeongseon , Lee Joo-Hyuk , Joung Hyojee
Published: April 2014

Cancer is a leading cause of death, and the dietary pattern in Korea is changing rapidly from a traditional Korean diet to a Westernised diet. In the present study, we investigated the effects of dietary factors on cancer risk with a prospective cohort study. Among 26 815 individuals who participated in cancer screening examinations from September 2004 to December 2008, 8024 subjects who completed a self-administered questionnaire concerning demographic and lifestyle factors, and a 3 d food record were selected. As of September 2013, 387 cancer cases were identified from the National Cancer Registry System, and the remaining individuals were included in the control group. The hazard ratio (HR) of cancer for the subjects older than or equal to 50 years of age was higher (HR 1·80, 95 % CI 1·41, 2·31; P< 0·0001) than that for the other subjects. Red meat consumption, Na intake and obesity (BMI ≥ 25 kg/m2) were positively associated with overall cancer incidence in men (HR 1·41, 95 % CI 1·02, 1·94; P= 0·0382), gastric cancer (HR 2·34, 95 % CI 1·06, 5·19; P= 0·0365) and thyroid cancer (HR 1·56, 95 % CI 1·05, 2·31; P= 0·0270), respectively. Participants who had at least three dietary risk factors among the high intakes of red meat and Na, low intakes of vegetables and fruits, and obesity suggested by the World Cancer Research Fund/American Institute for Cancer Research at baseline tended to have a higher risk of cancer than the others (HR 1·26, 95 % CI 0·99, 1·60; P= 0·0653). In summary, high intakes of red meat and Na were significant risk factors of cancer among Koreans.
The age-thickening of sweetened condensed milk: I. Rheological properties
Authors: Samel Ruth , Muers M. M.
Published: April 2014

The viscosity and flow properties of fresh and age-thickened separated sweetened condensed milk have been investigated using a rotating cylinder viscometer. The rheological properties, and the changes therein brought about by stirring, were studied by means of flow curves obtained by plotting stress against the corresponding rate of shear. Condensed milk during age-thickening is shown to develop thixotropic properties, with a high initial viscosity or ‘gel strength’ which, however, is easily reduced by stirring. On prolonged stirring the viscosity reaches a minimum (the ‘permanent’ viscosity), which becomes progressively higher as the age-thickening process continues. On storage subsequent to stirring there is only an insignificant recovery of the lost viscosity at room temperature, but a substantial recovery at higher temperature.

Sweetened condensed whey shows no age-thickening, and the casein-free supernatant liquids obtained by centrifuging dilutions of both fresh and age-thickened condensed milk have the same nitrogen contents and the same viscosities. This is interpreted to mean that the whey proteins play no significant part, directly or in association with casein, in the age-thickening process. Also the sedimentation rate of the casein during centrifuging is greater with age-thickened than with fresh condensed milk, which indicates an increase in casein particle size during agethickening.

The following working hypothesis is suggested to account for this behaviour. During age-thickening a slow irreversible change occurs in the size or shape of the casein micelles, probably by aggregation, which produces the rise in ‘permanent’ viscosity. These micelles orient themselves in such a way as to form a loose network enclosing some of the dispersion medium, thereby producing the large increase in the initial viscosity. On stirring, this network is broken down, and although it can reform in time at high temperatures, such recovery is greatly retarded at room temperature by the high viscosity of the aqueous phase containing the soluble constituents of the condensed milk.
Momentum Effect as Part of a Market Equilibrium
Authors: Choi Seung Mo , Kim Hwagyun
Published: April 2014

Does the momentum effect arise naturally from the determination of asset prices in market equilibrium? We calibrate a standard endowment model of multiple assets under recursive preferences. The momentum effect partly comes from investors’ aversion to consumption risks. An unexpected dividend increase generates a positive return and increases the asset’s proportion of consumption, raising the correlation between its future dividend growth and consumption growth. This is compensated by a higher expected return, generating the momentum effect. The cross-sectional difference in expected returns is also a key contributor. The quantified model produces sizable momentum profits, often close to the observed profits.
Can host ecology and kin selection predict parasite virulence?
Authors: GLEICHSNER ALYSSA M. , MINCHELLA DENNIS J.
Published: April 2014

Parasite virulence, or the damage a parasite does to its host, is measured in terms of both host costs (reductions in host growth, reproduction and survival) and parasite benefits (increased transmission and parasite numbers) in the literature. Much work has shown that ecological and genetic factors can be strong selective forces in virulence evolution. This review uses kin selection theory to explore how variations in host ecological parameters impact the genetic relatedness of parasite populations and thus virulence. We provide a broad overview of virulence and population genetics studies and then draw connections to existing knowledge about natural parasite populations. The impact of host movement (transporting parasites) and host resistance (filtering parasites) on the genetic structure and virulence of parasite populations is explored, and empirical studies of these factors usingPlasmodiumand trematode systems are proposed.
MARKOV MODELING AND DISCRETE EVENT SIMULATION IN HEALTH CARE: A SYSTEMATIC COMPARISON
Authors: Standfield Lachlan , Comans Tracy , Scuffham Paul
Published: April 2014

Objectives: The aim of this study was to assess if the use of Markov modeling (MM) or discrete event simulation (DES) for cost-effectiveness analysis (CEA) may alter healthcare resource allocation decisions.

Methods: A systematic literature search and review of empirical and non-empirical studies comparing MM and DES techniques used in the CEA of healthcare technologies was conducted.

Results: Twenty-two pertinent publications were identified. Two publications compared MM and DES models empirically, one presented a conceptual DES and MM, two described a DES consensus guideline, and seventeen drew comparisons between MM and DES through the authors’ experience. The primary advantages described for DES over MM were the ability to model queuing for limited resources, capture individual patient histories, accommodate complexity and uncertainty, represent time flexibly, model competing risks, and accommodate multiple events simultaneously. The disadvantages of DES over MM were the potential for model overspecification, increased data requirements, specialized expensive software, and increased model development, validation, and computational time.

Conclusions: Where individual patient history is an important driver of future events an individual patient simulation technique like DES may be preferred over MM. Where supply shortages, subsequent queuing, and diversion of patients through other pathways in the healthcare system are likely to be drivers of cost-effectiveness, DES modeling methods may provide decision makers with more accurate information on which to base resource allocation decisions. Where these are not major features of the cost-effectiveness question, MM remains an efficient, easily validated, parsimonious, and accurate method of determining the cost-effectiveness of new healthcare interventions.
COST-EFFECTIVENESS AND CLINICAL IMPLICATIONS OF ADVANCED BEARINGS IN TOTAL KNEE ARTHROPLASTY: A LONG-TERM MODELING ANALYSIS
Authors: Fennema Peter , Heyse Thomas J. , Uyl-de Groot Carin A.
Published: April 2014

Background:Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA). Advanced bearings are therefore required in TKA to reduce or eliminate wear-related loosening. A recently introduced bearing that combines oxidized zirconium with highly cross-linked PE has been shown to drastically reduce wear inin vitrosettings, due to its improved tribological characteristics in both tibial and femoral components. However, there are no data on its cost-effectiveness.

Data and Methods:A Markov model was developed to assess the cost-effectiveness of this low-wear bearing from a German societal perspective. The model population was derived from a registry of 75,000 patients requiring TKA. The model allocated patients to receive either a low-wear or standard articulation, and followed them until death. Revisions and re-revision were included. Input values were derived from registry databases or from published reports in the literature. Threshold analysis and probabilistic sensitivity analysis were conducted to estimate model robustness.

Results:The low-wear articulation prevented 24 (2.4 percent) revisions and 8 (0.8 percent) re-revisions. The total incremental cost-effectiveness ratio (ICER) of the low-wear articulation was EUR 16,474 per quality-adjusted life-year (QALY). For patients aged less than 55 years, an ICER of EUR 653 per QALY was observed. For patients aged over 75 years, this value was EUR 83,300. Threshold and probabilistic sensitivity analysis indicated that these findings were reasonably robust.

Conclusion:Low-wear articulations may be considered cost-effective, although the cost effectiveness is age-dependent, with the cost per QALY being significantly lower for younger people than for older people.
EVIDENCE, VALUES, AND DECISION MAKING
Authors: Rawlins Michael D.
Published: April 2014

Background: The evidence supporting the use of new, or established, interventions may be derived from either (or both) experimental or observational study designs. Although a rigorous examination of the evidence base for clinical and cost-effectiveness is essential, it is never sufficient, and those undertaking a health technology assessment (HTA) also have to exercise judgments.

Methods: The basis for this discussion is largely from the author's experience as chairman of the national Institute for Health and Clinical Excellence (NICE).

Results: The judgments necessary for HTA to make are twofold. Scientific judgments relate to the interpretation of the science. Social value judgments are concerned with the ethical principles, preferences, culture, and aspirations of society.

Conclusions: How scientific and social value judgments might be most appropriately captured is a challenge for all HTA agencies. Although competent HTA bodies should be able to exercise scientific judgments they have no legitimacy to impose their own social values. These must ultimately be informed by the general public.
Transposable character tables and group duality
Authors: ANDRUS IVAN , HEGEDŰS PÁL , OKUYAMA TETSURO
Published: April 2014

One way of expressing the self-duality $A\cong {\rm Hom}(A,\mathbb{C})$ of Abelian groups is that their character tables are self-transpose (in a suitable ordering). In this paper we extend the duality to some noncommutative groups considering when the character table of a finite group is close to being the transpose of the character table for some other group. We find that groups dual to each other have dual normal subgroup lattices. We show that our concept of duality cannot work for non-nilpotent groups and we describe p-group examples.
Campylobacterinfections in children exposed to infected backyard poultry in Egypt
Authors: EL-TRAS W. F. , HOLT H. R. , TAYEL A. A. , EL-KADY N. N.
Published: April 2014

Campylobacteriosis is a zoonotic disease which has a worldwide public health impact. The disease is endemic in Egypt; however, the epidemiology in animals and humans has not been fully characterized. The objective of this study was to compare the risk ofCampylobacterfaecal carriage in children exposed toCampylobacter-infectedvs.non-infected backyard poultry and to identify risk factors for a backyard being classified as infected. A total of 103 households which owned backyard poultry were sampled from a rural community in Egypt. Within these households 379 poultry and 106 children were tested forC. jejuniandC. coli; 23·5% and 5·5% of poultry were positive forC. jejuniandC. coli, respectively. In the studied households; 12·3% of children were positive forC. jejuni, and 2·8% were positive forC. coli. Using logistic regression, households with poultry positive forC. jejunihad 3·86 (95% confidence interval 1·0–15·0) times the odds of having children positive forC. jejunicompared to those housed with poultry which all tested negative. Backyard poultry may present a transmission route ofC. jejunito children. Backyards with poor cleaning and disinfection, wet litter and manure disposed of within the backyard had increased odds of being positive forC. jejuni. Enhancing biosecurity and management in poultry backyards may reduce the risk of the disease.
Consequentialist Options
Authors: SUIKKANEN JUSSI
Published: April 2014

According to traditional forms of act-consequentialism, an action is right if and only if no other action in the given circumstances would have better consequences. It has been argued that this view does not leave us enough freedom to choose between actions which we intuitively think are morally permissible but not required options. In the first half of this article, I will explain why the previous consequentialist responses to this objection are less than satisfactory. I will then attempt to show that agents have more options on consequentialist grounds than the traditional forms of act-consequentialism acknowledged. This is because having a choice between many permissible options can itself have value.
Overdemanding Consequentialism? An Experimental Approach
Authors: BRUDER MARTIN , TANYI ATTILA
Published: April 2014

According to act-consequentialism the right action is the one that produces the best results as judged from an impersonal perspective. Some claim that this requirement is unreasonably demanding and therefore consequentialism is unacceptable as a moral theory. The article breaks with dominant trends in discussing this so-called Overdemandingness Objection. Instead of focusing on theoretical responses, it empirically investigates whether there exists a widely shared intuition that consequentialist demands are unreasonable. This discussion takes the form of examining what people think about the normative significance of consequentialist requirements. In two experiments, the article finds that although people are sensitive to consequentialist requirements and, on average, find more extreme demands less reasonable, the level of disagreement with consequentialism falls short of qualifying as a widely shared intuition, even when demands are the highest. The article then ends with a general discussion of possible objections to its methods and its findings.
Triple outlet right ventricle: a previously unknown cardiac malformation
Authors: Tingo Jennifer E. , Carroll Sheila J. , Crystal Matthew A.
Published: April 2014

We present the case of an infant with three distinct outflow tracts from the right ventricle. Three outlets from the heart have been previously named the “Tritruncal Heart”. We review the two previously reported cases of tritruncal hearts and describe the anatomy, diagnosis, surgical management, and outcome of our case. Embryologic implications are also discussed.
The prevalence of attention-deficit/hyperactivity disorder following neonatal aortic arch repair
Authors: Sistino Joseph J. , Atz Andrew M. , Simpson Kit N. , Ellis Charles , Ikonomidis John S. , Bradley Scott M.
Published: April 2014

Objective: We sought to determine the prevalence of attention-deficit/hyperactivity disorder in a population of children who underwent neonatal heart surgery involving repair of the aortic arch for Norwood Stage I, interrupted aortic arch, and combined repair of aortic coarctation with ventricular septal defect. Methods: Children between the ages of 5 and 16 were surveyed using the ADHD-IV and the Child Heath Questionnaire-50. Classification as attention-deficit/hyperactivity disorder was defined for this study as either a parent-reported diagnosis of attention-deficit/hyperactivity disorder or ADHD-IV inattention score of ⩾93 percentile. Results: Of the 134 surveys, 57 (43%) were returned completed. A total of 25 (44%) children either had a diagnosis of attention-deficit/hyperactivity disorder and/or ADHD-IV inattention score ⩾93 percentile. Eleven of the 13 (85%) children with interrupted aortic arch, 3 of the 7 (42.9%) children with combined coarctation/ventricular septal defect repair, and 9 of the 33 (27.3%) children with hypoplastic left-heart syndrome were classified as having attention-deficit/hyperactivity disorder. Only 7 of the 25 (28%) children received medical treatment for this condition. Quality of life indicators in the Child Heath Questionnaire-50 Questionnaire were highly correlated with the ADHD-IV scores. Conclusion: The risks for the development of attention-deficit/hyperactivity disorder are multifactorial but are significantly increased in this post-surgical population. This study revealed a low treatment rate for attention-deficit/hyperactivity disorder, and a significant impact on the quality of life in these children.
Prophylactic antibiotics in interventional paediatric cardiac catheterisation: old habits die hard?
Authors: Gillett Christopher D. , Morgan Gareth J.
Published: April 2014

Antibiotic prophylaxis in congenital cardiac disease has long been a topic of debate. Although there is little dispute around antibiotic cover for surgical procedures and catheter interventions where foreign material is being inserted, there are little data specific to non-device-placement procedures such as atrial septostomy or balloon valvotomy. We sought to assess the effect of routine prophylaxis on post-interventional infections via a retrospective pseudo-randomised analysis, and an online survey on paediatric interventional cardiologists in the United Kingdom and United States.
Visions of the Self in Late Medieval Christianity: Some Cross-Disciplinary Reflections
Authors: Coakley Sarah
Published: April 2014

In a volume devoted to philosophy, religion and the spiritual life, I would like to focus the later part of my essay on a comparison of two Christian spiritual writings of the fourteenth century, the anonymous Cloud of Unknowing in the West (1981), and the Triadsof Gregory Palamas in the Byzantine East (1983). Their examples, for reasons which I shall explain, seem to me rich with implications for some of our current philosophical and theological aporias on the nature of the self. Let me explain my thesis in skeletal form at the outset, for it is a complex one, and has several facets.
China – Electronic Payment Services: discrimination, economic development and the GATS
Authors: HOEKMAN BERNARD , MEAGHER NIALL
Published: April 2014

This paper provides a legal–economic analysis of the unappealed WTO Panel Report inChina – Certain Measures Affecting Electronic Payment Services(WT/DS413/R). The core issue was whether China's measures that resulted in there being only one dominant supplier of electronic payment services (EPS) in China violated the specific commitments made by China under the GATS. The panel ruled that the measures did not violate China's market access commitments because there were no explicit limitations on the entry of foreign suppliers, but that the measures were inconsistent with China's national treatment commitments in that they modified the conditions of competition in favour of domestic suppliers. This case illustrates the complexity in interpreting WTO Members’ commitments under the GATS.
What is not so Cool aboutUS–COOLRegulations? A critical analysis of the Appellate Body's ruling onUS–COOL
Authors: MAVROIDIS PETROS C. , SAGGI KAMAL
Published: April 2014

InUS–COOL, the Appellate Body (AB) of the World Trade Organization (WTO) found that the US measure imposing country of origin labelling (COOL) requirements on livestock of domestic, foreign, and mixed origin was in violation of the obligation to avoid discrimination embedded in Article 2.1 of the WTO Agreement on Technical Barriers to Trade (TBT). We argue that the AB could not and should not have reached this decision based on the information available to it. The AB adopted an erroneous methodology: under its view, the consistency of a measure coming under the purview of the TBT can be examined under Article 2.1 irrespective of its evaluation under Article 2.2 thereby making the two obligations distinct. The AB also failed to address the central question raised by this dispute: Does there exist an alternative to COOL that is less trade restrictive? We argue that the over-arching issue in this case should have been to determine what, if anything, the TBT Agreement did to alter or enhance the obligation of non-discrimination that was already embedded in the arsenal of the multilateral trading rules. Unless the AB asks this question in subsequent case law pertaining to the TBT, we risk seeing repetitions of similar mistakes in the future.
United States – Measures Affecting Trade in Large Civil Aircraft (Second Complaint): some comments
Authors: NEVEN DAMIEN , SYKES ALAN
Published: April 2014

This paper provides limited comments on portions of the Appellate Body (AB) judgment. With respect to the existence of a subsidy under contracts with NASA and DOD, we find the discussion of whether Boeing has received a financial contribution to be a distraction from the core issue – whether the mix of monetary compensation, access to government personnel and facilities, and IP rights ‘overcompensated’ Boeing for the services it rendered (or whether the government paid more for those services than they were worth to the government). The panel's analysis of this core issue, which focused on whether Boeing was the principal beneficiary of the contracts, is flawed, but the alternative approach of the AB is equally flawed. The analogy between an R&D joint venture and equity infusion is dubious, and the existence of a benefit simply does not turn on how one dimension of the contract (the allocation of the resulting intellectual property rights (IP)) is specified. We also argue that even a contract that confers a ‘benefit’ (or economic rent) on Boeing could still be an efficient arrangement for the allocation of cost and prospective revenues between the two partners. With respect to adverse effects, we argue that the panel and AB failed to develop an adequate counterfactual with respect to product developments; that is, it is not implausible that if Boeing had not received a subsidy and would accordingly have developed the 787 later, Airbus would also have delayed the development of the A350. To determine the existence of adverse effects, the panel and AB should have considered the profit (or sales) of Airbus relative to what would have happened in this counterfactual world. Finally, we observe that the analysis of lost sales and ‘price suppression’ fails to consider the specific features of competition in the aircraft industry. Unlike what happens in the market with posted prices, when contracts are individually negotiated, whether the outcome of competition is affected by a subsidy depends on the relative cost position of the bidders. When Boeing is the lowest cost bidder, the only effect of the subsidy is to increase its rent, with no effect on sales or prices for Airbus.
China – Countervailing and Anti-dumping Duties on Grain Oriented Flat-rolled Electrical Steel from the United States: exporting US AD/CVD methodologies through WTO dispute settlement?
Authors: PRUSA THOMAS J. , VERMULST EDWIN
Published: April 2014

In July 2009, Chinese steel producers of grain oriented electrical steel filed anti-dumping (AD) and countervailing duty (CVD) cases against US and Russian producers. The US challenged the duties for a variety a reasons, many of which involved deficiencies in the producers' application to China's investigating authority, the Ministry of Commerce of the People's Republic of China (MOFCOM). The US also challenged certain aspects of MOFCOM's injury analysis. The Panel and Appellate Body ruled in favor of the US on virtually every issue. Given the deficiencies in the application and China's handling of the case, the Panel and AB decisions were justified. In a larger sense, however, we believe China may well emerge as the ‘winner’ in this dispute as this case establishes important standards for allegations and evidence in applications, standards that other countries (including the US) likely have failed to meet when they have imposed AD and CVD orders on the largest target country, China.
Safeguards and the perils of preferential trade agreements:Dominican Republic–Safeguard Measures
Authors: BOWN CHAD P. , WU MARK
Published: April 2014

The legal-economic implications of how WTO members apply an import-restricting safeguard measure become more complex in light of the increasing web of trade concessions undertaken through their preferential trade agreements (PTAs) in addition to their WTO commitments. This paper examines a number of complex issues that arose in the WTO litigation between five new PTA partners through theDominican Republic–Safeguard Measuresdisputes. First, we highlight the difficulties in assessing the extent to which safeguards imposed following a PTA are the result of PTA concessions relative to developments that pre-date or are otherwise unrelated to the PTA. Second, we examine how the WTO Panel resolved a number of previously unanswered questions in the WTO's safeguards jurisprudence that arose in these cases. We suggest that the Panel rightly foreclosed a number of potentially dubious practices that WTO members might otherwise have pursued when using safeguards to circumvent trade concessions. Third, we identify how safeguard-related provisions within a PTA may give rise to constraints that subsequently affect how a country may apply safeguards available under the WTO Agreements, and we describe some implications for PTA design and negotiation. Finally, we analyze the broader implications that arise from the interplay of PTAs, safeguards, and dispute settlement in light of the availability of both relatively substitutable policy instruments and dispute resolution forums.
“It's been quite a challenge”: Redesigning end-of-life care in acute hospitals
Authors: Hewison Alistair , Lord Laura , Bailey Cara
Published: April 2014

Objective:

This paper reports the findings of an interview-based study undertaken to investigate the introduction of end-of-life (EoL) care pathways in three acute trusts, as part of a larger project examining service redesign. The aim was to examine the barriers to and facilitators of change.

Method:

Twenty-one in-depth qualitative interviews were conducted with staff working in three National Health Service (NHS) acute hospital trusts. These staff members were involved in end-of-life care, and their accounts were analyzed to identify the key issues when introducing service changes in these settings.

Results:

Thematic analysis revealed five major themes—two of which, leadership and facilitation, and education and training, indicate what needs to be in place if end-of-life care pathways are to be adopted by staff. However, the remaining three themes of difficult conversations, diagnosing dying, and communication across boundaries highlight particular areas of practice and organization that need to be addressed before end-of-life care in hospitals can be improved.

Significance of results:

Organization of end-of-life care in acute hospitals is challenging, and care pathways provide a degree of guidance as to how services can be delivered. However, even when there is effective leadership at all levels of an organization and an extensive program of education for all staff support the use of care pathways, significant barriers to their introduction remain. These include staff anxieties concerning diagnosing dying and discussing dying and end-of-life care planning with patients and their families. It is hoped these findings can inform the development of the proposed new care plans which are set to replace end of life care pathways in England.