bluuebunny/crossref_metadata_2025 huggingface dataset:
Tickets … and More Tickets: A Case Study of the Enforcement of the Ontario Safe Streets Act
Authors: O’Grady Bill , Gaetz Stephen , Buccieri Kristy
Published: December 2013

Anti-social behaviour statutes are proliferating in western societies, yet little statistical analysis has been conducted on their enforcement patterns and trends, particularly in Canada. A study of the Ontario Safe Streets Act enforcement in Toronto shows a 2,000 percent increase in tickets from 2000 to 2010, with most being issued downtown to homeless individuals. Further research shows that this increase is not the result of increasing crime rates, increases in aggressive solicitation practices, widespread complaints from businesses or the public, or police responses to gangs, nor is it for revenue generation. We argue such anti-social behaviour statutes are a misguided public policy response to the visibility of homelessness.
Inequality below the Surface: Reviewing Immigrants’ Access to and Utilization of Five Canadian Welfare Programs
Authors: Koning Edward A. , Banting Keith G.
Published: December 2013

Since the 1990s, many Western countries have implemented restrictions on immigrants’ access to welfare programs, thereby creating new lines of exclusion between immigrants and the native-born. Canada is commonly seen to have resisted this trend. This view overlooks, however, that exclusion can come in different forms. In addition to direct formal exclusion from welfare programs, immigrants can also have more limited access because of indirect or informal mechanisms of differentiation. Reviewing five core welfare programs, this paper shows that direct, indirect, and informal types of exclusion exist in the Canadian welfare state, albeit with different consequences for different categories of newcomers. While this conclusion is not meant to suggest that immigrants face as much exclusion as they do in some other Western countries, it does demonstrate the need to avoid the complacency regarding immigrants’ social rights in Canada.
Ideal Friendship and the Paradoxes of Narration in Sarah Fielding’s David Simple
Authors: Mangano Bryan
Published: December 2013

Sarah Fielding’s The Adventures of David Simple and David Simple, Volume the Last engage with the social category of real friendship not only in representations of character ties, but also in the development of a third-person narrator that works to embody ideal amity through a triangulation of the reader’s attitude towards characters. In contrasting instances of true and false friendship, the novels generate a radical scepticism that the narrator must deflect by managing access to characters in a manner that stimulates the reader’s faith in their affections. The narrator’s performance of friendship towards character and reader generates contradictions around the epistemology of knowing other minds, the ethics of friendly intimacy, and power relations between writer and audience. In this article, I argue that Fielding’s technique suggests the broader significance of ideal friendship as a privileged moral concept for the history of eighteenth-century fiction.
Impact of PhD training on scholarship in a neurosurgical career
Authors: Choi Bryan D. , DeLong Michael R. , DeLong David M. , Friedman Allan H. , Sampson John H.
Published: December 2013

Object

The purpose of this study was to report the prevalence of neurosurgeons with both medical degrees (MDs) and doctorates (PhDs) at top-ranked US academic institutions and to assess whether the additional doctorate education is associated with substantive career involvement in academia as well as greater success in procuring National Institutes of Health (NIH) research funding compared with an MD-only degree.

Methods

The authors reviewed the training of neurosurgeons across the top 10 neurosurgery departments chosen according to academic impact (h index) to examine whether MD-PhD training correlated significantly with career outcomes in academia.

Results

Six hundred thirteen neurosurgery graduates and residents between the years 1990 and 2012 were identified for inclusion in this analysis. Both MD and PhD degrees were held by 121 neurosurgeons (19.7%), and an MD alone was held by 492. Over the past 2 decades, MD-PhD trainees represented a gradually increasing percentage of neurosurgeons, from 10.2% to 25.7% (p < 0.01). Of the neurosurgeons with MD-PhD training, a greater proportion had appointments in academic medicine compared with their MD-only peers (73.7% vs 52.3%, p < 0.001). Academic neurosurgeons with both degrees were also more likely to have received NIH funding (51.9% vs 31.8%, p < 0.05) than their single-degree counterparts in academia. In a national analysis of all active NIH R01 grants awarded in neurosurgery, MD-PhD investigators held a disproportionate number, more than 4-fold greater than their representation in the field.

Conclusions

Dual MD-PhD training is a significant factor that may predict active participation in and funding for research careers among neurological surgeons at top-ranked academic institutions. These findings and their implications are of increasing relevance as the population of neurosurgeons with dual-degree training continues to rise.
An analysis of publication productivity for 1225 academic neurosurgeons and 99 departments in the United States
Authors: Khan Nickalus R. , Thompson Clinton J. , Taylor Douglas R. , Venable Garrett T. , Wham R. Matthew , Michael L. Madison , Klimo Paul
Published: December 2013

Object

Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery is in its infancy. The authors calculate a number of publication productivity measures for almost all academic neurosurgeons and departments within the US.

Methods

The h-index, g-index, m-quotient, and contemporary h-index (hc-index) were calculated for 1225 academic neurosurgeons in 99 (of 101) programs listed by the Accreditation Council for Graduate Medical Education in January 2013. Three currently available citation databases were used: Google Scholar, Scopus, and Web of Science. Bibliometric profiles were created for each surgeon. Comparisons based on academic rank (that is, chairperson, professor, associate, assistant, and instructor), sex, and subspecialties were performed. Departments were ranked based on the summation of individual faculty h-indices. Calculations were carried out from January to February 2013.

Results

The median h-index, g-index, hc-index, and m-quotient were 11, 20, 8, and 0.62, respectively. All indices demonstrated a positive relationship with increasing academic rank (p < 0.001). The median h-index was 11 for males (n = 1144) and 8 for females (n = 81). The h-index, g-index and hc-index significantly varied by sex (p < 0.001). However, when corrected for academic rank, this difference was no longer significant. There was no difference in the m-quotient by sex. Neurosurgeons with subspecialties in functional/epilepsy, peripheral nerve, radiosurgery, neuro-oncology/skull base, and vascular have the highest median h-indices; general, pediatric, and spine neurosurgeons have the lowest median h-indices. By summing the manually calculated Scopus h-indices of all individuals within a department, the top 5 programs for publication productivity are University of California, San Francisco; Barrow Neurological Institute; Johns Hopkins University; University of Pittsburgh; and University of California, Los Angeles.

Conclusions

This study represents the most detailed publication analysis of academic neurosurgeons and their programs to date. The results for the metrics presented should be viewed as benchmarks for comparison purposes. It is our hope that organized neurosurgery will adopt and continue to refine bibliometric profiling of individuals and departments.
Quality of life after surgical treatment of primary intramedullary spinal cord tumors in children
Authors: Schneider Christian , Hidalgo Eveline Teresa , Schmitt-Mechelke Thomas , Kothbauer Karl F.
Published: December 2013

Object

Presently, the best available treatment for intramedullary spinal cord tumors (IMSCTs) in children is microsurgery with the objective of maximal tumor removal and minimal neurological morbidity. The latter has become manageable with the development and standard use of intraoperative neurophysiological monitoring. Traditionally, the perioperative neurological evaluation is based on surgical or spinal cord injury scores focusing on sensorimotor function. Little is known about the quality of life after such operations; therefore, this study was designed to investigate the impact of surgery for IMSCTs on the quality of life in children.

Methods

Twelve consecutive pediatric patients treated for IMSCT were included in this retrospective fixed cohort study. A multidimensional questionnaire-based quality of life instrument, the Pediatric Quality of Life Questionnaire version 4 (PedsQL 4.0), was chosen to analyze follow-up data. This validated instrument particularly allows for a comparison between a patient cohort and a healthy pediatric sample population.

Results

Of 11 mailed questionnaires (1 patient had died of progressive disease), 10 were returned, resulting in a response rate of 91%. There were 8 low-grade lesions (5 pilocytic astrocytomas, 1 ganglioglioma, 1 hemangioblastoma, and 1 cavernoma) and 4 high-grade lesions (2 anaplastic gangliogliomas, 1 glioblastoma, and 1 glioneuronal tumor). The mean age at diagnosis was 7.5 years, the mean follow-up was 4.2 years, and 83% of the patients were male. Total resection was achieved in 5 patients and subtotal resection in 7. Four patients had undergone 2 or more resections. The 4 patients with high-grade tumors and 2 with incompletely resected low-grade tumors underwent adjuvant treatment (2 chemotherapy and 4 both radiotherapy and chemotherapy). The mean modified McCormick Scale score at the time of diagnosis was 1.7; at the time of follow-up, 1.5. The mean PedsQL 4.0 total score in the low-grade group was 78.5; in the high-grade group, 82.6. There was no significant difference in PedsQL 4.0 scores between the patient cohort and the normal population.

Conclusions

In a small cohort of children who had undergone surgery for IMSCTs with a mean follow-up of 4.2 years, quality of life scores according to the PedsQL 4.0 instrument were not different from those in a normal sample population.
Distal cordectomies as treatment for lumbosacral myelomeningoceles
Authors: Albright A. Leland , Okechi Humphrey
Published: December 2013

Object

The purpose of this study was to evaluate the effect of distal cordectomies on motor function in the lower extremities of infants with lumbosacral myelomeningoceles.

Methods

Medical records were reviewed in 32 infants with lumbosacral myelomeningoceles who were 1 day to 7 months old, who had some lower-extremity function preoperatively, and who were treated by distal cordectomies, dividing the cord between its exit from the intact spinal canal and the neural placode. Neurological function was evaluated before and after operation by therapists who were unaware of the surgical technique.

Results

Neurological function was unchanged after operation in 29 of 32 cases. For the others, hip flexion, foot plantar flexion, and toe movement were lost in 1 case each.

Conclusions

The majority of infants treated by distal cordectomies retain preoperative motor function after operation.
Spondylolysis of C-2 in children 3 years of age or younger: clinical presentation, radiographic findings, management, and outcomes with a minimum 12-month follow-up
Authors: Gressot Loyola V. , Vadivelu Sudhakar , Hwang Steven W. , Fulkerson Daniel H. , Luerssen Thomas G. , Jea Andrew
Published: December 2013

Object

Cervical spondylolysis is a rare condition that results from a pars interarticularis defect. The C-6 level is the most frequently involved site in the cervical spine. Its clinical presentations range from incidental radiographic findings to neck pain and, rarely, neurological deficits. Although 150 patients with subaxial cervical spondylolysis have been reported, a mere 24 adult and pediatric patients with C-2 spondylolysis have been described. The long-term outcomes of very young children with bilateral C-2 spondylolysis are of great interest, yet only a few longitudinal studies exist.

Methods

The authors retrospectively reviewed 5 cases of bilateral C-2 spondylolysis at Texas Children's Hospital and Riley Children's Hospital; these were combined with 5 other cases in the literature, yielding a total of 10 patients. Data regarding the patients' age, sex, C2–3 angulation and displacement, associated spine anomalies, neurological deficits, treatment, and most recent follow-up were recorded.

Results

The patients' ages ranged from 3 to 36 months (mean 12.9 months). There were 6 boys and 4 girls. The C2–3 angulation, displacement, and width of pars defect were measured when available. The mean C2–3 angulation was 9.5° (range 1–34°), the mean C2–3 displacement was 4.78 mm (range 1.1–10.8 mm), and the mean width of the pars defect was 4.16 mm (range 0.9–7 mm). One patient developed myelopathy and spinal cord injury. All 10 of the patients were treated initially with conservative therapy: 3 with close observation alone, 1 with a rigid cervical collar, 4 with a Minerva jacket, 1 with a sternal-occipital-mandibular immobilizer, and 1 with a halo vest. Three patients ultimately underwent surgery for internal fixation due to progressive instability or development of neurological symptoms. All patients were neurologically intact at the last follow-up (mean 44.3 months, range 14–120 months).

Conclusions

Based on the literature and the authors' own experience, they conclude that most very young children with C-2 spondylolysis remain neurologically intact and maintain stability in long-term follow-up despite the bony defect. This defect is often an asymptomatic incidental finding and may be managed conservatively. More aggressive therapy including surgery is indicated for those patients with a neurological deficit from spinal cord compromise secondary to stenosis and local C-2 kyphosis, progressive deformity, or worsening C2–3 instability.
Surgeon-industry conflict of interest: survey of opinions regarding industry-sponsored educational events and surgeon teaching
Authors: DiPaola Christian P. , Dea Nicolas , Dvorak Marcel F. , Lee Robert S. , Hartig Dennis , Fisher Charles G.
Published: December 2013

Object

Conflict of interest (COI) as it applies to medical education and training has become a source of considerable interest, debate, and regulation in the last decade. Companies often pay surgeons as faculty for educational events and often sponsor and give financial support to major professional society meetings. Professional medical societies, industry, and legislators have attempted to regulate potential COI without consideration for public opinion. The practice of evidence-based medicine requires the inclusion of patient opinion along with best available evidence and expert opinion. The primary goal of this study was to assess the opinion of the general population regarding surgeon-industry COI for education-related events.

Methods

A Web-based survey was administered, with special emphasis on the surgeon's role in industry-sponsored education and support of professional societies. A survey was constructed to sample opinions on reimbursement, disclosure, and funding sources for educational events.

Results

There were 501 completed surveys available for analysis. More than 90% of respondents believed that industry funding for surgeons' tuition and travel for either industry-sponsored or professional society educational meetings would either not affect the quality of care delivered or would cause it to improve. Similar results were generated for opinions on surgeons being paid by industry to teach other surgeons. Moreover, the majority of respondents believed it was ethical or had no opinion if surgeons had such a relationship with industry. Respondents were also generally in favor of educational conferences for surgeons regardless of funding source. Disclosures of a surgeon-industry relationship, especially if it involves specific devices that may be used in their surgery, appears to be important to respondents.

Conclusions

The vast majority of respondents in this study do not believe that the quality of their care will be diminished due to industry funding of educational events, for surgeon tuition, and/or travel expenses. The results of this study should help form the basis of policy and continued efforts at surgeon-industry COI management.
Three-dimensional motion analysis of the cervical spine for comparison of anterior cervical decompression and fusion versus artificial disc replacement in 17 patients
Authors: McDonald Colin P. , Chang Victor , McDonald Michael , Ramo Nicole , Bey Michael J. , Bartol Stephen
Published: December 2013

Object

Cervical arthroplasty with an artificial disc (AD) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF) for the management of cervical spondylosis. This study aims to provide 3D motion analysis data comparing patients after ACDF and AD replacement.

Methods

Ten patients who underwent C5–6 ACDF and 7 who underwent C5–6 AD replacement were enrolled. Using biplanar fluoroscopy and a model-based track technique (accurate up to 0.6 mm and 0.6°), motion analysis of axial rotation and flexion-extension of the neck was performed. Three nonoperative segments (C3–4, C4–5, and C6–7) were assessed for both intervertebral rotation (coronal, sagittal, and axial planes) and facet shear (anteroposterior and mediolateral).

Results

There was no difference in total neck motion comparing ACDF and AD replacement for neck extension (43.3° ± 10.2° vs 44.3° ± 12.6°, p = 0.866) and rotation (36.0° ± 6.5° vs 38.2° ± 9.3°, p = 0.576). For extension, when measured as a percentage of total neck motion, there was a greater amount of rotation at the nonoperated segments in the ACDF group than in the AD group (p = 0.003). When comparing specific motion segments, greater normalized rotation was seen in the ACDF group at C3–4 (33.2% ± 4.9% vs 26.8% ± 6.6%, p = 0.036) and C6–7 (28.5% ± 6.7% vs 20.5% ± 5.5%, p = 0.009) but not at C4–5 (33.5% ± 6.4% vs 31.8% ± 4.0%, p = 0.562). For neck rotation, greater rotation was observed at the nonoperative segments in the ACDF group than in the AD group (p = 0.024), but the differences between individual segments did not reach significance (p ≥ 0.146). Increased mediolateral facet shear was seen on neck extension with ACDF versus AD replacement (p = 0.008). Comparing each segment, C3–4 (0.9 ± 0.5 mm vs 0.4 ± 0.1 mm, p = 0.039) and C4–5 (1.0 ± 0.4 mm vs 0.5 ± 0.2 mm, p = 0.022) showed increased shear while C6–7 (1.0 ± 0.4 mm vs 1.0 ± 0.5 mm, p = 0.767) did not.

Conclusions

This study illustrates increased motion at nonoperative segments in patients who have undergone ACDF compared with those who have undergone AD replacement. Further studies will be required to examine whether these changes contribute to adjacent-segment disease.
The accuracy of pedicle screw placement using intraoperative image guidance systems
Authors: Mason Alexander , Paulsen Renee , Babuska Jason M. , Rajpal Sharad , Burneikiene Sigita , Nelson E. Lee , Villavicencio Alan T.
Published: December 2013

Object

Several retrospective studies have demonstrated higher accuracy rates and increased safety for navigated pedicle screw placement than for free-hand techniques; however, the accuracy differences between navigation systems has not been extensively studied. In some instances, 3D fluoroscopic navigation methods have been reported to not be more accurate than 2D navigation methods for pedicle screw placement. The authors of this study endeavored to identify if 3D fluoroscopic navigation methods resulted in a higher placement accuracy of pedicle screws.

Methods

A systematic analysis was conducted to examine pedicle screw insertion accuracy based on the use of 2D, 3D, and conventional fluoroscopic image guidance systems. A PubMed and MEDLINE database search was conducted to review the published literature that focused on the accuracy of pedicle screw placement using intraoperative, real-time fluoroscopic image guidance in spine fusion surgeries. The pedicle screw accuracy rates were segregated according to spinal level because each spinal region has individual anatomical and morphological variations. Descriptive statistics were used to compare the pedicle screw insertion accuracy rate differences among the navigation methods.

Results

A total of 30 studies were included in the analysis. The data were abstracted and analyzed for the following groups: 12 data sets that used conventional fluoroscopy, 8 data sets that used 2D fluoroscopic navigation, and 20 data sets that used 3D fluoroscopic navigation. These studies included 1973 patients in whom 9310 pedicle screws were inserted. With conventional fluoroscopy, 2532 of 3719 screws were inserted accurately (68.1% accuracy); with 2D fluoroscopic navigation, 1031 of 1223 screws were inserted accurately (84.3% accuracy); and with 3D fluoroscopic navigation, 4170 of 4368 screws were inserted accurately (95.5% accuracy). The accuracy rates when 3D was compared with 2D fluoroscopic navigation were also consistently higher throughout all individual spinal levels.

Conclusions

Three-dimensional fluoroscopic image guidance systems demonstrated a significantly higher pedicle screw placement accuracy than conventional fluoroscopy or 2D fluoroscopic image guidance methods.
Coexistence of multiple cavernous angiomas in the spinal cord and skin: a unique case of Cobb syndrome
Authors: Matsui Yuya , Mineharu Yohei , Satow Takeshi , Takebe Noriyoshi , Takeuchi Eiji , Saiki Masaaki
Published: December 2013

Cobb syndrome is a rare, noninherited, neurocutaneous disease characterized by vascular abnormality of the spinal cord and is associated with vascular lesions in the skin at the same metamere. The majority of spinal vascular lesions are arteriovenous malformations, and skin lesions are mostly port-wine angiomas. The authors report the first case of multiple intramedullary cavernous angiomas (CAs) accompanied by skin CAs within the same metamere. A 42-year-old man presented with an acute onset of gait disturbance, low-back pain, and urinary incontinence. Magnetic resonance imaging of the thoracolumbar spine showed homogeneously enhanced lesions on a contrast-enhanced T1-weighted image and a hypointense area on a T2*-weighted image surrounding this enhanced lesion, between the T-12 and S-1 levels. Purple protruding skin lesions were detected on the left side of his gluteal region. The patient received a laminectomy followed by evacuation of a hematoma and partial removal of the tumor, which completely resolved his neurological symptoms. Pathological examinations showed that the spinal and skin lesions were CAs, suggesting that these vascular lesions developed congenitally. Cavernous angiomas associated with Cobb syndrome present with multiple lesions spanning more than 3 vertebral levels, making it difficult to completely resect these tumors. Although Cobb syndrome is an uncommon disease entity, it should be considered if a patient manifesting with neurological deficits has skin vascular lesions, including CAs.
Spontaneous spinal epidural abscess in patients 50 years of age and older: a 15-year institutional perspective and review of the literature
Authors: Adogwa Owoicho , Karikari Isaac O. , Carr Kevin R. , Krucoff Max , Ajay Divya , Fatemi Parastou , Perez Edgar L. , Cheng Joseph S. , Bagley Carlos A. , Isaacs Robert E.
Published: December 2013

Object

A spinal epidural abscess (SEA) is a rare but severe infection requiring prompt recognition and management. The incidence of SEA has doubled in the past decade, owing to an aging population and to increased use of spinal instrumentation and vascular access. The optimal management of SEAs in patients 50 years of age and older remains a matter of considerable debate. In an older patient population with multiple comorbidities, whether intravenous antibiotics alone or in combination with surgery lead to superior outcomes remains unknown. The present study retrospectively analyzes cases of SEAs, in patients 50 years of age and older, treated at Duke University Medical Center over the past 15 years.

Methods

Eighty-two patients underwent treatment for a spinal epidural abscess between 1999 and 2013. There were 46 men and 36 women, whose overall mean age (± SD) was 65 ± 8.58 years (range 50–82 years). The mean duration of clinical follow-up was 41.38 ± 86.48 weeks. Thirty patients (37%) underwent surgery for removal of the abscess, whereas 52 (63%) were treated more conservatively, undergoing CT-guided aspiration or receiving antibiotics alone based on the results of blood cultures. The correlation between pretreatment variables and outcomes was evaluated in a multivariate regression analysis.

Results

Back pain and severe motor deficits were the most common presenting symptoms. Compared with baseline neurological status, the majority of patients (68%) reported being neurologically “better” or “unchanged.” Twelve patients (15%) had a good outcome (7 [23%] treated operatively vs 5 [10%] treated nonoperatively, p = 0.03), while clinical status in 41 patients (50%) remained unchanged (10 [33%] treated operatively vs 31 [60%] treated nonoperatively, p = 0.01). Overall, 20 patients (25%) died (9 [30%] treated operatively vs 11 [21%] treated nonoperatively, p = 0.43). In a multivariate logistic regression model, an increasing baseline level of pain, the presence of paraplegia or quadriplegia on initial presentation, and a dorsally located SEA were independently associated with poor outcomes.

Conclusions

The results of the study suggest that in patients 50 years of age and older, early surgical decompression combined with intravenous antimicrobial therapy was not associated with superior clinical outcomes when compared with intravenous antimicrobial therapy alone.
Ethical Challenges of Using bST and Transgenic Animal
Authors: Bhuiyan ASM Anwarullah
Published: December 2013

This article examines whether using Bovine Somatotrophin (bST) and Transgenic Animal is compatible with the norms of animal welfare, environment, and public health. We cannot oppose its usefulness all on a sudden. Despite the usefulness of animal biotechnology, we cannot ignore the different adverse effects of this technology. All of these bring forth different ethical challenges. What is the environmental impact of this technology? Another ethical challenge is related to animals welfare and humans health. In order to assessing the ethical challenges, this article has opted for Mephams ethical matrix, which is a practical approach for addressing broader policy issues. I have focused on the application of this ethical matrix upon some contexts of animal biotechnology, such as bST and transgenic animal. Through the analysis, this article came to the conclusion that there are no short curt ways to reach an agreement on the application of animal biotechnology. DOI: http://dx.doi.org/10.3329/bioethics.v4i3.17372 Bangladesh Journal of Bioethics 2013; 4(3):1-10
Ethical Debate on Animal Research
Authors: Nurunnabi Abu Sadat Mohammad , Afroz Rokhsana Dil , Alam Salman Nur
Published: December 2013

Animal research or animal testing is done worldwide, where vertebrate animals, from zebrafish to non-human primates, millions in number are used annually. The practice is regulated to various degrees in different countries. Scientists and science authorities still have their arguments to justify animal testing. However, dialogues and protests are also evident against it. Awareness and campaign in recent years has made scientists and governments make statement that animal testing should cause as little suffering to animals as possible and that animal tests should only be performed where necessary. We should also look into the matter deeply and compassionately. DOI: http://dx.doi.org/10.3329/bioethics.v4i3.17373 Bangladesh Journal of Bioethics 2013; 4(3):11-18
Reflections on the Right to Palliative Care in Bangladesh: Legal Regime Revisited
Authors: Alam Md Jobair
Published: December 2013

Patients with life-limiting illness and their families face many problems and complexities. The gravity of such problem is often escalated with the fact of the patients deprivation of the proper care as a corollary to their fundamental health rights. The legal aspects of the palliative care thus concern the issues of concentrating more on the rights of the patients in getting relief from sufferings of all kinds, physical, psychological and spiritual. As such, it may include the opportunity of getting legal interventions not only in the way of claiming the protection of palliative care (such as securing access to health and social benefits) but also in the face of dealing with other life-transactions of the patients and their families (such as protecting and disposing of property; planning for children and other dependents). This paper is an attempt to articulate these legal dimensions of the right to palliative care in the context of Bangladesh. The major focus of this paper will be founded on the wide-ranging constitutional obligation on the right to health, which offers a meaningful space for the right to palliative care by way of implications. More importantly, this paper will clarify the point that taking the right to palliative care seriously will at least result in sensitizing the health right of the people of Bangladesh, especially for the poor communities, having limited awareness of their human rights and limited access to and little experience of legal services. DOI: http://dx.doi.org/10.3329/bioethics.v4i3.17375 Bangladesh Journal of Bioethics 2013; 4(3):25-33
‘Constipated, studio-bound, wall-confined, rigid’: The Influence of British Actors’ Equity on BBC Television Drama, 1948–72
Authors: McNaughton Douglas
Published: December 2013

Critical orthodoxies around the multi-camera television studio characterise it as a ‘theatrical’ space, driven by dialogue and performance. Troy Kennedy Martin (1964) decried television drama's essential naturalism, demanding a more filmic form of drama in a polemic which has strongly influenced critical thinking on multi-camera studio television. Caughie (2000) suggests that Armchair Theatre created a ‘space for acting’, but in the main, the studio is seen as a constraining and interiorising dramatic site, in thrall to liveness and reliant on theatrical unities. This article draws on research at the BBC Written Archives to extend current understanding of the determinants working upon multi-camera, studio television up to and into the 1970s. It shows how the actors’ union Equity insisted on preserving continuous performance as a specific feature of television drama. While other determinants (technical, institutional and economic) of course come into play, Equity's insistence on ‘theatrical’ continuous performance inhibited the narrative and aesthetic possibilities of studio drama, resisted the move to rehearse-record studio taping, and delayed the turn to all-film drama production at the BBC. Drawing on key productions which acted as contentious ‘test cases’ for negotiations, this article explores tensions between institutional and artistic determinants, complicating technologically determinist accounts to argue for a greater understanding of the role of Equity in dictating material conditions of production in the multi-camera studio paradigm.
Postmodernism, Culture and Feminism: The Aesthetics of Space and Performance in Rock Follies and Rock Follies of ’77
Authors: Panos Leah
Published: December 2013

This article discusses the aesthetic and spatial representational strategies of the popular studio-based musical television drama serials Rock Follies and Rock Follies of ’77. It analyses how the texts’ themes relating to women and the entertainment industry are mediated through their postmodern ironic mode and representation of fantastic spaces. Rock Follies’ distinctive stylised aesthetic and mode of caricature are analysed with reference to the visual intentions and ‘voice’ of the writer, Howard Schuman. Through considering the programmes’ various spatial strategies, the article draws attention to the importance of visual and performance style in their postmodern discourse on culture, fantasy, gender and subjectivity. Analysis of the spaces of musical performance, characters’ domestic environments and simulated entertainment spaces reveals how a dialectic is established between the escapist imaginative pleasures of fantasy and the manipulative and exploitative practices of the culture industry. The shift from the optimism of the first series, when the Little Ladies first form, to the darker mood of the second series, in which they are increasingly divided by industry pressures, is traced through changes in the aesthetics of space and characterisation. As a space of artifice, performance and electronic visual manipulation that facilitates the texts' reflexive representation of culture and feminised fantasy, the studio's unique aesthetic strengths emerge through this case study.
Projection, Substitution and Exaltation: Freud's Case Study of ‘Little Hans’ and the Creation of God inTotem and Taboo
Authors: Westerink Herman
Published: December 2013

In this article a new reading of Totem and Taboo is presented: the emergence and further development of totemic and advanced religion is interpreted from the perspective of Freud's case study of Little Hans and his short essay on family romances, in which he elaborates the psychic dynamics involved in father substitution and father exaltation. Freud's view of God as exalted father cannot be interpreted in terms of projection – a mechanism that is primarily associated with animism, belief in demons and philosophies of life – but should be associated with a decrease of hostility, estrangement and distantiation from the physically present father.
Malignant Melanoma
Authors: Perera Eshini , Gnaneswaran Neiraja , Jennens Ross , Sinclair Rodney
Published: December 2013

Melanomas are a major cause of premature death from cancer. The gradual decrease in rates of morbidity and mortality has occurred as a result of public health campaigns and improved rates of early diagnosis. Survival of melanoma has increased to over 90%. Management of melanoma involves a number of components: excision, tumor staging, re-excision with negative margins, adjuvant therapies (chemo, radiation or surgery), treatment of stage IV disease, follow-up examination for metastasis, lifestyle modification and counseling. Sentinel lymph node status is an important prognostic factor for survival in patients with a melanoma >1 mm. However, sentinel lymph node biopsies have received partial support due to the limited data regarding the survival advantage of complete lymph node dissection when a micrometastasis is detected in the lymph nodes. Functional mutations in the mitogen-activated pathways are commonly detected in melanomas and these influence the growth control. Therapies that target these pathways are rapidly emerging, and are being shown to increase survival rates in patients. Access to these newer agents can be gained by participation in clinical trials after referral to a multidisciplinary team for staging and re-excision of the scar.
Health in the New Scenarios for Climate Change Research
Authors: Ebi Kristie
Published: December 2013

The climate change research community is developing a toolkit for creating new scenarios to explore and evaluate the extensive uncertainties associated with future climate change and development pathways. Components of the toolkit include pathways for greenhouse gas emissions over this century and their associated magnitude and pattern of climate change; descriptions of a range of possible socioeconomic development pathways, including qualitative narratives and quantitative elements; and climate change policies to achieve specific levels of radiative forcing and levels of adaptive capacity. These components are combined within a matrix architecture to create a scenario. Five reference socioeconomic development pathways have been described along axes describing increasing socioeconomic and environmental challenges to adaptation and to mitigation. This paper extends these global pathways to describe their possible consequences for public health and health care, and considers the additional elements that could be added to increase the relevance of the new scenarios to address a wider range of policy relevant questions than previously possible.
Why Some Employees Adopt or Resist Reorganization of Work Practices in Health Care: Associations between Perceived Loss of Resources, Burnout, and Attitudes to Change
Authors: Dubois Carl-Ardy , Bentein Kathleen , Mansour Jamal , Gilbert Frédéric , Bédard Jean-Luc
Published: December 2013

In recent years, successive work reorganization initiatives have been implemented in many healthcare settings. The failure of many of these change efforts has often been attributed in the prominent management discourse to change resistance. Few studies have paid attention to the temporal process of workers’ resource depletion/accumulation over time and its links with workers’ psychological states and reactions to change. Drawing upon the conservation of resources theory, this study examines associations between workers’ perceptions of loss of resources, burnout, and attitudes to change. The study was conducted in five health and social service centres in Quebec, in units where a work reorganization project was initiated. A prospective longitudinal design was used to assess workers’ perceptions at two time points 12 months apart. Our findings are consistent with the conservation of resources theory. The analysis of latent differences scores between times 1 and 2 showed that the perceived loss of resources was associated with emotional exhaustion, which, in turn, was negatively correlated with commitment to change and positively correlated with cynicism. In confirming the temporal relationship between perceived loss of resources, occupational burnout, and attitude to change, this research offers a new perspective to explain negative and positive reactions to change implementation.
The C-Terminal Region of G72 Increases D-Amino Acid Oxidase Activity
Authors: Chang Sunny , Hsieh Chia-Hung , Chen Yen-Ju , Wang Chien-Ming , Shih Chung-Shiuan , Huang Pei-Wen , Mir Asif , Lane Hsien-Yuan , Tsai Guochuan , Chang Hao-Teng
Published: December 2013

The schizophrenia-related protein G72 plays a unique role in the regulation of D-amino acid oxidase (DAO) in great apes. Several psychiatric diseases, including schizophrenia and bipolar disorder, are linked to overexpression of DAO and G72. Whether G72 plays a positive or negative regulatory role in DAO activity, however, has been controversial. Exploring the molecular basis of the relationship between G72 and DAO is thus important to understand how G72 regulates DAO activity. We performed yeast two-hybrid experiments and determined enzymatic activity to identify potential sites in G72 involved in binding DAO. Our results demonstrate that residues 123–153 and 138–153 in the long isoform of G72 bind to DAO and enhance its activity by 22% and 32%, respectively. A docking exercise indicated that these G72 peptides can interact with loops in DAO that abut the entrance of the tunnel that substrate and cofactor must traverse to reach the active site. We propose that a unique gating mechanism underlies the ability of G72 to increase the activity of DAO. Because upregulation of DAO activity decreases d-serine levels, which may lead to psychiatric abnormalities, our results suggest a molecular mechanism involving interaction between DAO and the C-terminal region of G72 that can regulate N-methyl-d-aspartate receptor-mediated neurotransmission.
Gain of Imaging Fidelity by Employing a Higher Number of Independent Transmit Channels Together with Slice-Selective Radio-Frequency (RF) Shimming at 7T
Authors: Darji Niravkumar , Patel Gopesh , Speck Oliver
Published: December 2013

Dielectric resonance effects and radio-frequency (RF) power deposition have become challenging issues for magnetic resonance imaging at ultrahigh-field (UHF) strengths. The use of transmit (Tx) coil arrays with independently-driven RF sources using a parallel transmission system is a promising method for alleviating the resulting RF inhomogeneities. In this study, the effect on homogeneity and RF-power when employing a higher number of transmit channels with multi-slice acquisition in vivo at high field strength (7T) is scrutinized. An 8-channel head coil array was driven to emulate circular polarized (CP) and 2-, 4-, and 8-channel independent transmit configurations at 7T. Static RF shimming was employed on human subjects in order to homogenize the B1+ field in the excited volume. Slice-selective and global RF shimming methods were applied with CP and 2-, 4-, and 8-channel transmit channel configurations. RF shimming was performed from CP to 2-, 4-, and 8-channel Tx configurations globally and slice-selectively. Systematic improvement in B1+ homogeneity and/or reduction in RF-power were observed. RF shimming in the human brain with 8-channel transmit and slice-selective shimming yields an increase in B1+ homogeneity of 43% and/or reduces RF-power by 68% when compared with CP global RF shimming at 7T.
Three-Component Reaction of Tautomeric Amidines with 3-Ferrocenylmethylidene-2,4-pentanedione. Formation of Polymeric Coordination Complexes of Potassium Ferrocenyl-(hexahydro)pyrimidoxides
Authors: Klimova Elena , Flores-Alamo Marcos , Klimova Tatiana , Maya Sandra , Beletskaya Irina
Published: December 2013

Acetamidine hydrochloride and p-aminobenzamidine dihydrochloride interact with 3-ferrocenylmethylidene-2,4-pentanedione at 80–82 °C in the presence of K2CO3 in the water–alcohol medium in two tautomeric forms (the amidoimine and enediamine ones) with formation of mixtures of pyrimidine and piperidone derivatives and polymeric coordination complexes of potassium ferrocenyl(hexahydro)pyrimidoxides. The structure of the resultant compounds is elucidated on the basis of IR, 1H- and 13C-NMR spectroscopy, mass spectrometry and elemental analysis data. The crystal structures of 6-ferrocenyl-4-hydroxy-4-methyl-2-piperidone, potassium 6-ferrocenyl-4-methyl-2-methylidene(hexahydro)pyrimidin-4-oxide and 2-(4-aminophenyl)-4-ferrocenyl-6-methyl-pyrimidine were determined by X-ray analysis of suitable single crystals.
Design and Validation of a Physiologically-Adapted Bioreactor for Tissue Engineering of the Nucleus Pulposus
Authors: Naing May , Liu Yang , Sebastine Immanuel , Dingmann David , Williams Chrysanthi , Williams David
Published: December 2013

A novel multi-axial bioreactor was designed and developed to deliver combinations of the following dynamic mechanical stimulation conditions: hydrostatic pressure, pulsatile perfusion flow and uniaxial compression in order to mimic in vivo conditions. This mechanical arrangement simultaneously allows triaxial stimulation and characterization of mechanical properties of samples, in particular simulating the conditions experienced by the nucleus pulposus in vivo. A series of initial experiments were performed on this prototype system using consistent, commercially-available, three dimensional scaffolds in combination with human dermal fibroblasts. Our results show that while such bioreactors hold much promise in tissue engineering of desired organs, achieving the right combination of mechanical stimuli and other conditions required in order to enhance the final properties of the cell-scaffold systems is challenging.
A Phenology-Based Classification of Time-Series MODIS Data for Rice Crop Monitoring in Mekong Delta, Vietnam
Authors: Son Nguyen-Thanh , Chen Chi-Farn , Chen Cheng-Ru , Duc Huynh-Ngoc , Chang Ly-Yu
Published: December 2013

Rice crop monitoring is an important activity for crop management. This study aimed to develop a phenology-based classification approach for the assessment of rice cropping systems in Mekong Delta, Vietnam, using Moderate Resolution Imaging Spectroradiometer (MODIS) data. The data were processed from December 2000, to December 2012, using empirical mode decomposition (EMD) in three main steps: (1) data pre-processing to construct the smooth MODIS enhanced vegetation index (EVI) time-series data; (2) rice crop classification; and (3) accuracy assessment. The comparisons between the classification maps and the ground reference data indicated overall accuracies and Kappa coefficients, respectively, of 81.4% and 0.75 for 2002, 80.6% and 0.74 for 2006 and 85.5% and 0.81 for 2012. The results by comparisons between MODIS-derived rice area and rice area statistics were slightly overestimated, with a relative error in area (REA) from 0.9–15.9%. There was, however, a close correlation between the two datasets (R2 ≥ 0.89). From 2001 to 2012, the areas of triple-cropped rice increased approximately 31.6%, while those of the single-cropped rain-fed rice, double-cropped irrigated rice and double-cropped rain-fed rice decreased roughly −5.0%, −19.2% and −7.4%, respectively. This study demonstrates the validity of such an approach for rice-crop monitoring with MODIS data and could be transferable to other regions.
Dynamic Modeling and Simulation of Water Environment Management with a Focus on Water Recycling
Authors: Xiang Nan , Sha Jinghua , Yan Jingjing , Xu Feng
Published: December 2013

An integrated water environment management system is necessary in improving water quality, properly allocating water resources, and supporting socio-economic development. Specifically, dynamic modeling can be an efficient approach to accomplish this system. This paper aims to construct a dynamic linear optimization model to reflect a water environment management system which includes three sub-models with consideration of their interrelationships (a socio-economic model based on dynamic Input-Output model, a water resources cycle model, and a water pollutants flow model). Based on simulation, the model can precisely estimate trends of water utilization, water quality, and economic development under certain management targets, and propose an optimal plan. Taking Tianjin as a target area, this study utilized the model to analyze the potential of using reclaimed water to accomplish local water environment management and sustainable development plan while exploring the applicable approaches. This study indicates that the constructed water environment management system can be effective and easily adopted to assess water resources and environment while improving the trade-off between economic and environment development, as well as formulate regional development plan.
La seconde entrevue de Pélias et Jason dans la 4e Pythique de Pindare : essai d'interprétation
Authors: Schubert Paul
Published: December 2013

L'examen de la seconde entrevue de Pélias et Jason dans la 4e Pythique de Pindare (132-167) permet de montrer que les références généalogiques échangées par les deux interlocuteurs soulignent les concessions que Jason est prêt à faire à son oncle. Il permet aussi de mettre en évidence les rapports d'obligation réciproque au sein de la famille. Finalement, le lecteur peut tirer un parallèle avec la situation du destinataire de l'ode, le roi Arcésilas de Cyrène.
Poétique au seuil de l'alexandrinisme : l'idylle 16 de Théocrite
Authors: Willi Andreas
Published: December 2013

English summary: Poetics at the Threshold of Alexandrinism: Theocritus ' Idyll 16.

Theocritus' Idyll 16 is often read as a poem of praise and/or request addressed to Hieron II of Syracuse. However, the existence of a double title, Charites or Hieron, suggests that such a reading does not do justice to the intrinsic complexity of the poem. By analysing the function of the charites within the text and by comparing the tradition of praise poetry before Theocritus, it can be shown that Idyll 16 rather tries to define the social role of the poet in post-Classical Greek (and Sicilian) society. Unlike his contemporaries in Alexandria, Theocritus does not champion a concept of « l'art pour l'art » ; instead, while using the same strategies of allusion, he justifies more traditional ideas about the functions of poet and poetry. By adopting such a mediating stance, Idyll 16 represents an important link between Classical and Hellenistic poetry.