Pacific Rim treaty threatens public health: Patent law and medical procedures

Doctors, surgeons, and physicians around the Pacific Rim should be concerned by the proposals revealed by WikiLeaks in the Trans-Pacific Partnership (TPP). One of the most controversial features of the TPP is the proposal to provide for patent protection in respect of medical procedures. As Public Citizen observed, ‘Health providers, including surgeons, could be liable for the methods they use to treat patients.’ The civil society group noted: ‘Essentially, except for when a surgeon uses her bare hands, surgical methods would be patentable under the U.S. proposal.’ The TPP takes a broad approach to patents and medicine; lacks appropriate safeguards; and fails to address larger questions about equity, development, and human rights. Such a measure could result in greater litigation against medical professionals; barriers to access to medical procedures for patients; and skyrocketing health costs.

Policies and Procedures to Address Bullying at Australian Universities

While bullying is often researched in children and adolescents and in the workplace, there is limited research in the emerging adult population, especially in students at university. This is perhaps due to the fact that bullying generally declines as children and young people become older (e.g., Nansel et al., 2001; Wang, Iannotti, & Nansel, 2009). Although this may indeed be the case, it is apparent that bullying does not completely abate when students graduate from high school. The plethora of literature evidencing workplace bullying, clearly shows that bullying continues beyond the school years (e.g., Hoel, Cooper, & Faragher, 2001; Privitera & Campbell, 2009). With the advent of cyberbullying in the last decade it has been shown that this particular form of bullying may not decrease with age as does traditional bullying (Kowalski & Limber, 2007; Raskauskas & Stoltz, 2007). In addition, we know there is a spike in prevalence rates during the transition from primary to high school Pellegrini et al., 2010), so it is possible that new university students are at an increased risk of victimisation due to this being a transition period. This has led to some interest in examining the prevalence of bullying in the emerging adult population at universities (Chapell, Casey, & de la Cruz, 2004; Pontzer, 2010; Wensley & Campbell, 2009).

The Australian litigation landscape - Oral and Maxillofacial Surgery and general dentistry (oral surgery procedures): An analysis of litigation cases

Background: There are persistent concerns about litigation in the dental and medical professions. These concerns arise in a setting where general dentists are more frequently undertaking a wider range of oral surgery procedures, potentially increasing legal risk. Methods: Judicial cases dealing with medical negligence in the fields of general dentistry (oral surgery procedure) and Oral and Maxillofacial Surgery were located using the three main legal databases. Relevant cases were analysed to determine the procedures involved, the patients’ claims of injury, findings of negligence, and damages awarded. A thematic analysis of the cases was undertaken to determine trends. Results: Fifteen cases over a twenty-year period were located across almost all Australian jurisdictions (eight cases involved general dentists; seven cases involved Oral and Maxillofacial Surgeons). Eleven of the fifteen cases involved determinations of whether or not the practitioner had failed in their duty of care; negligence was found in six cases. Eleven of the fifteen cases related to molar extractions (eight specifically to third molar). Conclusions: Dental and medical practitioners wanting to manage legal risk should have regard to circumstances arising in judicial cases. Adequate warning of risks is critical, as is offering referral in appropriate cases. Pre-operative radiographs, good medical records, and processes to ensure appropriate follow-up are also important.

The enigma of IgE+ B-cell memory in human subjects

Our understanding of the origin and fate of the IgE-switched B cell has been markedly improved by studies in mouse models. The immediate precursor of the IgE-switched B cell is either a relatively naive nonswitched B cell or a mature IgG-switched B cell. These 2 routes are referred to as the direct and indirect pathways, respectively. IgE responses derived from each pathway differ significantly, largely reflecting the difference in time spent in a germinal center and thus time for clonal expansion, somatic hypermutation, affinity maturation, and acquisition of a memory phenotype. The clinical and therapeutic implications for IgE responses in human subjects are still a matter of debate, largely because the immunization procedures used in the animal models are significantly different from classical atopic sensitization to allergens from pollen and mites. On the basis of the limited information available, it seems likely that these atopic IgE responses are characterized by a relatively low IgG/IgE ratio, low B-cell memory, and modest affinity maturation, which fits well with the direct switching pathway. It is still unresolved how the IgE response evolves to cover a wide epitope repertoire involving many epitopes per allergen, as well as many different allergens from a single allergen source. © 2013 American Academy of Allergy, Asthma & Immunology.

Dual acquisition of 18F-FMISO and 18F-FDOPA

Metabolic imaging using positron emission tomography (PET) has found increasing clinical use for the management of infiltrating tumours such as glioma. However, the heterogeneous biological nature of tumours and intrinsic treatment resistance in some regions means that knowledge of multiple biological factors is needed for effective treatment planning. For example, the use of 18F-FDOPA to identify infiltrative tumour and 18F-FMISO for localizing hypoxic regions. Performing multiple PET acquisitions is impractical in many clinical settings, but previous studies suggest multiplexed PET imaging could be viable. The fidelity of the two signals is affected by the injection interval, scan timing and injected dose. The contribution of this work is to propose a framework to explicitly trade-off signal fidelity with logistical constraints when designing the imaging protocol. The particular case of estimating 18F-FMISO from a single frame prior to injection of 18F-FDOPA is considered. Theoretical experiments using simulations for typical biological scenarios in humans demonstrate that results comparable to a pair of single-tracer acquisitions can be obtained provided protocol timings are carefully selected. These results were validated using a pre-clinical data set that was synthetically multiplexed. The results indicate that the dual acquisition of 18F-FMISO and 18F-FDOPA could be feasible in the clinical setting. The proposed framework could also be used to design protocols for other tracers.

Evaluation framework to assess orthopaedic procedures

Introduction & aims The demand for evidence of efficacy of treatments in general and orthopaedic surgical procedures in particular is ever increasing in Australia and worldwide. The aim of this study is to share the key elements of an evaluation framework recently implemented in Australia to determine the efficacy of bone-anchored prostheses. Method The proposed evaluation framework to determine the benefit and harms of bone-anchored prostheses for individuals with limb loss was extracted from a systematic review of the literature including seminal studies focusing on clinical benefits and safety of procedures involving screw-type implant (e.g., OPRA) and press-fit fixations (e.g., EEFT, ILP, OPL). [1-64] Results The literature review highlighted that a standard and replicable evaluation framework should focus on: • The clinical benefits with a systematic recording of health-related quality of life (e.g., SF-26, Q-TFA), mobility predictor (e.g., AMPRO), ambulation abilities (e.g., TUG, 6MWT), walking abilities (e.g., characteristic spatio-temporal) and actual activity level at baseline and follow-up post Stage 2 surgery, • The potential harms with systematic recording of residuum care, infection, implant stability, implant integrity, injuries (e.g., falls) after Stage 1 surgery. There was a general consensus around the instruments to monitor most of the benefits and harms. The benefits could be assessed using a wide spectrum of complementary assessments ranging from subjective patient self-reporting to objective measurements of physical activity. However, this latter was assessed using a broad range of measurements (e.g., pedometer, load cell, energy consumption). More importantly, the lack of consistent grading of infections was sufficiently noticeable to impede cross-fixation comparisons. Clearly, a more universal grading system is needed. Conclusions Investigators are encouraged to implement an evaluation framework featuring the domains and instruments proposed above using a single database to facilitate robust prospective studies about potential benefits and harms of their procedure. This work is also a milestone in the development of national and international clinical outcome registries.

LiDAR Augmented Optimal Path Planning for Unmanned Aerial Vehicle during Remote Sensing at Low Altitude and Network Sensor Data Acquisition

This technical report describes a Light Detection and Ranging (LiDAR) augmented optimal path planning at low level flight methodology for remote sensing and sampling Unmanned Aerial Vehicles (UAV). The UAV is used to perform remote air sampling and data acquisition from a network of sensors on the ground. The data that contains information on the terrain is in the form of a 3D point clouds maps is processed by the algorithms to find an optimal path. The results show that the method and algorithm are able to use the LiDAR data to avoid obstacles when planning a path from a start to a target point. The report compares the performance of the method as the resolution of the LIDAR map is increased and when a Digital Elevation Model (DEM) is included. From a practical point of view, the optimal path plan is loaded and works seemingly with the UAV ground station and also shows the UAV ground station software augmented with more accurate LIDAR data.

Improving SEA procedures within Italian regions: Towards a more effective evaluation of urban sustainability

Sustainable urban development, a major issue at global scale, will become more relevant according to population growth predictions in developed and developing countries. Societal and international recognition of sustainability concerns led to the development of specific tools and procedures, known as sustainability assessments/appraisals (SA). Their effectiveness however, considering that global quality life indicators have worsened since their introduction, has promoted a re-thinking of SA instruments. More precisely, Strategic Environmental Assessment (SEA), – a tool introduced in the European context to evaluate policies, plans, and programmes (PPPs), – is being reconsidered because of several features that seem to limit its effectiveness. Over time, SEA has evolved in response to external and internal factors dealing with technical, procedural, planning and governance systems thus involving a shift of paradigm from EIA-based SEAs (first generation protocols) towards more integrated approaches (second generation ones). Changes affecting SEA are formalised through legislation in each Member State, to guide institutions at regional and local level. Defining SEA effectiveness is quite difficult. Its’ capacity-building process appears quite far from its conclusion, even if any definitive version can be conceptualized. In this paper, we consider some European nations with different planning systems and SA traditions. After the identification of some analytical criteria, a multi-dimensional cluster analysis is developed on some case studies, to outline current weaknesses.

Implicit and multigrid procedures for steady-state computations with upwind algorithms

A computational study for the convergence acceleration of Euler and Navier-Stokes computations with upwind schemes has been conducted in a unified framework. It involves the flux-vector splitting algorithms due to Steger-Warming and Van Leer, the flux-difference splitting algorithms due to Roe and Osher and the hybrid algorithms, AUSM (Advection Upstream Splitting Method) and HUS (Hybrid Upwind Splitting). Implicit time integration with line Gauss-Seidel relaxation and multigrid are among the procedures which have been systematically investigated on an individual as well as cumulative basis. The upwind schemes have been tested in various implicit-explicit operator combinations such that the optimal among them can be determined based on extensive computations for two-dimensional flows in subsonic, transonic, supersonic and hypersonic flow regimes. In this study, the performance of these implicit time-integration procedures has been systematically compared with those corresponding to a multigrid accelerated explicit Runge-Kutta method. It has been demonstrated that a multigrid method employed in conjunction with an implicit time-integration scheme yields distinctly superior convergence as compared to those associated with either of the acceleration procedures provided that effective smoothers, which have been identified in this investigation, are prescribed in the implicit operator.

Therapeutic upper gastrointestinal endoscopy in children : An audit of 443 procedures and literature review

The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures (n = 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n = 197 procedures; thermocoagulation for haemorrhagic gastritis, n = 1; and photocoaulation for Dieulafoy's disease, n = 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia (n = 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved (n = 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed (n = 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement (n = 5) and endoscopic diathermy of pyloric web (n = 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches.

Extrapolation and series acceleration procedures: Hard spheres and discs as illustrations

Three new procedures - in the context of estimation of virial coefficients and summation of the partial virial series for hard discs and hard spheres - are proposed. They are based on the parametrised Euler transformation, a novel resummation, identity and the ε-convergence methods respectively. A comparison with other estimates (molecular dynamics, graph theory and empirical methods) reveals satisfactory agreement.

Nés sous de bons auspices? Etude qualitative de facteurs contribuant à l'acquisition du bilinguisme par les enfants d'un couple mixte

Pro gradu- tutkielmassani tarkastelen suomi-ranska kaksikielisyyden kehittymistä perheissä, joissa vanhemmilla on eri äidinkieli. Työni tavoitteena on ollut tutkia kuinka eri ympäristötekijät vaikuttavat kaksikielisyyden omaksumiseen ja miten perheiden erilainen panostus vähemmistökielen, ts. kielen joka ei esiinny ympäristössä, oppimiseen näkyy saavutetuissa tuloksissa. Tutkimukseeni osallistui 13 perhettä, joilla on 10-12 vuotiaita, ranskaa ja suomea päivittäin käyttäviä lapsia. Lapsia oli yhteensä 18. Voidakseni tarkastella myös kieliympäristön vaikutusta oppimiseen valittiin perheistä kuusi Suomesta ja seitsemän Ranskasta sekä Sveitsin ranskankieliseltä alueelta. Tutkimusmenetelmiini kuului vanhempien haastattelu perheen sosiolingvististen tekijöiden selville saamiseksi ja lasten kanssa keskustelu suullisen kielitaidon arvioimiseksi. Pääpaino kielitaidon arvioinnissa oli kuitenkin kirjallisella tekstillä, jonka lapset tuottivat molemmilla kielillä tekstittömän kirjan kuvien perusteella. Teksteistä suoritettiin virheanalyysit, joissa eri virheet jaettiin ortografisiin, semanttisiin ja kieliopillisiin virheisiin. Jokaiselle lapselle lasketiin myös keskiarvo, joka osoitti kuinka monta sanaa tekstissä oli jokaista virhettä kohti. Näiden keskiarvojen pohjalta tutkittiin yhteneväisyyksiä virhemäärien sekä perheiden sosiolingvististen tekijöiden kesken. Yhteenvedossa verrattiin myös tuloksia teoriaosassa esitettyihin kielitieteilijöiden tarjoamiin periaatteisiin. Tutkielman perusteella voidaan todeta, että ympäristön vaikutus näytetään usein aliarvioitaneen kaksikielisyyttä koskevissa teoksissa. Hyvään kielitaitoon vähemmistökielessä tarvitaan enemmän kuin yksi kieli - yksi henkilö menetelmä, jossa vanhemmat puhuvat lapselle omaa äidinkieltään. Hyviksi vahvistuskeinoiksi havaittiin varsinkin kaksikielinen koulu sekä useat vierailut toisen vanhemman kotimaahan. Varsinkin perheen nuorimpien lasten vähemmistökielen oppimiseen tulisi panostaa sillä näillä on syntymästään asti mahdollisuus käyttää enemmistökieltä myös vanhempien sisarusten kanssa. Kieliympäristön vaikutuksesta havaittiin, että Suomessa asuvat lapset hallitsivat yleisesti ottaen paremmin vähemmistökielensä kuin Ranskassa asuvat. Tähän pidettiin syynä ranskalais-suomalaisen koulun positiivista vaikutusta kielen oppimiselle sekä ranskankielen arvostettua asemaa Suomessa. Avainsanat: Kaksikielisyys, kieltenoppiminen, bilinguisme, acquisition des langues, couple mixte

Observations on the influence of repeated sampling procedures on temperament changes of weaner cattle

Experimental cattle are often restrained for repeated blood collection and faecal sampling and may baulk at entering the crush, possibly from learning that crush entry is followed by an unpleasant experience. We asked whether repeated sampling affects temperament. One measure of temperament is flight speed, which is the time, measured electronically, for an animal to cover a set distance on release from a weighing crate (Burrow et al. 1988). 22nd Biennial Conference.

An experimental analysis of information acquisition in prediction markets

We study which factors in terms of trading environment and trader characteristics determine individual information acquisition in experimental asset markets. Traders with larger endowments, existing inconclusive information, lower risk aversion, and less experience in financial markets tend to acquire more information. Overall, we find that traders overacquire information, so that informed traders on average obtain negative profits net of information costs. Information acquisition and the associated losses do not diminish over time. This overacquisition phenomenon is inconsistent with predictions of rational expectations equilibrium, and we argue it resembles the overdissipation results from the contest literature. We find that more acquired information in the market leads to smaller differences between fundamental asset values and prices. Thus, the overacquisition phenomenon is a novel explanation for the high forecasting accuracy of prediction markets.

A generic design environment for the rural industry knowledge acquisition

This paper describes a new knowledge acquisition method using a generic design environment where context-sensitive knowledge is used to build specific DSS for rural business. Although standard knowledge acquisition methods have been applied in rural business applications, uptake remains low and familiar weaknesses such as obsolescence and brittleness apply. We describe a decision support system (DSS) building environment where contextual factors relevant to the end users are directly taken into consideration. This "end user enabled design environment" (EUEDE) engages both domain experts in creating an expert knowledge base and business operators/end users (such as farmers) in using this knowledge for building their specific DSS. We document the knowledge organisation for the problem domain, namely a dairy industry application. This development involved a case-study research approach used to explore dairy operational knowledge. In this system end users can tailor their decision-making requirements using their own judgement to build specific DSSs. In a specific end user's farming context, each specific DSS provides expert suggestions to assist farmers in improving their farming practice. The paper also shows the environment's generic capability.