Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

RATIONALE, AIMS AND OBJECTIVES: This paper deals with the problem of surgical waiting lists and is aimed, in particular, at comparing two different prioritization approaches: (1) the clinical assessment of treatment urgency aimed at categorizing patients into urgency-related groups (URGs) with a given recommended maximum waiting time for treatment; and (2) the implementation of an original prioritization scoring algorithm aimed at determining the relative priority of each patient in the waiting list and the corresponding order of admission. METHODS: A modelling (...) exercise based on a cohort of 236 patients enrolled on the waiting list of a surgical department in an Italian public university hospital, from 1 January to 30 June 2004, is presented. The comparison is based on a measure called need-adjusted-waiting-days, which allows to take into proper account both urgency and priority. RESULTS: The results show that both methods should be implemented simultaneously for increasing the department's performance in terms of both efficiency--outcome gained from a given amount of resources--and equity--how patients are admitted according to their need. CONCLUSIONS: Waiting list prioritization should not be limited to classifying patients into URGs, but to using a scoring system as well, in order to schedule patient admissions in an explicit and transparent way. (shrink)

Frank Jackson’s defense of a Lockean representationalist theory of perception is both tightly and boldly argued. It is a first-rate analytic dissection of the relevant arguments for and objections against the representationalist position and takes up swords with D. M. Armstrong, J. J. C. Smart, G. J. Warnock, Aune, Anscombe, Price, and others, with meticulous care. It is equally forthright in accepting and defending implications of the theory which have heretofore, for one reason or another, caused the less clear and (...) more timid to quiver, if not tremble. For example, in dealing with the question whether sense-data exist in space, he writes, "I am sometimes asked why I do not follow the lead of those who locate mental objects in a special, private space. To me, this is like saying, ‘I find it mysterious that mental objects are in normal space, so I will locate them in mysterious space'". (shrink)

The nine essays in this volume resulted from a symposium on "criminal justice and punishment" at the University of Nebraska at Omaha, in response to concerns about the workability and defensibility of any system of punishment. Among the contributors are Professors of Philosophy, Law, and Government, and the executive director of a Law Enforcement Commission. What emerges as the central focus of the book is a predominant interest in "retributivism." As J. B. Cederblom writes in the introduction, the retributive or (...) "just deserts" theory of punishment has come to dominate at the present time. The extent to which the retributivist position is promoted in opposition to an indistinct representation of utilitarianism, makes the book less challenging as a statement of the retributive position on punishment. Without a doubt, the more recent works of R. M. Hare and David Lyons, among others writing on utilitarian theory, do much to make easy claims against the theory appear facile if not naive. It is interesting that the bibliography does not refer to Hare’s work and mentions only one essay by Lyons. This is not to condemn the book, however, for it serves an important role in reawakening philosophers to the importance of a long-standing debate with a revived and healthy retributivism. But it is a warning that it is oftentimes too easy to defend a position when the opposition is not represented at the hearing. (shrink)

The hemidesmosome is a complex junction containing many proteins. The keratin cytoskeleton attaches to its cytoplasmic plaque, while its transmembrane elements interact with components of the extracellular matrix. Hemidesmosome assembly involves recruitment of α6β4 integrin heterodimers, as well as cytoskeletal elements and cytoskeleton-associated proteins to the cell surface. In our cell culture models, these phenomena appear to be triggered by laminin-5 in the extracellular matrix. Cell interaction with laminin-5 apparently induces both phosphorylation and dephosphorylation of subunits of α6β4 integrin. There (...) is emerging evidence that such events are necessary for subsequent cytoskeleton anchorage to the hemidesmosome cytoplasmic plaque. Once assembled, the hemidesmosome plays an essential role in maintaining firm epithelial adhesion to the basement membrane, with hemidesmosome disruption being a hallmark of certain devastating blistering diseases. However, the hemidesmosome is more than just a stable anchor, as it may also be the site of signal transduction, mediated by its α6β4 integrin component. This review discusses our current knowledge of the structure and assembly of the hemidesmosome. BioEssays 20:488–494, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

Having known classical wave optics and wave mechanics, can we reverse Schrödinger's path and extend the concept of families of rays of light to provide a new exact rendering of quantum optics including the Bose nature of photons? This question is answered in the affirmative, and the implications of the Bose symmetry for certain nonlocal correlations of the many-ray distribution functions are worked out. The similarities and the differences between classical and quantum wave optics are brought out. The ray-ray Bose (...) correlation is analyzed. The generating functional for the many-ray distribution functions is formulated; and the notion of paraxial illumination for quantum optics is made precise. (shrink)

We present here a direct elementary construction of continuous utility functions on perfectly separable totally preordered sets that does not make use of the well-known Debreu’s open gap lemma. This new construction leans on the concept of a separating countable decreasing scale. Starting from a perfectly separable totally ordered structure, we give an explicit construction of a separating countable decreasing scale, from which we show how to get a continuous utility map.

To localize wheat ESTs on chromosomes, 882 homoeologous group 6-specific ESTs were identified by physically mapping 7965 singletons from 37 cDNA libraries on 146 chromosome, arm, and sub-arm aneuploid and deletion stocks. The 882 ESTs were physically mapped to 25 regions flanked by 23 deletion breakpoints. Of the 5154 restriction fragments detected by 882 ESTs, 2043 were localized to group 6 chromosomes and 806 were mapped on other chromosome groups. The number of loci mapped was greatest on chromosome 6B and (...) least on 6D. The 264 ESTs that detected orthologous loci on all three homoeologs using one restriction enzyme were used to construct a consensus physical map. The physical distribution of ESTs was uneven on chromosomes with a tendency toward higher densities in the distal halves of chromosome arms. About 43% of the wheat group 6 ESTs identified rice homologs upon comparisons of genome sequences. Fifty-eight percent of these ESTs were present on rice chromosome 2 and the remaining were on other rice chromosomes. Even within the group 6 bins, rice chromosomal blocks identified by 1-6 wheat ESTs were homologous to up to 11 rice chromosomes. These rice-block contigs were used to resolve the order of wheat ESTs within each bin. (shrink)

Aims and background: The present work assessed the impact of two decrees on ethics committees in Italy, aimed at bringing the national laws on the conduct of clinical trials into line with the rest of the EC, and regulating and facilitating not-for-profit research.Material and methods: Prospectively collected data from an Italian multicentre study were examined with respect to the ethics review process. Administrative and time elements of the review process were audited. Main outcome measures were time between the application submission (...) and the ethics committee definitive opinion, type and number of application submission forms, number of ethics committees that refused fee exemption, and time between the ethics committee approval and the administrative authorisation.Results: A total of 134 local research ethics committees were approached. Application submission procedures and application forms varied greatly; paper submission was mandatory. The median time from submission to approval was 72 days. Only two LRECs refused the fee exemption. The median time from LREC approval to administrative agreement was 50 days and only 9.6% of local authorities came to a verbal agreement with the sponsor.Conclusions: Italian LRECs are still not sufficiently efficient in complying with the Directive 2001/20/EC requirement . Better coordination of LRECs work is needed although the optimal level of coordination between them is still not known. In the meantime, national guidelines are needed concerning the application of Directive 2001/20/EC. The behaviour of Italian LRECs towards not-for-profit research was excellent although only the fee exemption was requested. (shrink)

In R. C. Flickinger's (3rd ed. second impression 1929) we read on pp. 171In the iambic trimeters written by Aeschylus a trisyllabic substitution (tribrach, anapaest or dactyl) for the pure disyllabic iambus occurs only once in about twenty-five verses.Tragic Drama of the Greekstrimeters’ lines like.