Government Advisory Committees Research Articles

The Curtis Report as a critical juncture in Canadian urbanism

ABSTRACT Canada's post-Second World War policies on urbanism were first outlined in an obscure government document – the 1944 report of the Subcommittee on Housing and Community Planning of the federal government's Advisory Committee on Reconstruction (known colloquially as the ‘Curtis Report’). This article uses the tools of Historical Institutionalism and extensive archival research to analyse the Curtis Report. It examines antecedent conditions in the Depression and war; permissive conditions during the wartime housing crisis; the actors and choice of options at the critical juncture; the reactions during implementation and the path-dependent municipal planning and suburbanization outcomes of the report. The Curtis Report is identified as a critical juncture for major changes in housing and community planning that set Canada on a different course than the UK or the USA.

Perspective: Examining Conflicts of Interest for Professional Service within the 2020 Dietary Guidelines Advisory Committee.

Judgments and integrity uphold professionalism. Failure to manage professional conflicts of interest (COIs) may undermine trust in an individual, practitioner, or institution. This perspective article examines standards for nutrition researchers and practitioners to manage COIs for the Dietary Guidelines for Americans (DGA) process. Thereafter, this article analyzes a study published by Mialon etal. that raised concerns about the expert advisory committee selection process and management of COIs for 20 professionals appointed by the Department of Health and Human Services (HHS) and the USDA, who served on a federal government advisory committee to review evidence for the Dietary Guidelines Advisory Committee (DGAC) 2020 scientific report. The analysis found that Mialon etal. enumerated COIs for each DGAC member with industry, removed from the original context, which prevented readers from assessing the COI risk. Moreover, the USDA ethics office concluded that "the 20 committee members were in full compliance with the federal ethics rules applicable to special government employees." I conclude that Mialon etal. could use institutional mechanisms to encourage the USDA and HHS to strengthen future COI policies and procedures, aligned with the 2022 National Academies of Sciences, Engineering and Medicine report recommendations to improve the DGA 2025 to 2030 process.

Euthanasia for the Elderly: Multiple Geriatric Syndromes and Unbearable Suffering According to Dutch Euthanasia Review Committees.

The public debate on voluntary termination of life by elderly people, which has been an intensely controversial subject in the Netherlands for some time, has centered around the issue of "completed life" in recent years. In 2016, an ad hoc governmental advisory committee concluded that the already existing Euthanasia Act provided sufficient scope to resolve most of the problems related to the issue. Most of the older adults who feel they no longer have anything to look forward to in their lives and who have developed a wish to die as a result would be able to invoke this Act. Partly for this reason, the committee considered broadening the legal options relating to assisted suicide undesirable. Analysis of the assessment practice of the regional euthanasia review committees reveals that the room for interpretation offered by the Euthanasia Act is indeed considerable.

An outbreak of COVID-19 caused by a new coronavirus: what we know so far.

Allen Cheng and Deborah Williamson are members of government advisory committees; the opinions expressed here do not necessarily represent the views of those committees. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Barriers to Weight Loss in a Heart Failure with Preserved Ejection Fraction Clinic

Introduction Obesity is common in HFpEF, and likely contributes to its development and progression. Cohort studies and clinical trials suggest that weight loss is beneficial, but barriers to weight loss in this population may be substantial. Methods We performed a chart review of patients presenting to our HFpEF Clinic from 1/2015 to 9/2018. Obesity was defined as a body mass index ≥ 30 kg/m2. We evaluated physical activity using the Godin Leisure-Time Questionnaire. We evaluated for anxiety and depression with General Anxiety Disorder-7 (GAD7) and Patient Health Questionnaire-9 (PHQ9) scores. Pittsburgh Sleep Quality Index scores were used in combination with chart data to calculate risk of obstructive sleep apnea (OSA) using the STOP-BANG criteria. The Short Physical Performance Battery (SPPB) was used to assess frailty. Patient electronic medical records were reviewed for polysomnograms (PSG), outpatient nutrition consults, and bariatric surgery and cardiac rehabilitation referrals. Results We identified 127 obese HFpEF patients (61% female) with an average age of 69 ± 6.6 years. Comorbid conditions were common (85% hypertension, 70% hyperlipidemia, 59% diabetes mellitus). Of the 50 patients with adequate data to calculate a STOP-BANG score, 96% met criteria for high risk of OSA. All 35 patients that had a PSG tested positive for OSA. Barriers to weight loss were common including anxiety, depression, and frailty (see Table). Most did not meet the Government Advisory Committee recommended 500 MET-min/week and over half reported no exercise at all. The overall utilization of resources to facilitate weight loss was suboptimal. Fewer than one-third received an outpatient dietitian consultation. Less than half meeting criteria for bariatric surgery were offered the intervention. Three-quarters of patients with indications for cardiac rehabilitation were referred; however, many did not have Medicare-reimbursed indications. Conclusion Barriers to weight loss are highly prevalent in HFpEF, with many patients struggling with anxiety, depression, frailty, and decreased activity levels. Opportunities exist to facilitate weight loss and improve quality of life in HFpEF through multidisciplinary interventions to address these challenges.

Understanding Emerging Environmental Health Concerns and Environmental Public Health-Tracking Priorities Among State and Local Professionals in Colorado.

Colorado is experiencing dramatic changes related to population growth, climate change, and expanded industrial activity. Local and state public health professionals are trying to address a growing array of unique public health issues with stagnant or limited resources. To understand, through perspectives from local and state public health professionals, the alignment of contemporary environmental and community health issues with state and local capacity and state environmental public health-tracking priorities. During 2014-2015, we conducted semistructured interviews which informed the development of a statewide survey of Colorado's professionals from public health, emergency management, forestry, and transportation. This work took place in Colorado. Fifteen professionals from public (n = 9), academic (n = 4), and private (n = 2) sectors were interviewed. Forty-seven professionals, representing 34 counties and 40 public agencies, completed the 25-minute online survey. Environmental and community health concerns; contributing factors to environmental concerns; strengths and limitations of capacity to respond to issues; and frequency of community engagement activities. Top environmental health concerns were indoor air pollution (eg, radon), outdoor air pollution, and waste management. Transportation, extreme weather (eg, wildfires), and oil and gas development were most frequently reported as major contributing factors to concerns. Obesity, physical inactivity, and mental illness were the top community health concerns. To remain prepared for emerging challenges, professionals cited a need for more spatiotemporal-refined data related to their top concerns in the environmental public health-tracking database, and support from local, state, and federal agencies, in addition to personnel and funding. To address concerns, participants reported frequently working with government officials, advisory committees, and media outlets. This project illuminates opportunities to strengthen connections between the state's environmental public health-tracking priorities and local-level capacity related to professionals' top concerns. It also suggests reinforcing and broadening partnerships to improve data infrastructure and inform environmental public health priorities.

Getting hotter: are heat networks about to take off in the UK?

The UK's heat sector accounts for about a fifth of national CO2 emissions, and the government's advisory Committee on Climate Change has been highly critical of efforts to decarbonise it. In a recent report it recommends that new homes should not be connected to the gas grid from 2025. Instead, it says, they should be built on systems such as heat networks, where a group of buildings are linked to a central energy source through underground pipes. The promise of heat networks, also known as district heating systems, is that they can provide greener heating to many homes or businesses at once and may be cheaper and more reliable than alternatives. The UK's first district heating scheme was built in Pimlico in the 1950s to funnel waste heat from Battersea Power Station to thousands of homes and businesses. Heat networks grew in popularity and some councils bought into them enthusiastically, particularly for social housing. But the idea never gathered steam the way it did in parts of Europe, particularly the Nordic countries, Germany and the Netherlands, and fizzled out in the latter part of the 20th century.

A Jurisprudential Approach to Governments and Other Actors Attempts to Control the Internet Root Zone

In today’s world, no treaty regulates the Internet. Moreover, no international court has ruled over the Internet infrastructure. Despite this situation, governments (on behalf of their nation-states) and government bodies have tried to assert sovereignty over the Internet and stop or compromise the transmission of the Internet packets. Although the multi-stakeholder model of the Internet has been successful of keeping the Internet from a single point of control, many scholars and non-scholars have suggested the application of the rules of the United Nations Convention on the Law of the Sea (UNCLOS) over the Internet. The purpose of these claims is solving controversies when multiple jurisdictions are involved (Barcomb, 2013; Kalpokienė & Kalpokas, 2012; Schmidt, 2017; Steven, 2001). However, as previous research suggests the application of the UNCLOS rules is also a call to apply the Westphalian model of sovereignty over the Internet (Vargas-Leon, 2017; Vargas Leon & Badiei, 2017). The application of the rules of UNCLOS into the Internet Root Zone is an example of governments’ traditional practice to exercise their jurisdiction beyond their territorial borders. This practice is characterized by the “coexistence” of spaces where nation-states keep for themselves different levels of sovereignty. Similarly to the rules of UNCLOS over the territorial sea and the high sea, when it comes to the application of sovereignty rules into the Internet realm, governments developed the following practices: (1) leave spaces where no sovereignty claims exist (at least theoretically), like the Root Zone itself, (2) exercise some level of sovereignty over some of the elements of the Root Zone, such as the country-code-top-level-domains (ccTLDs) and (3) leave spaces where their jurisdiction is exclusive, like in the delegation of the ccTLDs (Vargas Leon & Badiei, 2017). By using a multiple case study approach including the Iranian registry case and the .Amazon and .Africa controversies, this paper is an attempt to analyze, from a jurisprudential point of view, how the coexistence of different levels of jurisdiction exist within the Internet realm and how different actors, like individuals, court systems and government bodies get involved. As we should remember each one of the proposed case studies represents a scenario where the involved actors attempted to control some elements of the Internet Root Zone. The case Ben Haim vs. the Islamic Republic of Iran was an attempt of U.S. terrorist victims to seize control of the .ir Internet domain name, which is also Iran’s national country-code top-level domain (ccTLD) (Rabkin, 2014). The case .Amazon pits U.S. Amazon against the government of Brazil and Peru. Although the final decision belongs to the Internet Corporation for Assigned Names and Numbers (ICANN), the Government Advisory Committee (GAC) (formed only by governments) backed Peru and Brazil claim (Segal, 2017). Finally the case .Africa controversy involves DotConnectAfrica (DCA) vs. ICANN; in this case, a Los Angeles court refused a preliminary injunction that prevents ICANN from adding .Africa to the Internet (McCarthy, 2017). This paper is an attempt to answer the following questions: What are the governments and governments’ organizations legal arguments to justify extending nation-states’ sovereignty into the Internet Root Zone? What are the non-governmental actors arguments use to try to control the Internet Root Zone? With this purpose in mind, our aim in this paper is to illustrate how the classic arguments governments used in the international domain affect the Internet Root Zone and the Internet infrastructure. Alongside with governments’ claims, we will attempt to look at the arguments non-governmental actors have used for the same purpose. Finally, we want to clarify that this paper does not advocate for any governance model for the root zone. Findings expect to explain the diverse legal opinions this matter has generated in the legal field and how they can influence the Internet governance debate.

A review of policy, practices, and players governing and involved in the United States vaccine and immunization enterprise

PurposeThe purpose of this paper is to outline the organization and governance of the US vaccine and immunization enterprise. It describes the major components of the US system including the various relationships between major federal government entities, stakeholders, and advisory committees that inform government policymaking at various points in the system.Design/methodology/approachThe authors describe the complex interdependent network of partners that engage in a wide range of activities such as disease surveillance, research, vaccine development, regulatory licensure, practice recommendations, financing, service delivery, communications, and post-licensure monitoring.FindingsThe US system of governance is highly participatory and focuses on a transparent and open engagement, with input from a wide range of partners to inform decision-making. This collaborative framework allows many inputs to be heard and helps support the US vaccine and immunization system as it evolves to meet the continued public health needs in the USA through the optimal use of safe and effective vaccines.Originality/valueThis is an invited article on the US vaccine and immunization enterprise. The development and availability of vaccines in the USA has had profound impact on mortality and morbidity and public health (Centers for Disease Control and Prevention, 2011). The success of this enterprise is a result of a blended public and private sector system with partnerships at the federal, state, and local levels of government to optimize the use of safe and effective vaccines. Governance structures have been established to support the interaction and decision-making among the federal and non-federal actors toward the common goal of controlling and preventing infectious diseases.

Breeding crops for the future

Breeding crops for the future

Human Papillomavirus Vaccine and Postural Orthostatic Tachycardia Syndrome: A Review of Current Literature.

The human papillomavirus (HPV) vaccine is efficacious in preventing complications of human papillomavirus infection including cervical cancer. However, there have been case reports of adverse events occurring after vaccination, one being postural orthostatic tachycardia syndrome (POTS). This article reviews published data and other available information regarding the relationship between the human papillomavirus vaccine and POTS. Background information is provided regarding the human papillomavirus vaccine and the proposed post-vaccination adverse event POTS. Peer-reviewed literature, statements by government and medical advisory committees, and publicly available information published on this topic are examined. At this time, there is no conclusive evidence supporting a causal relationship between the human papillomavirus vaccine and POTS. Though a causal relationship has been postulated, it is of utmost importance to recognize that while temporal associations may be observed, conclusions of causality cannot be drawn from case reports and case series due to the small sample size and lack of control population.

ICANN's GAC and the Global Governance of the Internet: The Role of the EU in Bringing 'Government' Back to Internet Governance

The European Commission has played a multi-faceted role in the global governance of the Internet. In some cases it strengthened the role of the state or it encouraged the growth of global institutions; in others it promoted the role of the market to the detriment of traditional state controls, be they national or international. This had, to a large extent, a domestic and global impact: the Commission has supported the growth of a European Market for ICT and telecommunications, and thus increased the role of the Commission in governing the Internet. This paper focuses on the activities of the European Commission in its dialogue with international partners on the subject of Internet governance, and examines in particular the growth of ICANN’s Governmental Advisory Committee. This paper illustrates the governing role of the EU outside its borders, by showing that it has pushed for a novel, yet international solution to the problem of governing the global Internet. As a case study for new forms of governance, the Internet is a worthy subject, particularly at the global level (Shahin 1999). Given that the Information Society is a matter for ‘high politics’1 the role of the European Commission in the GIS provides an under-studied case of the changing governance environment within the EU itself and particularly in the way it acts ‘on behalf’ of member states in certain areas. This case study of the role of the European Commission’s role in the global governance of the Internet shows where and how the Commission exercises its newly created mandate, and raises points for discussion concerning different forms of global governance that have been tried and tested with the birth and evolution of ICANN, and particularly the Governmental Advisory Committee (GAC). In order to do so, however, it elaborates upon different mechanisms of management in the field of Internet governance, and takes a look at the role of two other standards organisations: the IETF and W3C.

Getting to grips with the cannabis problem: the evolving contributions and impact of Griffith Edwards.

Griffith Edwards played an important role in cannabis policy debates within government advisory committees in the United Kingdom from the early 1970s until the early 1980s. This has largely been hidden from public knowledge by the confidentiality of these committee discussions. The purpose of this paper is to use Griffith's writings and the results of recent historical scholarship to outline the views he expressed, the reasons he gave for them, and to provide a brief assessment of his contribution to the development of British cannabis policy.

Www.smokehaz.eu – a review of the evidence on smoking and lung health

This year marks the 50th anniversary of the landmark report on smoking and health, released by US Surgeon General Dr. Luther Terry [1]. It was the first US government advisory committee report linking smoking and ill health. The report was a wake-up call for America and the world. The Advisory Committee, headed up by Terry, concluded in 1964 that: “Cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.” “Cigarette smoking is causally related to lung cancer in men; the magnitude of the effect of cigarette smoking far outweighs all other factors. The data for women, though less extensive, point in the same direction.” “Cigarette smoking is the most important of the causes of chronic bronchitis in the United States, and increases the risk of dying from chronic bronchitis and emphysema.” “Male cigarette smokers have a higher death rate from coronary artery disease than non-smoking males…” This rigorous scientific report laid the foundation for tobacco control efforts in the USA and around the world. This year sees the welcome continuation of the Terry tradition of rigorous science with …

What do the .XXX disputes tell us about Internet governance? ICANN’s legitimacy deficit in context

The Internet Corporation for Assigned Names and Numbers (ICANN) is a private, not-for-profit corporation incorporated under Californian law, which is responsible for managing and developing policies for the Domain Name System (DNS), a valuable global resource. As a non-state actor, with no clear source of authority under international law, ICANN has weak claims to formal legitimacy. To bolster its normative claims to legitimacy, ICANN has introduced internal structural and procedural safeguards to ensure transparency and accountability. Its structural safeguards, based on the multi-stakeholder model, entrench roles for governments, the private sector and civil society in the policy-making process. The privileged position given to government representatives in the Governmental Advisory Committee (GAC) enhances ICANN?s weak claims to legitimacy, but risks undermining procedural safeguards through undue government influence. ICANN?s procedural safeguards include requirements to act openly, transparently and fairly, and incorporate an independent review mechanism. This article evaluates ICANN?s claims to legitimacy by means of a case study of the process for approving the controversial .XXX gTLD. An analysis of the disputes involving .XXX reveals flaws with ICANN?s structural and procedural safeguards. As this article argues, however, ICANN?s weak claims to legitimacy do not necessarily mean that DNS management and policy-making should be transferred to an international treaty-based organisation. In a time when concepts of legitimacy are in transition, with traditional concepts being challenged and new concepts yet to fully emerge, all international organisations must continually negotiate their legitimacy with networks of stakeholders. While ICANN?s weak legitimacy will result in ongoing challenges to its key management and policy-making roles, attention should focus on improving its mechanisms for accountability and transparency, as well as the organisation?s competence and effectiveness.

In Vitro Screening of Psychoactive Drugs

Prior to the designation of illegal drugs (psychoactive drugs) by prefectural regulations, the Tokyo Metropolitan Government conducts surveys on the risk of drugs, reports the results to the governor through the Tokyo Metropolitan Government Advisory Committee on Illegal Drugs, an affiliated organization, and provides the central government with information. The Tokyo Metropolitan Institute of Public Health conducts identification of the constituents of drugs and biological effect tests to help the committee analyze and assess information on the risks of drugs. Narcotics and stimulants increase the concentrations of dopamine, serotonin, and norepinephrine, i.e., neurotransmitters, in the presynaptic clefts, exerting an excitatory effect. In the postsynaptic region, these neurotransmitters are considered to directly combine with the receptors and activate guanine nucleotide-binding proteins, causing activation. We have developed nine types (categorized into three groups) of simple, high-throughput measurement systems and examined their measurement methods. The systems are designed to assess the following properties of drugs: effects of: 1) inhibiting reuptake; 2) stimulating the release of neurotransmitters in the presynaptic region; and 3) activating G proteins in the postsynaptic region. The systems provide useful information in that they allow searches for the effects of a variety of psychoactive substances that are expected to become widespread, e.g., designer drugs, hallucinogenic plants and synthetic cannabinoids; they also allow you to conduct a test using micrograms of a drug, facilitating testing even when it is not available in a large quantity.

Carbon and environmental footprinting of low carbon UK electricity futures to 2050

Electricity generation contributes a large proportion of the total greenhouse gas emissions in the United Kingdom (UK), due to the predominant use of fossil fuel (coal and natural gas) combustion for this purpose. A range of future UK energy scenarios has been employed to determine their resulting environmental and carbon footprints. Methodologies have been established to calculate these footprints for the UK electricity supply industry on both a historic timescale and in accordance with the three selected scenarios. The latter scenarios, developed by the UK SUPERGEN Consortium on ‘Highly Distributed Power Systems’ (HDPS), were characterised as ‘Business As Usual’ (BAU), ‘Low Carbon’ (LC) and ‘Deep Green’ (DG) futures, and yielded possible electricity demands out to 2050. It was found that the environmental footprint of the current power network is 41 million (M) global hectares (gha). If future trends follow a ‘Business As Usual’ scenario, then this footprint is observed to fall to about 25 Mgha in 2050. The LC scenario implies an extensive penetration of micro-generators in the home to satisfy heat and power demands. However, these energy requirements are minimised by way of improved insulation of the building fabric and other demand reduction measures. In contrast, the DG scenario presupposes a network where centralised renewable energy technologies – mainly large-scale onshore and offshore wind turbines - have an important role in the power generation. However, both the LC and DG scenarios were found to lead to footprints of less than 4 Mgha by 2050. These latter two scenarios were found to give rise to quite similar trajectories over the period 2010–2050. They are therefore more likely to reflect an effective transition pathway in terms of meeting the 2050 UK CO2 reduction targets associated with decarbonisation of its power network. However, this appears unlikely to be achieved by 2030–2040 as advocated by the UK Government's advisory Committee on Climate Change in order to meet overall national carbon reduction targets.

The H5N1 Manuscript Redaction Controversy

Scientists are an argumentative bunch, and science is no stranger to controversy. Since the beginning of the scientific revolution, science has witnessed and engaged in great controversies, including heliocentrism, the theory of evolution, the N-ray affair, and most recently the debate over climate warming. Prior controversies were settled with additional scientific study, which provided convincing data for one faction or the other. Today scientists are engaged in a new type of controversy involving the benefits, debits, appropriateness, and wisdom of redacting experimental data from scientific manuscripts on the grounds that the information could be used for nefarious purposes. This controversy was triggered when a government advisory committee known as the National Science Advisory Board for Biosecurity (NSABB) examined two manuscripts describing genetic changes that enabled bird flu virus (H5N1) to become transmissible in mammals. The NSABB then advised the U.S. Department of Health and Human Services that …

Fibrinogen Concentrate Therapy Guided by Thromboelastometry as an Alternative to Fresh Frozen Plasma in Major Vascular Surgery

TYPE IV THORACOABDOMINAL aortic aneurysm (TAAA) repair is a major vascular procedure that involves replacing the native abdominal aorta, from the level of the diaphragm to the aortic bifurcation, with a synthetic graft. During surgery there is a period of complete ischemia of the liver, bowel, and kidneys followed by reperfusion of these organs and a more prolonged period of pelvic and lower limb ischemia. The operation is associated with large blood loss, often exceeding the patient's intravascular volume. Hemostasis usually becomes severely impaired during surgery as the concentrations of fibrinogen, other coagulation factors, and platelets in the patient's blood are decreased by dilution, consumption, hyperfibrinolysis, and the effects of visceral ischemia and reperfusion. 1 Cinà C.S. Clase C.M. Coagulation disorders and blood product use in patients undergoing thoracoabdominal aortic aneurysm repair. Transfus Med Rev. 2005; 19: 143-154 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar , 2 Gertler J.P. Cambria R.P. Brewster D.C. et al. Coagulation changes during thoracoabdominal aneurysm repair. J Vasc Surg. 1996; 24: 936-943 Abstract Full Text Full Text PDF PubMed Scopus (63) Google Scholar In addition, patients undergoing TAAA repair may be receiving antiplatelet agents, such as aspirin and clopidogrel, and they usually receive anticoagulants, such as heparin, during surgery. In an attempt to correct coagulopathy during surgery, infusions of blood components, such as fresh frozen plasma (FFP) and cryoprecipitate, often are used. However, the efficacy of FFP has been questioned, 3 Stainsby D. Jones H. Asher D. et al. Serious hazards of transfusion: A decade of hemovigilance in the UK. Transfus Med Rev. 2006; 20: 273-282 Abstract Full Text Full Text PDF PubMed Scopus (286) Google Scholar , 4 Stanworth S.J. Brunskill S.J. Hyde C.J. et al. Is fresh frozen plasma clinically effective? A systematic review of randomized controlled trials. Br J Haematol. 2004; 126: 139-152 Crossref PubMed Scopus (347) Google Scholar , 5 Stanworth S.J. Brunskill S.J. Hyde C.J. et al. Appraisal of the evidence for the clinical use of FFP and plasma fractions. Best Pract Res Clin Haematol. 2006; 19: 67-82 Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar and the transfusion of allogeneic blood components carries risks, including incompatibility reactions, immunosuppression, transfusion-related acute lung injury and the transmission of bacterial, viral, and prion infections. The UK Government's Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) has recommended that the use of UK-derived FFP should cease because of the concerns regarding variant Creutzfeldt-Jakob disease. 6 Summary of Seventh Meeting of SaBTO (Advisory Committee on the Safety of Blood, Tissues and Organs), July 14/15, 2009. http://www.dh.gov.uk/ab/SaBTO/DH_089412#_2 Google Scholar Cryoprecipitate has been withdrawn from use in many European Union countries and its continued use in the UK is under review by SaBTO. Is It Necessary to Maintain Fibrinogen During Hypothermia and Major Bleeding in Vascular Surgery?Journal of Cardiothoracic and Vascular AnesthesiaVol. 26Issue 5PreviewIn the case reports by Morrison et al,1 3 patients undergoing open thoracoabdominal aneurysm repairs received a continuous infusion of purified human plasma–derived fibrinogen concentrates (CSL Behring, Marburg, Germany) under the guidance of the FIBTEM assay on ROTEM (TEM International, Munich, Germany). There are some concerns about these cases. Full-Text PDF

Fukushima: The myth of safety, the reality of geoscience

In a report to the International Atomic Energy Agency (IAEA), the Japanese government stated that the Fukushima Daiichi nuclear disaster was caused not by the Tohoku earthquake but by the tsunami it generated, resulting in a loss of power for the station’s cooling systems and, consequently, three core meltdowns. The tsunami countermeasures taken when Fukushima Daiichi was designed in the 1960s were, arguably, marginally acceptable considering the scientific data then available. But, between the 1970s and the 2011 disaster, new scientific knowledge emerged about the likelihood of a large earthquake and resulting tsunami; however, this was ignored by both the plant operator, Tokyo Electric Power Company, and government regulators. The regulatory authorities failed to properly review the tsunami countermeasures in accordance with IAEA guidelines and continued to allow the Fukushima plant to operate without sufficient countermeasures, despite having received clear warnings from at least one member of a government advisory committee. The lack of independence of government regulators appears to have contributed to this inaction. The anzen shinwa (“safety myth”) image portrayed by the Japanese government and electric power companies tended to stifle honest and open discussion of the risks. Japan’s seismological agencies are locked into outdated and unsuccessful paradigms that lead them to focus on the hazard of a supposedly imminent earthquake in the Tokai district, located between Tokyo and Nagoya, while downplaying earthquake hazards elsewhere in Japan. Consequently, regulators and the plant operator missed many opportunities to avert the calamity at the Fukushima Daiichi Nuclear Power Station.