Scale Back Research Articles

Nuclear versus Natural Gas: An Assessment on the Drivers Influencing Japan's Energy Future

After decades of strong commitment to nuclear power by the Japanese government, rising anti-nuclear sentiment among the public following the 2011 Fukushima Daiichi nuclear incident has forced the government to re-evaluate the country's reliance on nuclear power. Japan's subsequent switch to Liquefied Natural Gas (LNG) demonstrated the utilities’ preference for LNG as the large scale alternative option to nuclear power. The reliance on natural gas looks set to grow in the years ahead as the utilities are constructing 12 new gas-fired power generation units in 2014 alone, as replacement for nuclear power and to scale back on the use of expensive oil for power generation. This growing reliance on LNG imports came at a time the IEA said that the world is entering into a “golden age of gas” due to progress in exploration and extraction technology resulting in the North American shale gas boom and the expansion of LNG trade. Although natural gas is much less polluting than all the other fossil-fuel alternatives, it is still a carbon intensive energy source. Japan's growing reliance on natural gas implies that it would be increasingly difficult for Tokyo to meet its Kyoto Protocol pledge in reducing carbon emissions. Moreover, the Levelized Cost of Electricity (LCOE) approach used by the International Energy Agency has demonstrated that the cost of electricity generation from natural gas is higher than nuclear. Already, Japan's growing reliance on LNG has contributed significantly to its first trade deficit since the second oil shock (1979-1980). In this paper, we examine, in economic and political terms, how energy security, international relations, and climate change policy considerations are shaping the Japanese policy-makers’ debate on the country's future energy mix. We argue that in addition to domestic concerns over cost and social acceptance, Japan's decision on its future energy mix will also be shaped by: first, global energy security trends; second, the priority the government attaches to addressing global climate change; and third, Tokyo's international relations strategy to elevate Japan's diplomatic and strategic clout.

Modified Marmot Operation Versus Spinous Process Transverse Cutting Laminectomy for Lumbar Spinal Stenosis

Retrospective comparative cohort study. To compare clinical outcomes for lumbar spinal stenosis (≥3 levels) treated with posterior decompression without exposing the paravertebral muscles (PVM) with outcomes from surgery with PVM exposure. Exposure of the PVM can cause muscle injury and denervation, which may induce failed back syndrome. However, it is unknown whether lumbar spinal stenosis is more likely to lead to clinical improvement after PVM preservation than the procedure involving exposure of the PVM. Fifty-three patients with lumbar spinal stenosis were divided on the basis of the timing of the surgery into 2 groups: modified split-spinous process laminotomy (Marmot operation) (MM) group (26 patients) and spinous process transverse cutting laminectomy through a unilateral approach (control) group (27 patients). The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, visual analogue scale score of low back pain, and patients' satisfaction were assessed preoperatively and 1 year postoperatively. Operation time, blood loss, and creatine phosphokinase and C-reactive protein levels were measured 7 days postoperatively. Magnetic resonance imaging changes in the PVM were evaluated at the follow-up. The preoperative visual analogue scale and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire scores did not differ between groups. The operation time did not differ between groups, but blood loss was less in the MM group than in the control group (129 vs. 205 mL) (P < 0.05). C-reactive protein (1.1 vs. 2.8 mg/dL) and creatine phosphokinase (68 vs. 253 IU/L) levels were lower in the MM group (P < 0.05). The visual analogue scale score for low back pain and patient satisfaction did not differ between groups. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire scores for pain-related disorders, gait disturbance, and social life disturbance improved significantly in the MM group compared with the control group (P < 0.05). Nine patients in the control group showed positive changes in the PVM. The MM operation was less invasive and produced superior clinical outcomes compared with laminectomy involving exposure of the PVM.

Does Mediation Make Us Better? Exploring the Capacity‐Building Potential of Community Mediation

AbstractThe prevailing measures of the success of mediation have largely focused on rates of settlement and satisfaction while overlooking the capacity‐building goals expressed by many mediation advocates. I address this through empirical study of the effects of mediation on participant capacity at two community mediation organizations in Toronto. I find that mediation has the potential to build participant capacity, but in the majority of cases, it does not have these lasting effects on participants. Based on these findings I conclude that mediation advocates should scale back and reconceptualize, though not entirely abandon, their claims about the capacity‐building potential of mediation.

Dimensions of Disrespect

The current study broadens our understanding of workplace gender harassment (a subdomain of sex-based harassment) by developing an expanded taxonomy and measurement instrument. We move beyond sexual insults to include hostility targeting one’s gender, gender role (non)conformity, and motherhood status. In Study 1, we convened a panel of seven subject matter experts to brainstorm behaviors covering the full content domain of gender harassment, which they later grouped into categories in an open card-sorting task. To tap these categories, we combined survey items from the existing literature with a pool of new items. In Study 2, we administered these items to 425 working women. Exploratory principal axis factoring and confirmatory factor analyses revealed an underlying five-factor structure in these data, reflecting both new and extant themes from the literature. This work culminated in a 20-item scale, the Gender Experiences Questionnaire, assessing five dimensions of gender harassment: Sexist Remarks, Sexually Crude/Offensive Behavior, Infantilization, Work/Family Policing, and Gender Policing. This multidimensional conceptualization of gender harassment, coupled with the new measure, offers a more nuanced view of women’s experiences of hostile work environments. This can further the work of researchers, human resources personnel, managers, educators, policy makers, law scholars and practitioners, and other specialists seeking to understand (and scale back) harassment based on sex and gender. This understanding can potentially inform intervention and prevention efforts in any organized setting (e.g., work, school, and politics) where gender may be devalued.

Decompression and Coflex Interlaminar Stabilization Compared With Decompression and Instrumented Spinal Fusion for Spinal Stenosis and Low-Grade Degenerative Spondylolisthesis

Prospective, randomized, multicenter, Food and Drug Administration Investigational Device Exemption trial. To evaluate the safety and efficacy of Coflex interlaminar stabilization compared with posterior spinal fusion in the treatment of 1- and 2-level spinal stenosis and degenerative spondylolisthesis. Long-term untoward sequelae of lumbar fusion for stenosis and degenerative spondylolisthesis have led to the search for motion-preserving, less-invasive alternatives. Three hundred twenty-two patients (215 Coflex and 107 fusions) from 21 sites in the United States were enrolled between 2006 and 2010. Subjects were randomized to receive laminectomy and Coflex interlaminar stabilization or laminectomy and posterolateral spinal fusion with spinal instrumentation in a 2:1 ratio. Overall device success required a 15-point reduction in Oswestry Disability Index, no reoperations, no major device-related complications, and no postoperative epidural injections. Patient follow-up at minimum 2 years was 95.3% and 97.2% in the Coflex and fusion control groups, respectively. Patients taking Coflex experienced significantly shorter operative times (P < 0.0001), blood loss (P < 0.0001), and length of stay (P < 0.0001). There was a trend toward greater improvement in mean Oswestry Disability Index scores in the Coflex cohort (P = 0.075). Both groups demonstrated significant improvement from baseline in all visual analogue scale back and leg parameters. Patients taking Coflex experienced greater improvement in Short-Form 12 physical health outcomes (P = 0.050) and equivalent mental health outcomes. Coflex subjects experienced significant improvement in all Zurich Claudication Questionnaire outcomes measures compared with fusion (symptom severity [P = 0.023]; physical function [P = 0.008]; satisfaction [P = 0.006]). Based on the Food and Drug Administration composite for overall success, 66.2% of Coflex and 57.7% of fusions succeeded (P = 0.999), thus demonstrating noninferiority. The overall adverse event rate was similar between the groups, but Coflex had a higher reoperation rate (10.7% vs. 7.5%, P = 0.426). At 2 years, fusions exhibited increased angulation (P = 0.002) and a trend toward increased translation (P = 0.083) at the superior adjacent level, whereas Coflex maintained normal operative and adjacent level motion. Coflex interlaminar stabilization is a safe and efficacious alternative, with certain advantages compared with lumbar spinal fusion in the treatment of spinal stenosis and low-grade spondylolisthesis. 1.

Whither the child?: causes and consequences of low fertility

Book synopsis: Birth rates are falling and fertility rates are well below replacement levels. At the same time, the economic crisis has forced governments to scale back public spending, reduce child support, and raise the retirement age, causing immense social conflict. Taking a step outside the disciplinary comfort zone, Whither the Child? asks how demography affects individuals and society. What does it feel like to live in a low fertility world? What are the consequences? Is there even a problem - economically, culturally and morally? No other book confronts so many dimensions of the low fertility issue and none engage with the thorny issues of child psychology, parenting, family, and social policy that are tackled head-on here.

Investigation on fabricating continuous vivid sharkskin surface by bio-replicated rolling method

Vivid sharkskin has been fabricated by a direct bio-replicated micro-imprinting method in previous studies, and the good drag-reducing effect has been validated in water tunnel. However, for surface of fluid is larger than the whole skin of shark, splicing and affixing steps are absolutely necessary. One hand, the complexity of process will be increased significantly, the other hand, the stress concentration produced by external flow will be produced on jointing seams, especially for those which are perpendicular to the flowing direction, the jointing surface will be destroyed at a high speed of flowing, and perhaps, the drag-reducing efficiency can be decreased. Therefore, how to manufacture continuous vivid sharkskin in a large area has become an urgent problem to be resolved. In this paper, for eliminating the influence of wedge angle on scale's back, the sputtering and photo lithography processes are put into application and the continuous vivid sharkskin surface with good forming effect is fabricated by rolling process at last.

Repairing Canada’s Mining-Tax System to Be Less Distorting and Complex

The province of Ontario ended its most recent fiscal year with a $12 billion deficit and the Fraser Institute has calculated that the province is in worse financial shape than even the fiscally appalling state of California. One would think that a province so financially debilitated would want to avoid giving unnecessary and wasteful tax breaks to resource companies. Yet, a review of the mining-tax regimes across the country finds that Ontario’s system — specifically its provincial resource allowance, which duplicates the allowances provided by Ottawa that shield miners from risk — is redundant, expensive and wasteful. Ontario is not the only province requiring a modernization of its mining-tax regime. In every province except Nova Scotia and New Brunswick, mining firms enjoy a lower marginal rate for taxes and royalties than for non-resource companies. The inevitable result has been a distortion of investment toward mining projects that might otherwise be economically inefficient. That means that in major oil-producing provinces, such as Alberta, Saskatchewan and Newfoundland, mining investment benefits from larger tax incentives than oil and gas investment. The reasons for favouring the mining of metal over oil are at least unclear and certainly economically unjustifiable. The federal government has already begun making several changes to its tax policies to scale back preferential and irrational inducements for mining investment, including, most recently, reducing accelerated depreciation allowances for certain mining assets and phasing out the corporate Mineral Exploration Tax Credit and the Atlantic Investment Tax Credit for resources. But Ottawa’s efforts to modernize Canada’s mining-tax structure can only go so far, when provinces continue to rely on what are often overly complex tax systems that have a distortionary effect on economic decisions being made by investors. The next step in modernizing Canada’s mining-tax system requires provinces to start eliminating preferential and wasteful tax breaks for miners. Provincial treasuries certainly cannot afford these breaks, and neither can the Canadian economy as a whole.

Changing values, changing outcomes: the influence of reprioritization response shift on outcome assessment after spine surgery

When patients experience a substantial health state change, they may undergo changes in the underlying meaning of their self-report to standardized outcome measures. These response shifts can reflect changes in the patient's internal standards, values or conceptualization of quality of life. We investigated the presence of changing values (reprioritization response shift) in a longitudinal cohort of spine surgery patients. Spinal decompression surgery patients (mean age 52years; 39% female, 36% working) provided visual analogue scale (VAS) back and leg pain items, the Short-Form-36 (SF-36v1), and the Oswestry Disability Index (ODI) data pre- and post-surgery (n pre=169; n 6weeks=102; n 3months=106; n 6months=68). Improved and No-Effect patient groups were compared using the VAS minimally important difference (±15 points) as a cutoff. Reprioritization response shift detection was based on change in the relative importance of the SF-36 domains for group discrimination pre- and post-surgery. The Improved group evidenced significant post-surgery differences from the No-Effect group on bodily pain, general health, physical functioning, social functioning, vitality, and the ODI. The relative importance analysis showed a differential effect with bodily pain (p<0.01) and physical functioning (p<0.05) becoming more important, and role physical (p<0.01) becoming less important post-surgery in distinguishing the Improved group as compared to the No-Effect group. The Improved patients also evidenced stronger associations between bodily pain and physical functioning, vitality and general health (p<0.05). The No-Effect group evidenced increased inter-correlations of bodily pain with social functioning, mental health, and general health (p<0.05). Patients who report clinically significant change in leg and back pain post-surgery using VAS pain scores are also distinguished by increased importance of bodily pain and physical functioning, and decreased importance of role physical. Bodily pain is primarily reflective of physical item response post-surgery among Improved patients, but reflects physical, social, and emotional item response among No-Effect patients. These changes in values may reflect a "moving goal post" in outcome assessment that complicates the interpretation of mean differences over time on standard spine outcome measures.

Advisers Urge NIH to Scale Back Chimpanzee Research

Most chimps owned by the National Institutes of Health could be headed for retirement.

The Coming Golden Age of Disruptive Innovation in Health Care

The Coming Golden Age of Disruptive Innovation in Health Care

A new type of medication shortage

Sample medications, controversial to many, have long been a useful adjunct for clinicians and patients in introducing new drugs and helping with compliance of their treatment regimen. Although the recent state of the economy has presented the need for more samples, diminishing margins have caused pharmaceutical companies to scale back on their sales forces and the total number of samples (average wholesale price) given, potentially changing an important dynamic for many practices and the patients they serve.

Engineering Optimal Network Effects via Social Media Features and Seeding in Markets for Digital Goods and Services

Firms nowadays are increasingly proactive in trying to strategically capitalize on consumer networks and social interactions. In this paper, we complement an emerging body of research on the engineering of word-of-mouth effects by exploring a different angle through which firms can strategically exploit the value-generation potential of the user network. Namely, we consider how software firms should optimize the strength of network effects at utility level by adjusting the level of embedded social media features in tandem with the right market seeding and pricing strategies in the presence of seeding disutility. We explore two opposing seeding cost models where seeding-induced disutility can be either positively or negatively correlated with customer type. We consider both complete and incomplete information scenarios for the firm. Under complete information, we uncover a complementarity relationship between seeding and building social media features that holds for both disutility models. When the cost of any of these actions increases, rather than compensating by a stronger action on the other dimension to restore the overall level of network effects, the firm will actually scale back on the other initiative as well. Under incomplete information, this complementarity holds when seeding disutility is negatively correlated with customer type but may not always hold in the other disutility model, potentially leading to fundamentally different optimal strategies. We also discuss how our insights apply to asymmetric networks.

Obama in Question

Obama in Question

Stand-alone Anterior Versus Anteroposterior Lumbar Interbody Single-level Fusion After a Mean Follow-up of 41 Months

Prospective cohort study comparing evaluations of single-level anterior lumbar interbody fusion (ALIF) versus anteroposterior lumbar fusion (APLF). To clinically and radiologically compare the outcome after angle-stable, locked, stand-alone ALIF with that obtained after APLF, in cases with degenerative disc disease (DDD). Fusion rates have been reported to be highest after interbody fusion with transpedicular fixation. However, transpedicular fixation is linked to significant damage of the paravertebral muscles, to screw displacement-related neurological and vascular complications, and to an increased rate of adjacent segment degeneration. When performed as a stand-alone procedure, the disadvantages of transpedicular fixation can be completely avoided by ALIF. Eighty patients with chronic low-back pain due to a single-level DDD (Modic ≥2) and facet joint arthritis (Fujiwara ≥3) were enrolled in this study. Forty patients received an anteroposterior fusion (ALIF with transpedicular fixation: APLF group) and 40 patients (ALIF group) were treated with a stand-alone ALIF using the Synfix-LR device. At 7 days, 3, 6, 12, and 24 months, and at a mean follow-up of 41 months, patients were clinically (visual analog scale, Oswestry Low Back Pain Disability Index, satisfaction) and radiologically (x-ray, and at 12 months, thin-slice computed tomography) compared. Blood loss and duration of surgery were significantly lower in the ALIF group (P<0.001). Visual analog scale and Oswestry Low Back Pain Disability Index improved significantly over time (analysis of variance, P<0.001) in both groups, but both scores were significantly better in ALIF group (analysis of variance, P<0.001). Patients' satisfaction consistently ranked higher in the ALIF group (P=0.042 at 12 mo). No significant difference was found in the fusion rate throughout the study. Stand-alone ALIF leads to better clinical results than APLF, without differences in fusion rates after 41 months. Therefore, when a posterior approach is not needed for decompression or reposition, we suggest performing a stand-alone ALIF in cases with single-level DDD.

Realizing Liberty: The Use of International Human Rights Law to Realign Immigration Detention in the United States

This article takes a comprehensive look at the extensive U.S. immigration detention system from a human rights perspective. The article represents a first effort to synthesize and present recently-developed international human rights standards and apply those rules to the U.S. immigration detention system. It engages in an in-depth analysis to identify the changes necessary to realign U.S. law and scale back immigration detention in accord with international human rights law. The article proposes that U.S. courts should effect those changes through the interpretation of constitutional and statutory provisions in light of the international human rights law standards. This use of the human rights standards is appropriate, because the standards represent binding obligations for the United States as a matter of international law and closely track U.S. constitutional law principles relating to civil detention in contexts less contentious than immigration. The article demonstrates how the application of international human rights law standards can bring rationality and humanity to U.S. immigration detention by revitalizing the right to liberty, which constitutes a core conception in both international human rights law and U.S. constitutional law.

Moodie and Evans Respond

Despite the charges by Stifelman et al., nowhere do we claim that blood lead levels (BLLs) were used as the sole criterion for cleanup actions at Bunker Hill. Rather, we argue that insofar as BLLs were one of the Remedial Action Objectives (RAOs) specified in the Record of Decision (ROD), this criterion was neither protective nor proactive in reducing risk. The threshold of concern (10 μg/dL) is far too high in light of a mounting body of evidence showing the adverse effect of lead at much lower levels.1–6 In addition, the other RAOs for environmental criteria (e.g., soil, dust, and water contaminant levels) were set at levels much higher than the Environmental Protection Agency’s (EPA’s) own standards.7 Although Stifelman et al. remain confident about the “protectiveness of the remedy,” this confidence does not equal valid and reliable data. The continued low participation in blood lead screening remains troublesome. In 2010, only 13 of 475 Medicaid children residing in the original Bunker Hill site (otherwise known as the “Box”) were screened; one had a BLL greater than 10 micrograms per deciliter. With less than three percent of Medicaid eligible children screened, let alone the broader population, safe lead exposure levels cannot be claimed. Although Stifelman et al. claim that “[a]chievement of BLLs below the RAO did not—and will not—stop remediation,” in February 2012 the EPA announced a massive scale back of the cleanup efforts at Bunker Hill.8,9 The EPA Region 10 director of environmental cleanup admitted that the work planned under this plan may not be sufficient. Finally, the social justice concerns raised by the use of BLLs (as well as other environmental criteria) as RAOs are not based on the distribution of exposure along socioeconomic lines. To the extent that the residents of Bunker Hill can be considered a vulnerable population (poverty, low educational achievement, and a background of poor health outcomes), exposure to lead increases the risk of adverse health outcomes compared with nondisadvantaged populations. The result is an exacerbation of the existing inequalities that threaten the health and well-being of Bunker Hill residents.

Percutaneous endoscopic treatment of foraminal and extraforaminal disc herniation at the L5-S1 level

Microsurgery of foraminal and extraforaminal disc herniation at the L5-S1 level remains a challenge because of the limited access by a high iliac crest, the sacral ala, large transverse processes of L5 and hidden disc fragments lateral to the zygapophyseal joint. Our aim was to present the outcome of percutaneous endoscopic lumbar discectomy (PELD) of these lateral and far lateral disc herniations at the L5-S1 level using the newly described foraminal retreat technique in a group of patients with similar preoperative diagnostic studies. A total of 22 patients, 13 males and 9 females, with foraminal and extraforaminal lumbar disc herniation at the L5-S1 level were treated by applying the PELD between September 2004 and April 2010. The clinical findings and MRI were the main diagnostic methods. Preoperative evaluation was performed with clinical examinations, the Visual Analog Pain Scale (VAS) and Oswestry Low Back Disability Index (ODI). According to the Macnab criteria, overall excellent or good outcomes were obtained in 18 patients (81.8 %), fair outcomes in 3 patients (13.6 %) and a poor outcome in 1 patient (4.5 %) at the last follow-up. The mean ODI was 67.3 ± 19.4 preoperatively and 26.7 ± 23.4 postoperatively. Preoperative VAS was 88.6 ± 7.6 and 28.6 ± 22.8 at 2 days, 40.5 ± 22.8 at 3 weeks, 34.3 ± 25.1 at 6-months and 32 at the last follow-up. At follow-up, two patients (9.1 %) had recurrent disc herniations that were corrected with open surgery. At the time of surgery, 16 patients held jobs. Fifteen (15) patients (93.8 %) returned to their original jobs postoperatively; one patient could not return to his original job postoperatively because of a comorbidity. Percutaneous endoscopic discectomy using the foraminal retreat technique is an effective treatment method for patients with foraminal and extraforaminal disc herniations at the L5-S1 level on appropriately selected patients.

Benign Neurological Recovery with Low Recurrence and Low Peridural Fibrosis Rate in Pediatric Disc Herniations after Lumbar Microdiscectomy

Lumbar disc herniation (LDH) is a very rare clinical entity in the pediatric age group, therefore only a few clinical studies have until now investigated the clinical behavior of pediatric LDH. The natural clinical history, postoperative neurological recovery with radiological follow-up and quality of life related to the disorder continue to be unknown. We prospectively planned and designed two groups of LDH patients scheduled for surgery in this study. The operations were performed by the same surgeon in a randomized fashion. The first group consisted of pediatric patients and the second group of adult patients. Both groups contained 32 cases. Postoperative neurological recovery was assessed using the visual analog scale and Aberdeen Low Back Pain Scale. Postoperative peridural fibrosis was also evaluated in postcontrast magnetic resonance sections. After 3 years of follow-up, all parameters were significantly better in the pediatric LDH group with no recurrence of the disease. The pediatric LDH group was postoperatively better than the adult group both clinically and radiologically. Although LDH seems a catastrophic disease in the pediatric age group, the clinical picture and neurological recovery have a significantly more benign course than in adult patients even in operated cases.

Development of the Water Cooled Ceramic Breeder Test Blanket Module in Japan

The development of a Water Cooled Ceramic Breeder (WCCB) Test Blanket Module (TBM) is being performed as one of the most important steps toward DEMO blanket in Japan. For the TBM testing and evaluation toward DEMO blanket, the module fabrication technology development by a candidate structural material, reduced activation martensitic/ferritic steel, F82H, is one of the most critical items from the viewpoint of realization of TBM testing in ITER. In Japan, fabrication of a real scale first wall, side walls, a breeder pebble bed box and assembling of the first wall and side walls have succeeded. Recently, the real scale partial mockup of the back wall was fabricated. The fabrication procedure of the back wall, whose thickness is up to 90mm, was confirmed toward the fabrication of the real scale back wall by F82H. Important key technologies are almost clarified for the fabrication of the real scale TBM module mockup. From the view point of testing and evaluation, development of the technology of the blanket tritium recovery, development of advanced breeder and multiplier pebbles and the development of the blanket neutronics measurement technology are also performed. Also, tritium production and recovery test using D-T neutron in the Fusion Neutronics Source (FNS) facility has been started as the verification test of tritium production performance. This paper overviews the recent achievements of the development of the WCCB TBM in Japan.