Blockchain Papers

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Sep 9, 2021¡Computer Systems Science and Engineering
20 cites
Blockchain and Artificial Intelligence Applications to Defeat COVID-19 Pandemic

Mohammed Baz, Sabita Khatri, Abdullah Baz, Hosam Alhakami ¡ 6 authors

The rapid emergence of novel virus named SARS-CoV2 and unchecked dissemination of this virus around the world ever since its outbreak in 2020, provide critical research criteria to assess the vulnerabilities of our current he... | Find, read and cite all the research you need on Tech Science Press

Open access
Blockchain Technology Applications and Security
COVID-19 diagnosis using AI
Internet of Things and AI
Original source
May 18, 2021¡arXiv
0 cites
DID-eFed: Facilitating Federated Learning as a Service with Decentralized Identities

Jiahui Geng, Neel Kanwal, Martin Gilje Jaatun, Chunming Rong

We have entered the era of big data, and it is considered to be the "fuel" for the flourishing of artificial intelligence applications. The enactment of the EU General Data Protection Regulation (GDPR) raises concerns about individuals' privacy in big data. Federated learning (FL) emerges as a functional solution that can help build high-performance models shared among multiple parties while still complying with user privacy and data confidentiality requirements. Although FL has been intensively studied and used in real applications, there is still limited research related to its prospects and applications as a FLaaS (Federated Learning as a Service) to interested 3rd parties. In this paper, we present a FLaaS system: DID-eFed, where FL is facilitated by decentralized identities (DID) and a smart contract. DID enables a more flexible and credible decentralized access management in our system, while the smart contract offers a frictionless and less error-prone process. We describe particularly the scenario where our DID-eFed enables the FLaaS among hospitals and research institutions.

Open access
cs.CR
cs.DC
cs.LG
Original source
Nov 1, 2020¡IEEE Network
165 cites
Blockchain-Based Data Security for Artificial Intelligence Applications in 6G Networks

Weiwei Li, Zhou Su, Ruidong Li, Kuan Zhang ¡ 5 authors

The sixth generation (6G) networks are expected to provide a fully connected world with terrestrial wireless and satellite communications integration. The design concept of 6G networks is to leverage artificial intelligence (Ai) to promote the intelligent and agile development of network services. intelligent services inevitably involve the processing of large amounts of data, such as storage, computing, and analysis, such that the data may be vulnerable to tampering or contamination by attackers. in this article, we propose a blockchain-based data security scheme for Ai applications in 6G networks. Specifically, we first introduce the 6G architecture (i.e., a space-air-ground-underwater integrated network). Then we discuss two Ai-enabled applications, indoor positioning and autonomous vehicle, in the context of 6G. Through a case study of an indoor navigation system, we demonstrate the effectiveness of blockchain in data security. The integration of Ai and blockchain is developed to evaluate and optimize the quality of intelligent service. Finally, we discuss several open issues about data security in the upcoming 6G networks.

Advanced Wireless Communication Technologies
IoT and Edge/Fog Computing
IoT Networks and Protocols
Original source
Jan 1, 2020¡Business Analytics in Practice
0 cites
Conclusions

Witold Srokosz, Paweł Lenio, Grzegorz Sobiecki

The main goal set in this monograph was to create an economic and legal model for financing long-term and capital-intensive investment projects utilizing the potential of DLT (Distributed Ledger Technology) so that the new solution is an effective alternative and is adapted to existing legal possibilities (compliance-by-design approach). The monograph is the most important result of the work carried out as part of a grant financed by the Polish National Science Centre, and contains a proposal for such a model (see Chapter 7 ).

3 source records
Blockchain Technology Applications and Security
FinTech, Crowdfunding, Digital Finance
Global Financial Regulation and Crises
Original source
Jul 21, 2019¡2019 3rd International Conference on Artificial Intelligence Applications and Technologies (AIAAT 2019)
16 cites
Biometric Blockchain: A Better Solution for the Security and Trust of Food Logistics

Xu, B., Agbele, T., Jiang, R.

Blockchain has been emerging as a promising technology that could totally change the landscape of data security in the coming years, particularly for data access over Internet-of-Things and cloud servers. However, blockchain itself, though secured by its protocol, does not identify who owns the data and who uses the data. Other than simply encrypting data into keys, in this paper, we proposed a protocol called Biometric Blockchain (BBC) that explicitly incorporate the biometric cues of individuals to unambiguously identify the creators and users in a blockchain-based system, particularly to address the increasing needs to secure the food logistics, following the recently widely reported incident on wrongly labelled foods that caused the death of a customer on a flight. The advantage of using BBC in the food logistics is clear: it can not only identify if the data or labels are authentic, but also clearly record who is responsible for the secured data or labels. As a result, such a BBC-based solution can great ease the difficulty to control the risks accompanying the food logistics, such as faked foods or wrong gradient labels.

Open access
3 source records
cs.CR
cs.CV
cs.DC
Original source
Oct 1, 2018¡2018 International Conference on Artificial Intelligence Applications and Innovations (IC-AIAI)
14 cites
Objective Barriers to the Implementation of Blockchain Technology in the Financial Sector

Inna A. Kruglova, Valery Alexandrovich Dolbezhkin

The article is devoted to the discussion of actual problems of introduction of blockchain technology in banking business, the solution of which determines the prospects of wide commercialization of these innovations. Commercial banks' interest in innovation is determined by the threat of steadily declining business profitability and a new competitive threat to traditional sources of income from new fin-technologies. Despite the active development of crypto-innovations (algorithms, platforms, crypto-currencies), the use of blockchain by banks in the financial sector is still very modest. Like most of the participants in this market, banks only carefully test computer technologies for managing a distributed ledger, and therefore objective barriers hindering progress in this area are of actual interest to specialists and researchers. The application of any innovative technology in the banking business depends on the successful compliance of new opportunities and time-tested requirements of consumers in the financial sector. In particular for the technology of the blockchain, just has not fully resolved key-problems of standardization, boundary identification, security and cyber-security, reliability of execution transaction, scalability of projects, etc. Here considered the main barriers, from the author's viewpoint, of implementation of the blockchain in the banking business, confirmed by the authoritative materials of centers for innovative financial technology.

Business and Economic Development
Digitalization and Economic Development in Agriculture
Digital Transformation in Financial Services
Original source
Oct 1, 2018¡2018 International Conference on Artificial Intelligence Applications and Innovations (IC-AIAI)
7 cites
Approaches to Evaluating the Function of Prediction of Decentralized Applications

Mariia Sigova, Igor Klioutchnikov, Anna Zatevakhina, Oleg I. Klioutchnikov

Is the distributed ledger technology able to predict the capital asset prices and digitizes any financial market participant? Prediction is a scary and tempting place to venture, profitable trading and the development of effective strategies. Will predictions fit into the everyday practice of financial markets? Is blockchain technology capable to revolutionize predictions? Is the blockchain able to compensate of the lack of individual intelligence in assessing market prospects? In the article, the authors do not so much raise these questions as they try to outline the directions for their solution. Financial inclusion is one of the problems that blockchain technology can solve, if it is applied properly. Transferring predictions to the online mode and providing each market participant with the opportunity to digitize their activities would help introduce new efficient mechanisms to improve performance of financial market practices. The article discusses two aspects of using blockchain technology in finance - forecasting financial markets using “collective knowledge” and digitizing assets of market participants based on blockchain. The article also raises the question of the possibility of using some fundamental physical laws for analyzing the impact of new technologies on the financial markets. An attempt is made to approach the assessment of the prospects of using a number of decentralized applications for financial market predictions and the creation of digital counterparts of market participants. A fundamental lesson from experiments in predicting financial markets and digitizing market participants is that decentralized solutions are still not sufficiently scaled and, as a result, are used by consumers.

Advanced Database Systems and Queries
Statistical and Computational Modeling
Advanced Research in Systems and Signal Processing
Original source
Jan 1, 1972¡Apress eBooks
2 cites
Introduction

B. Balamurugan, T. Poongodi, M. R. Manu, S. Karthikeyan ¡ 5 authors

The moving image archive of the US Agency for International Development (USAID) includes a copy of the film The Double Day (1975), cataloged in the series Moving Images Relating to International Development Programs and Activities, 1979–1991, a collection of more than eight hundred titles “created to provide information on assistance programs supported by the Agency for International Development (AID).”1 Yet, The Double Day does not, in fact, directly depict or engage with any specific development or aid initiative. Instead, the film—directed by US-based Brazilian filmmaker Helena Solberg as part of the International Women’s Film Project collective and described as “the first Latin American feminist documentary”—examines the gendered dynamics of paid and unpaid labor through the testimonies of women from Argentina, Bolivia, Venezuela, and Mexico.2 Its presence in the USAID archive is likely a consequence of its funding history, having received support from the Inter-American Foundation, a USAID-affiliated entity; the development agencies of Denmark, Norway, and Sweden; the United Nations Development Program; and US philanthropist Calvin Cafritz.3These transnational funding structures not only enabled the film’s production but also determined its archival destination, which renders legible its place within the history of international development.4 The Double Day’s institutional trajectory reflects the shifting configurations of aid, gender, and media during a historic moment when women were being repositioned at the center of what Arturo Escobar has described as development’s “regimes of visuality.”5 Especially relevant to The Double Day’s production and exhibition was the international institutional framework of Women in Development (WID). Emerging in the early 1970s and culminating in United Nations’ proclamation of 1975 as International Women’s Year, WID emphasized women’s participation in the global economy as both an index and mechanism of development. Indeed, The Double Day premiered at the World Conference of the International Women’s Year, held in Mexico City.6 Within this context, the film forms part of a broader trajectory of media use by international organizations that intensified during the 1970s—as best exemplified by Media Habitat, a collection of 236 documentary films commissioned by the United Nations to represent urban and rural development initiatives for the 1976 Habitat Conference on Human Settlements in Vancouver. As a policy-shaping initiative, Media Habitat primarily featured films from the Global South intended not only to illustrate but also to help codify standardized audiovisual markers of “underdevelopment” that determined access to the emerging global economic order and to international aid.7Framed in relation to these international institutions and their operations, The Double Day could similarly be considered “development media”—exemplifying the type of nonfiction media produced and distributed outside of the commercial film circuits whose aspects and subcategories have been variously described in scholarship as nontheatrical, useful, sponsored, institutional, industrial, educational, or nonprofessional/amateur.8 Scholars working in this area have emphasized the institutional contexts of such media’s production and exhibition infrastructures as shaping its instrumentalized effects. From a feminist perspective, such an approach is crucial to grappling with the broader question of how “gender impacts [these works’] shape, content, and trajectories.”9 Yet we also argue that, taken in isolation, the institutional and infrastructural contexts are insufficient to account for the complex relationship between media and development, potentially not only limiting our understanding of the reach and impact of development but also distorting our interpretive conclusions. For example, to categorize The Double Day as “development media” is to overlook the film’s place within Solberg’s directorial oeuvre, as well as within the histories of both transnational women’s filmmaking and radical Latin American documentary cinema to which it simultaneously belongs. Such exclusive framing is especially limiting given that women globally were disproportionately engaged in nonfiction production throughout the twentieth century—sometimes by political choice but more often due to structural exclusions from fiction filmmaking. Even in nonfiction historiography, however, institutional media has remained particularly marginal, reinforcing hierarchies that separate such works from the aesthetic and authorial frameworks through which film history has been constructed.10 This marginalization not only tends to erase women’s contributions but also presumes a “weak” or derivative authorship, rendering these films unworthy of the interpretive attention needed to apprehend their aesthetic and political complexity.11 The same dynamic is likely to structure assumptions about “development media” as well.Categorizing The Double Day exclusively within this category would further prompt us to assume top-down institutional analyses that have been characteristic of both institutional media methodologies and the scholarship on development at large. This, in turn, would risk obscuring this film’s radical Marxist approach to women’s labor as well as its concrete contribution to activism and its attendant grassroot structures. In Mexico City, The Double Day became a catalyst for feminist solidarity in practice when one of the film’s protagonists, Bolivian activist and trade unionist Domitila Barrios de Chungara, was invited to participate in the Tribune of Non-Governmental Organizations held alongside the official UN conference.12 There, Barrios de Chungara challenged Western feminist priorities by reframing the debate around labor, class, and imperialism, helping to articulate a shared Third World feminist agenda that significantly departed from the developmentalist vision of the United Nations and USAID.13 Seen through the lens of activist media, The Double Day helped forge transnational solidarity networks by enabling information exchange across the diverse voices that shaped its making—from the women featured in the film to the activists who circulated it—revealing a considerably more dynamic interplay between institutional and grassroots or contingent media practices.Moreover, the film’s Latin American context—reflected in Solberg’s formation in Brazil as the only woman in Cinema Novo, its focus on women from across the region, and its premiere and key reception in Mexico City—requires grappling with the regional specificities of the very notion of development in its multiple iterations.14 Far from being an epistemological and political framework imposed solely by the Global North, both the practices of development and the theoretical foundations of developmentalism (understood as a broad and polysemic set of discourses) were shaped through the active participation of Latin American economists.15 Within this iteration, underdevelopment, as a constitutive notion of developmentalism, became central to a distinctly critical strand, which by the late 1960s became known as the dependency theory.16 This same approach is reflected in some of the best-known Latin American radical film manifestos of the time, arising precisely from the same milieus to which Solberg belonged.17These various considerations of the film’s history illustrate the methodological challenges confronting feminist scholars seeking to assess the impact of development on media projects, theories, and practices. To disregard the developmentalist context of such works by emphasizing their political aesthetics and affects risks reproducing a romanticized narrative of heroic resistance (albeit from a feminist perspective). Yet to engage exclusively with their institutional and material infrastructures risks naturalizing developmentalism’s political and epistemological foundations at the expense of the goals and beliefs of the many women who participated in these projects. The contradictions and ambivalences that animate such histories call for feminist frameworks capable of holding both institutional complicity and radical possibility in view.This challenge resonates with ongoing debates about the politics of the archive and what Allyson Field has termed “the practice of informed speculation.”18 As she reminds us, feminist, queer, and decolonial methodologies have long taught us to “press at the limits” of the archive to “inoculate our scholarship against our evidence’s afflictions.”19 The concern that the evidence we draw on in our analysis reproduces the very structures and blind spots of the dominant ideology and therefore shapes and delimits our interpretation becomes particularly urgent when engaging the developmentalist media corpus. Informed speculation offers an alternative by inviting the experimental, creative, and speculative rewriting of history, mobilizing the archive “in a project that runs counter to the original purpose, or the imperative to preserve, or the conditions that led to erasure.”20 Yet, as Field cautions, such speculative gestures must remain grounded in a deep and “intimate familiarity with the archive” that we are working with and against. Building on this imperative, we suggest that the developmentalist archive, in particular, demands expansion and critical reconsideration in ways that unsettle the very disciplinary frameworks through which it has been studied as well as the larger institutional contexts for such knowledge production.Our focus on The Double Day in the opening of this introduction thus foregrounds the entanglements of institutional and grassroots forces, local and international contexts, structural and interpersonal relations, and creative and economic factors that have shaped not only this film but the broader ecosystem of development media projects—and their preservation—over time. Addressing such a constellation involves transgressing methodologically entrenched divisions between political economy and aesthetics, between material infrastructures and affective regimes; reckoning with divergent periodizations across film history and world economics; and situating these within the local specificities of women’s movements and international institutional programs. It also demands attentiveness to the coexistence of multiple, and sometimes competing, understandings of development—each historically, geographically, and ideologically situated.We imagine this special issue as an opening toward a critical dialogue, not only about how such an approach might be enacted in practice but also about the far-reaching ways development paradigms have shaped both our objects of study and the contours of the field itself. The decision to center institutionally sponsored films across all the essays in this issue is deliberate and enables us to highlight institutional critique as a vital methodological imperative within our analytical framework. Created within the frameworks of international organizations, state agencies, or NGOs, these films’ histories make legible the institutional logics that underwrite their production. Yet our critique does not stop at these specific entities. Rather, we argue for a broader interrogation of the political conditions and institutional infrastructures that shape media and knowledge production more generally. This includes contemporary corporations embedded in the digital platform economy, from streaming services to the rapid expansion of AI. Equally critical is a reflexive examination of academia itself, where departments of economics, political science, and centers for development have played a formative role in producing and legitimizing developmentalist theories and policy frameworks. While the humanities and arts have at times offered critical alternatives, they have also frequently mirrored and reinforced many of the same developmentalist assumptions. A feminist analysis of the nexus between development and media must therefore unsettle not only dominant archives but also the institutional and disciplinary foundations of our own scholarly practices.As scholars, we share the complex position of navigating the same tensions between institutional complicity and emancipatory aspiration as many of the media-makers whose work we study. Mirroring our subjects is also the transnational, collective mode of this special issue’s own production as it emerges from an ongoing informal working group we have sustained over several years. While relying on institutional and disciplinary affordances—such as university funding for conferences or access to academic publishing platforms—we have been working toward creating a community that exceeds, and often resists, the prevailing logics of our academic institutions. Our aim has been to create a space for shared inquiry and mutual support that pushes back against disciplinary siloing and technocratic neoliberal assessment modes of both labor and knowledge production—and this certainly extends to our experience collaborating with the journal editors throughout the publication process. Our goal has been to examine both the persistence and variability of developmentalism, understood as what Gustavo Esteva calls a “powerful but fragile semantic constellation,” as a conceptual formation that has historically inspired, legitimized, and mobilized media projects across Asia, Africa, and Latin America.21 And gendered biopolitics, from population control to gender mainstreaming, have remained integral to development policies and media practices, recurring across formats from institutional newsreels to film festivals.We share the conviction that, far beyond the history of nonfiction institutional media, development (as both a broad ideological project and a network of material and institutional practices) and developmentalism (as a set of discourses and theoretical models associated with development) have exerted a far-reaching influence on film and media cultures at large. As such, they must be treated as a major force in shaping global film and media systems and also the many ongoing assumptions behind their critical discourses. The discipline of communication studies was founded on modernization theory governed by Cold War goals of dissemination of Western liberal democracy around the world, while “an area studies framework allowed compartmentalizing Western and non-Western outcomes of technologies that were always claimed to be universal.”22 Despite critique from postcolonial and critical race studies, many of these frameworks have remained foundational for media theory.23 In historical scholarship, as we increasingly move beyond “modernity” as a dominant conceptual anchor, engaging with practices and discourses of development opens more precise analytical pathways. These film and media’s entanglements with the logics of and economic and the associated with as well as their conceptual underdevelopment, and impact in as diverse as and of media aesthetic and paradigms in film and film and funding are developmentalist assumptions to the they to underwrite the narrative and logics of and global media from the structure of the film to the cultures of argue that a examination of the historical entanglements between film and developmentalist aesthetics, modes of as well as infrastructures and critical the and that our contemporary media is a of the historical contours of development as a field of inquiry embedded within a of some of the methodologies by the featured in this special a of this complex history, to the larger at in media, development, and gender all its development a it as an of be with practices as divergent as and in In as we work on this the of the of the USAID the ideological that have the history of international the and of this on the global its a from development as a global practice and as an institutional and which over the has as a with its own media Yet or does not erase the historical impact of these the contradictions they have reflected and over the as the of development several crucial to the economic theories of development initiatives to and through the of the development an international policy framework at from the Global to the of the Global the by the political role of and the of the International the on was challenged by dependency theory and at development as global structural the neoliberal of the the Programs by the and World imposed and as conditions for and forms of assistance became known as the major markers for international development development has moving beyond economic to such as the Human Development and the Development and from international organizations such as the United Nations to a broader network of These frameworks increasingly of and liberal of and with what in many ways to various while the of the to development’s epistemological more scholarship has toward a of its and material the field has to a of and critical by and scholars, which development as a dynamic of conceptual and political to these the studies in this special issue call for sustained analysis in place of In we draw from a of and that in of of gender and to this special issue engage that and from Mexico to contemporary specific local historical of global distinctly feminist methodologies as well as attention to studies that this issue a in the global history of development on and documentary work in Mexico how early women infrastructures as of while US films an early of state and transnational on a outside the Global as the of developmentalist both the and markers of development media, its to the and Latin central grounded in archival also women’s in transnational and the methodological of archives on study of the series to a a digital media not by but by women not as but as subjects and within circuits of neoliberal and the aesthetics and of how development’s has models of to contemporary neoliberal paradigms of and analysis how digital and gender and practices, discourses on and their of these essays the of some of the historical of developmentalist as the question of the role of the state within such on a notion of economic as a and the dominant of development that the state as the for and through infrastructural projects. This understanding of development was shared across both of the as well as in the Third The United and the increasingly mobilized international in the of the modes of international at the postcolonial of policy and ideological These programs were at the expansion of their and of while with the and decolonial of The conceptual between modernization and development that the Cold in of and hierarchies of that long and As an of postcolonial their role as of international aid concern about the of Western development projects. In alternative across the Global South that to structural between and through policies of and In many they were further the global structures. In Latin for example, this approach was through organizations such as the United Nations for Latin and the both developmentalist projects and their have taken many forms historically, and they have and they have been to a of projects, and postcolonial and development has been and in ways and with frequently political While many of these alternative frameworks the embedded in dominant Western they often technocratic and assumptions. gender and gender as for the of to be shaped by This becomes particularly in the media that of development where women frequently a crucial associated with and women were as both the subjects and of their participation in the and labor often as the index of In this study of from the 1970s how women were as of this as these about women’s urban and recurring and of a within the own of and critique that official examination of archives and enables a feminist interrogation of their mobilizing a of the in the of contribution to this issue similarly the of a dynamic within as well as across ideological the of women’s and the media of the and as active in labor and as integral to the technocratic women became of as their labor remained a of and analysis and archival with attention to the specific of and It also transnational that as a and affective a nexus of and practices through which gender, media, and developmentalism one film not as a but as part of the of alongside and work a broader concern of this special media as a of developmentalist projects. The debates the World and which international such as the United Nations and a critical historical for such primarily by postcolonial and of the for the of media and communication infrastructures in as to counter Western The a between and economic how systems of media and reinforced global hierarchies of and in an agenda that supported and alternative media infrastructures across postcolonial contexts, the framework gender as an analytical This “gender in the 1970s by of the Women in Development in relation to The Double its political critique of with its broader to center women in development policy through and This was also in of media, which was shaped by its international reach and audiovisual production and and and Yet, as WID institutional it also to the and of the women’s development programs often by in These were by a of studies, and on and the to of women’s presence and through the of their economic and In this on the filmmaker this history directly by the and of for women by the WID framework during the with and agencies the of and against Women in at the of the neoliberal turn, when institutional media often the only to access and support to projects. The an by this dynamic as of the from the Global South are to engage with the developmentalist assumptions funding models that their similarly the as a in developmentalist media history by the of and centers on the Film a between of and the attention toward the and labor by and work was foundational the of and the of audiovisual aid, as both a of development projects and a critical for their the in this issue argue for a with media, gender, and developmentalism as an field of that is and shaped by feminist and methodologies and that challenge the entanglements between academic knowledge production and and technocratic development And while methodological these dynamics at the structural the of feminist in media and cinema by this the very a

Open access
51 source records
Blockchain Technology Applications and Security
Wikis in Education and Collaboration
Digital Education and Society
Original source
Mar 1, 1969¡Neurosurgery
8 cites
Foreword

William C. Hsiao, Alan Maynard

On behalf of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Section on Disorders of the Spine and Peripheral Nerves, it is my great privilege to introduce these Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries. These guidelines represent the initial installment of a more comprehensive guidelines initiative from the Joint Section on behalf of all practicing neurosurgeons and their patients. The Section is grateful to the small working group who devoted considerable time and effort to the generation of this outstanding document. We would like to formally recognize the Joint Section on Trauma for their important collaboration on this project. The Section would also like to acknowledge and thank the parent organizations, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, for their guidance of and support for this project, most notably through the efforts of the American Association of Neurological Surgeons/ Congress of Neurological Surgeons Guidelines Committee. The Section is also deeply indebted to Michael Apuzzo and the staff of Neurosurgery for their advice and editorial assistance in preparing this document for publication. The application of Neurosurgery’ s rigorous peer-reviewed editorial process has clearly enhanced the quality, balance, and stature of this document. Perhaps most importantly, Neurosurgery has provided an extraordinary vehicle for the widespread dissemination and ultimate incorporation of these guidelines to improve the care and enhance the outcomes of patients with traumatic cervical spine and spinal cord injuries. One of the truly important functions of organized neurosurgery is the generation of evidenced-based clinical practice guidelines. Properly developed, such guidelines can answer important questions, resolve uncertainty, identify areas of deficient knowledge and opportunities for future scientific investigation, standardize treatment, and improve the quality of care and the outcomes for patients. The now widely disseminated head trauma guidelines, for example, have clearly made a difference in the outcomes of patients with severe head injury. Guidelines development is a highly structured process with rigorous methodological criteria and exacting standards. It is a time-, labor-, and resource-intensive process that has served as a significant obstacle to more widespread guidelines development throughout neurosurgery. In the past, clinical practice guidelines have been developed by publicly supported epidemiologists and methodologists who understood study design, data analysis, and the guidelines process, but not the disease. This absence of context and clinical perspective significantly limited the value and relevance of their results. Alternatively, clinician-generated guidelines often took the form of methodologically flawed consensus panels and expert opinion, also of limited value. The Joint Spine Section recognized the importance of evidence-based clinical practice guidelines and the challenges of their development. The appropriate clinical expertise, strict adherence to established methodological standards for guidelines development, and considerable resource investment for the development, dissemination, and maintenance of the guidelines documents were deemed crucial to our guidelines initiative. Cervical spine and spinal cord injury was chosen as the initial guidelines topic because of the personal, social, and economic devastation of these injuries, their complex nature, and the high level of uncertainty, as reflected in wide practice variations, as to the value and indications for many of the aspects of evaluation and treatment. The clinical practice guidelines contained in this supplement to Neurosurgery represent a remarkable effort. They address the key issues related to the evaluation and management of these complex conditions that are relevant to the treating physician. In every chapter, the pertinent issues are succinctly stated, the published data are comprehensively presented in the evidentiary tables, and the evidence is thoroughly discussed and critically evaluated throughout the text. The linkage between the quality of the evidence and the strength of the recommendations was not a “black box” process but an open, deliberative exercise by skilled experts guided by a rigorous set of standards. Despite the strength and potential value of this document, it is important to acknowledge the inherent limitations of clinical practice guidelines. This, or any other, evidence-based clinical practice guidelines document does not represent the definitive source of knowledge on the stated topic. Rather, it represents recommendations of varying strength and certainty based on an analysis of the best available published data. These data, however, are often conflicting, flawed, or incomplete, and there are unavoidable elements of potential bias from subjectivity, perspective, and experience of the individuals and group involved in the analysis and interpretation of these data. In essence, proof is a relative term based on the interpretation of evidence. Furthermore, it is subject to different standards. A relevant example comes from the field of jurisprudence, where the standard of proof (i.e., guilt) for criminal trials is “beyond a reasonable doubt,” whereas the standard for civil courts must simply reflect “a preponderance of evidence” or “more likely than not.” These different standards evolved because of the perceived different consequences of a wrongful verdict. Moreover, as Stephen Haines likes to note, the verdict “not guilty” does not mean innocent; it merely says not proved. Such are the vagaries associated with the interpretation of even scientific evidence. Principled people can look at the same evidence and come to different conclusions subject to their own personal perspective, experience, and stake in the result. Nevertheless, the Joint Section and Guidelines Development Group went to great lengths to identify and avoid—or at least minimize—these potential problems. The working group adopted the most widely recognized and rigorous standards for guidelines development. A diverse panel of experts with expertise in spine, trauma, and epidemiology brought relevant clinical, scientific, and methodological competence to enhance both the analytical and the deliberative aspects of this process. Periodic outside reviews were routinely obtained for topics or areas of contention or uncertainty to add additional perspective and balance. Above all, the process was accountable and transparent at every stage. Ultimately, we offer these guidelines as a living document to those professionals who treat patients with traumatic spinal injury. We hope each practitioner will critically evaluate these guidelines and come to his or her own conclusion on how, whether, and when to implement its recommendations. It may be used either as a reference or as a basis for standardized protocols of evaluation and management of the patients with traumatic spinal injury. For clinical and basic science researchers, we hope that it will identify and catalyze scientific investigation in areas of deficient knowledge. As a Section, we stand firmly behind this important document and will continuously update the recommendations as new knowledge and understanding is developed. We sincerely believe that these guidelines can improve the care and enhance the outcomes of patients with traumatic injuries to the cervical spine and spinal cord.

Open access
5 source records
Spinal Cord Injury Research
Cervical and Thoracic Myelopathy
Spinal Fractures and Fixation Techniques
Original source