bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Speech-Language-Hearing Therapy Duration on the Degree of Improvement in Poststroke Language Impairment
Authors: Hayashi Hitoshi , Okada Eisaku , Shibata Yosuke , Nakamura Mieko , Ojima Toshiyuki
Published: January 2017

Background. The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear.Objective.To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare the findings with those for occupational therapy (OT) and physical therapy (PT).Methods. Data regarding patients with stroke sequelae who were registered in the Japanese Association of Rehabilitation Medicine database were analyzed. Propensity scores for ST, OT, and PT duration were calculated using logistic regression, followed by inverse probability weighting in generalized estimating equations to examine the odds ratio for improvement in the Functional Independence Measures scores for comprehension, expression, and memory. Analyses stratified by age and dementia severity were also conducted.Results. Compared with short-duration ST, long-duration ST was significantly associated with improved scores for comprehension and expression in the overall study population and in some groups, with higher benefit especially for younger participants (<64 years) and those with more severe dementia. A significant but less pronounced effect was also observed for OT and PT.Conclusion. Long-duration ST is more effective than long-duration OT or PT for improving language impairment occurring as stroke sequela. However, these effects are limited by age and severity of dementia.
A Case of Neonatal Marfan Syndrome: A Management Conundrum and the Role of a Multidisciplinary Team
Authors: Carande Elliott J. , Bilton Samuel J. , Adwani Satish
Published: January 2017

Neonatal Marfan syndrome (nMFS) is a rare condition with a poor prognosis. It is genotypically and phenotypically distinct from the typical Marfan syndrome and carries a poorer prognosis. This case report describes the progression of a 14-month-old girl diagnosed with nMFS at 5 months of age. Her diagnosis followed the identification of a fibrillin-1 mutation (FBN1gene, exon 26, chromosome 15), which is a common locus of nMFS. This patient developed severe cardiac complications resulting in congestive cardiac failure in early life and required major cardiac surgery. Since surgical intervention, our patient is still reliant on a degree of ventilator support, but the patient has gained weight and echocardiography has demonstrated improved left ventricular function and improved tricuspid and mitral valve regurgitation. Therefore, we argue the importance of a cautious multidisciplinary approach to early surgical intervention in cases of nMFS.
Agreement between Programmed Cell Death Ligand-1 Diagnostic Assays across Multiple Protein Expression Cutoffs in Non–Small Cell Lung Cancer
Authors: Ratcliffe Marianne J. , Sharpe Alan , Midha Anita , Barker Craig , Scott Marietta , Scorer Paul , Al-Masri Hytham , Rebelatto Marlon C. , Walker Jill
Published: January 2017

Purpose: Immunotherapies targeting programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) demonstrate encouraging antitumor activity and manageable tolerability in non–small cell lung cancer (NSCLC), especially in patients with high tumor PD-L1 expression, as detected by companion or complementary diagnostic assays developed for individual agents. A laboratory is unlikely to use multiple assay platforms. Furthermore, commercially available diagnostic assays are not standardized, and different assay methods could lead to inappropriate treatment selection. This study establishes the extent of concordance between three validated, commercially available PD-L1 IHC diagnostic assays for NSCLC patients [Ventana SP263 (durvalumab), Dako 22C3 (pembrolizumab), and Dako 28-8 (nivolumab)].

Experimental Design: Five hundred formalin-fixed, paraffin-embedded archival NSCLC samples were obtained from commercial sources. Stained slides were read in batches on an assay-by-assay basis by a single pathologist trained in all methods, in a Clinical Laboratory Improvements Amendments program–certified laboratory. An additional pathologist performed an independent review of 200 stained samples for each assay.

Results: PD-L1 expression was evaluable with all assays in 493 samples. The three assays showed similar patterns of tumor membrane staining, with high correlation between percent PD-L1 staining. An overall percentage agreement of >90% was achieved between assays at multiple expression cutoffs, including 1%, 10%, 25%, and 50% tumor membrane staining.

Conclusions: This study builds optimism that harmonization between assays may be possible, and that the three assays studied could potentially be used interchangeably to identify patients most likely to respond to anti-PD-1/PD-L1 immunotherapies, provided the appropriate clinically defined algorithm and agent are always linked. Clin Cancer Res; 23(14); 3585–91. ©2017 AACR.
Cardiac and Noncardiac Causes of Long-Term Mortality in ST-Segment–Elevation Acute Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention
Authors: Yamashita Yugo , Shiomi Hiroki , Morimoto Takeshi , Yaku Hidenori , Furukawa Yutaka , Nakagawa Yoshihisa , Ando Kenji , Kadota Kazushige , Abe Mitsuru , Nagao Kazuya , Shizuta Satoshi , Ono Koh , Kimura Takeshi
Published: January 2017

Background—

In patients with ST-segment–elevation acute myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention, long-term risks for cardiac and noncardiac death beyond acute phase of STEMI have not been thoroughly evaluated yet.

Methods and Results—

We identified 3942 STEMI patients who had primary percutaneous coronary intervention within 24 hours after onset between January 2005 and December 2007 in the CREDO-Kyoto AMI registry (Coronary Revascularization Demonstrating Outcome study in Kyoto Acute Myocardial Infarction) and evaluated their short-term (within 6-month) and long-term (beyond 6-month) incidences and causes of deaths. The cumulative 5-year incidence of all-cause death in the current study population was 20.4% (cardiac death, 12.2% and noncardiac death, 9.4%, respectively). The vast majority of deaths were cardiac in origin within 6-month (cardiac death, 8.0% and noncardiac death, 0.9%), whereas noncardiac death accounted for nearly two thirds of all-cause death beyond 6-month (cardiac death, 4.6% and noncardiac death, 8.5%). In the stratified analysis according to age, the proportion of noncardiac death was similar regardless of age although the absolute mortality rate was higher with increasing age. By the multivariable Cox regression models, the independent risk factors of all-cause death were advanced age, cardiogenic shock, renal dysfunction, large infarct size, and anterior wall infarction within 6 months after STEMI, and advanced age, previous heart failure, renal dysfunction, and liver cirrhosis beyond 6 months after STEMI, respectively.

Conclusions—

In STEMI patients who underwent primary percutaneous coronary intervention, the long-term risk for cardiac death was relatively low compared with that for noncardiac death, which accounted for nearly two thirds of all-cause death beyond 6 months.
Aldosterone Does Not Predict Cardiovascular Events Following Acute Coronary Syndrome in Patients Initially Without Heart Failure
Authors: Pitts Reynaria , Gunzburger Elise , Ballantyne Christie M. , Barter Philip J. , Kallend David , Leiter Lawrence A. , Leitersdorf Eran , Nicholls Stephen J. , Shah Prediman K. , Tardif Jean‐Claude , Olsson Anders G. , McMurray John J. V. , Kittelson John , Schwartz Gregory G.
Published: January 2017

Background

Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk.

Methods and Results

To address this question, we examined data from the dal‐OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome. Patients with New York Heart Association class
II
(with
LVEF
<40%),
III
, or
IV HF
were excluded. Aldosterone was measured at randomization in 4073 patients. The primary outcome was a composite of coronary heart disease death, nonfatal myocardial infarction, stroke, hospitalization for unstable angina, or resuscitated cardiac arrest. Hospitalization for HF was a secondary endpoint. Over a median follow‐up of 37 months, the primary outcome occurred in 366 patients (9.0%), and hospitalization for HF occurred in 72 patients (1.8%). There was no association between aldosterone and either the time to first occurrence of a primary outcome (hazard ratio for doubling of aldosterone 0.92, 95% confidence interval 0.78‐1.09,
P
=0.34) or hospitalization for HF (hazard ratio 1.38, 95%
CI
0.96‐1.99,
P
=0.08) in Cox regression models adjusted for covariates.

Conclusions

In patients with recent acute coronary syndrome but without advanced HF, aldosterone does not predict major cardiovascular events.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00658515.
Lectotypifications in Uruguayan Stevia (Asteraceae, Eupatorieae)
Authors: RODRÍGUEZ-CRAVERO JUAN F. , GUTIÉRREZ DIEGO G. , KATINAS LILIANA
Published: January 2017

Eleven species of Stevia were reported from Uruguay: S. aristata, S. burkartii, S. cinerascens, S. congesta, S. entreriensis, S. gratioloides, S. multiaristata, S. ophryodonta, S. sabulonis, S. satureiifolia, and S. selloi. Seven are shared with Argentina, five with Brazil, four with Paraguay, and two are endemic to Uruguay. During the revision of these species of Stevia, we detected names which need lectotypifications. As a result of our analysis four lectotypes are designated for names currently accepted in Stevia: S. congesta, S. gratioloides, S. polycephala (= Stevia aristata) and Dissothrix hassleriana (= Stevia entreriensis). We also clarified the original localities of type materials of S. congesta which occurs in Uruguay and, probably, in Brazil.
A new species of Guzmania (Bromeliaceae) from Southern Ecuador
Authors: GOUDA ERIC J. , MANZANARES JOSÉ M. , TAKIZAWA HIROYUKI
Published: January 2017

A new species of Guzmania from Ecuador, Province El Oro, closely related to G. teuscheri Smith (1960: 86), is described and illustrated here. It can easily be confused with this species, especially in herbarium specimen, in which the colour and structure of petals are lost.
Review of the genus Oncopsis Burmeister, 1838 (Homoptera: Auchenorrhyncha: Cicadellidae: Macropsinae) of Russia and adjacent countries with description of a new species from Central Asia
Authors: TISHECHKIN DMITRI YU.
Published: January 2017

Illustrated descriptions and data on host plants and distribution for 21 species of Oncopsis of Russia and adjacent countries are given, and O. abdykulovi sp. n. from Central Asia is described. Conspecificity of O. planiscuta from East Siberia and Sakhalin,of O. tristis from Moscow Area, Alati Mts., and Sakhalin, and of O. burjatica from East Siberia and Sakhalin is corroborated by male calling signal analysis.
Contact and Attitudes Between Ethnic Groups: A Survey-based Study of Adolescents in Norway
Authors: Bratt Christopher
Published: January 2017

Intergroup attitudes in a Norwegian town were investigated based on a survey with 12 to 16 year-old adolescents. Members of the ethnic majority group ( n > 1,100) and members of a minority group (ethnic Turks, n = 54) were studied. Two smaller immigrant groups (Pakistanis and Vietnamese) were used as additional attitude objects. The study demonstrated the expected association between outgroup friendships and more favourable outgroup attitudes. Explained variance of outgroup attitudes was limited among majority members, but was significantly higher among minority members. Boys among majority members demonstrated less favourable outgroup attitudes than those demonstrated by girls. However, they also revealed a higher association between contact and attitudes than girls did. The study was particularly interested in generalization effects across various outgroups. Although no common generalization effect was evident, the data indicated that friendships with members of one outgroup may be associated with either more positive or more negative attitudes towards another outgroup, dependent on the interrelations between the two outgroups. The study supported several hypotheses derived from the Contact Hypothesis, from Social Identity Theory, and from the Common Ingroup Identity Model. Still, it also demonstrated that intergroup relations in real world settings are more complex than laboratory experiments involving two groups can reflect. The data indicated that Muslim immigrant groups with different ethnic backgrounds might hold a common ingroup identity. At the same time, ethnic Norwegians demonstrated the least positive outgroup attitudes towards Muslim groups.
Comparison of Microflap Healing Outcomes with Traditional and Microsuturing Techniques: Initial Results in a Canine Model
Authors: Fleming Daniel J. , McGuff Stan , Simpson C. Blake
Published: January 2017

A prospective, blinded study was designed to determine whether placement of a microsuture in epithelial defects created on canine vocal folds results in histologically demonstrable improved healing. Epithelial defects similar to those created during microflap removal were made by means of traditional microsurgical techniques on both vocal folds of 4 adult dogs. One vocal fold defect on each dog was then closed with a single microsuture placed through the laryngoscope. The larynges were harvested approximately 6 weeks later, and blinded histologic quantification of scar formation was performed. Microsutures resulted in less scarring in all but 1 of the larynges studied. Unsutured vocal folds exhibited a 75% larger average scar cross-sectional area. Although the sample size was insufficient to establish statistical significance, the observed difference in scar formation between microsutured and unsutured vocal folds suggests that primary closure with a microsuture in the canine model results in less scarring than when healing occurs by secondary intention.
Tracheal Reconstruction with a Synthetic Material in a Porcine Model
Authors: Pearson Susan E. , Stelow Edward B. , Rimell Franklin , Pernell Kerri
Published: January 2017

The technique of tracheal reconstruction with costal cartilage or a pericardial patch has resulted in successful management of many patients with tracheal stenosis. Yet, it is often difficult, if not impossible, to harvest enough cartilage in a neonate. Pericardial patches are flimsy and can collapse. This pilot study evaluated the use of absorbable plates made of an alloplastic material, Lactosorb, as a substitute for cartilage on a growing porcine trachea. The rectangular plates were fashioned into an inverted U and placed into the airway through an anterior tracheal split. This placement resulted in granulation formation and failure. The plates were then fashioned into an I configuration and placed inside and outside the tracheal lumen. This attempt also resulted in failure, secondary to respiratory distress. Finally, the plates were fashioned into an inverted U and placed outside the trachea. In 67% of the subjects, the distraction was maintained and growth continued for the duration of the study. The stent was completely absorbed, with minimal scar or granulation tissue, in 4 months. In 1 subject, the stent migrated, and 1 subject died of a mucous plug. This study suggests that Lactosorb has no role in intraluminal stenting, but that it may be a viable alternative to a pericardial patch or cartilage in tracheal reconstruction when it is placed outside the airway lumen in a young animal.
Laryngospasm and Diaphragmatic Arrest in Immature Dogs after Laryngeal Acid Exposure: A Possible Model for Sudden Infant Death Syndrome
Authors: Duke Sanford G. , Ririe Douglas , Postma Gregory N. , Averill David B. , McGuirt William F. , Koufman James A.
Published: January 2017

Laryngopharyngeal reflux has been proposed as a possible cause of sudden infant death Syndrome (SIDS). We investigated the efferent laryngeal and diaphragmatic responses to acid exposure on the laryngeal mucosa using a neonatal canine model. Electromyographic (EMG) recordings from the thyroarytenoid muscle and the diaphragm were measured with hooked-wire electrodes. Reproducible laryngospasm responses occurred in all animals after laryngeal exposure to hydrochloric acid at pH 2.0 or less. Laryngospasm occurred in combination with tachypnea and increased diaphragmatic activity in most of the animals. Laryngospasm was associated with prolonged apnea and total cessation of diaphragmatic EMG activity in 1 animal, and in another, initial tachypnea was followed by erratic diaphragmatic activity and brief apnea. Laryngeal acid exposure (below pH 2.0) causes laryngospasm and may result in paradoxical apneic events in neonatal dogs. Acid-induce, laryngospasm-associated apnea may represent a potential cause of SIDS, and the immature dog appears to be an excellent model for further investigations.
Thyroglossal Duct Carcinoma: Alarge Case Series
Authors: Doshi Salil V. , Cruz Raul M. , Hilsinger Raymond L.
Published: January 2017

Thyroglossal duct cysts (TDCs) are common congenital abnormalities of thyroid development. Carcinoma occurs rarely in patients with TDCs. In a large case series drawn from medical records at a health maintenance organization from 1971 through 1995, 14 cases of carcinoma in a TDC were found. This represents the largest known reported case series to date. Demographics, diagnosis, and treatment methods are reviewed. We recommend the Sistrunk operation and evaluation of the thyroid gland and neck for potential abnormality that would necessitate thyroidectomy and lymph node dissection. Long-term follow-up incorporating clinical examination is mandatory.
Morphological and Histochemical Studies of the Genioglossus Muscle
Authors: Saigusa Hideto , Niimi Seiji , Gotoh Tadashi , Yamashita Kazuo , Kumada Masanobu
Published: January 2017

The purpose of this preliminary study was to assess the histoanatomic composition of the genioglossus muscle fibers. The genioglossus muscles were obtained from 4 cadavers and 1 autopsy specimen. On morphological study, the average diameters of the muscle fibers were seen to gradually increase, from the fibers that ran anteriorly to the dorsum of the tongue, to the fibers that ran posteriorly to the root of the tongue. Histochemical study revealed that type II fibers were significantly predominant in the anterior portion; there was no dominant fiber type in the posterior portion. Gradual changes in diameter were independent of fiber type. These findings may suggest that the fibers of the anterior portion are suitable for phasic action, and that the posterior is relatively tonic; and the posterior has larger absolute muscle strength than the anterior. It is thought that the fibers of the posterior portion might contribute to the maintenance of the mesopharyngeal airway and to vowel production, and that the anterior fibers might contribute to some fine movements and to consonant production.
Rhinomanometric and Olfactometric Variations Throughout the Menstrual Cycle
Authors: La Mantia Ignazio , La Boria Alessandro , Grillo Calogero , Triolo Carmela , Intelisano Giorgia , Scollo Annalisa , Caruso Salvatore
Published: January 2017

A prospective study was performed to evaluate the rhinomanometric values and the changes in the olfactory threshold that occur in women throughout the menstrual cycle. The subjects were 60 healthy volunteer premenopausal women 18 to 40 years of age. We performed rhinomanometric and olfactometric measurements during the follicular, periovular, and luteal phases of the menstrual cycle. Rhinomanometry showed a higher (not statistically significant) airflow during the periovular phase than during the follicular and luteal phases. Olfactometry showed a higher sensitivity during the follicular phase (p < .05) and the periovular phase (p < .001) than during the luteal phase. We conclude that airflow and transnasal pressure during spontaneous respiration, as well as the olfactory threshold to odors, seem to depend on the variations of the ovarian steroids that occur during the menstrual cycle.
Local Injection of Bevacizumab (Avastin) and Angiolytic KTP Laser Treatment of Recurrent Respiratory Papillomatosis of the Vocal Folds: A Prospective Study
Authors: Zeitels Steven M. , Barbu Anca M. , Landau-Zemer Tali , Lopez-Guerra Gerardo , Burns James A. , Friedman Aaron D. , Freeman Mason W. , Halvorsen Yuan-Di , Hillman Robert E.
Published: January 2017

Objectives:

Photoangiolytic laser treatment of recurrent respiratory papillomatosis (RRP) is effective, but does not reliably prevent recurrence. Therefore, sublesional injections of the antiangiogenic agent bevacizumab (Avastin) were given to assess the adjunctive effect on disease recurrence. Since bevacizumab is a new therapeutic modality for RRP, there were also primary safety objectives to determine whether there was a negative impact on the voice and whether there were local or systemic complications.

Methods:

A prospective open-label investigation was conducted in 20 adult patients with bilateral vocal fold RRP. The patients underwent planned 532-nm pulsed KTP laser photoangiolysis of bilateral glottal disease 4 times with an approximately 6-week interval between procedures. At each planned laser procedure, the vocal fold that on initial presentation had a greater volume of disease also underwent 4 serial sublesional bevacizumab injections (7.5 to 12.5 mg in 0.3 to 0.5 mL). A sham injection with saline solution was administered to the other vocal fold as a control. Disease resolution was compared between subjects' vocal folds, and objective measures of vocal function (acoustic, aerodynamic), as well as patients' self-assessments of vocal function (Voice-Related Quality of Life survey), were obtained.

Results:

All 20 patients completed the study, and there were no local or systemic complications. After 4 injections, 3 of the 20 patients had no discernible disease in either vocal fold. Of the remaining 17 subjects, 16 had less disease in the bevacizumab-treated vocal fold despite starting with more disease. Only 1 of the 17 had more disease in the bevacizumab-treated vocal fold after 4 injections. Moreover, 7 of the 20 patients (35%) did not require a laser procedure in the vocal fold that had received 4 bevacizumab injections, as compared with 3 of the 20 vocal folds (15%) that were treated with laser alone. All of the vocal function measures displayed statistically significant posttreatment improvements, except for average fundamental frequency in the 3 female patients, in whom it fell below the normal range.

Conclusions:

This prospective investigation provided evidence that bevacizumab injections enhanced KTP laser treatment of glottal papillomatosis without systemic or local complications. Coupling the antiangiogenesis agent bevacizumab with KTP laser photoangiolysis is conceptually synergistic and scientifically promising since the mechanisms of action are complementary.
The Conquering of Inner Space. Resources and Conflicts on the Seabed
Authors: Traavik Kim
Published: January 2017

In discussing the legal and political problems connected with exploitation of the inorganic resources of the continental shelf and deep seabed, the author examines the types and amount of resources available. Placing special emphasis on the interests of the developing countries, he goes on to suggest some of the probable consequences of large-scale extraction of offshore fuels and metals. Against this backdrop, the article concludes that, in the short run, the Third World countries are not likely to benefit greatly from the creation of a UN Sea-Bed Regime. In the final section of the article, some significant lines of division in UN Sea-Bed Committee are discussed.
The New Development in the Polar Regions
Authors: Sollie Finn
Published: January 2017

Due to factors connected with modern technological developments and with the increasing global demand for new sources of raw materials, there is today a growing interest in the possibilities for economic exploitation of the polar regions. This makes for a new development in these regions; a development comprising and affecting such fields as science and technology as well as economy, transportation, military strategy and ecology. The present paper discusses this new development and its implications in an international perspective. Special attention is paid to the significance – in the physical/geographical sense and otherwise – of the polar regions in the global context. A special section deals, on a general level, with ‘the problem of the new territories’, and the polar regions are discussed as new territories. Pointing out the risks and dangers inherent in the present and emerging developments, the author emphasizes the need for action, especially international cooperation, to meet and solve such problems. Cooperation may be facilitated through regular consultations between the states concerned, as is the case under the Antarctic Treaty. For the Arctic in particular, the author suggests a distinction between three basic zones (viz. the ‘Central’ the ‘Intermediate’ and the ‘National’ Arctic) as a possible point of departure for future discussion of measures of international cooperation.
Norway's Continental Shelf and the Boundary Question on the Seabed
Authors: Sollie Finn
Published: January 2017

One of the most important problems that should be solved at the UN Conference on the Law of the Sea, is that of determining the exact boundary between the continental shelf, where coastal states have exclusive rights of exploration and exploitation of resources, and the deep seabed, which is to be an international area and the common heritage of mankind.

With her long coastline and the generally very broad continental shelf lying off it, Norway is one of the countries which, both relatively and absolutely, have the greatest interest attached to their national seabed territories. However, the Norwegian continental shelf differs rather significantly from the ‘international norm’. Thus, large parts of the Norwegian shelf lie at greater depths than is normal off other countries. Also, the Norwegian shelf is exceptionally broad, especially in the north, where it has a width of more than 1,000 kilometers from the coast of Finnmark to the edge fronting the deep waters of the Arctic Ocean. Because of these extreme conditions, Norway could be adversely affected if an international agreement for a fixed boundary to the extent of the dominion of the coastal state over the seabed were to be based on global averages. Such an outcome to the negotiations taking place within the framework of the UN Conference on the Law of the Sea could be especially disadvantageous on the Norwegian shelf, where a narrowly-drawn boundary could, at worst, lead to a partition of the shelf between Norway and Svalbard (Spitsbergen); With the international agreement which applies to the Svalbard islands, and the special security policy situation which exists in the northern region, such a partition would be most unfortunate for Norway. The Norwegian ‘problem’ in the seabed issue arises because Norway negotiates from a position marked by extreme natural conditions and against the background of a security policy situation which makes the country especially dependent on a favorable outcome.
Natural Resources and Problems of Development
Authors: Antonsen Per
Published: January 2017

The author focuses on problems in the economy of the developing countries likely to arise as a consequence of mineral exploitation in the new territories. A general shortage of mineral resources, although predicted, should not uncritically be adopted as a sufficient explanation of the demonstrated interest of industrial enterprises in undertaking heavy investments in the new territories. The economic security claimed by institutions financing large-scale investments, may just as likely force the companies to seek options for long-term supplies from these areas, unhampered by the politically caused instabilities perceived in the Third World. This development may tend to push the developing countries into the role of subsidiary suppliers in the world market.

The committees preparing the UN Conference on the Law of the Sea have so far taken no realistic measures to counteract this possibility, which may prove detrimental to the economies of several developing countries. The Conference will, in the opinion of the author, provide little but a settlement of disputed interests among the coastal states.
Human Factors Research in India
Authors: Daftuar Chittranjan N.
Published: January 2017

This paper covers the published research in the area of human factors in India since 1955 under the following subheadings: (1) physiology and anthropometry, (2) accidents, (3) stress, (4) abilities requirements and performance, (5) decision making, and (6) displays.
Visual Performance with Simulated Flare Light: Effects of Flare-Ignition Altitude
Authors: Hilgendorf Robert L.
Published: January 2017

Four groups of ten subjects performed simulated target acquisition (detection and recognition) tasks under simulated Mark 24 flare light (2,000,000 cp.) One group performed with six aerial flares dropped 0.25 mi. apart (simulated), another group with six flares 0.50 mi. apart, another with four flares 0.75 mi. apart, and the last group with two flares 1 mi. apart. All groups performed at two simulated observer altitudes (2,000 and 2,500 ft. and with three simulated flare-ignition altitudes (2,000, 2,500, and 3,000 ft.). Generally, more targets were acquired at the 2,000-ft. flare-ignition altitude. There were no statistically significant differences attributed to flare separation or observer altitude.
Signal Detection and Chlorpromazine
Authors: Rappaport Maurice , Hopkins H. Kenneth
Published: January 2017

Nine normal subjects were tested on an auditory signal detection task under six signal-to-noise conditions while under the influence of different dosages of chlorpromazine, a commonly used major tranquilizer. A significant subject-x-drug-dosage-level interaction was found, some subjects showing impairment of signal detection performance while on medication while others did not show such impairment. Reasons for individual differences in response to the drug require further investigation. All subjects adopted increasingly conservative decision-making criteria and under-responded more as the signal-to-noise conditions became more difficult. It was suggested that chlorpromazine is likely to cause a greater deficit in signal detection performance in a continuous vigilance task than in a task where periodic brief focusing of attention is required and an alerting cue is provided immediately preceding the possible occurrence of a signal.
Detectability of Multiple Flaws
Authors: Geyer Lewis H. , Patel Shantilal , Perry Ronald F.
Published: January 2017

Two experiments measured detectability, d', and two measures of criterion location for multiple flaws presented separately versus mixed. In the first experiment, the different flaws were the same in type but differed in magnitude; in the second experiment the flaws were of different types. In Experiment 1 there was no difference in d' for either magnitude of flaw as a result of the separate versus mixed conditions, (i.e., each magnitude of flaw had its own d' in both separate and mixed conditions). However, in Experiment 2 all flaws had lower d's in the mixed condition than when each was presented alone. In neither experiment was there any difference in average criterion location between the separate and mixed conditions, nor did individual criterion locations for easy versus hard flaws presented separately differ in Experiment 1. In Experiment 2 there was a difference in individual criterion locations for the different flaws presented separately, such that for the hardest to detect flaw, false rejection error rate was lower and miss rate higher than for either of the two flaws with larger d's.
Nonparametric Measures of Sensory Efficiency for Sustained Monitoring Tasks
Authors: Craig Angus
Published: January 2017

The validity of d', the signal detection theory measure of sensory efficiency, seems suspect in applications to vigilance and inspection, and it is suggested that the investigator should use an alternative, distribution-free measure instead. Three nonparametric measures of efficiency which seem particularly well suited to vigilance applications are considered. The measures, AG (Green and Swets, 1966), A' (Pollack and Norman, 1964), and E (McCornack, 1961) are defined and illustrated, and an example is provided demonstrating their use and suitability in analyzing data from a sustained monitoring task. Norman's (1964) nonmetric procedure for comparing performance efficiency is also applied to the data and is shown to provide a useful means for distinguishing between measure-dependent and measure-independent inferences about changes in efficiency. The relative merits of the three non-parametric measures are discussed.
A Nonlinear Model Describing Driver Behavior on Straight Roads
Authors: Baxter John , Harrison John Y.
Published: January 2017

Experiments on a CRT driving simulator are used to develop a closed-loop human operator model for straight road driving in the absence of any externally applied disturbance such as side wind gusts or road roughness. It is shown that a significant portion of the driver's control characteristics can be represented by a stationary, nonlinear system with a single visual input. The driver's visual input is considered to be the angle subtended between the heading axis and a line connecting a point on the lane center at a preview distance with his eyes. An optimization procedure is used to evaluate the model parameters, and it is found that the driver's action can be best represented by a pure time delay cascaded with a classical hysteresis nonlinearity. The self-excited limit cycle frequency and amplitudes of this model system are shown to agree closely with respective quantitative aspects of the experimental data confirming the validity of the model.
Human Performance in Sampling Inspection
Authors: Tsao Yao-Chung , Drury Colin G. , Morawski Thomas B.
Published: January 2017

In the design of industrial inspection tasks, the assumption is usually made that human performance data collected in a 100% inspection scheme is valid for use when the inspector is engaged in sampling inspection. A direct test of this assumption using 60 student subjects showed it to be valid. Analysis of the inspection data in terms of stopping policy in selfpaced inspection showed close correspondence with a model of systematic visual search.
Human Stereopsis
Authors: Patterson Robert , Martin Wayne L.
Published: January 2017

This paper reviews much of the basic literature on stereopsis for the purpose of providing information about the ability of humans to utilize stereoscopic information under operational conditions. This review is organized around five functional topics that may be important for the design of many stereoscopic display systems: geometry of stereoscopic depth perception, visual persistence, perceptual interaction among stereoscopic stimuli, neurophysiology of stereopsis, and theoretical considerations. The paper concludes with the presentation of several basic ideas related to the design of stereoscopic displays.
Quality Criteria for Simulator Images: A Literature Review
Authors: Padmos Pieter , Milders Maarten V.
Published: January 2017

Quality criteria are presented for each of about 30 different outside-world image features of computer-generated image systems on vehicle simulators (e.g., airplane, tank, ship). Criteria derived are based on a literature review. In addition to purely physical properties related to image presentation (e.g., field size, contrast ratio, update frequency), attention is paid to image content (e.g., number of polygons, surface treatments, moving objects) and various other features (e.g., electro-optical aids, vehicle-terrain interactions, modeling tools, instruction tools). Included in this paper are an introduction on visual perception, separate discussions of each image feature including terminology definitions, and suggestions for further research.
The Stability of Blood Cholinesterase after Death
Authors: Edson E. F. , Sanderson D. M. , Watson W. A. , Noakes D. N.
Published: January 2017

Illness or death in a person who has recently used or had access to organophosphate insecticides—some of which are highly poisonous—may present a difficult problem in diagnosis. Post-mortem appearances are likely to be non-specific, and the gastric contents may not be helpful, especially if skin absorption or inhalation was the route of absorption. However, all organophosphate insecticides cause inactivation of the vital enzyme cholinesterase, which is present in the blood and tissues, and for which an accurate biochemical determination is possible. Is this inactivating effect on the enzyme persistent after death, or does the test become useless due to post-mortem changes? The investigation described in this report suggests that for at least one widely-used organophosphate, and probably for many others, the inactivation is persistent long after death, and that diagnosis of the probable cause of death may be possible for weeks afterwards, from the reduced enzyme content of the blood or tissues.
The Diagnosis of Drowning by Quantitative and Qualitative Diatom Analysis
Authors: Pachar J V , Cameron J M
Published: January 2017

The reliability and applicability of quantitative and qualitative diatom analysis in the diagnosis of drowning has been evaluated. Water and organ samples of immersion cases reported in the area covered by the Department of Forensic Medicine of the London Hospital Medical College, were analysed using both light and scanning electron microscopy. Controls included organ samples of the bodies of people who died from natural causes and exclusion of contamination. Organ samples of both immersion and control cases were prepared by chemical digestion with concentrated nitric acid.

Diatoms were present in the majority of samples of organs of both immersion and control cases but there was a significant quantitative difference between the number of diatoms in control and immersion cases. Qualitative analysis of water and organ samples of immersion cases supported the diagnosis of death due to aspiration of water in approximately a third of the total of bodies found in water. It has been suggested that the present analysis can be used as basic criteria for standardization of the diatom method.
Cave Vulgantem Morbum — Tuberculosis
Authors: Christiansen J , Koelmeyer T D
Published: January 2017

This study investigates the circumstances surrounding all cases of tuberculosis found at autopsy in Auckland during the period 1975–1992. Cases were placed in one of six categories according to the medical history and autopsy findings. Of the 34 cases in the study 22 were clinically undiagnosed prior to autopsy. Of these, six exhibited respiratory symptoms that should have led to a diagnosis and three reported unexplained chronic symptoms such as weight loss for which tuberculosis should at least have been considered. Only 10 cases were correctly diagnosed before death. The autopsy plays an important role in finding undiagnosed cases of tuberculosis, as patient contacts may then be followed up. The vital role of post-mortem examination in medical audit and public health is, once again, demonstrated.
1. A Bolt from the Blue
Authors: Claydon S. M.
Published: January 2017

The crossbow was one of the most efficient military weapons of the Middle Ages but the development of portable firearms meant that it was eventually relegated to the museum shelf. The medieval crossbow was accurate and deadly but took some time to load because of the windlass used to wind the string, thus increasing the velocity and range of the bolt, or quarrel. By contrast, the English longbows of Crecy and Agincourt were far less accurate but could fire six arrows in the time taken to shoot one bolt and the continual raining-down of missiles proved more successful in battle than accuracy of aim.

This paper describes the homicide of a young business woman outside her London flat in 1987. Today crossbow fatalities are extremely rare on both sides of the Atlantic but Dr Siva described a case of suicide in 1979 and Professor Gresham presented a case of crossbow homicide to the BAFM in June 1976.
Bacterial Contamination of Children's Toys Used in a General Practitioner's Surgery
Authors: McKay I. , Gillespie T.A.
Published: January 2017

General practitioners — and other healthcare professionals are encouraged to make their premises child friendly. One way of doing this is to provide toys for children to use. We looked at the appearance and bacterial colonisation of 50 toys after a busy morning surgery in an inner city general practice. The toys appeared generally unclean and 10% were contaminated by potential pathogens. Bacteria were cultured more frequently from soft toys than from hard toys (odds ratio 8.14; 95% confidence range 0.74 − 107.49). Although toys may appear to be physically dirty after use, the bacteria isolated from their surfaces are generally non-pathogenic to children with normal immune function and probably no worse than other objects in the environment. However, there does exist an appreciable (1 in 10) risk of cross-infection with the use of toys in a clinic. Toys with a hard surface are preferred as these are less likely to be contaminated and are more easily disinfected.
Health Advice and the Traveller
Authors: Harris C.B. , Welsby P.D.
Published: January 2017

We studied advice given by travel agents, the experiences of recent travellers, and the hidden costs for travellers to Kenya. There was a wide range of advice given by United Kingdom travel agents, much of it at variance with advice given by other travel agents and much of it incorrect. Nevertheless travel agents have a responsibility to give advice because they are often the only point of contact for health advice.
A Three Year Review of Injuries to Professional Footballers (1995–98) and Comparison with Previous Observations (1990–93)
Authors: McGregor J.C. , Rae A. , Melvin W.D.
Published: January 2017

A prospective study over a three year period (1995-8) of footballers' injuries in first team players was undertaken in a similar fashion to a previous study (1990-3). During the present study the Club had a major cup success and appeared to have a younger squad with less major injury and subsequent time out of action. As a result of the earlier paper it would appear that some lessons and observations may have been put into action and helped produce a more consistent standard for the club. Increasing recognition of the need to reduce and monitor the levels and types of injuries seems now to be established.
Optimising Direct Access Echo Referral in Suspected Heart Failure
Authors: Lindsay M. M. , Goodfield N.E.R. , Hogg K.J. , Dunn F.G.
Published: January 2017

The objective was to prospectively validate a method of increasing the sensitivity, specificity and negative predictive value of a normal ECG in the exclusion of left ventricular systolic dysfunction by the addition of clinical history. We performed a prospective three year study of all referrals to our direct access ECHO service for assessment of LV function. The ECG was reported blind of the result of the ECHO, history of MI or not was noted, and result of the ECHO predicted. Over three years 416 patients were assessed for the presence or absence of left ventricular systolic dysfunction and consequent changes in clinical management. A total of 320(77%) of patients referred with suspected left ventricular dysfunction were found to have normal left ventricular function. Of the 250(60%) patients treated prior to referral for assessment, 183(73%) were treated inappropriately. The combination of a normal ECG and a negative history of myocardial infarction had a sensitivity of 98% and a negative predictive value of 99% in the assessment of LV function. This was an improvement over a normal ECG alone. Our study shows that diagnosis and treatment of heart failure in the community remains sub-optimal. The combination of a normal ECG and no previous history of myocardial infarction is shown to be a sensitive and accurate predictor of normal left ventricular function. If adopted by general practitioners this would be a valuable method of optimising the use of ECHOCARDIOGRAPHIC in patients with suspected left ventricular dysfunction.
Setting up a Pain Management Programme the Ayrshire Experience
Authors: Martin C. , Obonyo T. , Carney T. , Lamont L.
Published: January 2017

A controlled trial of an outpatient cognitive behavioural pain management programme for sufferers of non-cancer chronic pain is described. A multidisciplinary team set up a programme of ten half day sessions for groups of ten to fourteen patients aiming to improve activity levels and control over pain; to reduce maladaptive pain behaviours and drug intake; to mitigate negative mood; to modify unhelpful beliefs and to maintain treatment gains by operant and cognitive methods. Self report questionnaires were employed before and six weeks, six months and one year after the programme. Fifty-eight patients entered the study group and 39 patients completed the programme and initial follow up with further attrition in long term follow up. There were no changes in the waiting list control group of twelve subjects but the study group made significant short and long term improvements in pain severity, activity levels, mood, coping and experienced fewer catastrophizing thoughts.
A Reappraisal of the Role of Chlorambucil in Patients with End Stage Ovarian Cancer Who Have Previously been Treated with Platinum Regimens
Authors: McCully K.S. , Narayansingh G.V. , Cumming G.P. , Sarkar T.K. , Parkin D.E.
Published: January 2017

The role of chlorambucil in end stage platinum resistant epithelial ovarian cancer was evaluated in women with end stage ovarian cancer. They had received platinum based chemotherapy and all other intravenous chemotherapeutic options had been exhausted. Over a 15 year period, 30 patients were identified. The median age was 64.5 years (range 45–81). The median number of chlorambucil pulses was 4 (range 1–16). The median survival following the introduction of chlorambucil was 5.5 months (range 0.72 – 38.8). The 22 patients who survived for longer than three months were significantly younger than those who did not (p= 0.03). Apart from two patients who developed transient myelosupression there were no toxic side effects. Chlorambucil should be considered as a therapeutic option in end stage ovarian cancer. It is has minimal toxicity, and can be prescribed safely for long term use. In younger women, an increase in benefit may be anticipated.
Intracerebral Haemorrhages and Oral Anticoagulation in the North of Scotland
Authors: Berwaerts J. , Robb O.J. , Jeffers T.A. , Webster J.
Published: January 2017

The aim of this study has been twofold: 1 - to examine the impact of oral anticoagulant (OAC) use on a possible recent rise in the admission rate of intracerebral haemorrhages to Aberdeen Royal Infirmary (ARI), and 2 - to estimate the absolute risk of intracranial haemorrhage for outpatients followed up in the OAC Clinic at AR1. The number of patients admitted to ARI with intracerebral bleedings increased by 60% between 1993 and 1998. A corresponding increase in the proportion of patients with concurrent OAC use (4.7% vs 15.7%, p=0.055) cannot sufficiently explain the increase in the total number of intracerebral haemorrhages. The average annual incidence of intracranial haemorrhages for the OAC Clinic at ARI is found to be acceptably low at 0.33% per year. Further audit of the large number of patients receiving warfarin outwith the supervision of the clinic is urgently required.