bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical, thermal, and rheological properties of polypropylene hybrid composites based clay and graphite
Authors: Bensalah Hala , Gueraoui Kamal , Essabir Hamid , Rodrigue Denis , Bouhfid Rachid , Qaiss Abou el kacem
Published: January 2017

Polypropylene hybrid composites based on a mixture of graphite and clay were compounded by twin-screw extrusion and injection molded. In particular, the effect of reinforcement content and ratio of each particle was studied via morphological, mechanical, rheological, and thermal properties. The properties were evaluated in both solid and melt state to determine the mechanical performance of these materials. The results showed that these composites have excellent mechanical properties when compared to the neat polymer matrix. For example, the tensile moduli are 1607 and 1445 MPa for 30 wt% of clay and graphite respectively, while a 10:10 ratio of clay/graphite produced a value of 1500 MPa. Morphological analyses showed good adhesion/dispersion of both particles in the matrix, which was confirmed by good tensile strength results. Also, thermal stability was improved by adding clay and graphite particles, the results showing between 40℃ and 50℃ increased at 20 wt% content. Finally, a combination of graphite and clay is shown to produce hybrid composites with improved performances.
Aftermath Neurosis: Psychological Sequelae of the Birmingham Bombings in Victims Not Seriously Injured
Authors: Sims A. C. P. , White A. C. , Murphy T.
Published: January 2017

This is a follow-up study of people who were involved in bomb explosions in two Birmingham public houses in November 1974, but were not seriously injured. One hundred and sixteen people were conveyed to hospital, registered, given casualty treatment and allowed home that evening. A small sub-sample of these survivors were visited at home two years after the disaster and the clinical characteristics were observed; the social and symptomatic disturbances were greater than expected. Work records of these survivors before and after the explosion were compared with matched outpatient casualties. On comparing disturbance to employment for the two groups, the bomb victims showed much greater incapacity.
Gm(5) Grouping of Dried Bloodstains
Authors: Khalap S. , Divall G. B.
Published: January 2017

An absorption—inhibition method for the detection of Gm(5) in dried bloodstains is described. This antigen compares very well with other blood group systems with regards to the amount of bloodstain required and its resistance to degradation.

Particular reference is made to the association of Gm(5) with Gm(-1, −2). When a stain fails to inhibit anti-Gm(1) and anti-Gm(2), this may represent a true Gm(-1, −2) result, or that there was insufficient material to inhibit each antiserum. The detection of Gm(5) in a bloodstain extract provides an objective means of confirming the apparent absence of Gra(1) and Gm(2) as representing a true Gm(-1, −2) result.
Medical Aspects of Management Problems in Maximum Security Prisons
Authors: Pope P. J. , Gibbens T. C. N.
Published: January 2017

Much has been written, especially recently, about the difficulties presented in prisons by the inclusion of mentally disordered or even psychotic offenders who would be more appropriately placed in mental hospitals. This study, carried out in 4 maximum security prisons during 1972–3, concludes that such men do not constitute any more than their fair share of all those who are seen as either disruptive or presenting management problems, probably less. Altogether a fifth of those men identified by prison staff as management problems had had some kind of psychiatric treatment before the sentence began, 4.4 per cent showed evidence of overt mental illness during it and 45 per cent were labelled as having either a psychopathic personality or a personality disorder of some kind. The great majority (85 per cent) of those presenting management problems spent the bulk of their sentences in the general wings of the four prisons and only a handful were felt to be better located in a psychiatric hospital.
The Child Abuse Syndrome in Nigeria
Authors: Nwako Festus A.
Published: January 2017

The child abuse syndrome is not uncommon in Nigeria. Every hospital handling accident cases should be aware of this fact. Diagnosis is based on a high index of suspicion and the pathognomonic radiological features. It is suggested that detection organizations be set up in each state to handle any suspicious or proven cases of child abuse.
Poisoning by Strychnine
Authors: Oliver J. S. , Smith H. , Watson A. A.
Published: January 2017

Four cases of strychnine poisoning are presented and compared with 5 cases from other sources. High levels of strychnine in the liver may result in death without evidence of physical struggle. Low levels suggest a delayed death probably accompanied by the physical responses commonly attributed to strychnine poisoning. In the 3 suicides described, the strychnine was obtained from farming sources.
Police Pay and the Royal Commission
Authors: Humphries H.
Published: January 2017

Mr. Humphries is Chairman of the Aberdeen City Police Joint Branch Board of the Scottish Police Federation.
The Liberty of the Subject and Law Enforcement
Authors: Chilmaid F. J. V.
Published: January 2017

We congratulate Chief Insp. Chilmaid on Winning the Queen's Gold Medal for the following essay.
Managing People
Authors: Mahir T. E.
Published: January 2017

We have particular pleasure in publishing the following article in which Mr. Mahir, who is in charge of “D” Department (Organization and Training) at Scotland Yard, applies management theory to the whole field of police leadership. We believe it will be of inestimable value to all police officers and to the Police Service.
The Promotion Exams
Authors: Devlin J. Daniel
Published: January 2017

This is the second of a series of articles of special interest to candidates for the Promotion Exams. The articles all deal with aspects of police administration and organization, which is one of the subjects in Part II of the syllabus, and of those sections of Part I of the syllabus which deal with police procedure. Mr. Devlin is author of Police Procedure, Administration and Organization
Authority in the Simpler Societies
Authors: Banton Michael
Published: January 2017

Professor Banton is Professor of Sociology in the University of Bristol. Many police officers know his pioneer book “The Policeman in the Community” (Tavistock Press, 1964). This is the first of a series of three articles on Authority, the second of which will be on “Authority in the Mass Society” and the third on “Authority and Police Science”
The Heart and Art of a Detective Officer-V
Authors: Lockley Thomas
Published: January 2017

Mr. Lockley considers the principles of detective training this month.
‘It's Good to Talk’: Community Mediation in Scotland
Authors: Clark Bryan , Mays Richard
Published: January 2017

It has often been suggested that one of the key tests of civilized society lies in the processes and mechanisms that exist for the resolution of disputes between citizens. Scotland has long adopted an adversarial court-based system of civil justice. Criticism of this system and its procedures has led to a search for new and better ways of resolving disputes. As a consequence there has been a growth in interest in ‘Alternative Dispute Resolution (ADR)’. One expression of this new interest has been the recent introduction of mediation programmes to tackle community and neighbourhood disputes. This article charts the inception of these initiatives and discusses the experiences of those active within the community mediation field in Scotland. Aspects of this article are drawn from Scottish Office research conducted by the authors, referred to in the text as ‘the study’.
Police Use of Lethal Force: A Different Test?
Authors: Palmer Phil
Published: January 2017

The lawful use of force is established when the act of force is aimed at resisting, repelling, or preventing an unlawful immediate threat. The purpose of this article is not simply to consider this definition, but to examine the nature and the limits of the permissible use of lethal force, specifically by those who are entrusted to enforce the law. These issues will to be considered in conjunction with Home Office and ACPO guidelines to police officers regarding the use of lethal force, and in the light of the present Government's public commitment to the European Convention on Human Rights.' It is arguable that these considerations impose on the police a more restrictive stipulation than the “reasonableness” criterion required by the domestic law.
Stress and the Woman Sergeant
Authors: Brown Jennifer , Grover Jennifer
Published: January 2017

Stress and gender are both somewhat contentious matters for the police service. This article describes the results of a study that attempts to draw these two issues together for the purpose of addressing the following question: are woman police sergeants more or less susceptible to the impacts of operationally generated stress than their male colleagues? The implications of the answers to this question relate to selection and training as well as broader issues of the confidence placed in and competence of women as supervisors.
The Role of Tactical Emergency Medical Support in Hostage and Crisis Negotiations
Authors: Greenstone James L.
Published: January 2017

The use of tactical medics by members of hostage and crisis negotiations teams has not been examined in the literature or in the field. Usually, negotiations teams are deployed within the confines of the established inner perimeter along with the tactical team and tactical medics. While the likelihood of injuries or performance degrading medical problems for negotiators is less than that expected for SWAT team members, they may occur and need attention. Additionally, there are other roles that tactical medical personnel can play that are specific to the needs of police negotiators. This article will examine these possible roles.
HIV Screening Practices and Hospital Characteristics in the U.S., 2009–2010
Authors: Herrin Jeph , Wesolowski Laura G. , Heffelfinger James D. , Bostick Nathan , Hall H. Irene , Ethridge Steven F. , Branson Bernard M.
Published: January 2017

Objectives.

The Centers for Disease Control and Prevention recommends HIV screening in U.S. health-care settings unless providers document a yield of undiagnosed HIV infections of <1 per 1,000 population. However, implementation of this guidance has not been widespread and little is known of the characteristics of hospitals with screening practices in place We assessed how screening practices vary with hospital characteristics.

Methods.

We used a national hospital survey of HIV testing practices, linked to HIV prevalence for the county, parish, borough, or city where the hospital was located, to assess HIV screening of some or all patients by hospitals. We used multivariate logistic regression analysis to assess the association between screening practices and hospital characteristics that were significantly associated with screening in bivariate analyses.

Results.

Of 376 hospitals in areas of prevalence ≥0.1%, only 25 (6.6%) reported screening all patients for HIV and 131 (34.8%) reported screening some or all patients Among 638 hospitals included, screening some or all patients was significantly (p<0.05) more common at teaching hospitals, hospitals with higher numbers of annual admissions, and hospitals with a high proportion of Medicaid admissions. In multivariable analysis, screening some or all patients was independently associated with admitting more than 15% of Medicaid patients and receiving resources or reimbursement for screening tests.

Conclusion.

We found that few hospitals surveyed reported screening some or all patients, and failure to screen is common across all types of hospitals in all regions of the country. Expanded reimbursement for screening may increase compliance with the recommendations.
Partners in Immunization: 2010 Survey Examining Differences among H1N1 Vaccine Providers in Washington State
Authors: Seib Katherine , Gleason Cindy , Richards Jennifer L. , Chamberlain Allison , Andrews Tracey , Watson Lin , Whitney Ellen , Hinman Alan R. , Omer Saad B.
Published: January 2017

Objectives.

Emergency response involving mass vaccination requires the involvement of traditional vaccine providers as well as other health-care providers, including pharmacists, obstetricians, and health-care providers at correctional facilities We explored differences in provider experiences administering pandemic vaccine during a public health emergency.

Methods.

We conducted a cross-sectional survey of H1N1 vaccine providers in Washington State, examining topics regarding pandemic vaccine administration, participation in preparedness activities, and communication with public health agencies We also examined differences among provider types in responses received ( n=619, 80.9% response rate).

Results.

Compared with other types of vaccine providers (e.g., family practitioners, obstetricians, and specialists), pharmacists reported higher patient volumes as well as higher patient-to-practitioner ratios, indicating a broad capacity for community reach. Pharmacists and correctional health-care providers reported lower staff coverage with seasonal and H1N1 vaccines. Compared with other vaccine providers, pharmacists were also more likely to report relying on public health information from federal sources They were less likely to report relying on local health departments (LHDs) for pandemic-related information, but indicated a desire to be included in LHD communications and plans. While all provider types indicated a high willingness to respond to a public health emergency, pharmacists were less likely to have participated in training, actual emergency response, or surge capacity initiatives. No obstetricians reported participating in surge capacity initiatives.

Conclusions.

Results from this survey suggest that efforts to increase communication and interaction between public health agencies and pharmacy, obstetric, and correctional health-care vaccine providers may improve future preparedness and emergency response capability and reach.
Using GIS and Secondary Data to Target Diabetes-Related Public Health Efforts
Authors: Curtis Amy B. , Kothari Catherine , Paul Rajib , Connors Elyse
Published: January 2017

Objectives.

To efficiently help communities prevent and manage diabetes, health departments need to be able to target populations with high risk but low resources To aid in this process, we mapped county-level diabetes-related rates and resources/use using publicly available secondary data to identify Michigan counties with high diabetes prevalence and low or no medical and/or community resources.

Methods.

We collected county-level diabetes-related rates and resources from Web-based sources and mapped them using geographic information systems (GIS) software. Data included age-adjusted county diabetes rates, diabetes-related medical resource and resource use (i.e., the number of endocrinologists and percentage of Medicare patients with diabetes who received hemoglobin A1c testing in the past year), community resources (i.e., the number of certified diabetes self-management education and diabetes support groups), as well as population estimates and demographics (e.g., rural residence, education, poverty, and race/ethnicity). We created GIS maps highlighting areas that had higher-than-median rates of disease and lower-than-median resources. We also conducted linear, logistic, and Poisson regression analyses to confirm GIS findings.

Results.

There were clear regional trends in resource distribution across Michigan. The 15 counties in the Upper Peninsula were lacking in medical resources but higher in community resources compared with the 68 counties in the Lower Peninsula. There was little apparent association between need (diabetes prevalence) and diabetes-related resources/use. Specific counties with high diabetes prevalence and low resources were easily identified using GIS mapping.

Conclusion.

Using public data and mapping tools identified diabetes health-service shortage areas for targeted public health programming.
Knowledge assessment regarding poliomyelitis among the caregivers of children who received oral polio vaccine reveals lack of awareness of the vaccine vial monitor (VVM): Implications extending beyond polio eradication
Authors: Bhilwar Meenakshi , Lal Panna
Published: January 2017

Vaccine vial monitor (VVM) is now commonly used for vaccines that are included in the National Immunization Schedule in India. It helps to indicate the viability of the vaccine and of the proper functioning of the cold chain. This is useful as it prevents health personnel from administering damaged vaccine. Studies have shown a lack of awareness of health workers regarding the use and interpretation of a VVM. The current study, undertaken among the caregivers of children who were immunized, showed that this lack of information about the VVM also exists among the caregivers. This deficiency in knowledge, both in the health workers and the caregivers, can affect the health of the child and needs urgent attention.
Management of Empyema and Bronchopleural Fistula
Authors: Adebo Oluwole A , Osinowo Olugbenro
Published: January 2017

Eloesser window was constructed in 8 patients with empyema and sepsis which failed to respond to more conservative measures. The empyema complicated pneumonectomy in 6 cases and was associated with bronchopleural fistula (BPF) in 4. Rapid control of the pleural space infection was obtained in all cases, allowing for further management on an outpatient basis. Closure of the fistula occurred within 4 months in 3 of 4 cases; one patient developed an oesophago-pleural fistula 31½ months later and succumbed from inanition. Spontaneous closure of the thoracostomy window with complete obliteration of pleural cavity has occurred in only 2 patients. In S others the persistent stoma with minimal drainage has been well tolerated. The Eloesser window is an acceptable method for treatment of recalcitrant empyema and BPF in our environment, with minimal morbidity and mortality.
An investigation of the verbal abilities of children with imaginary companions
Authors: Bouldin Paula , Bavin Edith L. , Pratt Chris
Published: January 2017

The purpose of this study was to investigate the language use of 40 children with imaginary companions (IC) and 40 children without imaginary companions (NIC) across two age levels: a younger group aged 4;0–5;11 and an older group aged 6;0–7;11. The study investigated the language of these children by examining their use of adverbial and relative clauses, complement clauses, co-ordinating conjunctions and modal types. The findings indicated that, compared with NICs, ICs used a significantly greater number of adverbial clauses, relative clauses, and and, with their use of but approaching significance. Overall, the results were interpreted as indicating that ICs use more mature language, and this demonstrates enhanced social-cognitive skills. It was concluded that the presence of imaginary companions is positively associated with language use and discourse competency of children.
The emergence of pragmatics: forms and functions of conventional gestures in young French children
Authors: Guidetti Michèle
Published: January 2017

The purpose of this study was twofold: to examine the forms of conventional gestures used by young French children aged 16 to 36 months when interacting with their mothers in everyday situations, and to look at the functions of those gestures based on an adapted version of the classification system proposed in speech act theory. The results showed that the most frequent types of gestures were pointing, and gestures of agreement or refusal. Pointing increased with age, particularly between 16 and 24 months. Most of the pointing gestures were assertives, produced in combination with words or vocalizations. The mean number of assertive agreements rose with age, especially purely gestural ones.
They look similar, but they are different: reading two morphological structures of Hebrew nouns
Authors: Schiff Rachel
Published: January 2017

This study examined the influence of two specific Hebrew nominal morphological structures on the accurate reading of Hebrew nouns. The study also analysed and categorized the reading errors within each nominal structure. All 24 nouns in this study looked similar, inasmuch as they were all four-lettered and ended with the final vowel letter [H]. Yet they were of two different morphological structures. Twelve were feminine nominal derivations, and 12 were feminine possessive optional inflections. The focus of the study was to discern if this difference was reflected in the respondents' reading accuracy and whether grade level had any effects. In addition, error types were analysed by morphology and grade level. The results of this study show that both reading accuracy and the type of errors are affected by morphological complexity and grade level. Thus, even in a shallow orthography such as vocalized Hebrew, morphological complexity seems to play an integral role in reading accuracy and error types at different grade levels.
Achievement of African American and Caucasian Students Referred and Placed or Not Placed in Gifted Programs
Authors: Romanoff Brenda S. , Algozzine Bob , Nielson Aleene B.
Published: January 2017

The identification of students who are gifted traditionally has been grounded in criteria with an emphasis on unitary measures of intellectual ability. The purpose of this research was to evaluate the performance of elementary school children in a Southeastern state identified as gifted using an assessment process based on MI theory, the Problem Solving Assessment, with a comparable group of students referred for assessment but not identified as gifted. We compared scores on statewide end-of-grade reading and math tests to evaluate the performance of African American and Caucasian students. Although scores for African American students were below those for the Caucasian peers in both groups, the difference between the groups was smaller in reading and mathematics for students identified and placed in gifted programs. We discuss the implications of our findings as they related to identification and program development.
Definition, Identification, Identity, and Culture: A Unique Alchemy Impacting the Success of Gifted African American Millennial Males in School
Authors: Bonner Fred A. , Lewis Chance W. , Bowman-Perrott Lisa , Hill-Jackson Valerie , James Marlon
Published: January 2017

This article focuses on the underrepresentation of African American males in gifted and talented programs, and offers a number of key recommendations to practitioners and researchers who seek viable strategies to circumvent this problem. Beyond the focus on underrepresentation, several additional topics for discussion are excogitated to provide a clear perspective on the challenges these students experience in school; namely, (a) definitions of giftedness, (b) identity development, (c) student Millennial culture, and (d) how gifted African American Millennial males in school contexts are treated. Additionally, data collected from a recent study of a large Midwestern school district will be presented to further highlight the topics under investigation.
The use of a Performance Assessment for Identifying Gifted Lebanese Students: Is DISCOVER Effective?
Authors: Sarouphim Ketty M.
Published: January 2017

The purpose of this study was to investigate the effectiveness of DISCOVER, a performance-based assessment in identifying gifted Lebanese students. The sample consisted of 248 students (121 boys, 127 girls) from Grades 3–5 at two private schools in Beirut, Lebanon. Students were administered DISCOVER and the Raven Standard Progressive Matrices (RSPM). Teachers and parents of identified students were interviewed. Results showed evidence for DISCOVER's concurrent validity with RSPM, as correlations between students' DISCOVER ratings in spatial intelligence and their Raven scores were high, whereas correlations between students' DISCOVER ratings in linguistic intelligences and their Raven scores were low. Parents' and teachers' interviews corroborated the results, with a few exceptions. Of the total sample, 14.5% were identified, with no gender differences. The researcher concluded that DISCOVER could be used effectively in Lebanon for identification purposes, but further research is needed to support the findings.
A Problem-Based Curriculum: Parallel Learning Opportunities for Students and Teachers
Authors: Boyce Linda Neal , VanTassel-Baska Joyce , Burruss Jill D. , Sher Beverly Taylor , Johnson Dana T.
Published: January 2017

One of the curriculum development efforts of the Center for Gifted Education at the College of William and Mary has resulted in a problem-based learning (PBL) science curriculum for high-ability learners in grades kindergarten through eight. Professional development programs accompany the curriculum, which are designed to facilitate unit implementation and to enable educators to develop their own units. The purpose of this discussion is to analyze the use of problem-based learning as a catalyst for developing and implementing a curriculum that is both challenging and constructivist in its orientation. The authors compare problem-based learning with creative problem solving and inquiry, explain how metacognition is linked to the approach of problem-based learning, and describe the PBL-based inservice programs developed for teachers and administrators. Implications for implementing problem-based learning in classrooms for gifted learners conclude the discussion.
Designing Problem-Based Learning Units
Authors: Stepien William J. , Pyke Sharon L.
Published: January 2017

Problem-based learning (PBL), initiated when learners meet an ill-structured problem, develops skills and subject-matter content needed by students to make the transition from novice to more expert problem solver. However, the construction of problem-based learning units can be a formidable task. After a brief comparison of the characteristics of well-structured and ill-structured problems, the authors outline a systematic, user-friendly process for finding potential PBL topics; constructing brainstorming maps to explore the possibility of each topic becoming the focus for a PBL unit; and, then, designing the student's role, the situation he or she meets at the opening of the unit, and the unit's assessments.
Pictorial Mnemonic Strategies for Special Education
Authors: Mastropieri Margo A. , Scruggs Thomas E. , Levin Joel R.
Published: January 2017

Recently, the associative learning of exceptional children has been found to be greatly facilitated by the use of pictorial mnemonic strategies. This paper reviews the use of such strategies as an instructional tool for both nonhandicapped and handicapped learners. Recent research has indicated that (a) mildly handicapped learners can sucessfully employ fairly complex mnemonic strategies, and (b) mnemonic strategies can be adapted to many different content areas. In this research, students taught to use mnemonic strategies have consistently outperformed students taught using direct instruction and free-study techniques. Implications for the improved learning and retention of school content by exceptional students are discussed.
Distance Education: A Unique Blend of Technology and Pedagogy to Train Future Special Educators
Authors: Johnson Marilyn Kay , Amundsen Cheryl
Published: January 2017

The geographical distances in Alaska create a unique educational challenge that is shared by other areas in the world. A three-year project at the University of Alaska, Anchorage attempted to integrate the author's experiences in Alaska with the growing technology available in the state.

Potential students in regions hundreds of miles away from an on-campus program were able to participate in a graduate level certification program maintaining the same accreditation standards as the on-campus program. The same faculty served both the on-campus and off-campus program employing video production, audioconferencing, audio cassettes and printed materials.

Distance teacher education programs need to consider individual student needs such as preparation, motivation and resource assistance. Good instructional practices should be considered along with the potential of technology in order to produce quality programs.
The System: A Process for Resource Room Management
Authors: Follis Mary G. , Lacourt Timothy
Published: January 2017

The resource room concept is commonly used to provide special education services to handicapped students. It has been difficult for school districts to reconcile the mechanics of such a classroom with departmentalization at the secondary level. Decreased funding and increased caseloads have resulted in the need for special educators to manage the prescriptive plans of each student, and to provide tutorial support for regular education classes. “The System”, as proposed in this article, provides a management plan that is expedient for the special education teacher to use with students of varying needs. It incorporates a clinical teaching model, task analysis, and the use of management objectives to provide individualized services to secondary handicapped students scheduled into a special group setting.
A Model for Direct, Data-Based Reading Instruction
Authors: Idol-Maestas Lorna , Ritter Shirley , Lloyd Sandra
Published: January 2017

An instructional model for improving reading skills of very poor readers is offered. The approach includes several basic components: curricular assessment and placement in lower levels of classroom curricula, direct instruction in deficit skill areas, data-based instruction as a means of evaluating daily pupil progress, repeated practice of reading stories to achieve proficiency, and contingency management, where stories must be mastered before proceeding to subsequent stories. Initially, students read orally and are evaluated daily for reading accuracy, rate, and oral comprehension. Gradually, students are encouraged to read silently and to write responses to comprehension questions. Included are pupil progress data for 159 mildly learning handicapped students who have received this type of instruction. Student gains have been similar for learning disabled, behavior disordered, and mildly retarded students. Economically disadvantaged and students served in cross-categorical resource rooms have progressed at a slightly higher rate than the other groups of mildly handicapped students.
Selective Facial Neurectomy for Spastic Disorders of the Facial Nerve
Authors: Spector Gershon J.
Published: January 2017

Selective facial neurectomy in combination with bilateral musculocutaneous resection, plication brow lift, upper lid blepharoplasty, and limited rhytidectomy was performed on 18 patients with essential blepharospasm, eight with hemifacial spasm, and two with CNS vascular compression malformations. Microscopy showed the nerve tissues to be normal. Initial results were excellent. At 3 months there was a slight, persistent spastic twitching of the affected muscles in five nerves (a 14% failure rate in correcting blepharospasm). After 13 months there were four additional failures resulting from nerve regrowth in three and from one patient not completing therapy. The overall blepharospasm failure rate was 26%. On repeat neurectomy those with nerve regrowth presented with a diffuse, fine meshwork of nerve fibers reinnervating the mimetic facial musculature. In six of seven patients operated on again, spasticity was eliminated. The initial surgical failure rate has been corrected by resecting the frontal branch and the superior division of the buccal branch of the facial nerve. Only repeat neurectomy can correct long‐term failures resulting from facial nerve regrowth.
Argon Laser Treatment of Head and Neck Vascular Lesions
Authors: Parkin James L. , Dixon John A.
Published: January 2017

Port wine stains (PWSs), hereditary hemorrhagic telangiectasias (HHTs), hemangiomas, arterial venous malformations (AVMs), vascular granulomas and polyps, glomus tumors, and nasopharyngeal angiofibromas are vascular lesions of the head and neck potentially responsive to treatment with the argon laser. One hundred consecutive patients with PWSs, 25 patients with HHTs, three with subglottic hemangiomas, three with oral and/or lingual hemangiomas, two with labial AVMs, three with vascular laryngeal polyps, and one patient with inoperable glomus tumor were treated with the argon laser. Results were good to excellent in 94% of the facial PWS patients. All treated patients in the HHT group demonstrated improvement. Results with the other lesions were variable. The argon laser is a valuable treatment modality in vascular lesions of the head and neck. Posttreatment scarring and failure to achieve desired results are complications encountered. Pretreatment counseling will assist the patient in understanding the expected results.
Radioisotope Measurement of the Velocity of Tracheal Mucus
Authors: Russo Kenneth J. , Palmer David W. , Beste David J. , Carl Greg A. , Belson Thomas P. , Pelc Lorie R. , Toohill Robert J.
Published: January 2017

A radioisotope scanning technique for measuring the velocity of tracheal mucus has been developed utilizing a canine model. A solution of stannous phytate labeled with 99mTc is introduced percutaneously into the lower trachea and the upward movement of the leading edge of the radioactivity is followed by repeat scanning at 2‐minute intervals using a modified rectilinear scanner, thus allowing calculation of the velocity of the mucus. It Is believed that this technique may be of value in studying the effect of experimentally induced tracheal injuries on mucus velocity. Possible applications of the technique for the study of the velocity of mucus in the human trachea are discussed.
Further Evaluation of Uvulopalatopharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome
Authors: Katsantonis George P. , Walsh James K. , Schweitzer Paula K. , Friedman William H.
Published: January 2017

Since its introduction in 1981 uvulopalatopharyngoplasty (UPPP) has become an alternative surgical approach to permanent tracheostomy in treating obstructive sleep apnea (OSA). However, the criteria for selecting candidates for this procedure are unclear and the prediction of a positive response remains an enigma. This article presents the experience with UPPPs performed on 35 patients who had moderate to severe OSA. Criteria for patient selection included apnea severity, cardiopulmonary sequelae, and clinical symptomatology. All but two patients demonstrated clinical improvement, although there was considerable variability in the degree of response. Patients were classified as good or poor responders on the basis of the severity index (SI), which represents the number of apneas and hypopneas per hour of sleep resulting in oxygen saturation below 85%. A greater than 50% improvement in the SI was considered a good response. Twenty‐three patients (65.7%) were good responders and the remaining 12 (34.3%) were poor responders. The need for permanent tracheostomy was obviated In 16 of 32 patients presenting with disabling daytime sleepiness or severe cardiopulmonary sequelae. Therefore it appears that UPPP is useful for treating most OSA patients.
Otosclerosis: The University of Minnesota Temporal Bone Collection
Authors: Hueb Marcelo M. , Goycoolea Marcos V. , Paparella Michael M. , Oliveira Jose A.
Published: January 2017

A study of 1452 human temporal bones revealed a previously unpublished material of 144 bones with otosclerosis. After exclusion of infants and individuals of races other than white, the incidence of otosclerosis was 12.75%. Of the bones with otosclerosis, 56.1% belonged to men and 43.9% to women. The incidence of clinical and histologic otosclerosis was practically the same for men (44.7% to 55.3%) as for women (47% to 53%). However, the incidence of bilateral otosclerosis was higher in women (88.9%) than in men (65.2%). Bilateral otosclerosis was present in 75.6%, whereas it was unilateral in 24.4%. Sixty‐six (66) ears (45.8%) had clinical otosclerosis, whereas 78 (54.2%) had histologic otosclerosis—frequently unifocal lesions. The most common site was anterior to the oval window (117 ears, 81.25%), followed by round window niche (52 ears, 36.11%), apical and medial cochlear wall (31 ears, 21.52%), and anterior wall of the internal auditory canal (27 ears, 18.75%). The activity of lesions was directly related to their size. Smaller lesions were predominantly inactive, whereas medium and larger lesions were predominantly active. There was a positive correlation when the size of the lesions, activity, and degree of cochlear endosteal involvement were compared with bone conduction thresholds (37 cases). Correlations between size and activity, and between activity and associated sensorineural hearing loss did not necessarily follow the sequence of an initial active stage (spongiotic) to a final inactive one (sclerotic). Comparison of cases of otosclerosis with equivalent age groups of the normal population yielded worse bone conduction thresholds for the otosclerosis cases only in the age group 60 to 69 years and older. Comparison of average bone conduction thresholds between bones with one site of endosteal involvement (28.26 dB HL) revealed no significant differences. Bones with two or more sites of endosteal involvement had significant differences. Bones with two or more sites of endosteal involvement had significantly worse bone conduction thresholds (62 dB HL). The overall results are not suggestive of an association of sensorineural hearing loss with otosclerosis without stapedial fixation.
Passive Exposure to Cocaine in Medical Personnel and its Effect on Urine Drug Screening Tests
Authors: Kavanagh Kevin T. , Maijub Amado Gabriel , Brown James R.
Published: January 2017

This report studies the importance of passive exposure of medical personnel to cocaine hydrochloride and its impact on urine screening testing. Eleven medical staff members were exposed to cocaine hydrochloride by means of aerosol and cutaneous application, similar to that which may occur in medical practice. Urine drug screening tests were negative for everyone tested. This finding is supported by known drug kinetics. It is unlikely that a single passive exposure of medical staff to cocaine hydrochloride will produce a positive urine screening test. In all cases of positive urine tests, contaminants should be tested for which may indicate a source of the drug. The routine use of gloves and masks—which is recommended to prevent HIV infection—should further decrease medical personnel's passive exposure to cocaine hydrochloride.
Cochlear Implants in Children: Reliability of Computed Tomography
Authors: Seicshnaydre Michael A. , Johnson Michele H. , Hasenstab M. Suzanne , Williams George H.
Published: January 2017

Preoperative temporal bone computed tomography (CT) can demonstrate anatomic details relevant to surgical management and is therefore essential in the presurgical evaluation of patients receiving cochlear implants. The purpose of this study was to evaluate preoperative CT studies and compare them to surgical findings in 34 children who received the Nucleus multichannel cochlear implant. The focus of this report is to discuss the dependability of CT scans in predicting surgical findings at the time of cochlear implantation. Results indicate that agreement of CT interpretations with surgical findings is partially related to the etiology of hearing loss and the experience of the surgeon and neuroradiologist. Advantages and limitations of the CT scans in predicting surgical findings are discussed.
Pain after Surgery for Acoustic Neuroma
Authors: Schessel David A. , Nedzelski Julian M. , Rowed David , Feghali Joseph G.
Published: January 2017

Postoperative pain after surgery in the cerebellopontine angle (CPA) is acknowledged to occur, but is rarely taken into account as a factor in the analysis of morbidity of such surgery. It is widely acknowledged that some patients, having undergone such surgery, particularly by means of the suboccipital approach, report significant postoperative pain and headache. This study was undertaken to determine the incidence and severity of pain after excision of acoustic neuromas and to establish whether this differed between the suboccipital and translabyrinthine routes. Ninety‐one percent of all patients (n = 58), who had the suboccipital approach used for removal of their tumor, were surveyed. A smaller group (n = 40), MAtched for tumor size, age, and sex, but in whom the translabyrinthine approach was used, was similarly studied. A standard questionnaire, designed to detect and quantify postoperative pain, was administered to each patient. Of patients who underwent tumor excision by means of the suboccipital approach, 63.7% experienced significant local discomfort and headache, whereas this was notably absent in all those who had undergone translabyrinthine excision. In view of the significant morbidity noted to follow the suboccipital approach, several modifications of the surgical technique used were devised.
The Riddle of the Uvula
Authors: Finkelstein Yehuda , Meshorer Asher , Talmi Yoav P. , Zohar Yuval , Brenner Jacob , Gal Rivka
Published: January 2017

Since ancient times, the uvula has been a subject of interesting and contradictory observations. On the one hand, it was regarded as having a functional role in speech and in immunology, but on the other hand it was regarded as a potentially hazardous organ, possibly responsible for sudden infant death syndrome. None of these hypotheses, however, has been proved. In a previous study on patients undergoing uvulopalatopharyngoplasty, we suggested that the most important function of the uvula is connected with the muscularis uvulae. Its function could be related to drinking while bending over. This previous assumption was that the uvula is a philogenetic remnant from mammals that drink while bending their neck downward. In the present study, the soft palate of eight different mammals was macroscopically and microscopically studied and compared. Of all animals in the study, a small underdeveloped uvula was found only in two baboons. We found that the human uvula consists of an intermix of serous and seromucous glandular masses, muscular tissue, and large excretory canals. The serous and seromucous glands are absent in the other mammals. Thus, the uvula is a highly sophisticated structure, capable of producing a large quantity of fluid saliva that can be excreted in a short time. Both uvula and speech serve to differentiate human beings from animals. Our conclusion is that the uvula is possibly an accessory organ of speech, and may be another marker of human evolution that differentiates man from other mammals.
Neck dissection with or without postoperative radiotherapy in supraglottic carcinomas
Authors: Suárez Carlos , Llorente Jose Luis , Nuñez Faustino , Diaz Celso , Gomez Justo
Published: January 2017

A retrospective review of 302 previously untreated patients with primary supraglottic carcinoma was undertaken to ascertain the efficacy of postoperative radiotherapy. The 302 patients underwent a total of 383 functional neck dissections and 45 classic radical neck dissections. Pathological examination revealed nodal involvement in 117 patients (39%). In the histologically N0 group, the incidence of contralateral neck recurrence when a unilateral neck dissection and postoperative radiotherapy were carried out was 8%, rising 21% when no postoperative radiation was given. There was no difference in the ipsilateral recurrence rate in the N0 group, radiated patients (3%) and nonradiated patients (2%). Similar figures were found in the N1 group. Bilateral functional neck dissection in histologically N0, N1, and N2 necks had similar recurrence rates with or without radiotherapy. Distant metastasis appeared in 10% of N0 patients and in 35% of N3 patients. Patients who received postoperative radiotherapy showed a significantly higher rate of distant metastasis (21%) than patients who did not (8%). The number of involved lymph nodes had no relevance both in neck recurrence and distant metastasis.
Enlargement of the cochlear aqueduct: Fact or fiction?
Authors: Jackler Robert K. , Hwang Peter H.
Published: January 2017

Enlargement of the cochlear aqueduct (CA) is often mentioned in the otologic literature, usually in its purported association with sensory hearing loss, stapes gusher, and transotic cerebrospinal fluid leak. In CT scans of 100 ears, the diameter of the CA medial aperture was found to be highly variable, ranging from 0 to 11 mm, with a mean of 4.5 mm. In contrast, the otic capsule segment was very narrow in every case. It could be visualized in only 56% of cases, none of which exceeded 2 mm in diameter. Several published reports of supposed CA enlargement presented images of a dilated medial aperture that was well within the range of normal variability according to the present study. In a thorough review of the literature on radiology of the CA, we were unable to find a single published image that convincingly demonstrated enlargement of the otic capsule portion. As radiographic CA enlargement has not been convincingly reported to date, it appears to be an exceedingly rare or perhaps even nonexistent malformation. It is important to recognize than even a radiographically normal CA may be hyperpatent. It is theoretically possible for increased fluid flow to result from either deficiencies in intraluminal membrane baffles or subtle canal enlargement beneath the resolution limits of CT scanning. However, as fluid flow through a tube is regulated by its narrowest point, It is extremely improbable that stapes gusher, transotic CSF leak, and vigorous perilymphatic fistula are generated by the CA when CT scans show any portion of it to be very narrow. A substantial body of evidence points to a deficient partition between the internal auditory canal and inner ear as causative in such cases. We propose that the criteria for the diagnosis of CA enlargement on high‐resolution CT scan be a diameter exceeding 2 mm throughout its course from the posterior fossa to the vestibule.
Preoperative differentiation between meningioma of the cerebellopontine angle and acoustic neuroma using MRI
Authors: Lalwani Anil K. , Jackler Robert K.
Published: January 2017

Preoperative differentiation between acoustic neuroma (AN) and meningioma of the cerebellopontine angle (CPA) is important in selection of the surgical approach, successful tumor removal, and preservation of hearing and facial nerve. We retrospectively reviewed the magnetic resonance imaging (MRI) findings associated with 30 meningiomas involving the CPA (MCPA) encountered between 1987 to 1991 at the University of California, San Francisco. Magnetic resonance imaging was critical in differentiating meningioma from AN in the CPA. Typical findings on MRI associated with MCPA, differentiating them from ANs, Include: Meningiomas are sessile, possessing a broad base against the petrous face, whereas ANs are globular; they are often extrinsic and eccentric to the internal auditory canal (IAC); when involving the IAC, they usually do not erode the IAC; MCPAs demonstrate hyperostosis of the subjacent bone and possess intratumoral calcification; they involve adjacent intracranial spaces and structures; and meningiomas are characterized by a distinctive dural “tail” extending away from the tumor surface. While any one finding may not be diagnostic by itself, taken together the constellation of these findings is strongly Indicative of meningioma. In our experience, MRI with gadolinium enhancement was able to distinguish MCPA from AN in nearly every case.