bluuebunny/crossref_metadata_2025 huggingface dataset:
A Step towards Neuro-Steered Hearing Aids: Integrated Portable Setup for Time- Synchronized Acoustic Stimuli Presentation and EEG Recording
Authors: Dasenbrock Steffen , Blum Sarah , Debener Stefan , Hohmann Volker , Kayser Hendrik
Published: December 2021

Aiming to provide a portable research platform to develop algorithms for neuro-steered hearing aids, a joint hearing aid - EEG measurement setup was implemented in this work. The setup combines the miniaturized electroencephalography sensor technology cEEGrid with a portable hearing aid research platform - the Portable Hearing Laboratory. The different components of the system are connected wirelessly, using the lab streaming layer framework for synchronization of audio and EEG data streams. Our setup was shown to be suitable for simultaneous recording of audio and EEG signals used in a pilot study (n=5) to perform an auditory Oddball experiment. The analysis showed that the setup can reliably capture typical event-related potential responses. Furthermore, linear discriminant analysis was successfully applied for single-trial classification of P300 responses. The study showed that time-synchronized audio and EEG data acquisition is possible with the Portable Hearing Laboratory research platform.
In vitro validation of a non-invasive continuous blood pressure measurement method for the perioperative application
Authors: Geus Paul , Laidig Daniel , Borchers Patrick , Seel Thomas , Stettin Johanna , Kertzscher Ulrich
Published: December 2021

Hypotensive periods during surgery lead to an increase in postoperative complications. To further avoid the adverse events associated with the invasive measurement of the blood pressure, a perioperative, continuous, non-invasive blood pressure measurement method was developed. The precision of the method was tested for different mean pressure values and different thicknesses of the tissue model using a specifically designed and validated simulator that has the characteristics of the lower arm. The mean pressure difference between the pressure determined by the proposed method and simulated blood pressure from the simulator was 3.93 mmHg (±4.75 mmHg) for the systole and 4.89 mmHg (±6.10 mmHg) for the diastole. The results showed that the method can be a promising alternative to invasive blood pressure measurement methods.
Bioreactor design for the mechanical stimulation by compression of 3D cell cultures
Authors: Micheler Carina M. , Geck Paulina A. , Charitou Fiona , Leix René , Foehr Peter , Lang Jan J. , Wilhelm Nikolas J. , Tuebel Jutta L. , Burgkart Rainer H. H.
Published: December 2021

Bioreactors with a controlled physiological environment are being developed to study various cell processes. The influences of mechanostimulation on bone cell cultures can be investigated using a compression bioreactor. The developed bioreactor system applies a cyclic compression force to the specimen via an eccentrically mounted push rod. The compression force is monitored by a force sensor to detect changes in the material properties of the specimen. Depending on the piston setting, a stroke of 0.28 - 2.50 mm can be applied to the specimen. The bioreactor system was tested with a trial run of 18 days. A sample was continuously stimulated with a loading frequency of 2 Hz and a stroke of 1.50 mm. The sterility in the cell chamber as well as the functionality of the realised bioreactor stimulation system could be successfully confirmed
Genre Effect on L2 Syntactic Complexity and Holistic Rating for Writing Quality of Intermediate EFL Learners
Authors: zhang Lili , liu Haitao
Published: December 2021

This exploratory study examines whether genre has an impact on syntactic complexity and holistic rating in EFL writing. Over 300 sample texts produced by intermediate learners were collected from a test and some regular after-class assignments for English writing courses. Each participant completed two writing tasks, one argumentative and the other narrative. Results show that genre type has a significant impact on L2 syntactic complexity. Genre effect is found stronger with timed writing tasks. L2 holistic ratings show correlation with syntactic complexity on the different measure(s) depending on genre type and planning conditions. Regression analyses reveal that for timed writing tasks, clausal density (clauses per sentence) is a reliable predictor for holistic assessment on intermediate EFL learners’ writing quality. It is found to account for 6% of the score variance for timed writing and 10% for timed argumentative writing. Genre is evidenced to be related to EFL writing holistic ratings. Closer examination indicates that while syntactic complexity is predictive of holistic writing scores for argumentative writing, it does not correlate with holistic scores for narrative writing. Other linguistic features rather than syntactic complexity may be accountable. Overall, the study lends support to genre effect in the relationship between syntactic complexity and L2 writing quality holistic rating.
A machine-learning reduced kinetic model for H2S thermal conversion process
Authors: Dell’Angelo Anna , Andoglu Ecem Muge , Kaytakoglu Suleyman , Manenti Flavio
Published: December 2021

H2S is becoming more and more appealing as a source for hydrogen and syngas generation. Its hydrogen production potential is studied by several research groups by means of catalytic and thermal conversions. While the characterization of catalytic processes is strictly dependent on the catalyst adopted and difficult to be generalized, the characterization of thermal processes can be brought back to wide-range validity kinetic models thanks to their homogeneous reaction environments. The present paper is aimed at providing a reduced kinetic scheme for reliable thermal conversion of H2S molecule in pyrolysis and partial oxidation thermal processes. The proposed model consists of 10 reactions and 12 molecular species. Its validation is performed by numerical comparisons with a detailed kinetic model already validated by literature/industrial data at the operating conditions of interest. The validated reduced model could be easily adopted in commercial process simulators for the flow sheeting of H2S conversion processes.
Das Können des Nichtkönnens und das Tun ohne Tun
Authors: Xísān Lài
Published: December 2021

In this essay, Christoph Menke’s “aesthetics of force” converses with contemporary Chinese philosophy, especially with the field of Transcultural Research in the Zhuāngzǐ conducted in Taiwan. The starting point of the following reflections is that “the artist is able to be unable” (der Künstler kann das Nichtkönnen). How can we philosophically describe a way of doing that retains self-awareness in the midst of self-forgetfulness? What Zhuāngzǐ discusses is an aesthetic cultivation of “contemplative perception” (Schau/guān 觀) in the midst of doing. His language is able to describe and interpret from within a way of doing that refrains from purposeful action. Menke’s approach corresponds with my reflections on Daoism and the book Zhuāngzǐ developed in recent years. Particularly important in this context is the exploration of relating aesthetics to ethical and political questions through an aesthetic transformation of subjectivity. Following the linguistic dynamics associated with the transcultural interweaving of texts, this essay connects Menke’s interpretation of Nietzsche and my interpretation of the Zhuāngzǐ. In so doing, I hope to set in motion a change in thinking on both sides.
Periphrastic passive and resultative in Hittite and Proto-Indo-European
Authors: Shatskov Andrey
Published: December 2021

There are several ways to express passive meaning in ancient Indo- European languages, one of them being periphrastic constructions. This paper argues that periphrastic passives in these languages developed from earlier object-oriented resultative constructions, which can be reconstructed for the proto-language as well.
The history of Old English būgian and bōgian ʻdwellʼ, and some related morphonological problems
Authors: Vijūnas Aurelijus
Published: December 2021

In this article, an alternative historical analysis of the Old English verbs būgian and bōgian is presented, whereby it is suggested that they are relatively late formations. The verb *bū̆wōja- (> būgian) evolved out of the verb *bū̆wa- (> būan) during the Proto-Northwest Germanic era by way of a paradigmatic split. The vowel ū̆ in the root of *bū̆wōja- was subject to assimilatory lowering due to the influence of the following non-high vowels: the lowering of the root vowel produced the stem *bō̆wōja- (> OE bogian). It is argued here that the vowel /u/ was susceptible to lowering in this environment because in the sequence -V(w)V-, it was phonetically short (phonologically, it was length-neutral in this position).
Small-scale patterns in a larger picture
Authors: Sonnenhauser Barbara , Escher Anastasia
Published: December 2021

Telling apart family-internal developments from contact-induced changes and socio-geographically conditioned areal trends is still one of the main challenges in tracing the development - and stability - of languages. Notably prima facie contact phenomena might turn out to have resulted from the interaction of a variety of sources upon closer inspection; assessing their interaction is a crucial requirement for comprehending the dynamics of change. Based on the example of simplification patterns in the system of short personal pronouns observed in the Balkan Slavic dialects located in the territory of North Macedonian and Greece, the present paper illustrates the necessity of identifying the multiplicity of triggers and their interaction, thereby making a case for the relevance of small-scale, transient patterns in understanding diachronic processes. In particular, it places the simplifications within the pronominal system into the larger context of differential object indexing by preverbal pronominal elements in the Balkan languages. With the loss of agreement distinctions on pronouns being characteristic for the last phase in the emergence of object indexing, both processes appear to be closely related. Obviously, in this case, the convergence of various different processes has created a favorable environment for the mutual reinforcement and stabilization of two otherwise highly volatile phenomena.
A functional discourse approach to the particle ἀτάρ in Classical Greek
Authors: Lacerda Crepaldi Clara
Published: December 2021

Taking into consideration both discourse structure and the pragmatics of contrast, this paper draws on Functional Discourse Grammar (FDG) to provide a comprehensive and unified account of ἀτάρ in Classical Greek. In classical Greek drama, the particle ἀτάρ designates two main types of contrast. In its most common usage, it marks a discourse contrast, a boundary in conversational structure, such as the beginning of a new exchange or adjacency pair. More specifically, ἀτάρ can signal a change of addressee; the introduction of a new topic or new visual focus; or an abrupt thematic discontinuity such as an interruption. Moreover, ἀτάρ can also mark denial of expectation, especially when preceded by a preparatory μέν. When expressing counterexpectation, the particle instructs the addressee to process the next discourse segment in such a way as to contradict or eliminate some piece of information possibly inferred from the preceding segment. Very similarly, the classical prose of Herodotus, Plato and Xenophon shows analogous usages of ἀτάρ, namely, as a boundary between larger portions of discourse with or without thematic discontinuity, or as a marker of denial of expectation between acts and moves.
The Hieroglyphic Luwian genitive case
Authors: Palmér Axel I.
Published: December 2021

Descriptions of Hieroglyphic Luwian grammar assert that the genitive endings ‑as(a) and ‑asi are interchangeable; their distribution is said to be random rather than governed by any conditioning factor. However, recent studies have shown that the ending ‑asi is geographically and chronologically restricted in the corpus of Hieroglyphic Luwian texts, which suggests that the distribution is not entirely random. In this paper, it is argued that in texts from the “‑asi area” - where texts containing both endings are found - the genitive endings are distributed in a non-random way. Genitives in ‑as(a) are dependent on neuter gender head nouns, whereas genitives in ‑asi are dependent on common gender head nouns. This means that, syntactically, Hieroglyphic Luwian genitives resemble genitival adjectives by agreeing with the gender of their head. Although several counterexamples exist, they are probably caused by translation errors, by language change in late Hieroglyphic Luwian, and possibly by the fact that -as(a) may reflect -asa as well as -as. Finally, a new account of the historical development of Luwian genitives is presented.
παλίντονος
Authors: Lundquist Jesse
Published: December 2021

The Ancient Greek feminines to u-stem adjectives (e.g. ἡδεῖα ‘sweet’ to ἡδύς) diverge from their Old Indic counterparts in terms of accentuation (cp. Ved. svādvī´ ). Homeric Greek possesses a couple of corresponding archaisms with oxytone accent (θαμειαί, ταρφειαί); in this paper, I will propose that Greek in fact runs the gamut, showing recessive accentuation as well, specifically in stems that have been “demorphologized” (e.g., λίγεια). This threefold accentuation provides a unique window onto the diachrony of accents in the prehistory of Greek. I bring to bear previously undertreated, and untranslated, evidence from ancient grammarians to bolster my position. Beginning from this reexamination, I turn to the controversial class of nouns in -υια, which have been held to show extraordinarily archaic properties of accent and ablaut. I propose that these nouns reflect not archaisms, but inner-Greek innovations.
On the inflection of palatal stems in Vedic
Authors: Rothstein-Dowden Zachary
Published: December 2021

This paper re-examines the historical phonology and morphology of the palatal-stem declension of Vedic and concludes that the phonologically regular outcome of the animate nominative singular was -ṭ, while the “bh-cases” should by regular sound change have contained a cluster *°dbh°, the former existence of which can be inferred but which was replaced by °ḍbh° (or °gbh°) under the influence of the nominative singular.
Tocharian B santse ‘daughter-in-law’
Authors: Peyrot Michaël , Xiaoqiang Meng
Published: December 2021

In Ogihara’s edition of the Tocharian B so-called “Avadāna-Manuscript”, a fragment from the Dhanika-Avadāna contains a word santse. On the basis of parallel texts, it is shown that santse means ‘daughter-in-law’. This newly identified word is cognate with a.o. Greek νυός ‘daughter-in-law’ and derives from Proto-Indo- European *snusó-.
Strict Products Liability 2.0: The Triumph of Judicial Reasoning Over Mainstream Tort Theory
Authors: Geistfeld Mark A.
Published: December 2021

Strict products liability has evolved in a manner that is widely misunderstood. The liability rule was first formulated to govern defective products that did not minimally perform one of their ordinary functions as expected by consumers—a malfunction that violates the implied warranty of quality. After adopting this rule, courts began applying it to products that did not malfunction and found that a test for defect based on consumer expectations often is indeterminate or can otherwise unduly limit liability in an important class of cases. To address these problems, most courts adopted the risk-utility test, a form of cost-benefit analysis that functions like the negligence standard of reasonable care. Relying on these cases, the Restatement (Third) of Torts: Products Liability embraced the risk-utility test, jettisoned the consumer expectations test, and characterized strict products liability as a misleading label that perpetuates confusion about liability being strict when it instead is based on negligence. In response, a clear majority of courts have rejected this negligence-based framework and affirmed the continued vitality of strict products liability. Puzzled by this unexpected development, mainstream scholars claim that courts are confused by the rhetoric of strict products liability. The prevailing scholarly opinion about this matter is confused; its fixation on negligence ignores the implied warranty rationale for strict products liability. Having been largely formulated as a rule of contract law, the implied warranty is under-theorized as a tort doctrine. Once adequately developed, the tort version of the implied warranty shows why courts have transformed the rule of strict products liability from the last century into a more comprehensive regime—“strict products liability 2.0”—that relies on consumer expectations to incorporate the risk-utility test into the framework of strict products liability. As compared to ordinary negligence liability, the implied warranty defines the safety problem in the normatively appropriate manner, thereby sharpening the inquiry about what’s at stake. In dismissing this important development, mainstream tort theory relies on legal categories that fundamentally differ from the ones courts have used to develop strict products liability with analogical reasoning. Scholars have either resorted to overly general theories of tort liability or have otherwise focused on narrow doctrinal questions. By not engaging in the mid-level categorical theorizing required by analogical reasoning, the mainstream position could not see how this characteristic form of judicial reasoning has created the substantively sound regime of strict products liability 2.0.
Perceptual mapping of linguistic variation in Saudi Arabic dialects
Authors: Al-Rojaie Yousef
Published: December 2021

This article provides a perceptual dialectology account of linguistic diversity in Saudi Arabia. Using the map-drawing and labeling task, the study examined the perceptions and ideologies of 674 speakers of Saudi Arabic dialects about the perceived boundaries of regional dialect varieties, as well as their social evaluation of and beliefs about the dialects. The analysis of the results as displayed in composite maps using a Geographic Information System (GIS) mapping program revealed that respondents identified five major dialect areas as having the most distinct features: the Najdi, Hijazi, southern, eastern, and northern regions. Ten categories of respondents’ labels emerged out of the qualitative analysis: style, influence, Bedouin/urban, fast, open/closed, vowel lengthening, unique vocabulary, alternation of /k/ and /g/, attraction, and social media. The present findings show the salience of certain linguistic and social features that respondents associate with certain dialect areas. Such perceptions can ultimately guide and enhance future descriptions and analyses of actual linguistic variation in Saudi Arabia.
Ungeheure Kräfte
Authors: Renner Adrian
Published: December 2021

This article examines Friedrich Nietzsche’s recourse to Robert Mayer’s physical and physiological concept of release (Auslösung) in various fragments, notes and writings from the 1880ies. Nietzsche’s understanding of force can be articulated as a critic of a purely mechanical understanding of the thermodynamic law of the conservation of energy. Based on Mayer’s writings, Nietzsche describes the eruptive quantitative release of forces as a qualitative process shaped by the bodily perception of forces. The underlying feeling of force (Kraftgefühl) can be traced in biological, psychological, historical and aesthetic phenomena and is rendered by Nietzsche both anthropomorphically as will and as a universal physiological law that determines bodily, social and moral actions.
Serum markers, obesity and prostate cancer risk: results from the prostate cancer prevention trial
Authors: Chau Cindy H , Till Cathee , Price Douglas K , Goodman Phyllis J , Neuhouser Marian L , Pollak Michael N , Thompson Ian M , Figg William D
Published: December 2021

Molecular mechanisms linking obesity to prostate cancer involve steroid hormone and insulin/insulin-like growth factor 1 (IGF1) pathways. We investigated the association of circulating serum markers (e.g. androgens and IGFs/IGFBPs) with BMI and in modifying the association of obesity with prostate cancer risk. Data and specimens for this nested case–control study are from the Prostate Cancer Prevention Trial, a randomized, placebo-controlled trial of finasteride for prostate cancer prevention. Presence or absence of cancer was determined by prostate biopsy. Serum samples were assayed for sex steroid hormone concentrations and IGF1 axis analytes. Logistic regression estimated odds ratio and 95% CIs for risk of overall, low-grade (Gleason 2–6), and high-grade (Gleason 7–10) cancers. We found significant associations between BMI with serum steroids and IGFs/IGFBPs; the IGF1 axis was significantly associated with several serum steroids. Serum steroid levels did not affect the association of BMI with prostate cancer risk; however, IGFBP2 and IGFs modified the association of obesity with low- and high-grade disease. While serum steroids and IGFs/IGFBPs are associated with BMI, only the IGF1 axis contributed to obesity-related prostate cancer risk. Understanding the biological mechanisms linking obesity to prostate cancer risk as it relates to circulating serum markers will aid in developing effective prostate cancer prevention strategies and treatments.
НАЦІОНАЛЬНО-КУЛЬТУРНИЙ РУХ УКРАЇНЦІВ ГАЛИЧИНИ ДРУГОЇ ПОЛОВИНИ ХІХ – ПОЧАТКУ ХХ ст. НА СТОРІНКАХ ТОГОЧАСНИХ ПУБЛІЦИСТИЧНИХ ПРАЦЬ
Authors: Шологон Лілія
Published: December 2021

У статті проаналізовано публіцистичні праці другої половини ХІХ – початку ХХ ст., присвячені найважливішим проблемам національно-культурного руху українців Галичини. Метою статті є роз­кри­ти погляди переважно лідерів цього руху на найбільш  актуальні питання українського куль­турного жит­тя краю та прослідкувати за трансформацією національно-культурного руху українців Галичини у національно-визвольний. За допомогою джерелознавчої критики ми спробували з’ясувати об’єктивно-суб’єктивний інформаційний потенціал публіцистичних праць українських, польських та російських гро­мадсько-культурних діячів та політиків, що дозволило зробити реконструкцію різних аспектів націо­нально-культурного руху українців Галичини впродовж другої половини ХІХ – початку ХХ ст. Герменев­тика, як мистецтво правильно розуміти мову іншої людини, зокрема писемний текст, мала також важливе значення для аналізу творів учасників національно-культурного руху. Нам вдалося вста­новити, що наприкінці ХІХ – початку ХХ ст. простежується стійка тенденція до політизації україн­ського націо­нально-культурного руху та трансформації його у національно-визвольний. Це позначилася на творах громадських діячів цього часу (Юліана Бачинського, Леона Василевського, Станісла­ва Людке­ви­ча, Івана Труша, Івана Франка та інших), де акцентується на тому, що тільки політична самостійність українців може стати передумовою до вирішення найнагальніших проблем, у тому числі культурного характеру. Такий світоглядний підхід має важливе суспільне значення в умовах сучасної гібридної російсько-української війни, коли боротьба за українську державність триває.

Ключові слова: Галичина, національно-культурний рух, публіцистичні праці, громадське това­риство, політична самостійність.
П’ЯТА МІЖНАРОДНА НАУКОВА КОНФЕРЕНЦІЯ “ОБЛИЧЧЯ ВІЙНИ. МІСТО І ВІЙНА”, 26–27 листопада 2020 р., Лодзь, Польща
Authors: Ганський Олег
Published: December 2021

Вже п’ятий рік поспіль на історико-філософічному факультеті Лодзинського універ­ситету відбувається наукова дводенна конференція під промовистою назвою “Обличчя війни”. Темою цьогорічної конференції організатори обрали гасло “Місто і війна”. У зв’язку зі склад­ною ситуацією на фронті боротьби з вірусом COVID-19, конференція відбулась з піврічним за­пізненням і в новому форматі: за допомогою безкоштовної платформи Microsoft Teams. Ос­кіль­ки конференція відбувалась онлайн, то це дало змогу взяти участь в засіданнях конференції близько ста представникам різних наукових дисциплін і установ, як з Польщі, так і з-за кор­дону: України, Угорщини, Румунії, Литви та Росії. Робочими мовами конференції була поль­ська, англійська і російська.
ГРОМАДСЬКО-ПОЛІТИЧНА ДІЯЛЬНІСТЬ ВАСИЛЯ СТЕФАНИКА НА ПОКУТТІ НА ПОЧАТКУ ХХ ст.
Authors: Королько Андрій
Published: December 2021

У статті досліджується громадсько-політична діяльність відомого українського письменника Василя Стефаника на Покутті на початку ХХ ст. Простежено особливості формування світогляду та становлення суспільно-політичних поглядів українського письменника-новеліста у кінці ХІХ ст. Про­аналізовано його участь у передвиборчих кампаніях до Державної ради (австрійського парламенту) та Галицького крайового сейму, які відбувалися на теренах краю. Розглянуто основні напрямки практичної діяльності громадсько-політичного діяча в УРП на початку ХХ ст.: участь у роботі з’їздів УРП, на­родних віч; агітація на підтримку членів УРП під час виборів до австрійського парламенту і Гали­цького крайового сейму. Показано його внесок в організацію українського січового руху та діяль­ність това­риства “Просвіта” на Покутті, зокрема, на Снятинщині. Простежено участь пись­менника в ювілейних заходах з нагоди вшанування сторіччя від дня народження Тараса Шевченка.

Ключові слова: Василь Стефаник, Українська радикальна партія, Покуття, віче, Державна Рада, Галицький крайовий сейм, “Січ”, “Просвіта”.
Educational Perspectives: Boot Camps for Neonatal-Perinatal Medicine Fellows
Authors: Sawyer Taylor , French Heather , Soghier Lamia , Barry James , Johnston Lindsay , Anderson JoDee , Ades Anne
Published: December 2021

Fellowship training is a required component of the transformation of a pediatrician into an independent practitioner of neonatal-perinatal medicine (NPM). Exposure to neonatal intensive care, experience in the management of neonatal patients, and successful performance of neonatal procedures is lower in trainees entering NPM fellowship today as compared with the past. To address this change in the baseline competency of incoming fellows, many NPM fellowship programs have begun to conduct intensive, simulation-based training sessions at the beginning of fellowship, commonly called “boot camps.” In this article, we explore the concept of boot camps, examine curriculum design elements of boot camps for NPM fellows, provide examples of collaborative and regional NPM boot camps, explore challenges to conducting a boot camp for NPM fellows, and discuss future directions for NPM fellowship boot camps, on a national and international level.
DEVELOPMENTAL PEDIATRICS: ITS TASK AND POSSIBILITIES
Authors: GESELL ARNOLD
Published: December 2021

SHORTLY after the American Board of Pediatrics was established in 1935, a basic requirement in Growth and Development was set up for specialty certification. When the medical history of the 20th century is written, we know this formal action will be regarded as a uniquely important event in the evolution of clinical medicine. Already we can see that a clinical science of development is in the making, and that the hygiene of the growing child is being envisaged in the dynamics of his growth. (We shall use the terms growth and development interchangeably for they are virtually synonymous.) Health is a somewhat static idea, unless by health we mean that condition which promotes optimal development.

Pediatrics is distinctive among all the specialties in three ways:

1.It is a specialty of general medicine.

2.It is directed to an age sector of life, rather than to an organ system.

3.It is basically interested in normality as well as disease.

Developmental Pediatrics is a form of clinical medicine which is systematically concerned with the diagnosis and supervision of child development, normal and abnormal.

Doctrine of Development

Development is a very usable concept—both for theoretic and for practical purposes. It is a unifying concept. It applies with equal force to body and mind. It resolves the false dualisms of psyche and soma. It also helps to resolve artificial distinctions between heredity and environment; between normal and abnormal; between structure and function. Development is an integrating concept. In fact, it is development which keeps the child from falling apart under the disrupting stress of excessive medical specialization.

Every newborn child traverses an indivisible, continuous cycle of growth. And for that very reason, the child remains the most cohesive force for the maintenance of family life in our democratic culture. The practicing pediatrician instinctively thinks of the child not only as the end product of eons of evolution, but also as a most important member of a family group; and by the way, also as the citizen of the future.
Special Report From the Committee for the Improvement of Child Health
Authors: WILSON JAMES L. , HUBBARD JOHN P.
Published: December 2021

The Health of the Nation Depends on the Health of the Child

The number one health problem of this country is not any one aspect of medical care. Cancer, heart disease, mental illness, important in themselves, are less vital to the nation's well-being than the general health of its children. Organic and mental health of adults depend largely on the care they received as children. Only in old age is the incidence of disease as high as in childhood; in no other age group does disabling disease strike as often. In infancy the very survival rate varies directly with the availability and quality of medical care.

The need for preventive, diagnostic, and curative services of high quality for all children has beenn established and agreed upon by the government, organized medicine, voluntary agencies and the public. Furthermore, there is general agreement on the need for improvement of child health. So much evidence has already been givn on the subject that the case for better medical care and health supervision for children is well established.

Better Child Health Depends on More Well-Trained Doctors

How is better medical care for children to be achieved? In the last analysis, success in this field depends not so much upon the physical facilities of the hospital, the laboratory or the pharmacy as upon the judgment and skill of the individual physician. This skill is a result of training and experience.

Deficiencies in Pediatric Training

As a step toward better and more evenly distributed health services for children the American Academy of Pediatrics has conducted a nation-wide study of all factors involved in the medical care of children in the United States—hospitals, community health services, private practice of physicians and dentists, and pediatric education.

The preliminary findings of the Study reveal a startling lack of adequate training of a considerable portion of both general practitioners and pediatricians.
Round Table Discussion
Authors: HANSEN ARILD E. , FASHENA GLADYS J.
Published: December 2021

Chairman Hansen: That we are here today bespeaks our interest in the problem of rheumatic fever. Undoubtedly some have come in hopes of finding new clues to a better understanding of a difficult problem, in spite of quite intimate knowledge of the field. Others may feel they have been pressed with variable agitations from many sources, hence desire to become more familiar with general features as well as details. From the viewpoint of the persons asked to conduct this Round Table Discussion, the same features apply; namely, the desire to gain exact information, yet help if possible in the clarification of points which are becoming generally accepted. The subject is broad, varied, indefinite and controversial at times even to the point of provoking emotional responses. Its importance is undisputed, the frequently cited comparatives and invectives in vogue may be mentioned as evidence:

"One of the chief causes of death in the school age child—responsible for more deaths in this age group in almost any year than the combined deaths from ordinary childhood diseases, e.g. diphtheria, poliomyelitis, scarlet fever, measles, mumps, with meningococcic meningitis thrown in— responsible for seven times the number of deaths as poliomyelitis in this age group—significantly more deaths than from all forms of tuberculosis—chief cause of death from heart disease in the young adult—and one of the chief causes of disability in children and youth—producing 'cripples who do not limp' also 'cripples who cannot even walk.' "

Textbook knowledge, perusal of current literature and personal consultation coupled with practical experiences allow one to comprehend the problem of rheumatic fever in childhood almost as well as the "expert".
LIPOID NEPHROSIS
Authors: BLOCK WALTER M. , JACKSON ROBERT L. , STEARNS GENEVIEVE , BUTSCH MIRIAM P.
Published: December 2021

Clinical and biochemical studies of 40 children with lipoid nephrosis are evaluated. Twenty-six (65 %) are alive; 19 have been entirely well for 1 to 16 years, including three who had minimal hematuria on various occasions. Three have been well for less than a year, one still has proteinuria only, and three still have active disease. Of 22 children who had received sulfonamides for infections, only three have died. Necropsy was done on 10 of the 14 children who died. Minor glomerular changes were seen in the kidneys of four children not known to have had hematuria. Pronounced glomerular changes occurred in two children who had minimal hematuria. Of the four children who did not show any glomerular changes, two had minimal hematuria on several occasions. Pathologic changes in the liver were minimal unless acacia had been given.

Laboratory determinations revealed no significant alteration of the prothrombin time. Most of the increase in the plasma fats was in the cholesterol fraction. The precentage of cholesterol esters was not decreased. In case of recovery, the cholesterol seemed to return to normal values at a slower rate than the serum albumin. Plasma fat reached values exceeding 5 gm./100 ml. in some instances. No "critical edema level" for albumin was found. The erythrocyte sedimentation test was a reliable guide in determining the course of the disease.

Choline citrate (0.8 gm. each day), given to seven children for prolonged periods, failed to produce essential changes in the plasma fats or definite clinical improvement.

Periods of sudden change in edema were found to be critical times for the nephrotic child. Two children developed cardiac failure after injection of large volumes of sucrose.

Early diagnosis is important, for treatment is most effective in the early stage.

The prognosis is good since the advent of chemo- and antibiotic therapy, and is not impaired by prolonged duration of the disease. Growth of the children who recover is good.
A HOSPITAL ROOMING-IN UNIT FOR FOUR NEWBORN INFANTS AND THEIR MOTHERS
Authors: JACKSON EDITH B. , OLMSTED RICHARD W. , FOORD ALAN , THOMS HERBERT , HYDER KATE
Published: December 2021

introduction

Rooming-in is the term currently in use to designate the hospital arrangement whereby a mother may have her newborn baby in a crib by her bedside whenever she wishes. The term was first used by Gesell and Ilg.1 Such an arrangement was established for study purposes on the University Service of the Grace-New Haven Community Hospital in October 1946. The four-bed ward used for this purpose is known as the Rooming-In Unit. An account of development of this Unit with a few preliminary observations is the subject of this paper.

Because of the enthusiastic participation of fathers in the project from the day of its inception, the authors were inclined to entitle the paper,“Rooming-In for Parents and Newborns.” The husband may be with his wife throughout the first stage of labor if mutually agreeable; under normal circumstances he may see his baby shortly after birth—even hold him; he may continue to get closely acquainted with his child day after day in the hospital, and watch his wife and the baby at nursing time if that happens to occur during visiting hours. This paternal participation has afforded obvious satisfaction to both parents which we believe is salutary for the baby. Indeed, the first major assumption in making plans for the Rooming-In Unit has been that a mother's satisfaction with herself and with the attention and care bestowed upon her (by husband, parents, members of medical and nursing staff)is the best guarantee for her inclination and ability to satisfy
CONCEALED DIVERTICULUM OF THE MALE URETHRA AS A CAUSE OF URINARY OBSTRUCTION
Authors: GROSS ROBERT E. , BILL ALEXANDER H.
Published: December 2021

In infancy and childhood there are many causes for obstruction to the flow of urine through the urethra. These include preputial adhesions,meatal narrowing, urethral stricture, posterior urethral valves, and contracted bladder neck. It has been known also that congenital diverticula of the urethra can give rise to urinary obstruction. These have been studied by Watts1 in 1906, by Lowsley and Gutierrez2 in 1928, by Kretschmer3 in 1936, and by Campbell4 in 1937. Such diverticula have been detected heretofore by the presence of a swelling on the ventral surface of the penis, in the peno-scrotal angle, or in the perineum. It is the purpose of this paper to present three cases of concealed diverticula of the urethra in each of which there was urinary obstruction; in none of these was there any swelling on the external surface of the penis. In two of these children the cause of obstruction was not recognized during life;death ensued as a result of urinary tract infection and the urethral abnormalities were found at autopsy. In the third child the cause of obstruction was found by roentgenologic visualization of the urethra, and surgical relief of the obstruction was prompdy instituted.

CASE REPORTS

Case 1

Children's Hospital #153,603. This 5-year-old boy was admitted to the Surgical Service on October 3, 1931, with a history of urinary dribbling,intermittent fever, and pyuria. The mother stated that until 1½ years of age, the child had had no urinary stream, the urine coming away only in a slow
THE AGE INCIDENCE OF POLIOMYELITIS IN CLEVELAND
Authors: DEHN HELMUT M.
Published: December 2021

An apparent increase in the number of older children and adults attacked by poliomyelitis has been reported by a number of observers who have compared age distribution data of more recent epidemics (after 1930) with those of the years before 1920. Such reports have come from the northeastern,midwestern, and north central states,1,2,3 from California,4 from Sweden and Australia5 and from Germany.6 Relatively fewer infants and pre-school children have been affected, while the percentile participation of older children and adults has increased. Of course, adults have still remained a minority of patients everywhere.

Maxcy7 has questioned the reality of such an age shift for several reasons: (1) the shift may be merely an expression of the changing age distribution of the general population; (2) diagnosis may have become more accurate, especially for abortive forms; (3) selective under-reporting may obscure real conditions.

That the epidemiologic pattern of poliomyelitis can be badly distorted by under-reporting was shown by Nelson and Aycock8 in a thorough analysis of the data for Massachusetts. In brief, they found that of 2300 patients who were registered between 1928 and 1941 with the Harvard Commission for Infantile Paralysis for the treatment of paralysis due to poliomyelitis,23.1% or almost 1 out of 4 were not reported to the authorities at the time of their acute illness, although most of these unreported patients were attended by a physician. The greatest percentages of unreported cases occurred in non-epidemic years, off season months, small towns, and among infants and adults. One-third
CURARE (INTOCOSTRIN) IN THE ACUTE STAGE OF ANTERIOR POLIOMYELITIS
Authors: ROSENBERG DAVID , FISCHER ALFRED E.
Published: December 2021

The efficacy of curare was tested in a hospital for communicable diseases during an epidemic of acute anterior poliomyelitis. Previous reports indicated that rapid results were to be expected. When the physical therapists who were treating our patients found little or no relaxation in the affected muscles, and the goniometric measurements showed no evidence of improvement, the dose of curare was cautiously increased in some patients. Larger doses than previously prescribed were tolerated with safety by some patients. Others, however, reacted alarmingly to small doses. This difference in therapeutic response may be explained by individual variations in response to a drug or by the fact that the concentration of the drug may rise rapidly, sometimes to unpredictable heights, before falling (Schlesinger).

The dangers of giving curare to patients with bulbar involvement, especially to those in which there is beginning bulbar or intercostal muscle weakness have been pointed out; also the probable cumulative effect when injections are given less than eight hours apart. The beneficial effects of small doses of curare, with which we obtained little or no muscle relaxation, cannot be confirmed or denied, when such doses are given for weeks in combination with physical therapy.
THE METABOLISM OF BILIRUBIN
Authors: NAJJAR VICTOR A. , PARK EDWARDS A.
Published: December 2021

A little girl was asked by her teacher to write an essay on Benjamin Franklin and to make it short. She wrote: "Benjamin Franklin was born in Boston: he married a Philadelphia lady and discovered electricity." Dr. Najjar made an independent discovery of electricity in Missouri, a gentle, even and altogether pleasing current. I shall be short in my turn.

I regard my function on this occasion to be like that of a keeper whose business it is to exhibit to you a greyhound and, after demonstrating his points and recounting his exploits, to turn him loose.

Victor Najjar was born in Lebanon. He graduated from the American University of Beirut in 1932. After interning in pediatrics at the American University Hospital, Beirut, 1935 to 1937, he became instructor in Public Health and Hygiene at The Rural College for Teachers, Bagdad, Iraq, and the following year pediatrician-in-charge to the Children's Clinic, Bagdad. Najjar's residence in Bagdad leads me to believe that he could tell us much about grand viziers, caliphs and harems. In 1939 he came to this country joining the pediatric staff of Johns Hopkins University. In 1944 he became Associate and in 1945 was promoted to be an Assistant Professor of Pediatrics. In 1946 he was accorded a National Research Council Fellowship and elected to the laboratory of Carl F. Cori, Washington University School of Medicine, St. Louis, where he remained until The Department of Pediatrics, Johns Hopkins University Medical School, and the Harriet Lane Home, Johns Hopkins Hospital, Baltimore. 1948.
FURTHER STUDIES ON THE TREATMENT OF CONGENITAL ADRENAL HYPERPLASIA WITH CORTISONE
Authors: CRIGLER JOHN F. , SILVERMAN SAMUEL H. , WILKINS LAWSON
Published: December 2021

Three cases of congenital adrenal hyperplasia with disturbed electrolyte metabolism, followed for 14 to 20 months, have been reported in detail.

The effects of cortisone (compound E) and corticosterone (compound B) on the suppression of the abnormal adrenals and on the electrolyte disturbance have been discussed. Cortisone produces more marked suppression of the adrenal overactivity/mg. (as measured by the urinary excretion of 17-KS), but less sodium retention than corticosterone. Both steroids, however, significantly improve the electrolyte abnormality.

The possible mechanism of action of cortisone on the electrolyte metabolism is discussed.

Suggestions concerning the therapeutic management of these patients are offered. The use of adequate NaCl without DCA in the initial treatment is emphasized, since suppression of the adrenal with cortisone seems to alter materially DCA requirement. The final combination of therapy, however, must be decided in each patient individually.
STUDIES OF THE IMMUNOLOGY OF THE NEWBORN INFANT
Authors: OSBORN JOHN J. , DANCIS JOSEPH , ROSENBERG BLANCHE V.
Published: December 2021

The titer of diphtheria antitoxin in maternal and infant (cord) blood was compared in 56 premature infants. A significant correlation was found between birth weight and placental permeability to diphtheria antitoxin. Small premature infants (under 1200 gm.) have much less circulating antitoxin derived from the mother than do larger premature infants. In 10 premature infants with high cord titers of diphtheria antitoxin, this passive immunity was lost at about the same rate as by normal newborn infants.
ELECTROPHORETIC ANALYSIS OF SERUM PROTEINS IN PREMATURE INFANTS
Authors: NORTON PATRICIA M. , KUNZ HANS , PRATT EDWARD L.
Published: December 2021

Forty-four measurements of the concentrations of total serum protein determined by a Kjeldahl procedure and of albumin, alpha 1, alpha 2, beta and gamma globulins determined electrophoretically in the serum of 27 premature infants ranging in age from 7 hours to 65 days are reported.

Wide variations in all values are evident in individual cases. Certain trends are nevertheless apparent. During the first 5 to 6 weeks there is a gradual decline in the concentrations of total serum protein, albumin and gamma globulins. The alpha and beta globulins show no trend with age in this study.

Except for slightly higher values for alpha 1 globulins in the smaller infants, none of the concentrations could be correlated with the birth weights of the patients.
LEVEL OF HYALURONIDASE INHIBITOR IN THE SERUM OF PREMATURE INFANTS WITH RETROLENTAL FIBROPLASIA
Authors: MACKENZIE JULIA B.
Published: December 2021

The serum of the premature infant contains material which inhibits bovine hyaluronidase. This inhibitor was found to be present to about the same degree in infants with and without retrolental fibroplasia and appeared to be unrelated to the severity of the disease.

The level of the physiologic inhibitor of hyaluronidase found in the blood of the premature and full term infant is approximately of the same order of magnitude.
BIRTH AND MORTALITY RATES AMONG SLAVE INFANTS ON SOUTHERN PLANTATIONS
Authors: POSTELL WILLIAM DOSITE
Published: December 2021

THERE seems to be no end of writings about the Ante-bellum South but one of the most neglected fields has been the health of the slaves. Recently a monograph appeared dealing with this subject and since there are no better criteria in judging health standards than a study of infant birth and mortality rates, a further interpretation of the data presented in this monograph with some additional facts is herewith presented. There was nothing the planter was more interested in than the increase of his slaves through the birth and rearing of children, and within the bounds of medical knowledge of the period, he took the time and effort to promote conditions that were conducive to the rearing of large families.

The first care of the planter was the prenatal care of the mother. Rules were drawn up by the planter and overseers were instructed in the care of the expectant mother. Crude as this care was in comparison to our knowledge today it was still far superior to anything the Negro had known in Africa, and it compared favorably with the medical knowledge of the ante-bellum period. As soon as the mother reported her condition she was assigned lighter tasks. On confinement she was sent to the lying-in room of the plantation hospital or, if the plantation was large enough, to a separate hospital maintained for such cases. Throughout rural America confinement cases were usually handled by midwives or "grannies" as they were sometimes known. A Negro woman would serve as midwife for the plantation, serving both white and black.
MOBILITY OF THE UPPER CERVICAL SPINE IN HEALTH AND DISEASE
Authors: TOWNSEND EDWARD H. , ROWE M. LAURENS
Published: December 2021

Four cases of cervical "subluxation" have been presented due to muscle spasm in the cervical region, which occurred during an upper respiratory infection. This syndrome differs from the atlanto-axial subluxation.

Roentgenograms in the diagnosis of this condition may lead to erroneous diagnosis and treatment.

The normal anatomic and functional ranges of the cervical spine were studied and are discussed. The degree of mobility of the cervical spine is greater than previously assumed.