bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Standing Long Jump Developmental Levels Using an Inertial Measurement Unit
Authors: Sgrò Francesco , Mango Pietro , Pignato Salvatore , Schembri Rosaria , Licari Danilo , Lipoma Mario
Published: January 2017

This study tested the feasibility of using an inertial measurement unit to discriminate different developmental levels of children performing the standing long jump (SLJ). Sixty-four children (54.6% boys, 46.4% girls) aged 8 to 11 years old ( M = 9.17, SD = 0.97) performed the SLJ three times and were classified by rater observations into three developmental levels. Concurrently, they wore an inertial measurement unit from which a set of temporal and kinematic parameters for the quantitative assessment of their jumps. A multivariate analysis of variance revealed that variability among the developmental groups was identified by the overall set of parameters, while discriminant function analysis verified that these parameters discriminated among developmental levels. Primary predictors for developmental group discrimination were maximum peak acceleration in the vertical and anteroposterior directions, respectively, and normalized preparation time. These outcomes represent significant steps toward improving the assessment of SLJ rate of development in childhood and supporting physical education.
Sex and Ability Differences in Neural Strategy for Piaget’s Water Level Test
Authors: Wu Sina , Li Yingli , Kong Ming
Published: January 2017

To explore brain activation differences between the sexes and between high and low performers on spatial perception performance, 43 college students (20 males and 23 females) performed the Piaget’s Water Level Test (WLT) while their electroencephalogram signals were recorded. A 2 (Sex) × 2 (Group: high performing vs. low performing) × 2 (Hemisphere: left vs. right) × 3 (Region: frontal, parietal, and temporal) mixed analysis of variance on beta power data showed that females more significantly activated the left hemisphere when performing the WLT, suggesting their application of an analytic strategy. In contrast, males showed a bilateral activation pattern, suggesting their use of an analytic- or holistic-combined strategy. Moreover, superior performance on the WLT was associated with enhanced temporal lobe functioning, suggesting that a superior analytic skill is key to successful performance on the WLT. There is likely modulating impact of both cognitive style and specific task properties on spatial perception strategy preferences.
Anatomy in Scotland: 20 Years of Change
Authors: Pryde F R , Black S M
Published: January 2017

Background & Aims: To document changes in the educational infrastructure of anatomy in Scotland over the past 20 years. To investigate the possible impact of the GMC 1993 recommendations and assess the preparedness of Scottish anatomy to meet the implications of the proposed amendment to the 1984 Anatomy Act. Results: Over the past 20 years in Scotland, the total number of teaching staff in anatomy (full time, part time and honorary) has decreased by over 24%, full time teaching staff numbers have decreased by more than 33% and the number of clinical demonstrators by more than 70%. However, medical student intake has risen by 38% and the overall student number experiencing anatomical teaching (medicine, science and dentistry) has more than doubled, resulting in a current average staff:student ratio of 1:58. Anatomy contact hours between staff and medical students have decreased by just over 60% in the last 20 years. Conclusions: In the last 20 years, contact hours and staffing levels have decreased substantially in Scotland whilst student numbers (medical, science and dental) have increased significantly. On average the anatomical input to the medical curriculum decreased by 28% between 1983 and 1993 but post the CMC initiative, there was a further decrease of 43% resulting in current medical students in Scotland experiencing a 60% reduction in contact anatomy time compared to their peers in the early 1980's. The decline in anatomical infrastructure is not a reassuring indicator of its ability to meet substantial future demands.
Colistin Sulphate in the Treatment of Specific Bacterial Intestinal Infections
Authors: Lamb R.
Published: January 2017

An attempt has been made to evaluate colistin sulphate in the treatment of specific intestinal infections. Ninety three patients were treated with the antibiotic comprising 48 cases of specific E. coli infection and 45 cases of Shigella. Eradication of the infecting organism was achieved in these two groups in 39 (81.25%) and 33 (73.3%).

No problems were associated with administration of colistin and toxic effects were not seen.

Considering the fact that six negative daily dismissal swabs were taken as criterion of cure, the results obtained compare very favourably with other antibiotics. The necessity of the treatment of E. coli gastro-enteritis is discussed and the good results obtained with colistin would suggest it to be an appropriate choice of antibiotic. The findings in all groups would suggest that colistin is a very useful antibiotic in the treatment of specific intestinal infections.
Acute Suppurative Adenitis in Children: A Review of 964 Cases
Authors: Scobie William G.
Published: January 2017

A review of 964 cases of acute suppurative adenitis in children treated surgically during the period 1960 to 1968 is reported. Findings with respect to aetiology, age, site, duration of illness, and stay in hospital, are in accord with other reported series. Seventy per cent had received an antibiotic prior to admission, penicillin being the commonest. All were treated by incision and drainage under general anaesthesia. Staphylococcus pyogenes was grown from 67 per cent of the abscesses. Resistance of this organism to penicillin rose progressively over the period of review. In the last 20 years, the staphylococcus has replaced the streptococcus as the most common infecting organism in suppurative adenitis. It is suggested that these patients present late for medical treatment and come to surgery in spite of antibiotic treatment.
Developing Myelin in Human Peripheral Nerve
Authors: Dunn J. Shaw
Published: January 2017

The process of myelination is examined in the axillary part of the radial nerve in human foetuses of 50 to 150 mm. At first bundles of unmyelinated axons share a common invagination of the membrane of the Schwann cell. They are then separated from each other by processes of cytoplasm and finally segregated in individual Schwann cells as a result of repeated Schwann cell division. During myelination the mesaxon forms first loose whorls and then tight spirals around the axon. Compact myelin first appears focally in the outer layers of the spiral. Non-compacted areas appear to persist as the Schmidt-Lantermann clefts; it is suggested that these are areas of growth for the expanding sheath. Redundant folds of myelin are described and discussed.
Diabetic Angiopathy
Authors: MacSween R. N. M.
Published: January 2017

The vascular complications occurring in diabetes mellitus are reviewed. In addition to the long recognised involvement of large vessels by atheroma and Monckeberg's sclerosis, the more recently described microangiopathy affecting arterioles, venules and, in particular, capillaries is also described. The significance of this microangiopathy in the diabetic syndrome is outlined, and possible pathogenetic mechanisms involved in its development are discussed.
M-Complex: The Electrocardiographic Sign of Impending Cardiac Rupture following Myocardial Infarction
Authors: Mir M. Afzal
Published: January 2017

Out of 284 patients admitted to the Coronary-Care Unit, 60 patients showed an acute monophasic injury pattern (M-Complex) on their initial electrocardiogram (ECG). There were 13 fatalities on the first day of myocardial infarction; 6 from the M-complex group. Three of these 6 patients died with cardiac rupture. The ECG features of these 3 patients were compared with the 3 non-rupture patients. A progressive increase in the elevated R-ST segment of the M-complex with an upward ‘pull’ of the R-ST junction, proved to be an ominous ECG sign of impending cardiac rupture in patients with protracted chest pain and persistent hypertenison. The 3 non-rupture patients remained in a hypotensive state from admission to the time of death. Atrioventricular block and A-V junctional tachycardia were the commonest rhythm disturbances in patients dying with cardiac rupture.
Acute Leukaemia in Kenya
Authors: Barr R. D. , McCulloch P. B. , Mehta Sudha , Kendall A. G.
Published: January 2017

Acute leukaemia is not as uncommon in equatorial East Africa as has until recently been believed. The acute myelogenous variety is disproportionately common in children and has an unusually frequent chloromatous presentation. Although the reasons for this are not entirely clear, the effect of environmental factors is considered. The possible inter-relationship of malaria, Burkitt's lymphoma and acute leukaemia remains an enigma. Poor therapeutic results demand greater attention to the problem.
Potentiation by Previous Drug Therapy of Hepatotoxicity following Paracetamol Overdosage
Authors: Wright N. , Prescott L. F.
Published: January 2017

Patients developing hepatic necrosis following intoxication with paracetamol were classified as either ‘potentially induced’ or ‘non-induced’ according to their consumption during the previous 3 weeks of drugs likely to cause liver microsomal enzyme induction. Despite uncontrolled differences between the two groups the ‘potentially induced’ group developed statistically significantly more severe hepatic necrosis than the ‘non-induced’ patients. The greater severity of liver damage in the former group was accompanied by a higher incidence of death and acute renal failure. This is consistent with the observation that paracetamol-induced hepatic necrosis in animals is mediated by toxic intermediate metabolites.
The Patterns of Infection in Cystic Fibrosis
Authors: McCrae W. Morrice , Raeburn J. A.
Published: January 2017

Thirty-five patients with cysticfibrosis (aged 11 months to 13.5 years) have been investigated with regard to respiratory symptoms, respiratory tract pathogens, serum immunoglobulins and serum precipitins. Haemophilus influenzae was the commonest pathogen being supplanted in advanced disease by Pseudomonas aeruginosa. Those patients who had no respiratory infection had levels of IgG significantly lower than normal children of comparable ages. In children with severe respiratory infection the immunoglobulins were raised and precipitins to the predominant respiratory organism were present. These findings differ from the prevalent view that patients with cystic fibrosis have a normal response to infection and that the common infecting organism is Staphylococcus aureus.
Augmentin (Amoxycillin and Clavulanic Acid) in the Treatment of Urinary Tract Infections
Authors: Leigh A.
Published: January 2017

Augmentin (amoxycillin and clavulanic acid) is a new oral antibiotic combination which is particularly indicated in the treatment of urinary tract infections. Potentiation of amoxycillin by the clavulanic acid reduces the level of resistance in most Gram-negative urinary pathogens and these organisms are then sensitive to urinary levels of amoxycillin achieved on standard dosage. Clinical trials in urinary tract infections have shown a success rate of about 70 per cent for amoxycillin-resistant organisms. Augmentin in a dose of 375 mg tds is well tolerated and minimal gastrointestinal side effects occur.

Augmentin is a novel antibiotic combination and will be particularly valuable in the oral treatment of urinary tract infections caused by multiply resistant bacteria.
Have the Newer Nsaids Contributed to the Management of Rheumatoid Arthritis?
Authors: Pullar T. , Zoma A. A. , Madhok R. , Hunter J. A. , Capell Hilary A.
Published: January 2017

Approximately 30 non-steroidal anti-inflammatory agents are available for the treatment of rheumatoid arthritis. In this study patient acceptability of five such agents (benoxoprofen, fenbufen, feprazone, flurbiprofen, ketoprofen) is compared in groups of 50 patients with rheumatoid arthritis. Less than 40 per cent of patients continued on the prescribed drug for six months. Significantly more patients stopped fenbufen than stopped feprazone, otherwise dropout rates between the groups were similar. The overall efficacy and toxicity of most currently prescribed NSAIDs appear to be similar, and the availability of a surfeit of such agents dilutes clinical experience with any one drug. Despite subsequent events this method failed to differentiate benoxaprofen from the other agents. It would seem likely that this surfeit of similar drugs hinders detection of unusual complications, and impedes satisfactory management of inflammatory rheumatic disorders.
Successful Trigeminal Thermocoagulation for Paroxysmal Trigeminal Neuralgia in a Patient with Severe Haemophilia
Authors: Pettigrew Anna , Harvie Ann , Lowe G.D.O. , Turner J. , Forbes C.D.
Published: January 2017

Neurosurgical procedures in patients with severe haemophilia carry a major risk of bleeding. We describe successful thermocoagulation of the trigeminal nerve for neuralgia in a severe haemophiliac, under cover of factor VIII concentrate. This is the first case report of such an operation in severe haemophilia.
An Outbreak of ‘Slapped Cheek’ Parvovirus Infection (Erythema Infectiosum) in a Scottish Street
Authors: Boyce B.F. , Forgie I.
Published: January 2017

One adult and six children living in a small Scottish street developed erythema infectiosum (fifth disease) during the summer of 1985. The rash was attributed to infection with the human parvovirus. Leg pain and arthralgia occurred in five of the children.
Meningioma in a Chronic Schizophrenic
Authors: Roberts J.A. , Williams D.J. , Stack B.H.R.
Published: January 2017

A patient with a 27 year history of schizophrenia is described. Post-mortem revealed the presence of a right sided parietal meningioma. It is possible that this lesion caused the schizophrenic symptoms and that earlier investigation might have led to removal of the lesion.
Breast Ductography — Its Role in the Diagnosis of Breast Disease
Authors: Reid A.W. , McKellar N.J. , Sutherland G.R.
Published: January 2017

Breast ductography is a safe and simple technique to outline the duct system of the breast with contrast medium in patients with nipple discharge. The results of 60 successful ductograms are presented and an assessment of its clinical usefulness is made.
Pathology and Clinical Features of Gastrointestinal Lymphoma in Saudi Arabia
Authors: Kyriacou C. , Loewen R.D. , Gibbon K. , Hafeez M. , Stuart A.E. , Whorton G. , Al-Faleh F.Z. , Al-Mofleh I. , Jessen K. , Mass R.E. , El-Saghir N. , Al-Khudairy N. , Rifai M.M. , Qteishat W.
Published: January 2017

The histopathology and clinical presentation of 19 cases of primary gastrointestinal lymphoma is described. Our patients are similar to others in the Middle East but have a lower incidence of diarrhoea and malabsorption. All revealed a widespread chronic inflammatory background. Four patients with primary gastric lymphoma had endoscopic biopsies from the duodenum; these biopsies were completely free from tumour but showed a moderate to severe diffuse lymphoplasmacytic infiltrate. Electron microscopy shows that tumour cells penetrate basement membranes and invade the epithelium which becomes thin and attenuated. Substances which inhibit lymphocyte tropism might be useful in preventing intestinal ulceration. The MALT concept has been found useful in classification of the tumours. Two patients with unusual mesenteric node histology are described and it is thought that the appearances may indicate a substantial capacity for differentiation in the group of tumours.
Alcoholism, Hyponatraemia and Central Neurological Damage: More than Pontine Myelinolysis?
Authors: Adamson D.J.A. , Laing R.B.S. , Nathwani D.
Published: January 2017

Three patients with alcoholism and severe hyponatremia are described. Permanent neurological damage occurred in each case with cerebral, cerebellar or pontine damage from infarction or haemorrhage following correction of the biochemical disturbance. No patient developed Central Pontine Myelinolysis (CPM), the condition usually associated with profound hyponatremia and its correction.
Pasteurella Multocida Abscess Complicating a Femoral Vein Thrombosis
Authors: Petermann A. , Naylor A.R. , Donnelly P.K.
Published: January 2017

We describe the first reported case of a Pasteurella multocida thigh abscess complicating a femoral vein thrombosis in a non-immunocompromised patient with no history of animal bites or scratches.
Perceived Mismatches between Needs and Services in the Health Care of Elderly People
Authors: Spicker P. , Hanslip J.
Published: January 2017

A postal enquiry to professionals involved in service delivery points to a number of problems in the process of referring elderly people appropriately. These problems related to lack of choice and constrained options, rather than mis-referral through inadequate assessment.
The Influence of a Nurse Practitioner on Out of Hours Work Intensity for Surgical House Officers
Authors: Henderson N.C. , Cookson D.T. , Plumley R. , Cairns M. , Paterson-Brown S.
Published: January 2017

We have prospectively studied the influence of a nurse practitioner service on out of hours work intensity of surgical house officers. Data collection was achieved by prospective audit. The study was set in the surgical wards in a large teaching hospital. The main outcome measures were; 1) the nature and frequency of overnight calls to the nurse practitioner, and 2) the outcome of these calls (doctor not bleeped, telephone advice given by doctor or doctor attended ward). A total of 645 calls were made over the 75 night study period (8.6 calls/night). Two hundred and ninety-six calls were managed by the nurse practitioner alone. This represents a 46% reduction in work intensity for the surgical house officer. This study illustrates the benefits of a nurse practitioner service and also identifies important areas for undergraduate education in preparing medical students for the common problems encountered during the surgical on-call period.
Study of Soil Removal from Grafted Polypropylene
Authors: Katsumi M. , Tsuji T.
Published: January 2017

Soil deposition retention on acrylic acid-grafted polypropylene fabrics, which change continuously from hydrophobic to hydrophilic with the degree of grafting, are correlated with the work of adhesion of an oil drop to fabrics in water and the zeta potential on the fabric-water interface. The maximum soil deposition on fabric was at 0.4% of grafting ratio in air, while the minimum of soil removed by washing was at 0.2–0.4% of the grafting ratio in water. These results help to explain, in the light of the theory of hydrophobic soil stabilization, the detergency mechanism and to understand the influence of such factors as electrical repulsion and adhesive energy on the fabric surface. Correlations have been established between the physico-chemical properties and hydrophobic-hydrophilic surfaces. This should make possible greater soil-release effect with the finishes on hydrophobic fabrics. Electron micrographs of fabric surfaces, on which soils were deposited and retained before and after washing, show no significant differences in morphological differences with the degree of grafting.
The Creed
Authors: Parsenios George L.
Published: January 2017

This essay is a brief exposition on the Nicene Creed, and its primary emphasis is on the scriptural nature of the Creed. The language and imagery that express the relations between Father, Son, and Spirit in the Creed are the language and imagery of the Bible. But the Creed is not simply a set of propositions that our minds must accept. Like the Bible, the Creed offers a view of life that calls us to turn the world upside down.
Is the housing market blind to religion? A perceived substitutability approach to homophily and social integration
Authors: Dean Nema , Pryce Gwilym
Published: January 2017

Housing markets are unlikely to be impervious to the preferences and prejudices associated with urban segregation. For example, two neighbourhoods with very different religious attributes are unlikely to be perceived as close substitutes by homebuyers that have a strong preference for neighbours of a particular religion. This paper offers a new framework for the conception and measurement of social integration, defined in terms of perceived homophily. Homophily is the tendency for links to form between similar nodes in a network and we can think of perceived homophily as the tendency for any pair of neighbourhoods to be considered by the housing market to be close substitutes. Textbook economic theory suggests that we should expect the degree of perceived substitutability to affect cross-price elasticities. These can be measured empirically to reveal discontinuities in the network of perceived substitutability of different housing locations. Applying homophily coefficients to substitutability measures allows us to estimate perceived religious homophily between neighbourhoods. The approach can be applied to any city or region that has geocoded house transactions and socio-demographic data. We illustrate the method using data on Glasgow and find strong evidence of religious homophily. This suggests an underlying lack of social integration/cohesion and implies that the Glaswegian housing market is by no means blind to religion.
The tent: The uncanny architecture of agonism for Israel–Palestine, 1910–2011
Authors: Allweil Yael
Published: January 2017

Mass social protest erupted in Israel in 2011 around the banner of housing, with citizens pitching hundreds of tents in urban public spaces all over the country. The tent, as a symbol of and the architecture for political action, aligned communities deeply alienated from each other – the middle class and very poor, renters and homeowners, Ashkenazim and Mizrahim, Jews and Arabs-Palestinians – in a shared demand for housing. Solidarity revolving around shared bodily discomfort over the precarious dwelling situation deepened as communities faced the uncanny realisation that tents invoke the dwelling history of each of them: Ashkenazi Zionist pioneers of the 1920s credited as founders of the nation, Palestinian refugees’ facing dispossession and negotiating right of return, and Mizrahim who were marginalised and racialised in immigrant absorption camps. In 2011 protest tents materialised the competing narratives of these conflicted social groups while simultaneously serving as a shared space for political action. This paper explores the history of tent dwellings in Israel–Palestine since the 1910s as the uncanny architecture of nation building and object of shared, though conflicting, narratives of gain and loss. Architectural space emerges from this study as the ‘matter that matters’, producing a political community of conflicted groups, as proposed by Chantalle Mouffe and Bruno Latour. Mouffe and Latour identified the social role of designed spatial objects as crucial for understanding ways in which politics and space are affected by changes to the material world. This paper’s contribution expands on the architectural history of Israel–Palestine and adds to scholarship of the political meaning of architecture as a social ‘object of concern’, applicable beyond this case.
The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations
Authors: Stroo Marissa , Conover Christopher , Adcock Gale , Myneni Radhikha , Olaleye David , Østbye Truls
Published: January 2017

Worksite medical homes may be a good model for improving employee health. The aim of this study was to compare the likelihood of being seen in the emergency department (ED) or being hospitalized by level of use (no use, occasional use, or primary care) of a worksite medical home, overall and by type of user (employee, adult dependent, or pediatric dependent). This was a retrospective analysis of claims data, using covariate-adjusted logistic regression models for ED visits and inpatient hospitalizations. Secondary data for the years 2006 to 2008 from a company that offers an on-site health care center (HCC) were used. Analyses were based on a data set that combines health plan claims and human resources demographic data. Overall, people who did not use the HCC were more likely to be seen in the ED (adjusted odds ratio [OR] = 1.20, 95% confidence interval or CI [1.06, 1.37], P = .005) or to be hospitalized (adjusted OR = 1.58; 95% CI [1.34, 1.86]; P < .0001) compared with those who used the HCC for primary care. Both ED visits and hospitalizations for employees and dependents in this study were lower among those who used the worksite medical home for primary care. Worksite medical homes can improve chronic disease management and thus reduce ED visits and hospitalizations. These findings contribute to growing evidence that worksite medical homes are potentially cost-effective.
Abdominal Closure
Authors: Bewes Peter
Published: January 2017

There have been considerable developments in abdominal closure over the past 30 years or so, and (happily for some of the poorer countries of the world) they have not largely involved undue expense. Indeed many of the developments are compatible with considerable cost-saving.

I have changed over from the traditional (as it was then) method of multilayer closure with catgut to a one-layer method with monofilament nylon (often fishing nylon) in 1971. Since that time, despite a previous unhappy experience with the upper abdominal paramedian closure, I have not had a single ‘burst abdomen’ in any adult patient since making that change.
Anti-Tuberculous Drug Prescribing: Doctors' Compliance at a Private Teaching Hospital in Pakistan
Authors: Khan Javaid A , Hussain S Fayyaz
Published: January 2017

An adequate and appropriate anti-TB drug prescription is of crucial importance in order to “cure” a TB patient of his or her disease. This study looked at the prescribing habits of doctors working in a private teaching hospital of Pakistan. The results showed that the majority of doctors (79%) were choosing the correct four-drug regiment of RHZE in the intensive phase, as recommended in the National Guidelines. However, the dosage of some drugs were below the recommended ranges (43% of prescriptions for Pyraizinamide and 48% for Ethambutol). Regular audit of doctors' prescriptions is necessary in order to ensure that the National TB Guidelines are fully implemented by physicians working in the private sector of Pakistan.
Critical Evaluation of Compartment Pressure Measurement by Saline Manometer in Peripheral Hospital Setup
Authors: Sangwan S S , Marya K M , Devgan A , Siwach R C , Kundu Z S , Gupta P K
Published: January 2017

A hundred limbs of patients suffering limb trauma were assessed by at least two different reviewers for symptoms of compartment syndrome, both clinically, and by a simple, locally devised apparatus for pressure measurement. We have found the apparatus to be very effective, safe, reproducible and simple. Orthopaedic surgeons working in peripheral hospitals in the developing world can make use of this apparatus which costs less than $5 to assemble. This technique may assist an early decision regarding surgical decompression at a peripheral hospital or referral to specialist unit, thus saving valuable time and expense.
The Early Effects of Delayed Cordc Clamping in Term Infants Born to Libyan Mothers
Authors: Emhamed Musbah Omar , van Rheenen Patrick , Brabin Bernard J
Published: January 2017

This study was conducted to evaluate the haematological effects of the timing of umbilical cord clamping in term infants 24 h after birth in Libya. Mother-infant pairs were randomly assigned to early cord clamping (within 10 s after delivery) or delayed clamping (after the cord stopped pulsating). Maternal haematological status was assessed on admission in the delivery room. Infant haematological status was evaluated in cord blood and 24 h after birth. Bilirubin concentration was assessed at 24 h. 104 mother-infant pairs were randomized to delayed (n=58) or early cord clamping (n=46). At baseline the groups had similar demographic and biomedical characteristics, except for a difference in maternal haemoglobin, which was significantly higher in the early clamping group (11.7 g/dL, SD 1.3 g/dL versus 10.9 g/dL, SD 1.6 g/dL; P=0.0035). Twenty-four hours after delivery the mean infant haemoglobin level was significantly higher in the delayed clamping group (18.5 g/dL versus 17.1 g/dL; P=0.0005). No significant differences were found in clinical jaundice or plethora. Surprisingly, blood analysis showed that two babies in the early clamping group had total serum bilirubin levels (>15 mg/dL) that necessitated phototherapy. There were no babies in the late clamping group who required phototherapy. Three infants in the delayed clamping group had polycythaemia without symptoms, for which no partial exchange transfusion was necessary. Delaying cord clamping until the pulsations stop increases the red cell mass in term infants. It is a safe, simple and low cost delivery procedure that should be incorporated in integrated programmes aimed at reducing iron deficiency anaemia in infants in developing countries.
Transfontanelle Ultra-Sonography: An Invaluable Tool in the Assessment of the Infant Brain
Authors: Nzeh D A , Erinle S A , Saidu S A , Pam S D
Published: January 2017

Transfontanelle (cranial) ultrasonography, was carried out in 98 Nigerian infants over a period of 5 years. Of the infants, 38 (38.8%) had hydrocephalus from various causes while 26 (25.5%) had congenital anomalies. As ultrasound equipment is becoming a more readily available and affordable tool in the developing countries, it should become much easier for medical staff in these countries to arrive at the correct diagnosis of intracranial diseases in infants.
Visceral Leishmaniasis in a Non-Endemic Area of India
Authors: Sud A , Varma N , Marwaha R K , Patel F M , Trehan A , Singh S , Varma S
Published: January 2017

The study included 57 patients with visceral leishmaniasis. The average duration of symptoms was 3.8 ± 3.55 months and pancytopenia was the commonest haematological abnormality. The parasite load directly correlated with the degree of anaemia at presentation (P=0.03). Splenic regression took 9.58 ±4.5 days and haematological parameters recovered in 14.5±9.07 days. There were five deaths over the five-year study duration. Leishmaniasis was not the first diagnosis in 14 patients, of whom eight were residents of non-endemic regions. Diagnosis was achieved in 13.5 days in these patients, compared to 4.5 days in patients where leishmaniasis was suspected at the outset.
The Importance of Early Erythematous Reaction in Purified Protein Derivative Skin Testing
Authors: Barlan I B , Basaran M M
Published: January 2017

We attempted to assess the diagnostic value of the early erythematous reaction observed at the sixth hour after the application of purified protein derivative (PPD) skin testing. For this purpose, 64 children with pulmonary tuberculosis and 49 healthy age-matched controls were PPD skin tested.

Our results showed that the erythematous reaction of 5 mm or greater at the sixth hour was able to detect patients with active tuberculosis with 76% sensitivity, 85% specificity, 87% positive predictivity and 73% negative predictivity. Among 113 subjects, 6 h erythematous reaction of 5 mm or greater in size had 83% sensitivity to detect the ones who subsequently developed 10 mm or greater induration reaction at 48 h.

We concluded that the sixth hour early erythematous reaction is just as helpful as the 48 h induration of 10 mm or greater in detecting patients with pulmonary tuberculosis.
Neonatal Care during a Residents' Strike
Authors: Daga S R , Shende S R
Published: January 2017

Medical offcers from a primary health centre and rural hospital were posted at our neonatal care unit during the residents' strike that lasted 69 days. They were trained in labour room care and in special care of high-risk babies. Four weeks later they were to be first-on-call.

During the pre-strike, strike and post-strike period, there was no significant difference in the number of high-risk deliveries and admissions and deaths at the special care unit (SCU). The low-tech neonatal care that we followed, can be practised at the first referral centre in rural areas of developing countries by the team led by a medical officer.
Active Prophylactic Management of Respiratory Obstruction after Standard Thyroidectomy for Giant Goitre in the Middle Belt Region of Nigeria
Authors: Obekpa P O , Onuminya J E , Punnoose V A
Published: January 2017

Respiratory obstruction is a lethal complication of thyroidectomy for giant goitre.

Prophylactic tracheal splintage by retaining the endotracheal tube in situ for 24 h post-operatively and its meticulous management in the intensive care unit (ICU) is a safe and rewarding practice. Over a 7-year period, 33 patients, all women who had standard thyroidectomy for giant goitre were managed accordingly. There was no incidence of post-operative respiratory distress, nor mortality in the series. The average duration of stay in ICU was 2 days for all patients and the average hospital stay was 6 days for 27 of the 33 patients (81.8%). We suggest that judicious post-thyroidectomy management of giant goitre patients in ICU with endotracheal tube in situ for 24 h improves their survival chances.
Community-Based Teaching of Tropical Diseases: An Experience with Filariasis
Authors: Norman Gift , Joseph Abraham , Theodore Aravindan , Maruthamuthu M
Published: January 2017

The Department of Community Health Christian Medical College, Vellore, India, developed a module in 1981 to teach filariasis to medical undergraduates, using a community-based approach aimed at providing a comprehensive picture of this disease. Students learn in four phases during the 5½ years they spent in medical school. Student assessment is done during and at the end of each phase. Student feedback of the programme has been very positive. This paper describes the salient features of the module and suggests it could be adopted by other institutions to teach tropical diseases of public health importance that are relevant to that particular region or country.
Neisseria Meningitidis Nasopharynx Colonization of Diseased Patients on Presentation and on Discharge
Authors: Barroso David
Published: January 2017

Fifty-one meningococcal disease patients were randomly selected and a paired throat swab was taken before and after specific therapy. Neisseria meningitidis nasopharyngeal carriage after intravenous antibiotic therapy were found in only two cases (4%; 95% confidence interval (CI) 0.5–13). All close contacts of the cases received chemoprophylaxis and throat swabs taken 10 days later were negative.
Lessons Across the Pond: Assisted Reproductive Technology in the United Kingdom and the United States
Authors: Ouellette Alicia , Caplan Arthur , Carroll Kelly , Fossett James W. , Bjarnadottir Dyrleif , Shickle Darren , McGee Glenn
Published: January 2017

Scholars of differing political affiliation and the President's Council on Bioethics have called for regulation of assisted reproductive technology (ART) that would emulate many aspects of the regulatory system of the United Kingdom, in particular that of the Human Fertilisation and Embryology Authority. Specifically, scholars and the Council have argued that research in the U.S. involving gametes and human embryos lacks consistent oversight. While the Centers for Disease Control and Prevention (CDC) produces an annual ART success rate report, submission of data is guaranteed only by the promise that non-responders will be noted as such in the appendix of CDC's report, and most ART clinics publish success rates on the Internet in a much more recognized forum: website advertising. Moreover, U.S. law does not require licensing or accreditation of infertility programs and few regulations govern embryo research. While the large majority of clinics report their success rate data, and many follow practice standards and apply for accreditation from private agencies, these practices are strictly voluntary. Clinics failing to report their success rates face no legal consequence.
Prison Health, Public Health: Obligations and Opportunities
Authors: Jacobi John V.
Published: January 2017

We don't care enough about prisoners’ welfare. We should care deeply because, as two prominent commentators on the history of prisons have said, “Prisoners are ourselves writ large or small. And, as such, they should not be subjected to suffering exceeding fair expiation for the crimes for which they have been convicted.” Well over two million persons are imprisoned in America today. We imprison a higher percentage of our population than any other country. Those we imprison are disproportionately poor, of color, uneducated, and sick. They have chronic conditions, mental illnesses, sexually transmitted diseases and other infectious diseases. They usually receive inadequate health care—and sometimes shockingly poor care.6 It has always been so. Prison reformers have argued for decent prison care based on humanitarian principles since the founding of the Republic, and, notwithstanding some notable achievements, have failed to achieve decent conditions. In the last fifty years, reformers shifted to individual rights arguments based on prisoners’ constitutional rights.
Some Realism about End of Life: The Current Prohibition and the Euthanasia Underground
Authors: Smith Stephen W.
Published: January 2017

It is revolting to have no better reason for a rule of law than that so it was laid down in the time of Henry IV. It is still more revolting if the grounds upon which it was laid down have vanished long since, and the rule simply persists from blind imitation of the past.

–Oliver Wendell Holmes

This well-known quotation from one of America's foremost judges provides an important admonishment about the role of history within the law. Holmes’ admonishment is that, even in common law systems, we should not allow ourselves to become too dependent on legal rules laid down in the past. Legal rules laid down long ago are as likely as newly constructed ones to have flaws in their reasoning or be difficult to implement in real-life situations. Furthermore, even in cases where the rule may have originally served some purpose, it may nevertheless be out of date and therefore have little continuing benefit to a particular legal system.
Imaging the Mind, Minding the Image: An Historical Introduction to Brain Imaging and the Law
Authors: Khoshbin Laura Stephens , Khoshbin Shahram
Published: January 2017

Since ancient times, people have yearned to attribute human behaviors to a physical source within the head. Recently, neuroimaging technologies have given us the technical ability to look at the living brain, its structures, and some of its functions without the need for invasive procedures. However, the science has a long way to go before these technologies can allow us fully to appreciate the anatomical and physiologic underpinnings of human thoughts, states of mind, motives, will, or behaviors.

In this Article, we use an historical overview to introduce the various new technologies for imaging the brain. Today, the goal of medical science is the same as it has always been: to make medical technologies valid, useful, effective, and safe; and to guide appropriate uses while protecting the public from the misuse of them. Brain images are particularly vulnerable to misuse because they are so visually attractive. This visual power can easily result in misunderstanding about what the images show and what they mean.
MRIs and the Perception of Risk
Authors: Goldberg Steven
Published: January 2017

The most important safety decision concerning MRIs was to change the name of the procedure. In the late 1970s, the procedure known as nuclear magnetic resonance (NMR) became magnetic resonance imaging (MRI) because of the negative connotations the word “nuclear” invited. Since then, the use of MRIs has flourished. The procedure is now routinely conducted to make medical diagnoses and to study the brain functioning of healthy volunteers participating in research studies devised by, among others, neuroscientists and economists.

There is nothing intrinsically wrong with changing a procedure's name to respond to a public perception of risk, especially when experts do not share that perception. Yet, while MRIs rarely injure patients or test subjects, there is reason to believe that they have important health and safety consequences not captured in standard informed consent forms. These concerns ironically involve perception of risk. On the one hand, unexpected incidental findings of clinically significant conditions in volunteer research subjects raise a host of ethical concerns.
The Brain and Behavior: Limitations in the Legal Use of Functional Magnetic Resonance Imaging
Authors: Tancredi Laurence R. , Brodie Jonathan D.
Published: January 2017

Brain imaging is one of the most remarkable technological advances towards understanding the relationship of behavior to brain anatomy and physiology. Brain images provide insight to understanding behavior. Additionally, the images themselves carry great impact, particularly when used to show differences in either the anatomy or the biological functioning of two different brains. For these reasons, brain images have increasingly been used in both criminal and civil trials.

After describing some general features of brain imaging, we will focus on functional magnetic imaging (fMRI), as many believe this technology has the most potential for advancing our understanding of how parts of the brain function, including perhaps linking specific functions with cognition and behavior. Brain imaging as a field is vast and therefore our discussion will be limited. First, we will assess the advantages and limitations of fMRI, including research efforts towards standardizing equipment thereby assuring reliability and reproducibility.
A Brave New World of Interrogation Jurisprudence?
Authors: Thompson Sean Kevin
Published: January 2017

I doubt that the uneasiness about electrical lie detectors would disappear even if they were refined to place their accuracy beyond question. Indeed, I would not be surprised if such a development would only heighten the sense of unease and the search for plausible legal objections.

We are told that functional magnetic resonance imaging (fMRI) is “not ready for use, despite optimism about its commercial potential.” This is probably true—it is also, in terms of legal analysis, irrelevant. Although the development of fMRI technology is still in its relative infancy, there is no guarantee that the law governing its use will wait for it to grow up. Thus, the recent backlash against the initial flurry of articles, both academic and general, on the promise and legal issues surrounding fMRI is unwarranted. The conclusion that so many—even many of the contributors to this volume—seem to be drawing, namely, that law, as a field, must abstain from analyzing the legal implications of fMRI until those with more scientific expertise deem it ready to look at, is at best wrong and, at worst, irresponsible.
Punishment, Freedom, and the Culture of Control: The Case of Brain Imaging and the Law
Authors: Arrigo Bruce A.
Published: January 2017

The centrality of freedom as a philosophical construct is often neglected in contemporary academic circles and popular media outlets when it comes to discussions of crime, criminals, and the criminal law. This is surprising, especially since freedom—its absence or its presence—is an important ethical dimension underpinning all transgressive acts, including delinquency and crime. More specifically, the notion of freedom problematizes wayward conduct because transgression can (and does) emerge from freedom's limits rather than its excesses. What this suggests, then, is that criminality is not necessarily an artifact of one's autonomy gone awry or of making “bad” choices; rather, criminality may be a moment of self-discovery, transformation, and transcendence in which a “critical freedom” is borne. This is a period marked by living life on the edge; of contesting thresholds and boundaries in which “a plethora of original ideas, thoughts, inventions, new forms of resistance, and so forth” emerge.
No Healthcare Penalty? No Problem: No Due Process
Authors: Willis Steven J. , Chung Nakku
Published: January 2017

The Patient Protection and Affordable Health Care Act (“Act”), which mandates all individuals to have health insurance and “penalizes” those who do not, is unconstitutional for five well-documented and well-argued reasons:

1.

The mandate for individuals to purchase healthcare (“Mandate”) exceeds Congress's power to regulate commerce among the several states under the Commerce Clause of article I, section 8, clause 3 of the U.S. Constitution.

2.

The penalty imposed on individuals who fail to honor the Mandate (“Penalty”) is an unconstitutional direct tax because it is unapportioned, as required by article I, section 1, clause 3, and by article 1, section 9, clause 4.

3.

The Penalty does not satisfy the Necessary and Proper Clause of article I, section 8, clause 18.

4.

The Act violates the Tenth Amendment reservation of unenumerated powers to the states and to the people.

5.

The mechanical, procedural aspects of the Penalty violate the due process guarantee in the Fifth Amendment.
State-Run Insurance Exchanges in Federal Healthcare Reform: A Case Study in Dysfunctional Federalism
Authors: Thomson Kyle
Published: January 2017

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law, resulting in the most sweeping reform of the healthcare marketplace and one of the largest expansions in access to healthcare in American history. A key component to both restructuring the healthcare marketplace and improving access are the health insurance exchanges contained in the ACA. Today, individual and small group purchasers have difficulty finding affordable health insurance in the marketplace because they lack the tools to gather information about plans and because they lack the bargaining power to negotiate for affordable rates the way large purchasers can. In conjunction with the individual mandate, the health insurance exchanges aim to solve inefficiencies in the current marketplace by creating a centralized venue to connect insurers with individual and small business purchasers. Thus it both creates a place for insurers to readily find customers, who are now guaranteed to be there because of the individual mandate, and provides a place for customers to shop for insurance.
Prevention of Recurrent Spontaneous Abortions by Leukocyte Transfusions
Authors: Taylor C G , Faulk W Page , McIntyre J A
Published: January 2017

One hundred and thirty-nine couples referred because of recurrent abortions with no obvious cause were assessed for genetic similarity using the HLA major histocompatibility system. Comparison with 103 fertile control couples demonstrated that a much higher proportion of couples in the abortion group shared two or more HLA antigens. Using this criterion, 44 wives out of the 139 couples referred, when compared with a child-bearing group, appeared to share a greater than expected number of histocompatibility antigens and were therefore considered suitable for treatment. Twenty-eight wives have received treatment with white cell infusions from erythrocyte-compatible donors and so far they have delivered 17 babies plus 2 second babies. Another 3 wives are pregnant beyond their previous dates for abortions (1 first and 2 second pregnancies). There have been 5 failures (4 first pregnancy and 1 second pregnancy); one of these was treated a second time and has now successfully delivered. Seven couples are awaiting conception. Of the patients who have become pregnant, 81.5% have had successful deliveries. No adverse transfusion reactions have been observed.