bluuebunny/crossref_metadata_2025 huggingface dataset:
Placed Amongst Strangers – the Tenth Biennial Report (2001–2003) of the Mental Health Act Commission
Authors: Kinton Mat
Published: December 2015

The Mental Health Act Commission’s Tenth Biennial Report was laid before Parliament and published in December 2003. The report covers two years’ activity – financial years 2001 to 2003 – monitoring the operation of the Mental Health Act 1983 as it relates to the detention and treatment of patients. In twenty chapters it deals with a range of issues pertinent to the care of mental health patients subject to compulsory treatment.

I will not attempt here to list systematically the points made by our report. Readers of this journal are likely already to have thumbed a copy of the report itself, or accessed it on the Commission website, and, if not, I hope that this article will encourage them to do so. Instead, I will seek to explain in more general terms the context and themes of the report, and what we would wish to see as its desired outcome.
Making Sense of Bournewood
Authors: Robinson Robert , Scott-Moncrieff Lucy
Published: December 2015

The judgment of the European Court of Human Rights in HL v UK has been understood by some commentators as making it unlawful, without the use of formal legal powers, to give treatment in a psychiatric hospital to a person who lacks capacity to consent and over whom the mental health professionals directly involved are exercising complete and effective control. This understanding follows from a reading of the judgment which equates complete and effective control with deprivation of liberty for the purposes of Article 5 of European Convention on Human Rights. If this interpretation is correct, the same principle would apply to people living in nursing homes who require a high level of care and supervision and who lack capacity. While the former could be formally detained in hospital (or a ‘registered establishment’) under the Mental Health Act 1983, the Act’s detention powers do not extend to other care settings.

This article suggests that to understand the European Court of Human Rights' judgment in HL v UK it is necessary to take account of the unusual facts of the case. It is suggested that it does not follow from the judgment that the admission of a compliant incapacitated patient will necessarily deprive that person of liberty for the purpose of Article 5. The Government’s initial responses to the judgment fails to distinguish admissions which do engage Article 5 from those which do not. It is suggested that the Government should provide guidance to assist mental health professionals and others to make this distinction in individual cases.
Foreword
Authors: Horne John
Published: December 2015

As this issue of the JMHL goes to press, the projected Mental Health Bill discussed in our previous issue has not been introduced. Press reports indicated that it had been shelved, but there has been no official announcement confirming this. On the contrary, Department of Health activities such as their consultation on the race equality impact assessment on the Bill, would suggest a continuing intention to proceed. Presumably the position will be clearer by the time of publication of the May 2006 issue.

In the meantime, this issue of the JMHL provides an opportunity for further reflection on the Government’s response to the Scrutiny Committee’s Report, and on provisions within the 2004 Draft Bill.
Mental Capacity Act 2005: The Statutory Principles and Best Interests Test
Authors: Letts Penny
Published: December 2015

The Mental Capacity Act 2005, due for implementation in 2007, will create a new statutory framework intended to improve and clarify the decision-making process for people aged 16 and over who are unable to make decisions for themselves. Section 1 of the Act sets out five statutory principles intended to underline the provisions of the Act and guide its implementation and operation. The first part of this paper will look at the origins of each of the statutory principles. The second part will consider one of the principles – acting in the best interests of a person lacking capacity – in greater detail by looking at the requirements set out in the Act for determining a person’s best interests.
The House of Lords and the Unimportance of Classification: A Retrograde Step
Authors: Gledhill Kris
Published: December 2015

R (B) v Ashworth Hospital Authority

House of Lords; 17 March 2005

[2005] UKHL 20, [2005] Mental Health Law Reports 47
The Balancing Act
Authors: Kingston Helen
Published: December 2015

R (on the application of E) v Bristol City Council

Queen’s Bench Division (Adminstrative Court) Bennett J., 13 January 2005

EWHC (Admin) 74
“Hospital” Treatment Further Refined
Authors: Thompson Susan , Marchant Stuart
Published: December 2015

R (on the application of CS) v Mental Health Review Tribunal; Managers of Homerton Hospital (East London and the City Mental Health NHS Trust) (Interested Party)

Queen’s Bench Division, (Administrative Court), Pitchford J., 6 December 2004

EWHC (Admin) 2958

The decision of a Mental Health Review Tribunal under section 72(1) Mental Health Act 1983 not to discharge a patient on section 17 leave from hospital was not unlawful. The link between hospital and treatment may be “gossamer thin” but still a “significant component” to justify renewal of detention
Foreword
Authors: Horne John
Published: December 2015

The Foreword to the November 2005 issue of the JMHL voiced ‘uncertainty’ about the future of the Draft Mental Health Bill 2004. A presumption was made that "the position will be clearer by the time of publication of the May 2006 issue". Well, the future of the 2004 Draft Bill has of course now been resolved - as all readers will know, it has followed the 2002 Draft Bill into the shredder.

Instead the 1983 Act is to be amended. On the presumption (yet another) that the proposed amendments will be published by the time the next issue is being prepared, we give an assurance that they will be considered then.

So far as this issue is concerned, we have decided to publish both articles which clearly sit within the term ‘mental health law’, and others which might be viewed as more on the fringes, but presumed to be on matters of interest to the majority, if not all, the JMHL readership.
Vindicating the right to bodily security of the incapable in research – Part 1
Authors: Garwood-Gowers Austen
Published: December 2015

The concept of a right to bodily security centres partly on freedom from being forced to do things with one’s body and freedom from intrusion on it. Restriction of this right can be consistent with respecting individuals but seemingly only where its exercise would clash with their own interests or the rights of others. In spite of this, restriction founded on meeting the mere needs of others has been a persistent feature of discourse, law and practice in a number of fields, not least research where it is often targeted at incapable persons.
Provocation: the fall (and rise) of objectivity
Authors: Kerrigan Kevin
Published: December 2015

This article reviews the recent turbulent history of the partial defence of provocation. It assesses the current state of the law, the continuing dissatisfaction among the judiciary and academic commentators, and goes on to consider the current proposals for reform from the Law Commission. In an attempt to retain the reader’s attention, it takes the form of a (wholly imagined) exchange between a professor and student.
Amending the Mental Capacity Act 2005 to provide for deprivation of liberty
Authors: Robinson Robert
Published: December 2015

This article considers the Government’s legislative proposals against the domestic law background, specifically their relationship with existing detention powers in the Mental Health Act 1983 (MHA) and the provisions already enacted by Parliament in the Mental Capacity Act 2005 (MCA) which expressly do not authorise deprivation of liberty. Consideration is given to whether the proposed amendments to the MCA create undesirable overlap with the existing detention powers under the MHA.

The final part of the article questions the Government’s approach to demarcating the boundary between the two detention regimes. It proposes that if MCA detention were confined to those who lack capacity and do not object to their care, compliance with Article 5 could be achieved more simply and at less cost than under the Government’s proposed amendments to the MCA.
‘Sunlight [as] the best of disinfectants’?
Authors: Anderson John
Published: December 2015

Mersey Care NHS Trust v Ackroyd

Court of Appeal; Sir Anthony Clarke MR, Lord Neuberger of Abbotsbury and Leveson LJ

[2007] EWCA Civ 101 (‘Ackroyd’)
Foreword
Authors: Horne John
Published: December 2015

On 19th July 2007, the Mental Health Act 2007 received the Royal Assent. The 2007 Act amends the Mental Health Act 1983, the Mental Capacity Act 2005 and the Domestic Violence, Crime and Victims Act 2004.

For those engaged in the mental health field, be it as lawyers, doctors, nurses, social workers or in some other professional role, or as service users, carers or family members, there is a great deal to take on board before most of these provisions are implemented on the intended date of October 2008. Much of the contents of this issue of the JMHL will hopefully assist readers who need to get to grips with the changes ahead.
Psychiatry and the Law, edited by Warren Brookbanks and Sandy Simpson
Authors: Brereton William
Published: December 2015

 
The Secretary of State for Justice has a duty to provide Offending Behaviour Programmes in prison – submissions to the contrary are lacking in realism!
Authors: Bickle Andy
Published: December 2015

R (on the application of Walker) v Secretary of State for Justice; R (on the application of James) v Secretary of State for Justice

[2008] EWCA Civ 30
English Mental Health Reform: Lessons from Ontario?
Authors: Bartlett Peter
Published: December 2015

Reforms in areas related to mental disability are under debate in England to an extent unprecedented for almost half a century. The Law Commission’s proposals on incapacity, following further consultation from the Lord Chancellor’s Department, have now largely been accepted in principle by the government for legislative enactment at some time in the undetermined future. A joint green paper from the Home Office and the Department of Health has established a policy agenda concerning the governance of people with serious personality disorders. Proposals by an expert committee chaired by Professor Genevra Richardson on mental health reform have likewise been followed up by a government green paper, and the two green papers have in turn resulted in a joint white paper on reform of the Mental Health Act 1983. All this takes place as the Human Rights Act 1998 takes effect, with its guarantees relating to liberty and security of the person, standards for hearings, respect for private and family life, and protection from inhuman or degrading treatment. Throughout the development of the reforms, a number of similar themes have recurred, involving civil rights, the provision of appropriate legal processes, anti-discrimination, the respect for people with capacity, the extension of controls into the community, and the safety both of people with mental disabilities and of the public as a whole.

At least in the public arena, most of the debate has focussed on the English situation. The premise of this paper is that the situation in the rest of the world may have something to teach us. The paper examines the law of Ontario. While it focuses primarily on those issues related to the Richardson Report and its subsequent government response, Ontario legislation divides issues somewhat differently to English law, and thus overlap with the other reform proposals is inevitable.
Casenotes: Clinical Disagreement with a Deferred Conditional Discharge
Authors: Stern Kristina
Published: December 2015

R v. Camden and Islington Health Authority ex parte K

[2001] EWCA Civ 240

Court of Appeal (21st February 2001)

The Master of the Rolls, Buxton LJ and Sedley LJ
How Viscoelastic-Polymer Flooding Enhances Displacement Efficiency
Authors: Clarke A.. , Howe A. M. , Mitchell J.. , Staniland J.. , Hawkes L. A.
Published: December 2015

Increasing flooding-solution viscosity with polymers provides a favorable mobility ratio compared with brine flooding and hence improves volumetric sweep efficiency. Flooding with a polymer solution exhibiting elastic properties has been reported to increase displacement efficiency, resulting in a sustained doubling of the recovery enhancement compared with the use of conventional viscous-polymer flooding (Wang et al. 2011). Flooding with viscoelastic-polymer solutions is claimed also to increase recovery more than expected from changes in capillary number alone (Wang et al. 2010). This increase in displacement efficiency by viscoelastic polymers is reported to occur because of changes in the steady-state-flow profile and enhancements in oil stripping and thread formation. However, within the industry there are doubts that a genuine effect is observed, or that improvements in displacement efficiency occur with field-applicable flow regimes (Vermolen et al. 2014).

In this study, we demonstrate that flooding with viscoelastic-polymer solutions can indeed increase recovery more than expected from changes in capillary number. We show a mechanism of fluctuations in flow at low Reynolds number by which viscoelastic-polymer solutions provide improvements in displacement efficiency. The mechanism, known as elastic turbulence, is an effect previously unrecognized in this context. We demonstrate that the effect may be obtained at field-relevant flow rates. Furthermore, this underlying mechanism explains both the enhanced capillary-desaturation curves and the observation of apparent flow thickening (Delshad et al. 2008; Seright et al. 2011) for these viscoelastic solutions in porous media. The work contrasts experiments on flow and recovery by use of viscous and viscoelastic-polymer solutions. The circumstances under which viscoelasticity is beneficial are demonstrated. The findings are applicable to the design of formulations for enhanced oil recovery (EOR) by polymer flooding.

A combination of coreflooding, micromodel flow, and rheometric studies is presented. The results include single-phase and multiphase floods in sandstone cores. Polymer solutions are viscoelastic [partially hydrolyzed polyacrylamide (HPAM)] or viscous (xanthan). The effects of molecular weight, flow rate, and concentration of the HPAMs are described. The data lead us to suggest a mechanism that may be used to explain the observations of improved displacement efficiency and why the improvement is not seen for all viscoelastic-polymer floods.
Soil Water Repellency and its Impact on Hydraulic Characteristics in a Beech Forest under Simulated Climate Change
Authors: Schwen Andreas , Zimmermann Michael , Leitner Sonja , Woche Susanne K.
Published: December 2015

Core Ideas

Rainfall redistribution increased soil water repellency in a beech forest soil

Soil water repellency correlated with organic matter composition and C/N ratio

Contact angles correlated with air‐entry value of hydraulic soil characteristics

Climate change is expected to result in prolonged dry periods and an increased occurrence of extreme rainfall events that can increase soil water repellency (SWR). However, this relationship has not been studied under field conditions yet. Also, for the development of hydrological models accounting for SWR, dependencies between SWR and soil hydraulic characteristics would be required. Our hypotheses were that (i) prolonged dry periods increase SWR by changing the composition of the soil organic matter (SOM) and that (ii) SWR alters hydraulic soil properties by the air‐entry value. The objective of the study was to assess the impact of different rainfall redistributions on the degree of SWR, physicochemical soil characteristics, and soil hydraulic properties. A field experiment was conducted on a Podsolic Cambisol in a beech forest with plots covered by roofs and irrigated artificially. Two rainfall redistribution treatments (moderate and extreme) and control plots were compared after two vegetation periods. Potential SWR was characterized by the soil–water contact angle, while the actual degree of SWR was derived indirectly from infiltration experiments with water and ethanol. We found an increase in SWR due to rainfall redistribution. Contact angles correlated positively with the contents of organic carbon (OC) and nitrogen and the relative amount of hydrophobic groups in the organic matter and negatively with the C/N ratio. Differences between intrinsic and actual hydraulic properties increased with prolonged dry periods. Contact angles correlated with the air‐entry value (inverse of van Genuchten parameter α). This finding offers a way to account for SWR in hydraulic models.
Nitrogen and carbon removal efficiency of a polyvinyl alcohol gel based moving bed biofilm reactor system
Authors: Gani Khalid Muzamil , Singh Jasdeep , Singh Nitin Kumar , Ali Muntjeer , Rose Vipin , Kazmi A. A.
Published: December 2015

In this study, the effectiveness of polyvinyl alcohol (PVA) gel beads in treating domestic wastewater was investigated: a moving bed biofilm reactor (MBBR) configuration (oxic-anoxic and oxic) with 10% filling fraction of biomass carriers was operated in a continuously fed regime at temperatures of 25, 20, 15 and 6 °C with hydraulic retention times (HRTs) of 32 h, 18 h, 12 h and 9 h, respectively. Influent loadings were in the range of 0.22–1.22 kg N m−3 d−1 (total nitrogen (TN)), 1.48–7.82 kg chemical oxygen demand (COD) m−3 d−1 (organic) and 0.12–0.89 kg NH4+-N m−3d−1 (ammonia nitrogen). MBBR performance resulted in the maximum TN removal rate of 1.22 kg N m−3 d−1 when the temperature and HRT were 6 °C and 9 h, respectively. The carbon removal rate at this temperature and HRT was 6.82 kg COD m−3 d−1. Ammonium removal rates ranged from 0.13 to 0.75 kg NH4+-N m−3 d−1 during the study. Total phosphorus and suspended solid removal efficiency ranged from 84 to 98% and 85 to 94% at an influent concentration of 3.3–7.1 mg/L and 74–356 mg/L, respectively. The sludge wasted from the MBBR exhibited light weight features characterized by sludge volume index value of 185 mL/g. Experimental data obtained can be useful in further developing the concept of PVA gel based wastewater treatment systems.
Outcomes of Primary Percutaneous Coronary Intervention for Patients with Previous Coronary Artery Bypass Grafting Presenting with STsegment Elevation Myocardial Infarction
Authors: Garg Pankaj , Kamaruddin Hazlyna , Iqbal Javaid , Wheeldon Nigel
Published: December 2015

Background:

There are limited data on outcomes of patients with previous coronary artery bypass grafting (CABG) presenting acutely as ST-segment elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PPCI).

Objectives:

To compare outcomes in STEMI patients undergoing PPCI with or without previous CABG surgery.

Methods:

An all-comer single-centre observational registry from a cardiothoracic centre in UK. All consecutive patients presenting for PPCI between 2007 and 2012 were included. Electronic records were used to extract relevant information. Mortality data were obtained from the Office of National Statistics. Overall median follow-up period was 1.7 years (intraquartile range 0.9-2.5).

Results:

Complete data were available for 2133 (97%) patients. 47-patients had previous history of CABG. Out of these, the infarct related artery (IRA) was native vessel in 22 and graft in 25 patients. Post re-vascularization TIMI flow was inferior in CABG cohort (<TIMI 3 flow in 17% vs. 10%, p=0.012) and they were less likely to achieve acute reperfusion (TIMI 0 in 9% vs. 3%, p=0012). In-hospital-mortality was not different in both groups (2%vs.4%, p=0.23). 30-day (HR 0.54; 95%CI 0.17-1.73; P=0.301), 1-year-mortality (HR 0.77; 95%CI 0.31-1.87; P=0.56) and over a median follow-up of 1.7 years (HR 1.1; 95%CI 0.54-2.27; P=0.79) were also not different.

Conclusion:

Patients presenting with STEMI to PPCI service with history of CABG are less likely to achieve acute reperfusion and have worse angiographic outcomes. Post PPCI, the prior CABG patients do not seem to have worse shortterm and long-term prognosis.
Palliative radiation therapy for solid tumors in dogs: 103 cases (2007–2011)
Authors: Tollett Melissa A. , Duda Lili , Brown Dorothy C. , Krick Erika L.
Published: December 2015

OBJECTIVE To evaluate the clinical response, adverse effects, and outcomes associated with palliative radiation therapy (PRT) in dogs with various solid tumor types at various body locations.

DESIGN Retrospective case series.

ANIMALS 103 dogs with solid tumors.

PROCEDURES Medical records for dogs with solid tumors treated with PRT between July 2007 and January 2011 at a veterinary teaching hospital were reviewed. Data collected included signalment, tumor type and location, initial staging results, PRT protocol, other tumor-specific treatments, patient and tumor response, outcome, and acute and chronic adverse effects. Median progression-free survival time, median survival time (MST), and other descriptive statistics were calculated.

RESULTS Types of tumors treated included carcinoma, sarcoma, melanoma, primary bone tumor, mast cell tumor, and ameloblastoma. For all dogs, the overall tumor and clinical response rates to PRT were 75% and 77%, respectively, and the MST was 134 days, but those responses varied substantially among tumor types. Dogs that developed a positive clinical response or maintained stable disease after PRT had a significantly longer MST than did dogs with progressive disease. Tumor location was not significantly associated with median progression-free survival time or MST. Most dogs tolerated the PRT well. Acute and chronic adverse effects were observed in 57 and 8 dogs, respectively, but were generally self-limiting.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs with various types of solid tumors that received PRT had objective beneficial responses and an improvement in quality of life that was positively associated with survival time.
Hemorrhagic presentations of cerebellar pilocytic astrocytomas in children resulting in death: report of 2 cases
Authors: Wilson Mitchell P. , Johnson Edward S. , Hawkins Cynthia , Atkins Kerry , Alshaya Wael , Pugh Jeffrey A.
Published: December 2015

Acute hemorrhagic presentation in pilocytic astrocytomas (PAs) has become increasingly recognized. This type of presentation poses a clinically emergent situation in those hemorrhages arising in PAs of the cerebellum, the most frequent site, because of the limited capacity of the posterior fossa to compensate for mass effect, predisposing to rapid neurological deterioration. As examples, we describe two cases of fatal hemorrhagic cerebellar PAs: one of a child with a slowly growing stereotypical WHO Grade I PA with a 1-year period of symptomatology that preceded a rapid clinical deterioration, and another of an asymptomatic child having a PA variant, presenting with progressive obtundation following a presumed Valsalva event. These two scenarios parallel previous reports in the literature of either a setting of progressive expression of cerebellar dysfunction and transient episodes of raised intracranial pressure (ICP), or abrupt onset of features of increased ICP in a previously well child. The literature is further reviewed for a current understanding of the factors that predispose, initiate and propagate bleeding, with specific reference to the role of vascular endothelial growth factor and other angiogenic agents in the genesis and stability of the vasculature in PAs. In this context, we propose that obliterative vascular mural hyalinization with associated altered flow dynamics and microaneurysm formation was the pathogenesis of the hemorrhage in our first case. In the second case, large tumor size, increased growth rate, looseness of the background myxoid matrix, and thinness of the tumor blood vessels with calcospherite deposition predisposed to vascular leakage and bleeding concurrent with sudden increases in intravascular hydrostatic pressure. In that cerebellar PAs are common, this report underscores the importance of considering in the differential diagnosis the possibility of a spontaneous hemorrhage in a posterior fossa PA in a child presenting with a sudden neurological ictus and raised ICP.
Connectivity of the frontal and anterior insular network: a cortico-cortical evoked potential study
Authors: Enatsu Rei , Gonzalez-Martinez Jorge , Bulacio Juan , Mosher John C. , Burgess Richard C. , Najm Imad , Nair Dileep R.
Published: December 2015

OBJECT

The frontal and insular fiber network in humans remains largely unknown. This study investigated the connectivity of the frontal and anterior insular network in humans using cortico-cortical evoked potential (CCEP).

METHODS

This retrospective analysis included 18 patients with medically intractable focal epilepsy who underwent stereoelectroencephalography and CCEP. Alternating 1-Hz electrical stimuli were delivered to parts of the frontal lobe and anterior insula (prefrontal cortex [PFC], ventrolateral and dorsolateral premotor area [vPM and dPM, respectively], presupplementary motor area [pre-SMA], SMA, frontal operculum, and anterior insula). A total of 40–60 stimuli were averaged in each trial to obtain CCEP responses. The distribution of CCEP was evaluated by calculating the root mean square of CCEP responses.

RESULTS

Stimulation of the PFC elicited prominent CCEP responses in the medial PFC and PMs over the ipsilateral hemisphere. Stimulation of the vPM and dPM induced CCEP responses in the ipsilateral frontoparietal areas. Stimulation of the pre-SMA induced CCEP responses in the ipsilateral medial and lateral frontal areas and contralateral pre-SMA, whereas stimulation of the SMA induced CCEP responses in the bilateral frontoparietal areas. Stimulation of the frontal operculum induced CCEP responses in the ipsilateral insula and temporal operculum. CCEPs were observed in the ipsilateral medial, lateral frontal, and frontotemporal operculum in the anterior insular stimulation. Stimulation of the vPM and SMA led to the network in the dominant hemisphere being more developed.

CONCLUSIONS

Various regions within the frontal lobe and anterior insula were linked to specific ipsilateral and contralateral regions, which may reflect distinct functional roles.
Bilateral deep brain stimulation of the fornix for Alzheimer's disease: surgical safety in the ADvance trial
Authors: Ponce Francisco A. , Asaad Wael F. , Foote Kelly D. , Anderson William S. , Rees Cosgrove G. , Baltuch Gordon H. , Beasley Kara , Reymers Donald E. , Oh Esther S. , Targum Steven D. , Smith Gwenn S. , Lyketsos Constantine G. , Lozano Andres M.
Published: December 2015

OBJECT

This report describes the stereotactic technique, hospitalization, and 90-day perioperative safety of bilateral deep brain stimulation (DBS) of the fornix in patients who underwent DBS for the treatment of mild, probable Alzheimer's disease (AD).

METHODS

The ADvance Trial is a multicenter, 12-month, double-blind, randomized, controlled feasibility study being conducted to evaluate the safety, efficacy, and tolerability of DBS of the fornix in patients with mild, probable AD. Intraoperative and perioperative data were collected prospectively. All patients underwent postoperative MRI. Stereotactic analyses were performed in a blinded fashion by a single surgeon. Adverse events (AEs) were reported to an independent clinical events committee and adjudicated to determine the relationship between the AE and the study procedure.

RESULTS

Between June 6, 2012, and April 28, 2014, a total of 42 patients with mild, probable AD were treated with bilateral fornix DBS (mean age 68.2 ± 7.8 years; range 48.0–79.7 years; 23 men and 19 women). The mean planned target coordinates were x = 5.2 ± 1.0 mm (range 3.0–7.9 mm), y = 9.6 ± 0.9 mm (range 8.0–11.6 mm), z = −7.5 ± 1.2 mm (range −5.4 to −10.0 mm), and the mean postoperative stereotactic radial error on MRI was 1.5 ± 1.0 mm (range 0.2–4.0 mm). The mean length of hospitalization was 1.4 ± 0.8 days. Twenty-six (61.9%) patients experienced 64 AEs related to the study procedure, of which 7 were serious AEs experienced by 5 patients (11.9%). Four (9.5%) patients required return to surgery: 2 patients for explantation due to infection, 1 patient for lead repositioning, and 1 patient for chronic subdural hematoma. No patients experienced neurological deficits as a result of the study, and no deaths were reported.

CONCLUSIONS

Accurate targeting of DBS to the fornix without direct injury to it is feasible across surgeons and treatment centers. At 90 days after surgery, bilateral fornix DBS was well tolerated by patients with mild, probable AD.

Clinical trial registration no.: NCT01608061 (clinicaltrials.gov)
Direct visualization of improved optic nerve pial vascular supply following tuberculum meningioma resection: case report
Authors: Han Seunggu J. , Magill Stephen T. , Tarapore Phiroz E. , Horton Jonathan C. , McDermott Michael W.
Published: December 2015

Tuberculum sellae meningiomas frequently produce visual loss by direct compression from tumor, constriction of the optic nerve (ON) under the falciform ligament, and/or ON ischemia. The authors hypothesized that changes in visual function after tumor removal may be related to changes in blood supply to the ON that might be seen in the pial circulation at surgery. Indocyanine green (ICG) angiography was used to attempt to document these changes at surgery. The first patient in whom the technique was used had a left-sided, 1.4-cm, tuberculum meningioma. Time-lapse comparison of images was done postsurgery, and the comparison of video images revealed both faster initial filling and earlier complete filling of the ON pial circulation, suggesting improved pial blood flow after surgical decompression. In follow-up the patient had significant improvements in both visual acuity and visual fields function. Intraoperative ICG angiography of the ON can demonstrate measurable changes in pial vascular flow that may be predictive of postoperative visual outcome. The predictive value of this technique during neurosurgical procedures around the optic apparatus warrants further investigation in a larger cohort.
The lateral extracavitary approach to the thoracolumbar spine: a case series and systematic review
Authors: Foreman Paul M. , Naftel Robert P. , Moore Thomas A. , Hadley Mark N.
Published: December 2015

OBJECT

Since its introduction in 1976, the lateral extracavitary approach (LECA) has been used to access ventral and ventrolateral pathology affecting the thoracolumbar spine. Reporting of outcomes and complications has been inconsistent. A case series and systematic review are presented to summarize the available data.

METHODS

A retrospective review of medical records was performed, which identified 65 consecutive patients who underwent LECA for the treatment of thoracolumbar spine and spinal cord pathology. Cases were divided according to the presenting pathology. Neurological outcomes and complications were detailed. In addition, a systematic review of outcomes and complications in patients treated with the LECA as reported in the literature was completed.

RESULTS

Sixty-five patients underwent the LECA to the spine for the treatment of thoracic spine and spinal cord pathology. The most common indication for surgery was thoracic disc herniation (23/65, 35.4%). Neurological outcomes were excellent: 69.2% improved, 29.2% experienced no change, and 1.5% were worse. Two patients (3.1%) experienced a complication. The systematic review revealed comparable neurological outcomes (74.9% improved) but a notably higher complication rate (32.2%).

CONCLUSIONS

The LECA provides dorsal and unilateral ventrolateral access to and exposure of the thoracolumbar spine and spinal cord while allowing for posterior instrumentation through the same incision. Although excellent neurological results can be expected, the risk of pulmonary complications should be considered.
Patterns of epidural progression following postoperative spine stereotactic body radiotherapy: implications for clinical target volume delineation
Authors: Chan Michael W. , Thibault Isabelle , Atenafu Eshetu G. , Yu Eugene , John Cho B. C. , Letourneau Daniel , Lee Young , Yee Albert , Fehlings Michael G. , Sahgal Arjun
Published: December 2015

OBJECT

The authors performed a pattern-of-failure analysis, with a focus on epidural disease progression, in patients treated with postoperative spine stereotactic body radiotherapy (SBRT).

METHODS

Of the 70 patients with 75 spinal metastases (cases) treated with postoperative spine SBRT, there were 26 cases of local disease recurrence and 25 cases with a component of epidural disease progression. Twenty-four of the 25 cases had preoperative epidural disease with subsequent epidural disease progression, and this cohort was the focus of this epidural-specific pattern-of-failure investigation. Preoperative, postoperative, and follow-up MRI scans were reviewed, and epidural disease was characterized based on location according to a system in which the vertebral anatomy is divided into 6 sectors, with the anterior compartment comprising Sectors 1, 2, and 6, and the posterior compartment comprising Sectors 3, 4, and 5.

RESULTS

Patterns of epidural progression are reported specifically for the 24 cases with preoperative epidural disease and subsequent epidural progression. Epidural disease progression within the posterior compartment was observed to be significantly lower in those with preoperative epidural disease confined to the anterior compartment than in those with preoperative epidural disease involving both anterior and posterior compartments (56% vs 93%, respectively; p = 0.047). In a high proportion of patients with epidural disease progression, treatment failure was found in the anterior compartment, including both those with preoperative epidural disease confined to the anterior compartment and those with preoperative epidural disease involving both anterior and posterior compartments (100% vs. 73%, respectively). When epidural disease was confined to the anterior compartment on the preoperative and postoperative MRIs, no epidural disease progression was observed in Sector 4, which is the most posterior sector. Postoperative epidural disease characteristics alone were not predictive of the pattern of epidural treatment failure.

CONCLUSIONS

Reviewing the extent of epidural disease on preoperative MRI is imperative when planning postoperative SBRT. When epidural disease is confined to the anterior epidural sectors pre- and postoperatively, covering the entire epidural space circumferentially with a prophylactic “donut” distribution may not be needed.
Effect of resident handoffs on length of hospital and intensive care unit stay in a neurosurgical population: a cohort study
Authors: Kuhn Elizabeth N. , Davis Matthew C. , Agee Bonita S. , Oster Robert A. , Markert James M.
Published: December 2015

OBJECT

Handoffs and services changes are potentially modifiable sources of medical error and delays in transition of care. This cohort study assessed the relationship between resident service handoffs and length of stay for neurosurgical patients.

METHODS

All patients admitted to the University of Alabama at Birmingham neurosurgical service between July 1, 2012, and July 1, 2014, were retrospectively identified. A service handoff was defined as any point when a resident handed off coverage of a service for longer than 1 weekend. A conditional probability distribution was constructed to adjust length of stay for the increasing probability of a random handoff. The Student t-test and ANCOVA were used to assess relationships between resident service handoffs and length of hospital stay, adjusted for potential confounders.

RESULTS

A total of 3038 patients met eligibility criteria and were included in the statistical analyses. Adjusted length of hospital stay (5.32 vs 3.53 adjusted days) and length of ICU stay (4.38 vs 2.96 adjusted days) were both longer for patients who experienced a service handoff, with no difference in mortality. In the ANCOVA model, resident service handoff remained predictive of both length of hospital stay (p < 0.001) and length of ICU stay (p < 0.001).

CONCLUSIONS

Occurrence of a resident service handoff is an independent predictor of length of hospital and ICU stay in neurosurgical patients. This finding is novel in the neurosurgical literature. Future research might identify mechanisms for improving continuity of care and mitigating the effect of resident handoffs on patient outcomes.
Experimental investigation of dielectric properties of seasonal snow at field observatories in the northwest Himalaya
Authors: Singh Kamal K. , Kumar Ashavani , Kulkarni Anil V. , Datt Prem , Dewali Sanjay K. , Kumar Manoj
Published: December 2015

Radio-echo sounding techniques are very useful for fast profiling of seasonal snowpack. Ground-penetrating radar (GPR) is used widely for various cryospheric applications, such as snow/glacier depth estimation, snow layer identification and snow water equivalent assessment. The dielectric constant of snow is an important input parameter for the acquisition and interpretation of GPR data from the snowpack. In this study, snow dielectric constant was measured along with physical properties of snow using a snow fork operating at 1 GHz frequency. Experiments were conducted at field observatories of the Snow and Avalanche Study Establishment located in different Himalayan ranges: Patseo (Greater Himalayan range), Dhundhi and Solang (Pir Panjal range). Interseasonal spatial and temporal variations in snow dielectric constant and associated snowpack properties were analysed for five winter seasons (2010-14). The mean seasonal snow dielectric constant is higher at Dhundhi (1.82 ±0.02) than at Patseo (1.69 ±0.02). The measured snow dielectric constant was used to derive snow density and liquid-water content (LWC). A better correlation between snow dielectric constant and LWC is observed for high-density snow (>300kgm-3; R2 = 0.95) than for low-density snow (<200kgm-3; R2 = 0.73). Snow-fork-derived snow density was in good agreement with manually measured values. The snow dielectric constant database generated during this study can be used as a reference for various field applications of GPR in snow-related studies.
Complexity Analysis and DSP Implementation of the Fractional-Order Lorenz Hyperchaotic System
Authors: He Shaobo , Sun Kehui , Wang Huihai
Published: December 2015

The fractional-order hyperchaotic Lorenz system is solved as a discrete map by applying the Adomian decomposition method (ADM). Lyapunov Characteristic Exponents (LCEs) of this system are calculated according to this deduced discrete map. Complexity of this system versus parameters are analyzed by LCEs, bifurcation diagrams, phase portraits, complexity algorithms. Results show that this system has rich dynamical behaviors. Chaos and hyperchaos can be generated by decreasing fractional order q in this system. It also shows that the system is more complex when q takes smaller values. SE and C 0 complexity algorithms provide a parameter choice criteria for practice applications of fractional-order chaotic systems. The fractional-order system is implemented by digital signal processor (DSP), and a pseudo-random bit generator is designed based on the implemented system, which passes the NIST test successfully.
Reading Comprehension Instruction for Adolescents with Learning Disabilities: A Reality Check
Authors: Ko Tiffany , Tejero Hughes Marie
Published: December 2015

Reading comprehension is a significant concern for adolescents with learning disabilities (LD), particularly in secondary schools in the United States (US) where content is taught primarily through textbooks. Surprisingly little is known about the actual reading instruction for students with LD in secondary classrooms. Thus, the purpose of this study was to examine the reading comprehension instruction in US secondary special education classrooms. Eight special education teachers in urban high schools were observed and interviewed. Findings showed that teachers implemented a number of reading comprehension practices, not all were considered “best practice”. The most frequently observed practices included reading aloud, questioning, seatwork, activating prior knowledge, and using graphic organizers. Explicit instruction in how and when to use reading comprehension strategies, however, was not observed. This study reveals the extent to which evidence-based reading comprehension practices are not making their way into secondary reading classrooms and offers insight into factors that teachers state as influencing their instruction for students with LD.
Improving Teacher Effectiveness: Designing Better Assessment Tools in Learning Management Systems
Authors: Kruger Dov , Inman Sarah , Ding Zhiyu , Kang Yijin , Kuna Poornima , Liu Yujie , Lu Xiakun , Oro Stephen , Wang Yingzhu
Published: December 2015

Current-generation assessment tools used in K-12 and post-secondary education are limited in the type of questions they support; this limitation makes it difficult for instructors to navigate their assessment engines. Furthermore, the question types tend to score low on Bloom’s Taxonomy. Dedicated learning management systems (LMS) such as Blackboard, Moodle and Canvas are somewhat better than informal tools as they offer more question types and some randomization. Still, question types in all the major LMS assessment engines are limited. Additionally, LMSs place a heavy burden on teachers to generate online assessments. In this study we analyzed the top three LMS providers to identify inefficiencies. These inefficiencies in LMS design, point us to ways to ask better questions. Our findings show that teachers have not adopted current tools because they do not offer definitive improvements in productivity. Therefore, we developed LiquiZ, a design for a next-generation assessment engine that reduces user effort and provides more advanced question types that allow teachers to ask questions that can currently only be asked in one-on-one demonstration. The initial LiquiZ project is targeted toward STEM subjects, so the question types are particularly advantageous in math or science subjects.
Applications of 3D City Models: State of the Art Review
Authors: Biljecki Filip , Stoter Jantien , Ledoux Hugo , Zlatanova Sisi , Çöltekin Arzu
Published: December 2015

In the last decades, 3D city models appear to have been predominantly used for visualisation; however, today they are being increasingly employed in a number of domains and for a large range of tasks beyond visualisation. In this paper, we seek to understand and document the state of the art regarding the utilisation of 3D city models across multiple domains based on a comprehensive literature study including hundreds of research papers, technical reports and online resources. A challenge in a study such as ours is that the ways in which 3D city models are used cannot be readily listed due to fuzziness, terminological ambiguity, unclear added-value of 3D geoinformation in some instances, and absence of technical information. To address this challenge, we delineate a hierarchical terminology (spatial operations, use cases, applications), and develop a theoretical reasoning to segment and categorise the diverse uses of 3D city models. Following this framework, we provide a list of identified use cases of 3D city models (with a description of each), and their applications. Our study demonstrates that 3D city models are employed in at least 29 use cases that are a part of more than 100 applications. The classified inventory could be useful for scientists as well as stakeholders in the geospatial industry, such as companies and national mapping agencies, as it may serve as a reference document to better position their operations, design product portfolios, and to better understand the market.
Applications of Micro-Fourier Transform Infrared Spectroscopy (FTIR) in the Geological Sciences—A Review
Authors: Chen Yanyan , Zou Caineng , Mastalerz Maria , Hu Suyun , Gasaway Carley , Tao Xiaowan
Published: December 2015

Fourier transform infrared spectroscopy (FTIR) can provide crucial information on the molecular structure of organic and inorganic components and has been used extensively for chemical characterization of geological samples in the past few decades. In this paper, recent applications of FTIR in the geological sciences are reviewed. Particularly, its use in the characterization of geochemistry and thermal maturation of organic matter in coal and shale is addressed. These investigations demonstrate that the employment of high-resolution micro-FTIR imaging enables visualization and mapping of the distributions of organic matter and minerals on a micrometer scale in geological samples, and promotes an advanced understanding of heterogeneity of organic rich coal and shale. Additionally, micro-FTIR is particularly suitable for in situ, non-destructive characterization of minute microfossils, small fluid and melt inclusions within crystals, and volatiles in glasses and minerals. This technique can also assist in the chemotaxonomic classification of macrofossils such as plant fossils. These features, barely accessible with other analytical techniques, may provide fundamental information on paleoclimate, depositional environment, and the evolution of geological (e.g., volcanic and magmatic) systems.
Short- and Long-Term Effects of Prenatal Exposure to Iron Oxide Nanoparticles: Influence of Surface Charge and Dose on Developmental and Reproductive Toxicity
Authors: Di Bona Kristin , Xu Yaolin , Gray Marquita , Fair Douglas , Hayles Hunter , Milad Luckie , Montes Alex , Sherwood Jennifer , Bao Yuping , Rasco Jane
Published: December 2015

Iron oxide nanoparticles (NPs) are commonly utilized for biomedical, industrial, and commercial applications due to their unique properties and potential biocompatibility. However, little is known about how exposure to iron oxide NPs may affect susceptible populations such as pregnant women and developing fetuses. To examine the influence of NP surface-charge and dose on the developmental toxicity of iron oxide NPs, Crl:CD1(ICR) (CD-1) mice were exposed to a single, low (10 mg/kg) or high (100 mg/kg) dose of positively-charged polyethyleneimine-Fe2O3-NPs (PEI-NPs), or negatively-charged poly(acrylic acid)-Fe2O3-NPs (PAA-NPs) during critical windows of organogenesis (gestation day (GD) 8, 9, or 10). A low dose of NPs, regardless of charge, did not induce toxicity. However, a high exposure led to charge-dependent fetal loss as well as morphological alterations of the uteri (both charges) and testes (positive only) of surviving offspring. Positively-charged PEI-NPs given later in organogenesis resulted in a combination of short-term fetal loss (42%) and long-term alterations in reproduction, including increased fetal loss for second generation matings (mice exposed in utero). Alternatively, negatively-charged PAA-NPs induced fetal loss (22%) earlier in organogenesis to a lesser degree than PEI-NPs with only mild alterations in offspring uterine histology observed in the long-term.
RETRACTED: Ma et al. Hybrid Endovascular Repair in Aortic Arch Pathologies: A Retrospective Study. Int. J. Mol. Sci. 2010, 11, 4687–4696
Authors: Richter Mark ,   International Journal of Molecular Sciences Editorial Office
Published: December 2015

We have been made aware that the figures and experimental data reported in the title paper [...]