bluuebunny/crossref_metadata_2025 huggingface dataset:
Privilege—a Comparative Study
Authors: Weiner Myron F. , Shuman Daniel W.
Published: February 2018

In a questionnaire study, the authors compared psychiatrist-patient communications in the two states (South Carolina and West Virginia) that lack a privilege statute with psychiatrist-patient communications in the state of Texas, in which a privilege statute has been enacted. Although there were differences in the patient populations and in the nature of the psychiatrists’ practices, there seemed to be little impact of privilege or lack of privilege on therapist-patient communication. A small percentage of patients in all three states would have sought treatment earlier had they known of the existence of privilege, but most patients relied more on their doctors’ ethics than on statutory protection of their confidences. Patients who thought they were protected by privilege did not disclose more to their psychiatrists than patients who did not think they were so protected.
Declarations versus Investigations: The Case for the Special Reasoning Abilities and Capabilities of the Expert witness in Psychology/Psychiatry
Authors: Faust David
Published: February 2018

Arguments regarding the credibility of psychologists’ and psychiatrists’ expert testimony are commonly restricted to impressions about whether claims to special reasoning powers or capabilities are justified or not. The large, but often neglected body of research on human judgment provides a means for analyzing these claims scientifically. Systematic review shows that claims for the beneficial effects of experience and practice on judgment accuracy, the clinician's powers of data integration, the ability to utilize clinical impression, and the capacity to detect malingering have little evidence and extensive counterevidence. Caution is advised in using these claims to bolster one's credibility.
A Psychoanalytic Approach to the Law of Evidence
Authors: Schoenfeld C. G.
Published: February 2018

This article seeks to reveal how psychoanalytic insights and discoveries can help in evaluating and reforming the law of evidence. Examined are the oath that witnesses take, the view that the effects of prejudicial evidence can be overcome by a judge's instructions to a jury to disregard it, the “opinion evidence” rule and its logically indefensible distinction between “fact” and “opinion” evidence, and the failure of the hypothetical question to live up to its promise as a vehicle for expert testimony. Also considered in light of psychoanalytic concepts and discoveries is the much-mooted hearsay rule and three of its major exceptions: “excited utterances, ” “declarations against interest, ” and “admissions. ” Throughout, reforms are suggested that, it is hoped, will increase the soundness and effectiveness of evidentiary law.
United States Supreme Court and Psychiatry: A Critical Look
Authors: Malmquist Carl P.
Published: February 2018

The entrance of the United States Supreme Court into the field of mental health law in the last decade has been seen by some as heralding a commitment of the Court to mental health issues. A review of key cases reveals a disjointed approach to the issues with an ambivalence and inconsistency in the viewpoint taken toward the role and efficacy of psychiatry. While some cases have emphasized individual rights, such as incompetency issues, and a newly created right to psychiatric assistance at trial for indigents, other cases have refused to give psychiatric treatment centers the right to administer treatment without at least administrative if not judicial supervision. The cases reveal the lack of an overall jurisprudential viewpoint, and perhaps even a trend to return to the level of letting each state go its own way.
A Cry for Help: An Analysis of Wife Abuse
Authors: Bascelli Jeffrey R.
Published: February 2018

In the last decade, wife abuse has become one of society's most severe social problems. As the frequency of wife beating increases, the complexities of this issue remain enigmatic. In order to alleviate the continuing spread of this deviant behavior, inquiry must be focused on the kind of men who beat their wives, the kind of women who become battered wives, why the battered woman remains with her assailant, and how society keeps her in this abusive environment. As society grows increasingly aware of this problem, the frequency of the events of wife abuse may begin to decline.
Treatment Choices and Informed Consent in Psychiatry: Implications of the Osheroff Case for the Profession
Authors: Malcolm John Gulton
Published: February 2018

In a case that is presently pending, a patient sued a private psychiatric facility alleging that the hospital committed malpractice by treating his disorder through psychodynamic rather than biological techniques. In this article, the author discusses the potential implications this suit may have for psychiatrists faced with making decisions about alternative treatment modalities. The article also discusses the role of the informed consent doctrine in this decision-making process. The impact of third-party reimbursement and the erosion of the so-called “respectable minority” rule are also discussed.
The Quandaries of Enforced Community Treatment and Unenforceable Outpatient Commitment Statutes
Authors: Geller Jeffrey L.
Published: February 2018

One response to the problems created by deinstitutionalization has been outpatient commitment. Involuntary community treatment presents a series of dilemmas, including those involving the role of enforced treatment in psychiatry, the implementation of informed consent, the application of “least restrictive alternative,” and the ever-widening liability of psychiatrists. While outpatient commitment itself presents conundrums, outpatient commitment which is unenforceable brings the psychiatrist to even further quandaries. Using Pennsylvania as an example, the difficulties posed by unenforceable outpatient commitment are presented. The author concludes that although coerced community treatment may be successful even without legal sanctions, this is not an ethically sound solution.
Characteristics of Competency Referral Defendants and Nonreferred Criminal Defendants
Authors: Aubrey Moss
Published: February 2018

This study examines correlates of referral for evaluation of competency to stand trial. Two hundred and four arrestees were studied; one-half of the cases included referrals for evaluation of competency. Characteristics of referred and nonreferred cases are examined. Several variables appear to be associated with such referrals, including the defendant's marital status and age, the history of prior contact with both the mental health and criminal justice systems, and the presence or absence of impulsive or violent behavior during the commission of the crime. Defendants’ personal characteristics seem more closely associated with referral than do demographic or crime characteristics. Directions for future study are suggested.
The Operation of the “Guilty but Mentally ill” Verdict in Pennsylvania
Authors: Mackay R. D. , Kopelman Jerry
Published: February 2018

This article contains a study of the first four years of the operation of the “guilty but mentally ill” (GBMI) verdict in Pennsylvania. The authors found that the number of successful insanity defenses had been significantly reduced during this period. In addition, the majority of GBMI convictees received hospital treatment. Although the results of this study tend to confirm that GBMI is operating differently in states such as Michigan and Illinois, the Pennsylvania provision cannot be said to be working in a uniform manner, as there are major regional variations in its operation. The authors conclude that there appears to be little or no advantage to a defendant in using or pleading GBMI, but that more research is required to monitor the verdict's continued utilization.
Dangerousness and Legal Insanity
Authors: Heilbrun Alfred B. , Heilbrun Mark R.
Published: February 2018

Men found not guilty by reason of insanity (NGRI) are not held responsible for their criminal acts because it is assumed that in some way mental disturbance was responsible for those acts. The present study considered dangerousness as an alternative explanation of violent acts committed by NGRI patients. Three correlates of dangerousness–-high antisocial behavior, low intelligence, and high social withdrawal–-were combined into a single index. Comparison of 55 NGRI patients who had committed violent acts and 204 violent criminals revealed that the NGRI patients scored higher on this dangerousness index than did the criminals. This difference was obtained even after a control for disturbed thinking was introduced.
National Survey of the Frequency and Success of the Insanity Plea and Alternate Pleas
Authors: Mcginley Hugh , Pasewark Richard A.
Published: February 2018

The 50 states and the District of Columbia were surveyed for the operative insanity rule and frequency and success of the insanity plea and related alternate pleas. These data were compared with data collected for the year 1983. As in the earlier report, there seems to be a dearth of information about the use and success of the pleas. The information that is available is quite varied. There is a discussion of why basic data may not be available and what information is needed in order to have a basic understanding of the use of the insanity plea and alternate pleas.
A Demographic Study of 100 Admissions to a Female Forensic Center: Incidences of Multiple Charges and Multiple Diagnoses
Authors: Strick S. E.
Published: February 2018

This paper was presented at the Pennsylvania Psychological Association convention in June 1988. This paper is a descriptive study and represents a statewide sample of the initial 100 admissions to a female forensic center over a three-year period. The author examines the characteristics of the women by age, race, education, marital status, nature of criminal charges, length of commitment, length of hospitalization, diagnostic categories, and final disposition. Incidences of multiple criminal charges and multiple diagnoses are reviewed.
Homosexuality and Immigration Law: A Reexamination
Authors: Loue Sana
Published: February 2018

Homosexuals have been excluded from entry into the United States since 1917. The issue of an individual's sexual orientation may also arise in the context of naturalization proceedings. This article examines the statutory and judicial development of these laws and the conflict that exists between their enforcement and current medical and psychological knowledge regarding homosexuality. The author concludes with a proposal for the elimination of the exclusion provision and the establishment of a “uniform rule of naturalization” that does not seek to judge private sexual behavior between consenting adults.
The Negotiation of Voluntary Admission in Chicago's State Mental Hospitals
Authors: Reed Susan C. , Lewis Dan A.
Published: February 2018

This study examines the admission of emergency certified patients to Chicago's state mental hospitals and the process by which patients decide to sign a voluntary admission form. Involuntary commitment is rarely used to admit Chicago's state mental patients. Patients, staff and court personnel negotiate with a common interest in avoiding commitment court.

Hospital staff use three different strategies to convince emergency certified patients to admit themselves voluntarily and avoid involuntary commitment: persuasion/coercion, bartering and stalling. Similar strategies are employed to discourage voluntary patients’ requests for release. Hospital staff in Chicago are disinclined to commit patients because they feel pressured to discharge the majority of patients as quickly as possible to make room for a steady flow of new admissions. Workers manage their caseload by choosing the most expedient form of admission, which is to obtain their patients’ signatures on a voluntary admission form. In order to accomplish this task, however, hospital staff sometimes circumvent legal standards of voluntariness in the admission process.
Recidivism among Male Insanity Acquittees
Authors: Rice Marnie E. , Harris Grant T. , Lang Carol , Bell Valerie
Published: February 2018

Although there have been studies of the relative criminal recidivism rates of insanity acquittees and of those of persons found guilty of similar offenses, little is known about whether the same factors are related to recidivism in both groups. In the present study, we compared the general and violent recidivism rates of insanity acquittees and convicted men who had been assessed in a maximum security psychiatric hospital prior to their trials. The groups were matched on age, offense and criminal history. Recidivism for the convicted group was found to be higher than for the insanity acquittees. Similar to the findings for the convicted men, subject characteristics that reflected past criminal and antisocial behavior were more closely related to outcome for the insanity acquittees than were clinical variables. Furthermore, multiple discriminant equations to predict recidivism were constructed for each group separately, and they performed well on cross-validations using the other group. The results are discussed in terms of their implications for policy and treatment planning for mentally disordered offenders.
A Profile of Mentally Ill Offenders and their Adjustment in the Community
Authors: Feder Lynette
Published: February 2018

The research focuses on a little-studied group of mentally disordered offenders: inmates requiring psychiatric hospitalization during imprisonment. Information is provided on the pre-prison and prison histories of all male mentally ill offenders (MIOs) released during a 13-month period (N = 150) and followed for 18 months in the community. Results indicate that MIOs displayed a marginal existence prior to their incarceration, with the vast majority having had a prior criminal and/or psychiatric contact. Problems in both domains continued upon release into the community. By followup's end, 48% required at least one psychiatric commitment, and 64% experienced at least one rearrest. Multiple regression indicated that recidivism among MIOs was associated with standard criminological variables: age and prior criminal record. These findings are then compared with research on other mentally disordered offender groups.
Rorschach Testimony
Authors: Meloy J. Reid
Published: February 2018

The Rorschach test is widely used in both clinical and forensic evaluations, but a standard of practice for its use in courtroom testimony has not been articulated. The author develops six guidelines for expert witnesses who testify about the scientific data generated by the Rorschach: training and use of a scoring system, accurate scoring, knowledge of validation research, avoidance of overinterpretation of the data, use of plain language to describe Rorschach variables, and the appropriate material to bring to the witness stand to ethically protect the security of psychological tests and measures.
Professional Controversies in Child Sexual Abuse Assessment
Authors: Simring Milchman Madelyn
Published: February 2018

This paper examines controversies between the child-protective and defense-protective positions in the field of child sexual abuse assessments. It argues that the child-protective position is based on valid empirical generalizations that nevertheless can cause injustice because they are mistaken for scientific laws. It argues that the defense-protective position offers important criticisms that nevertheless can cause injustice because they are based on a misunderstanding of the nature of scientific reasoning. Clinical examples of errors in both positions are discussed.
Litigation, Mediation and the Psychology of Divorce
Authors: Margulies Sam , Luchow Anya
Published: February 2018

The adversary legal system has frequently been criticized by the mental health professions as poorly designed to meet the psychological needs of families. This article explores why that criticism is true. Successful adjustment to divorce by couples and their children requires the completion of critical psychological and practical tasks early in the divorce. In particular, the noninitiating spouse must come to terms with the fact of divorce and control the intense emotions that accompany the decision to divorce. The norms and values of the legal system and the perceptions and behaviors of the lawyers interfere with completion of the psychological tasks and retard adaptation. Mediation is viewed as an appropriate model for supporting the completion of successful divorce.
Detection of Malingering in a Forensic Sample: a Study of the M Test
Authors: Smith Glenn Paul , Borum Randy
Published: February 2018

The validity of the M Test in the assessment of malingering was examined in a sample of male prisoners. Malingerers and non-malingerers were compared on the M Test and on the demographic variables of age, race, and education. Although M Test scores were statistically related to the malingering criteria, the M Test showed poor discriminative capability, achieving an overall hit rate of only 67%. Currently, the M Test appears to be of limited utility as a screening device for malingering in forensic populations.
Diagnosis of sucker rod pumping based on dynamometer card decomposition and hidden Markov model
Authors: Zheng Boyuan , Gao Xianwen
Published: February 2018

In oil field production, dynamometer card is the key source of information to analyze the down-hole operating conditions of sucker rod pumping. However, under different operating conditions, most of the existing diagnostic technologies are incapable to extract features from dynamometer cards automatically and comprehensively. Based on the mechanism analysis of dynamometer card, a useful diagnostic method with novel feature extraction method is proposed for diagnosing the operating condition of sucker rod pumping. A novel barycentric decomposition strategy is applied to divide the dynamometer cards, which can automatically adjust divided regions according to the shape change of dynamometer card. The curve moments are extracted from the parts of divided results to obtain the comprehensive features for the follow-up algorithm. Subsequently, the hidden Markov model with mixture density function is designed as a classifier to map the relationship between the operating condition and the features of dynamometer card. This technique is successfully carried out in a fault dynamometer card atlas that is collected from productive field. Finally, the experimental results confirm the validity of the proposed diagnosis approach.
Characteristics and quantitative study on gas breakthrough in developing Yaha-2 condensate gas reservoir in Tarim Basin, China
Authors: Xia Jing , Liu Pengcheng , Jiao Yuwei , Dong Mingda , Zhang Jing , Zhang Jiucun
Published: February 2018

In order to keep the formation pressure be larger than the dew-point pressure to decrease the loss of condensate oil, cyclic gas injection has been widely applied to develop condensate gas reservoir. However, because the heterogeneity and the density difference between gas and liquid are significant, gas breakthrough appears during cyclic gas injection, which apparently impacts the development effects. The gas breakthrough characteristics are affected by many factors, such as geological features, gas reservoir properties, fluid properties, perforation relations between injectors and producers, and operation parameters. In order to clearly understand the gas breakthrough characteristics and the sensitivity to the parameters, Yaha-2 condensate gas reservoir in Tarim Basin was taken as an example. First, the gas breakthrough characteristic of different perforation relations by injecting natural gas was studied, and the optimal relation was achieved by comparing the sweep efficiency. Then, the designs of orthogonal experiments method were employed to study the sensitivity of gas breakthrough to different parameters. Meanwhile, the characteristic parameters, such as gas breakthrough time, dimensionless gas breakthrough time, and sweep volume, were calculated and the prediction models were achieved. Finally, the prediction models were applied to calculate the gas breakthrough time and sweep volume in Yaha-2 condensate gas reservoir in Tarim Basin. The reliability of the model was verified at the same time. Please see the Appendix for the graphical representation of the abstract.
The Biomedicalization of Social Egg Freezing
Authors: Bhatia Rajani , Campo-Engelstein Lisa
Published: February 2018

In 2012, two major professional societies representing Europe and the United States released influential statements that would propel a commercial market for social egg freezing (SEF), in which women bank their oocytes for later use in order to avoid compromised fertility that comes with age. While the European Society of Human Reproduction and Embryology (ESHRE) condoned SEF based on reproductive autonomy and justice, the American Society for Reproductive Medicine (ASRM) discouraged SEF based on insufficient data and concerns about false hope. In this article, we map the contexts and discursive moves by which the biomedicalization of SEF proceeded since 2012. We compare professional bioethical arguments that made the case to approve SEF in Europe with news and popular media discourse that formed and shaped the commercial marketization of SEF in the United States despite the recommendation of the ASRM. While a statist pronatalist perspective informed the former, a distinctly private labor market recruitment strategy utilizing a Lean In efficiency model of feminism buttressed the latter.
Is the Program‐Specific Paragraph Responsible for Declining Application Numbers? A Commentary
Authors: Kramer Scott
Published: February 2018

An alarming trend of declining applications to otolaryngology–head and neck surgery has surfaced over the past 3 years. There are many possible explanations for this decline, and a recent publication has implicated “impossible” qualifications as the reason for this decline. While these qualifications may deter a significant number of potential applicants, they have not changed significantly in the past 5 years and do not seem to explain a sudden decline. This commentary argues that the program‐specific paragraph, which was introduced in 2015, may be at least in part responsible.
Challenges for development and technological advancement
Authors: Malaquias Rodrigo Fernandes , Albertin Alberto Luiz
Published: February 2018

This study addresses the challenges for development in Latin America considering the framework of a contemporary technological advancement: the Internet of Things (IoT). Based on this framework, this paper shows the diffusion of IoT-related aspects in three different dimensions: individuals (demand), environment, and technology offer. The low availability of secure Internet servers, the low widespread rate of Internet adoption, inequalities in access to electricity, and adult illiteracy represent important challenges to be faced in Latin America. These variables directly affect IoT diffusion; thus, this paper also presents further directions in this field.
The incompatibility of healthcare services and end-of-life needs in advanced liver disease: A qualitative interview study of patients and bereaved carers
Authors: Hudson Benjamin , Hunt Victoria , Waylen Andrea , McCune Catherine Anne , Verne Julia , Forbes Karen
Published: February 2018

Background:

Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking.

Aim:

To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care.

Design:

Qualitative study – semi-structured interviews analysed using thematic analysis.

Settings/participants:

A total of 17 participants (12 patients, 5 bereaved carers) recruited from University Hospitals Bristol.

Results:

Participants described escalating physical, psychological and social needs as liver disease progressed, including disabling symptoms, emotional distress and uncertainty, addiction, financial hardship and social isolation. End-of-life needs were incompatible with the healthcare services available to address them; these were heavily centred in secondary care, focussed on disease modification at the expense of symptom control and provided limited support after curative options were exhausted. Attitudes towards palliative care were mixed, however, participants valued opportunities to express future care preferences (particularly relating to avoidance of hospital admission towards the end of life) and an increased focus on symptomatic and logistical aspects of care.

Conclusion:

The needs of patients with liver disease and their carers are frequently incompatible with the healthcare services available to them towards the end of life. Novel strategies, which recognise the life-limiting nature of liver disease explicitly and improve coordination with community services, are required if end-of-life care is to improve.
Working With Chinese Triad Youth Gangs: Correct Diagnosis and Strategic Intervention
Authors: Lo T. Wing , Tam H. L.
Published: February 2018

Across the world, youth workers have been active in helping vulnerable youth groups. In Hong Kong, government-funded youth services are conducted by professional social workers to help vulnerable youths. This article adopted a case study approach to investigate a youth group who committed a murder. Nine murderers and two social workers were interviewed. It aims to uncover the structure and activities of the group and analyse the gang intervention prior to the murder to find out what had gone wrong and identify the lessons that social workers can learn from the murder. Four misconceptions in gang intervention have been identified. First, because of the Triad (Chinese-organised crime) affiliation, this is not just a group of deviant youths but a youth gang. Second, because it is a gang, the social workers should not group them but should instead degroup them to avoid contamination. Third, diagnosis is different from labelling. With the right diagnosis, services can be tailor-made to delabel them. Fourth, when the youths are diagnosed as a gang, outreach work instead of centre work should be provided—social workers should reach out to the gangland to uncover the youths’ gang participation and crime involvement.
Prostitution Myth Endorsement
Authors: Menaker Tasha A. , Franklin Cortney A.
Published: February 2018

Women in the sex trade have experienced victim blame from first responders and victimization from buyers and traffickers. Women’s ability to exit the sex trade may be negatively affected by bias from prostitution myth adherence that has normalized sexual exploitation and violence against women. Few studies have examined beliefs and behaviors that predict these problematic attitudes. In the current study, we assessed predictors of prostitution myth endorsement in a sample of 355 college students (196 women, 159 men). Gender, increased sexist attitudes toward women, frequency of pornography consumption, and self-control deficits significantly predicted prostitution myth adherence. Interactions between gender and study variables were not significant, demonstrating that gender did not moderate the relations between sexist attitudes toward women, lifetime sexual victimization, self-control deficits, and frequency of pornography consumption on prostitution myth endorsement. We discuss practice implications and future research directions with particular focus on the need to challenge and transform the current sociopolitical culture related to gender equity and healthy sexuality through advocacy and education.
Environmental Justice in Warehousing Location
Authors: Yuan Quan
Published: February 2018

With the rapid spatial expansion of the warehousing industry in major metropolitan areas, environmental impacts associated with warehousing activities have been growing in the recent decades. This study focuses on the disproportionate distribution of warehousing facilities in disadvantaged neighborhoods and discusses how the disparities result from the interactions between various socioeconomic processes. From the perspective of environmental justice, warehousing-related environmental hazards affect the spatial relationship between warehouses and local communities. The changing factors in the firm location choice of warehousing facilities and the housing location choice of disadvantaged population jointly lead to the environmental justice problem in warehousing location.
Financial Incentives for Chronic Disease Management: Results and Limitations of 2 Randomized Clinical Trials With New York Medicaid Patients
Authors: VanEpps Eric M. , Troxel Andrea B. , Villamil Elizabeth , Saulsgiver Kathryn A. , Zhu Jingsan , Chin Jo-Yu , Matson Jacqueline , Anarella Joseph , Roohan Patrick , Gesten Foster , Volpp Kevin G.
Published: February 2018

Purpose:

To identify whether financial incentives promote improved disease management in Medicaid recipients diagnosed with hypertension or diabetes, respectively.

Design:

Four-group, multicenter, randomized clinical trials.

Setting and Participants:

Between 2013 and 2016, New York State Medicaid managed care members diagnosed with hypertension (N = 920) or with diabetes (N = 959).

Intervention:

Participants in each 6-month trial were randomly assigned to 1 of 4 arms: (1) process incentives—earned by attending primary care visits and/or receiving prescription medication refills, (2) outcome incentives—earned by reducing systolic blood pressure (hypertension) or hemoglobin A1c (HbA1c; diabetes) levels, (3) combined process and outcome incentives, and (4) control (no incentives).

Measures:

Systolic blood pressure (hypertension) and HbA1c (diabetes) levels, primary care visits, and medication prescription refills.

Analysis and Results:

At 6 months, there were no statistically significant differences between intervention arms and the control arm in the change in systolic blood pressure, P = .531. Similarly, there were no significant differences in blood glucose control (HbA1c) between the intervention arms and control after 6 months, P = .939. The majority of participants had acceptable systolic blood pressure (<140 mm Hg) or blood glucose (<8.0%) levels at baseline and throughout the study.

Conclusion:

Financial incentives—regardless of whether they were delivered based on disease-relevant outcomes, process activities, or a combination of the two—have a negligible impact on health outcomes for Medicaid recipients diagnosed with either hypertension or diabetes in 2 studies in which, among other design and operational limitations, the majority of recipients had relatively well-controlled diseases at the time of enrollment.
Successful Phenobarbital Desensitization After DRESS Reaction in the Management of Refractory Status Epilepticus
Authors: Witcher Robert H. , Ramirez Michelle M.
Published: February 2018

Purpose:

Drug reaction with eosinophilia and systemic symptoms (DRESS) is associated with antiepileptic drug use and is a rare but life-threatening side effect. We present a case of phenobarbital-induced DRESS in a patient who subsequently required phenobarbital and was successfully desensitized.

A 5-year-old male presented with medically refractory status epilepticus (SE). He had been trialed on several antiepileptic medications without achieving burst suppression. Burst suppression was achieved with a pentobarbital infusion, and thus, phenobarbital was initiated as the pentobarbital was weaned. After five days of phenobarbital, the patient developed signs and symptoms concerning for DRESS; a punch biopsy confirmed the drug reaction. Two months later, he again developed SE unresponsive to antiepileptic infusions. Burst suppression was achieved with pentobarbital, and it was decided to transition the patient to phenobarbital. Due to concerns of phenobarbital-induced DRESS, the patient underwent a phenobarbital desensitization consisting of 6 doses sequentially administered in 10-fold increasing concentrations before achieving therapeutic dosing. Three days later, the patient achieved therapeutic phenobarbital levels, was weaned off of pentobarbital, and remained seizure-free without recurrence of DRESS.

Conclusions:

Graded desensitization may be an option to minimize recurrence of DRESS in patients where avoidance of the offending agent is not possible.
Improving machining performance of Ti-6Al-4V through multi-point minimum quantity lubrication method
Authors: Banerjee Nilanjan , Sharma Abhay
Published: February 2018

This article provides an improved lubrication system for minimum quantity lubrication machining wherein oil is locally supplied and individually controlled at different heating zones during machining operation. The proposed lubrication method, that is, a multi-point minimum quantity lubrication system, is aimed at improving energy efficiency and environmental friendliness of cutting process. An experimental system is devised in which process parameters, such as air pressure, stroke volume (i.e. amount of oil in one stroke of pump), stroke frequency, and oil distribution factor (i.e. proportion of oil at rake and flank face), are individually controlled for each supply system. The devised system is demonstrated through machining of Ti-6Al-4V. The results of the experimental study on effects of oil quantity and supply method on specific cutting energy, tool wear, and machined surface quality are presented and discussed and corroborated with scientific evidence. The study suggests that distributing oil at the rake face and the flank face in unequal proportions can be more beneficial than injecting it solely at a single location. The investigation also provides mechanism of multi-point minimum quantity lubrication machining through analysis of adiabatic shear zones, observed in scanning electron microscope images of chips.
Research on machining topography of point grinding based on correlation function method
Authors: Shi Xiaoliang , Xiu Shichao , Meng Zhu , Xing Chunsheng
Published: February 2018

Point grinding uses the point contact to shape surface topography of workpiece which has high machining precision. Its surface topography has a close relation with its service performance. In order to study the topography of point grinding, these authors carried out the experiment and established a new assessing model based on the correlation function method. The inner characteristics of topography are revealed by self-correlation and mutual correlation function method and its mechanism is analyzed. The study shows that the topography of point grinding has obvious periodical portions, which means it is consistent and uniform. The mutual correlations of every direction show the surface topography of point grinding is isotropic. Point grinding surface has better consistency under larger included angle and smaller grinding depth. And it has better isotropy under larger included angle. Surface roughness has the opposite rule from the consistency and isotropy. The influence of point grinding angle on surface topology is much larger than grinding depth.
Performance analysis of an electrically assisted propulsion system for a short-range civil aircraft
Authors: Ang A W X , Gangoli Rao A , Kanakis T , Lammen W
Published: February 2018

With civil aviation growing at around 4.7% per annum, the environmental footprint of aviation is increasing. Moreover, the use of kerosene as a fuel accelerates the depletion of non-renewable fossil fuels and increases global warming. Hence, the aviation industry has to come up with new technologies to reduce its environmental impact and make aviation more sustainable. An electrically assisted propulsion system can combine the benefits of an electrical power source with a conventional turbofan engine. However, the additional electrical system increases the weight of the aircraft and complexity of the power management system. The objective of this research is to analyze the effect of an assistive electrical system on the performance of a turbofan engine for an A320 class aircraft on a short-range mission. The developed simulation model consists of an aircraft performance model combined with a propulsion model. The power management strategy is integrated within the simulation model. With the proposed propulsion system and power management strategy, the electrically assisted propulsion system would be able to reduce fuel burn, total energy consumption, and emissions for short-range missions of around 1000 km.
Systematic review of the prevalence of psychiatric illness and sleep disturbance as co-morbidities of HIV infection in the UK
Authors: Chaponda Mas , Aldhouse Natalie , Kroes Michel , Wild Laurence , Robinson Christopher , Smith Alan
Published: February 2018

Psychiatric illness and sleeping disorders are important co-morbidities of human immunodeficiency virus (HIV) infection, which impact both the individual and antiretroviral therapy (ART) selection. This systematic review aimed to assess the prevalence of psychiatric illness and sleep disturbance in people living with HIV (PLHIV) in the UK. Systematic searches for publications reporting epidemiological data for psychiatric co-morbidities and sleep disturbance with HIV were conducted in Embase, MEDLINE, Cochrane Library, eight key conferences (2013–2015), and by hand-searching references of included publications. Data were extracted from publications (2000 onwards) reporting the UK prevalence of depression, anxiety, suicide ideation, or sleep disturbance as a co-morbidity of HIV infection. Comparative UK general population data were obtained from the 2007 Adult Psychiatric Morbidity in England household survey, the 2012 Health Survey for England, and ‘PatientBase’ (epidemiological database). Sixteen publications met the inclusion criteria. Amongst PLHIV in the UK, the prevalence of depression varied from 17–47%, compared with a reported 2–5% prevalence for the UK general population. A similar disparity was observed in the prevalence of anxiety (22–49% PLHIV versus 4–5% general population), depression or anxiety (50–58% PLHIV versus 27% general population), difficulty sleeping (61% PLHIV versus 10% population), and suicide ideation (31% PLHIV versus 1% general population). This systematic review of UK data demonstrates that rates of psychiatric illness and sleep disturbance are substantially higher amongst PLHIV than in the general population. These data underline the importance of fully considering sleep and psychiatric issues prior to selection and prescription of antiretroviral drugs, as well as the need for ongoing psychiatric and psychological support for PLHIV on ART.
Normative Distortions in Labour Law
Authors: Julén Votinius Jenny
Published: February 2018

This article identifies, conceptualizes and analyses a normative conflict, embedded in social practises and conceptions on gender in the institutional framework of the market, which underlies labour law regulation as well as legal argumentation regarding working parents. The article evinces and models the basic structure of vital mechanisms operative in weakening parental rights in working life and labour law. The model is fleshed out inductively, using examples from Swedish national law, where the protection of parental rights is fairly strongly formulated, but where, in the same time, the provisions concerning employees’ parenthood have a relatively weak position in the living law. The weakness is explained as a normative incoherence, as expressed in labour law adjudication. In their application, legal provisions to support parental caring and gender equality thus can be forced to give way to encroaching norms based on the value of market efficiency.
Witchcraft Accusations as Gendered Persecution in Refugee Law
Authors: Dehm Sara , Millbank Jenni
Published: February 2018

Witchcraft-related violence (WRV), in particular directed towards women and children, has become a source of increasing concern for human rights organizations in the current century. Yet for those fleeing WRV, this heightened attention has not translated across into refugee status. This research examines how claims of WRV were addressed in all available asylum decisions in English, drawn from five jurisdictions. We argue that WRV is a manifestation of gender-related harm; one which exposes major failings in the application of refugee jurisprudence. Inattention to the religious and organizational elements of witchcraft practices, combined with gender insensitivity in analysis, meant that claims were frequently reconfigured by decision makers as personal grudges, or family or community disputes, such that they were not cognizable harms within the terms of the Refugee Convention; or they were simply disbelieved as far-fetched. The success rate of claims was low, compared to available averages, and, when successful, claims were universally accepted on some basis other than the witchcraft element of the case. This article focuses in particular upon cases where the applicant feared harm as an accused witch, while a second related article addresses those fearing persecution from witches or through the medium of witchcraft.
Using modified early warning score to predict need of lifesaving intervention in adult non‐trauma patients in a tertiary state hospital
Authors: Peng Leong Shian , Hassan Azhana , Bustam Aida , Noor Azhar Muhaimin , Ahmad Rashidi
Published: February 2018

Background:

Modified early warning score has been validated in many uses in the emergency department. We propose that the modified early warning score performs well in predicting the need of lifesaving interventions in the emergency department, as a predictor of patients who are critically ill.

Objective:

The study aims to evaluate the use of modified early warning score in sorting out critically ill patients in the emergency department.

Methods:

The patients’ demographic data and first vital signs (blood pressure, heart rate, temperature, respiratory rate, and level of consciousness) were collected prospectively. Individual modified early warning score was calculated. The outcome was a patient received one or more lifesaving interventions toward the end of stay in emergency department. Multivariate logistic regression analysis was utilized to assess the association between modified early warning score and other potential predictors with outcome.

Results:

There are a total of 259 patients enrolled into the study. The optimal modified early warning score in predicting lifesaving intervention was ≥4 with a sensitivity of 95% and specificity of 81%. Modified early warning score ≥4 (odds ratio = 96.97, 95% confidence interval = 11.82–795.23, p < 0.001) was found to significantly increase the risk of receiving lifesaving intervention in the emergency department.

Conclusion:

Modified early warning score is found to be a good predictor for patients in need of lifesaving intervention in the emergency department.
Analysis of chest compression depth and rate during cardiopulmonary resuscitation with and without a feedback device
Authors: Fronczek-Wojciechowska Magdalena , Kopacz Karolina , Jaźwińska Anna , Padula Gianluca , Gaszyński Tomasz
Published: February 2018

Background:

Many feedback devices have been designed to improve the resuscitation outcomes. None have been implemented as a standard in patient care.

Objectives:

The aim of this study was to evaluate the chest compression depth and rate during cardiopulmonary resuscitation with and without a feedback device and to evaluate differences regarding the impact of a feedback device based on provider experience.

Methods:

The study was performed on 20 men divided into two groups: group A (n = 10)—paramedics; group B (n = 10)—non-paramedics, trained to provide resuscitation. Participants were examined during resuscitation with Ambu Megacode manikin and with or without the feedback device—CPRmeter. Depth of compressions was evaluated in the first and fourth minute of resuscitation with a BTS Smart DX7000 motion capture system. For statistical analysis, summary statistics, Shapiro–Wilk Test of normality, dependent samples t-test, Levene test, t-test for independent samples, or Welch’s t-test were used. Accepted level of significance was α = 0.05.

Results:

Statistically significant greater depth of chest compressions in group A was observed in the first minute of resuscitation with the device versus the first minute without the device. Significant differences in compressions rate between attempts with and without the device were observed in both groups in the first and fourth minute.

Conclusion:

Only the group of paramedics showed in time some benefits of the device related to the depth, whereas for the group of non-paramedics, the device seemed to have even a deleterious effect. The group of paramedics met the 2015 recommendations related to compressions rate all the time, while the non-paramedics only in the fourth minute of the procedure.
Self-sensing and quantitative assessment of prestressed concrete structures based on distributed long-gauge fiber Bragg grating sensors
Authors: Hong Wan , Lv Kui , Jiang Yuchen , Yang Caiqian , Wu Zhishen , Hu Xiamin , Qu Qizhong
Published: February 2018

Quantitative assessment of strengthened concrete structures using self-sensing fiber-reinforced polymer sheets is presented in this article. First, strain distribution along the height of a structure induced by pre-tension force (initiate state) is theoretically estimated. Second, the procedure for parameter estimation of prestressed fiber-reinforced polymer–strengthened structures under external load using measured and pre-tension force–induced strain is established, and nonlinearity caused by random cracks is considered in the method. Both local parameters (neutral axis position, bending stiffness distribution, strain distribution along the cross section, etc.) and global parameter (deflection) of structures can be accurately estimated by measured long-gauge strain responses. Finally, both prestressed fiber–reinforced polymer–strengthened and reinforced concrete beams installed with long-gauge fiber Bragg grating sensors have been experimentally investigated to prove the effectiveness of this method. Experimental results indicate that the estimated neutral axis height and local bending stiffness can reflect initiation of random cracks and deterioration process of structures under increasing external load. Meanwhile, the estimated strain along the beam height and deflection at mid-span agree well with the measured ones, which further verifies the accuracy of the estimated neutral axis position affected by randomly appeared cracks. Hence, the method can be utilized for assessment and maintenance of fiber-reinforced polymer–strengthened structures.
Malignant Ewing-Like Neoplasm With an EWSR1-KLF15 Fusion: At the Crossroads of a Myoepithelial Carcinoma and a Ewing-Like Sarcoma. A Case Report With Treatment Options
Authors: Stevens Todd M. , Qarmali Morad , Morlote Diana , Mikhail Fady M. , Swensen Jeffrey , Gatalica Zoran , Siegal Gene P. , Conry Robert M.
Published: February 2018

We present a case of a malignant Ewing-like neoplasm of the parotid gland in a 20-year-old woman with an EWSR1-KLF15 gene fusion that presented with pulmonary metastasis. Despite the fact that the tumor was essentially immunohistochemically negative for keratins, p63, and p40, we interpret this neoplasm as an unusual form of a high-grade myoepithelial carcinoma based on its focal plasmacytoid cytology, chondromyxoid matrix, SOX10, S100 protein, and calponin expression, and the knowledge that the EWSR1-KLF15 gene fusion has, to date, only been identified in 2 tumors, both myoepithelial carcinomas of the kidney. We also present a cytogenetic analysis of this unusual tumor. This “Ewing-like myoepithelial carcinoma” initially did not respond to 2 cycles of ifosfamide and etoposide alternated with a cycle of cytoxan, adriamycin, and vincristine, a standard regimen for Ewing sarcoma. Subsequent oral pazopanib therapy did result in a reduction of the patient’s pulmonary and nodal disease.