bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cost-Effectiveness of Visual Triage of Human Papillomavirus–Positive Women in Three Low- and Middle-Income Countries
Authors: Campos Nicole G. , Jeronimo Jose , Tsu Vivien , Castle Philip E. , Mvundura Mercy , Kim Jane J.
Published: July 2017

Background: World Health Organization guidelines support human papillomavirus (HPV) testing alone (followed by treatment with cryotherapy) or in conjunction with visual inspection with acetic acid (VIA) triage testing. Our objective was to determine the cost-effectiveness of VIA triage for HPV-positive women in low-resource settings.

Methods: We calibrated mathematical simulation models of HPV infection and cervical cancer to epidemiologic data from India, Nicaragua, and Uganda. Using cost and test performance data from the START-UP demonstration projects, we assumed screening took place either once or three times in a lifetime between ages 30 and 40 years. Strategies included (i) HPV alone, followed by cryotherapy for all eligible HPV-positive women; and (ii) HPV testing with VIA triage for HPV-positive women, followed by cryotherapy for eligible women who were also VIA-positive (HPV-VIA). Model outcomes included lifetime risk of cervical cancer and incremental cost-effectiveness ratios (ICERs; international dollars/year of life saved).

Results: In all three countries, HPV alone was more effective than HPV-VIA. In Nicaragua and Uganda, HPV alone was also less costly than HPV-VIA; ICERs associated with screening three times in a lifetime (HPV alone) were below per capita GDP. In India, both HPV alone and HPV-VIA had ICERs below per capita GDP.

Conclusions: VIA triage of HPV-positive women is not likely to be cost-effective in settings with high cervical cancer burden. HPV alone followed by treatment may achieve greater health benefits and value for public health dollars.

Impact: This study provides early evidence on the cost-effectiveness of HPV testing followed by VIA triage versus an HPV screen-and-treat strategy. Cancer Epidemiol Biomarkers Prev; 26(10); 1500–10. ©2017 AACR.
O público e seu teatro: notas em forma de ensaio
Authors: Kinas Fernando
Published: July 2017

Análise das relações entre a cena e o público nos fenômenos teatrais modernos e contemporâneos, com defesa de uma abordagem socioestética das relações entre ator e espectador nos contextos históricos, estéticos e políticos em que são produzidas.
Eicosapentaenoic and Docosahexaenoic Acids Attenuate Progression of Albuminuria in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease
Authors: Elajami Tarec K. , Alfaddagh Abdulhamied , Lakshminarayan Dharshan , Soliman Michael , Chandnani Madhuri , Welty Francine K.
Published: July 2017

Background

Albuminuria is a marker of inflammation and an independent predictor of cardiovascular morbidity and mortality. The current study evaluated whether eicosapentaenoic acid (
EPA
) and docosahexaenoic acid (
DHA
) supplementation attenuates progression of albuminuria in subjects with coronary artery disease.

Methods and Results

Two‐hundred sixty‐two subjects with stable coronary artery disease were randomized to either Lovaza (1.86 g of EPA and 1.5 g of DHA daily) or no Lovaza (control) for 1 year. Percent change in urine albumin‐to‐creatinine ratio (
ACR
) was compared. Mean (
SD
) age was 63.3 (7.6) years; 17% were women and 30% had type 2 diabetes mellitus. In nondiabetic subjects, no change in urine
ACR
occurred in either the Lovaza or control groups. In contrast,
ACR
increased 72.3% (
P
<0.001) in diabetic subjects not receiving Lovaza, whereas those receiving Lovaza had no change. In diabetic subjects on an angiotensin‐converting enzyme‐inhibitor or angiotensin‐receptor blocker, those receiving Lovaza had no change in urine
ACR
, whereas those not receiving Lovaza had a 64.2% increase (
P
<0.001). Change in
ACR
was directly correlated with change in systolic blood pressure (
r
=0.394,
P
=0.01).

Conclusions

EPA
and
DHA
supplementation attenuated progression of albuminuria in subjects with type 2 diabetes mellitus and coronary artery disease, most of whom were on an angiotensin‐converting enzyme‐inhibitor or angiotensin‐receptor blocker. Thus,
EPA
and
DHA
supplementation should be considered as additional therapy to an angiotensin‐converting enzyme‐inhibitor or angiotensin‐receptor blocker in subjects with type 2 diabetes mellitus and coronary artery disease.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01624727.
Elevation of B‐Type Natriuretic Peptide at Discharge is Associated With 2‐Year Mortality After Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis: Insights From a Multicenter Prospective OCEAN‐TAVI (Optimized Transcatheter Valvular Intervention–Transcatheter Aortic Valve Implantation) Registry
Authors: Mizutani Kazuki , Hara Masahiko , Iwata Shinichi , Murakami Takashi , Shibata Toshihiko , Yoshiyama Minoru , Naganuma Toru , Yamanaka Futoshi , Higashimori Akihiro , Tada Norio , Takagi Kensuke , Araki Motoharu , Ueno Hiroshi , Tabata Minoru , Shirai Shinichi , Watanabe Yusuke , Yamamoto Masanori , Hayashida Kentaro
Published: July 2017

Background

In this study, we sought to investigate the 2‐year prognostic impact of B‐type natriuretic peptide (
BNP
) levels at discharge, following transcatheter aortic valve replacement.

Methods and Results

We enrolled 1094 consecutive patients who underwent transcatheter aortic valve replacement between 2013 and 2016. Study patients were stratified into 2 groups according to survival classification and regression tree analysis (high versus low
BNP
groups). We evaluated the impact of high
BNP
on 2‐year mortality compared with that of low
BNP
using a multivariable Cox model, and assessed whether this stratification would improve predictive accuracy for determining 2‐year mortality by assessing time‐dependent net reclassification improvement and integrated discrimination improvement. The median age of patients was 85 years (quartile 82–88), and 29.2% of the study population were men. The median Society of Thoracic Surgeons score was 6.8 (4.7–9.5), and
BNP
at discharge was 186 (93–378) pg/mL. All‐cause mortality following discharge was 7.9% (95% CI, 5.8–9.9%) at 1 year and 15.4% (95% CI, 11.6–19.0%) at 2 years. The survival classification and regression tree analysis revealed that the discriminating
BNP
level to discern 2‐year mortality was 202 pg/mL, and that elevated
BNP
had a statistically significant impact on outcomes, with an adjusted hazard ratio of 2.28 (1.36–3.82,
P
=0.002). The time‐dependent net reclassification improvement (
P
=0.047) and integrated discrimination improvement (
P
=0.029) analysis revealed that the incorporation of
BNP
stratification with other clinical variables significantly improved predictive accuracy for 2‐year mortality.

Conclusions

Elevation of
BNP
at discharge is associated with 2‐year mortality after transcatheter aortic valve replacement.
Nemo Judex in Sua Causa: Apparent Bias Prevention in Jordanian Law – Comparative Analytical Study of Judges Disqualification Cases
Authors: Alserhan Bakr A.F.
Published: July 2017

This article deals with a very important issue within the regulation of the judicial profession in Jordanian law, which is the disqualification of a judge in a civil case under the Judges Disqualification System. The importance of this article stems from the importance of the role played by a judge in a civil case. A judge is supposed not only to be impartial but to appear impartial as well. The Jordanian law maintained certain cases, if established, a judge is deemed disqualified. This article assesses and addresses, in detail, these cases. Moreover, this article sheds the light on the approach followed by other jurisdictions (the Australian law’s approach) towards this issue. The article introduces more than one recommendation for the Jordanian law that aims at readdressing the shortages or confusions found in the current adopted regulation to the matter in question, in order to achieve a higher level of justice.
The Need for Legal Framework to Regulate Franchising in Palestine
Authors: Khalil Amir
Published: July 2017

Franchising has become one of the premier vehicles for international business expansion and the fastest growing way of playing a crucial role in international commercial transactions. Franchising is already practiced in Palestine; however, there is an ambiguity as to the legal nature of franchising work in Palestine and it is not directly regulated by the Palestinian legislature. This article examines the need for a coherent legal regulation of franchising work in Palestine.
Placing the Military in African History: A Reflection
Authors: Thornton John K.
Published: July 2017

While discussions of the military are notably absent in academic African History, it doesn’t mean that the subject is absent from the history left by the Africans. Sources that have been used for generations contain extensive discussions of the organization, arming, training, and utilization of military forces in Africa by Africans, but these aspects of the sources are largely ignored or interpreted within the frame of other violent activity, such as slave raiding. However, simply by their existence, these sources offer future generations the opportunity to expand and finally tell the story of formal military activity in Africa. This in turn will allow for the creation of a more complete record of African political, social, and even state-building activity before the advent of European colonization.
Therapeutic Technique in Psychoanalysis and Psychoanalytic Psychotherapy
Authors: Weinshel Edward M.
Published: July 2017

As the distinctions between what we consider to be psychoanalysis and what we consider to be psychoanalytic psychotherapy have become more uncertain and more blurred, it follows that it is equally difficult to designate the techniques that would be appropriate and specific for each modality. The problem has been compounded by the fact that in recent years psychoanalysis in the United States has become considerably less homogeneous than in the past and the ego-psychological structural model is no longer the only point of view in the psychoanalytic marketplace. Further, with alterations in the criteria for analyzability, cases which, generally, had not been viewed as suitable for analysis, have been appearing with increasing frequency on psychoanalysts' couches. We have also recognized that the degree of congruence between our expectation from and the results of psychoanalytic treatment was often less than anticipated. It appears that analysis have become considerably less arbitrary about what psychoanalysis is and how a psychoanalysis can be carried out. The author is unable to delineate one technique that is intrinsic to and limited to psychoanalysis. There are, however, differences in degree and emphasis in the ways in which various techniques are applied in the therapy of psychoanalysis as compared to the therapy of psychoanalytic psychotherapy. Special attention is given to the role of a psychoanalytic process and the central place the analysis of resistance plays in psychoanalytic therapy.
On the Clinical Utility of the Concept of Depressive Affect as Signal Affect
Authors: Hoffman Leon
Published: July 2017

The author reviews the scant literature relating to the concept of depressive affect as an affect parallel to anxiety. Then, through the presentation of detailed clinical psychoanalytic data, in particular the patient's associations to interpretation, he demonstrates the value to the conduct of a psychoanalysis of an awareness of the role of depressive affect as a signal affect that triggers defense.
The Concept of Phylogenetic Inheritance in Freud and Jung
Authors: Hoffer Peter T.
Published: July 2017

At the height of their collaboration in late 1911, Freud had succeeded in persuading Jung of the role of phylogenetic factors in the etiology of neuroses and psychoses. Phylogenetic considerations play an important part in the formulation of Jung's genetic standpoint of psychology with its conception of a desexualized primal libido, which figured prominently in the dispute which ended the relations between Freud and Jung. Freud's unpublished draft of “Overview of the Transference Neuroses” was in part an attempt to counter Jung's revisions of libido theory by using phylogenetic considerations to reaffirm his original conception of a unified sexual libido. Despite the sharp divergence of many aspects of their respective psychologies after the break, a conception of phylogenetic inheritance continued to play an important role in their developing theoretical formulations.
When Theory and Practice Diverge: Gender-Related Patterns of Referral to Psychoanalysts
Authors: Mayer Elizabeth Lloyd , De Marneffe Daphne
Published: July 2017

This study tests the hypothesis that female analysts, relative to male analysts, receive a disproportionately small percentage of male referrals. Referral patterns for 170 analysts from four institutes accredited by the American Psychoanalytic Association were examined. One thousand, five hundred and ten patient referrals were studied. The findings were extremely robust and offered dramatic confirmation of our hypothesis. The major implications of the study are as follows: (1) Women analysts receive relatively few adult male referrals, making it difficult for them to gain requisite clinical experience with men. (2) Analysts and nonanalysts alike demonstrate a reluctance to refer male patients to female analysts. (3) Adult referrals, including those made by analysts, are significantly influenced by the issue of gender match between patient and analyst. (4) Analysts' behavior with regard to making referrals does not correspond to explicit clinical theory regarding how analysts make referrals—specifically, the extent to which gender influences the referral process is not adequately described by theory. We believe that these findings are of some concern from the standpoint of analytic education and that they also raise questions regarding unacknowledged aspects of how gender match between patient and analyst enters into clinical decision making.
Longitudinal Shear Loading of a Unidirectional Composite
Authors: Adams Donald F. , Doner Douglas R.
Published: July 2017

The behavior of a unidirectional fiber-reinforced composite ma terial subjected to a shear loading in the direction of the filaments is of fundamental importance in the understanding of composite material behavior. The shear stiffness and strength values asso ciated with this type of loading can be considered as fundamental properties characterizing the material.

The problem of a doubly periodic rectangular array of parallel elastic filaments of doubly symmetric but otherwise arbitrary shape contained in an elastic matrix material subjected to shear stress components in the directions of the filament axes has been formulated using a theory of elasticity analysis. A finite difference representation of the governing partial differential equations of equilibrium and stress-displacement equations has been utilized in obtaining a solution by a systematic over-relaxation procedure.

Numerical results have been obtained for a variety of filament cross-sectional shapes, various filament-to-matrix shear modulus ratios (ranging from zero to infinity), and a range of filament spacings varying from filaments nearly in contact to extremely wide spacings in which interaction effects between filaments are essentially zero. Theoretical results have been compared with the limited experimental data presently available.

The results obtained permit a detailed description of the micro mechanical behavior of a composite material subjected to longitudinal shear loading. A study of local stress distributions in the composite provides a means of predicting shear strength as well as stiffness as a function of the material properties of the constituents and their geometry.

1. S. W. Tsai, "Strength Characteristics of Composite Materials," NASA Contractor Report NASA CR-224, April 1965.

2. S. W. Tsai, D. F. Adams, and D. R. Doner, "Effect of Constituent Material Properties on the Strength of Fiber-Reinforced Composite Materials," Air Force Materials Laboratory Contractor Report AFML-TR-66-190, August 1966.

3. Z. Hashin and B. W. Rosen, "The Elastic Moduli of Fiber-reinforced Materials," J. Applied Mechanics, Vol. 31E (1964), p. 223.

4. C. H. Chen and Shun Cheng, "Mechanical Properties of Fiber-reinforced Com posites and of Perforated Solids," J. Composite Materials, Vol. 1 (1967), p. 30. 5. H. B. Wilson, Jr. and J. G. Goree, "Transverse Shear Loading in an Elastic Matrix Containing Two Elastic Circular Cylindrical Inclusions," Mathematical Studies of Composite Materials III, Rohm and Haas Company Report, Hunts ville, Alabama, June 1966.
Oriented Noncontinuous Boron Composites
Authors: Kane J.L.
Published: July 2017

The process for producing tape from noncontinuous boron fibers is explained. Composite mechanical properties of both uni directional and bidirectional noncontinuous boron composites are given. Comparisons of the properties with continuous boron com posites show utilization factors of 80 percent for modulus, and 40 percent for strength. Process parameters that may effect com posite properties are also investigated.
Evidence for Chemical Bond Formation at Silane Coupling Agent Interfaces
Authors: Johannson O.K. , Stark F.O. , Vogel G.E. , Fleischmann R.M.
Published: July 2017

An investigation of the physical chemical role of silane coupling agents at the glass-resin interface has been conducted. Radio actively labeled coupling agents were synthesized and purified, and their adsorption on E-glass and aerosil surfaces studied. The infor mation obtained from these tracer studies and from electron photo micrographic examination of fiber surfaces indicate that coupling agents form continuous films on E-glass surfaces with covalent bonding occurring at the interface. Failure of the glass-coupling agent interface in the presence of boiling water occurs by attack on the glass substrate itself.

Using radioactive tracer techniques, it was also determined that copolymerization can occur at the coupling agent-resin interface.
Local Stress Concentrations in Imperfect Filamentary Composite Materials
Authors: Hedgepeth John M. , Van Dyke Peter
Published: July 2017

Solutions are presented for two stress distribution problems which result from breaking of the filaments in a composite material composed of high modulus elements embedded in a low modulus matrix. Both problems represent extensions of the two-dimen sional filamentary structure stress concentration problem: the first concerns the determination of static stress concentration factors in the unbroken elements of a three-dimensional square or hexagonal array where specified filaments are broken; the second involves the stress concentration factor in the element adjacent to a broken filament in a two-dimensional array where the shear stress in the matrix adjacent to the broken filament is restricted by a limit stress in an ideally plastic sense.
Two-Dimensional Cure Simulation of Thick Thermosetting Composites
Authors: Bogetti Travis A. , Gillespie John W.
Published: July 2017

An investigation into the two-dimensional cure simulation of thick thermosetting composites is presented. Temperature and degree of cure distributions within arbitrary cross-sectional geometries are predicted as a function of the autoclave temperature history. The heat conduction equation for two-dimensional, transient anisotropic heat transfer is coupled to the cure kinetics of the thermosetting composite material. A heat generation term, expressed as a function of cure rate and the total heat of reaction, is introduced to account for the heat liberated during the curing process. A generalized boundary condition formulation is employed, enabling arbitrary temperature boundary conditions to be enforced straightforwardly. An incremental, transient finite difference solution scheme is implemented to solve the pertinent governing equations and boundary conditions. The boundary-fitted coordinate system (BFCS) transformation technique is combined with the Alternating Direction Explicit (ADE) finite difference method in the solution strategy. Complex gradients in temperature and degree of cure are predicted and the influence of the tool on the curing process is demonstrated. Correlation between experimentally measured and predicted through-the-thickness temperature profiles in glass/polyester laminates are presented for various arbitrary temperature cure cycle histories. Several typical glass/polyester and graphite/epoxy structural elements of arbitrary cross-section (ply-drop and angle bend) are analyzed to provide insight into the non-uniform curing process unique to thick-sections. Spatial gradients in degree of cure are shown to be strongly dependent on part geometry, thermal anisotropy, cure kinetics and the temperature cure cycle. These spatial gradients directly influence the quality and in-service performance of the finished component by inducing warpage and residual stress during the curing process.
Damage Tolerance of Laminated Composites Containing an Open Hole and Subjected to Tensile Loadings
Authors: Chang Kuo-Yen , Llu Sheng , Chang Fu-Kuo
Published: July 2017

An investigation was conducted to study tensile failure of laminated composites containing an open hole. This investigation was especially concerned with determining the response, type and extent of damage in composites as a function of applied load. Both an analysis and experiments were performed for graphite/epoxy composites during the study. A progressive damage analysis was developed to study the problem. The analysis was verified by an extensive comparison between the numerical calculations based on the analysis and the experimental data obtained during the investigation as well as from published literature. Different graphite/epoxy composite materials were considered in the study. Overall, good agreements were found between the calculations and the data. Based on the study, it was found that the types and extent of internal damage in the notched composites strongly depend on the ply orientation of the laminates. The types and the size of damage directly affect the strength and failure mode of the composites.
Reconviction after Discharge from a Regional Secure Unit
Authors: Falla Sara , Sugarman Philip , Roberts Lona
Published: July 2017

There are at present no published data on criminal conviction following discharge from medium-secure psychiatric facilities in the United Kingdom. The results of an audit at the Kent Forensic Psychiatry Service found a 7% rate for serious offences in an average follow-up period of three years and five months, a figure similar to high-security hospital studies. Only one serious offence was unknown to the clinical team. Reports on larger samples are awaited.
Aluminum Phosphide Fatalities, New Local Experience
Authors: Abder-Rahman H A , Battah A H , Ibraheem Y M , Shomaf M S , Ei-Batainch N
Published: July 2017

Aluminum phosphide (AlP) pesticide is a highly toxic, low cost, and easily accessible rodenticidal agent. Its toxicity results from the liberation of phosphine gas upon exposure to moisture, which leads to multisystem involvement, resulting in serious consequences. The highly toxic parathion insecticide was a common cause of mortality in pesticide fatalities, prior to its banning. Its toxicity was familiar to the public as well as to physicians. Recently, ten fatalities due to AlP were encountered within a three-month period during spring, when it was used as a rodenticide in the vicinity of grain stores. The victims' ages ranged from 1–34 years. The circumstances of death were accidental in six cases, suicidal in two and possibly homicidal in two cases. Retrospectively, the clinical manifestations, scene investigation, autopsy, histological and toxicological findings supported the diagnosis of AlP intoxication. Immediate recognition was difficult due to unfamiliarity of the agent to the physicians.

The occurrence of these fatalities might suggest changes of pattern in pesticide poisoning. This should raise the attention of the physician to the problem of AlP poisoning and also necessitates the awareness of the public to the hazards of this poison. Education, proper handling, strict observation and abiding by the regulations controlling this material are good protective measures against AlP poisoning.
Environment: Physical and Social Aspects
Authors: Banks A. Leslie
Published: July 2017

If crime is mainly due to environmental influences, it follows that a high proportion is preventable, with a “hard core” composed of the mentally backward, mentally ill, personality disorders and misfits.

It is suggested that intensive research is required to bring the problem into focus, that the probation service should be built up to produce a cadre of experienced officers capable of mobilising the other community services in the prevention of crime, that the hard core should be dealt with by the appropriate experts, and that public opinion must be influenced to accept responsibility for the maintenance of discipline.
The Cruelty to Animals Act, 1876
Authors: Lane-Petter W.
Published: July 2017

This article deals with the historical background of the law relating to animal experimentation in Great Britain; the present application of the law and its effect on biological research; the licence and certificate system; Home Office inspection and control; the safeguards that the law provides for animals and for scientists and the prospects of further legislation.
The Pathology of Unsuccessful Escape in Flight
Authors: Mason J. K.
Published: July 2017

The demonstration of specific injuries resulting from the escape is the only way in which the limitations of unassisted escape can be assessed in relation to aircraft performance and design; a study of such deaths provides a useful comparison with fatalities following ejection and emphasises both the advantages and disadvantages of the more modern item of equipment.
The Identification of Skin
Authors: Swinburne Layinka M.
Published: July 2017

In medico-legal work the identification of skin, hair or secretions can be very important. Here an adaptation of the mixed agglutination technique suitable for determining the major blood group of skin is described as a step towards this goal and a foundation for further work. The advantages of the newer immunological methods lie particularly in the very minute amount of material needed and the direct significance of the result, in contrast with older methods which depended on the indirect inhibition of the agglutinating power of a serum, or a precipitin reaction with much-altered and processed material.
The Quantitative Assessment of Violence in Adult and Young Offenders
Authors: Nicol A. R. , Gunn J. C. , Foggitt R. H. , Gristwood J.
Published: July 2017

The reliability and validity of a method of estimating violent behaviour at an interview is explored and discussed.

Methods of studying violent behaviour have tended at one extreme to be by analysis of official statistics and at the other by a non-quantitative casework style of approach to the individual offender. Attempts to measure violent behaviour from interview accounts have been far less frequent and the present paper describes the use of this method in groups of men in prison and boys in Borstal.
Homicides and Suspected Homicides in Singapore
Authors: Chao T. C.
Published: July 2017

Details of 292 cases of homicide from Singapore during the years 1965–70 were tabulated and presented. It was calculated that the homicide rate was 2–5 per 100,000 population. A large proportion of the killings were done in gang clashes and in the heat of the moment, with few premeditated killings. Two weapons peculiar to this region, the bearing scraper and the parang, were described. In suspected homicides, wounds produced by counter-irritation and by ants after death were described, so that they would not be confused with injuries of violence.
Pathology of Suicide
Authors: Patel N. S.
Published: July 2017

From approximately fifteen thousand consecutive medicolegal autopsies, a series of 764 completed ‘suicides’ have been collected and studied. When analysed, this series revealed 3 principal types of self-destruction. Over 50 per cent of the cases, irrespective of age and sex, changed the methods employed for subsequent suicide attempts and 30 per cent of the men and 40 per cent of the women, irrespective of age, had made attempts prior to the final act.

Mental illness was noted in 76 per cent of those cases with previous suicide attempts compared with 40 per cent of those without a history of previous attempts, in whom other factors, such as physical and social, were predominant. Medical treatment, gastric casts, and missed suicides are also discussed, so as to reveal their significance in lowering the suicide rate at a time when it has been escalating.
Criminal Law and Complicity in Suicide and Attempted Suicide
Authors: Parry-Jones William Ll.
Published: July 2017

The current legal provisions relating to criminal liability for complicity in the suicide of another person are summarized. The application of these provisions during the decade 1961–70 is reviewed, based on data extracted from the files of persons prosecuted, which are held by the Director of Public Prosecutions. The role of these statutory provisions and the need for possible modifications are discussed.
Parents Who Kill Their Children
Authors: Scott P. D.
Published: July 2017

The annual incidence of filicide by mothers and fathers in England and Wales leads to discussion on classification of the killers, with particular emphasis on the difficulties associated with the criteria of motive and depression. A modified classification is suggested and applied to the cohort made available by Morris and Blom-Cooper (1964). The origin of the stimulus to kill (whether arising in the child, or displaced from elsewhere onto the child) may be a useful alternative to motive as a criterion for filicide.
A Simplified Method for Examining the Conducting Tissues of the Heart
Authors: Ferris James A. J. , MacLennan John R.
Published: July 2017

A simplified method of obtaining and processing blocks from the heart for examination of the cardiac conducting tissue is described. The value of this type of procedure is discussed in relation to the apparently negative autopsy.
Accidental Death Due to Explosion of Gas Cylinder
Authors: Chandulal R.
Published: July 2017

A case of accidental death due to the explosion of a ‘balloon gas cylinder’ is reported in which two people died instantaneously and of the others injured, a child, died four days later.
Liability for the Unauthorized Removal of Cadaveric Transplant Material
Authors: Skegg P. D. G.
Published: July 2017

It has been assumed that the removal of cadaveric transplant material would result in liability being incurred, if not done in accordance with the Human Tissue Act 1961. This might not always be so. There are no established torts which would normally be applicable—although on general principles the unauthorized removal might well be actionable, on the ground that it constituted an interference with the right to possession of the person under a duty to dispose of the body. If this person had given his consent, he could not subsequently recover damages. Where the unauthorized removal obstructed coronial or police inquiries, or the course of public justice, a doctor would sometimes be criminally liable. However, in the usual case, it is not certain that the unauthorized removal would itself amount to any crime. In those cases where the unauthorized removal did bring the doctor within the range of some tort or crime, there is the possibility that he might be able to escape liability if his action was necessary to save the potential recipient's life.
Intention at the Moment of Crime … Beyond Reasonable Doubt?
Authors: Briscoe O. V.
Published: July 2017

An essay arguing that tome legally sane accused persons do not form a conscious intention before the offence charged, and that for many of those who might have formed one its nature cannot be determined by later inquiry. The implications of this are considered.
The Medicolegal Implications of the Terms ‘Psychopath’, ‘Psychopathic Personality’ and ‘Psychopathic Disorder’
Authors: Blair Donald
Published: July 2017

The difficulty in diagnosing various types of personality is considerable. What are the dividing lines between the so-called ‘ordinary personality’, ‘trend disturbances of personality’, ‘trait disorders of personality’ and ‘psychopathic disorders of personality’. There are no border lines and the qualities of one may shade into those of another.

From the medicolegal point of view, however, it is obviously essential to determine which disorders of personality, if any, make sufferers not legally fully responsible for their actions. It is evident that only psychopathic disorders qualify for legal disposals that recognize their lack of legal responsibility to one degree or another. On the other hand, the latitude of interpretation of this diagnosis since it was recognized legally in the Mental Health Act 1959, has led to its use in the courts being in many cases of nebulous and doubtful value. If the conception of this entity is not to be abolished altogether there will in my estimation have to be a more exclusive and narrow meaning signified by psychopathic disorder and this article presents provocative suggestions how this may be achieved as well as a precise description of all aspects of psychopathy.

The snags and illusions which have so far resulted in the mêlée of opinion regarding the whole of this matter and the influence this has had on the custodial and therapeutic disposal of this group of antisocial offenders and criminals will be discussed in a further article to be published in a subsequent issue of this journal.
Fatal Intoxication with Amphetamines (A Case Report)
Authors: Adjutantis G. , Coutselinis A. , Dimopoulous G.
Published: July 2017

A case of fatal intoxication with amphetamines taken as psychedelic drugs is described in detail. Concentration levels of drug in blood, urine and liver are given. The use of amphetamines in Greece as stimulants or psychedelic drugs is limited; it concerns particularly the few heroin addicts who attempt to substitute their needs with this compound. Fatal intoxications with amphetamines are quite rare. That is the reason for this paper: to recount the story of a 30-year-old male who died after taking an overdose of this drug.
Who is the Psychopath? A Rejoinder and a Comment
Authors: Prins Herschel A.
Published: July 2017

In response to an article in this journal by another contributor, a modest attempt is made in the present paper to put forward additional perspectives concerning the classification and aetiology of psychopathy. An attempt is made also to distinguish between ‘essential’ psychopathy and ordinary recidivist criminality. Finally, some observations are made concerning the question of treatment.
The Measurement of Inter-Personal Violence: A Review
Authors: Parker Elizabeth
Published: July 2017

The qualitative assessment of violence is discussed and four scales which have been used to measure interpersonal violence are described. These scales are then compared with regard to how far they take into account the intent of the aggressor, the circumstances of the offence and the degree of injury inflicted and the advantages and disadvantages of these various criteria of violence are appraised.
Authorization of the Removal of Cadaveric Transplant Material at Common Law
Authors: Skegg P. D. G.
Published: July 2017

This article examines the possibility of authorizing the removal of transplant material from corpses without having recourse to s. 1 of the Human Tissue Act 1961.
Two Fatal Cases of Ethylene Glycol Poisoning
Authors: Bowen D. A. L. , Minty P.S. B. , Sengupta A.
Published: July 2017

Two cases of self poisoning by ethylene glycol are reported. The salient features of fatal acute ethylene glycol poisoning are mentioned with detailed histological and toxicological findings. Gas chromatographic analysis was used to determine ethylene glycol levels in serum and urine.
Estimation of Stature from Parts of Bones—Lower End of Femur and Upper End of Radius
Authors: Mysorekar V. L. , Verma P. K. , Mandedkar A. N. , Sarmat T. C. S. R.
Published: July 2017

A hundred and one right and 109 left dry, fully ossified, human femora have been studied to derive regression formulae for the establishment of the total length of the femur from the length of the lower end taken from the adductor tubercle. The formulae are statistically significant and their validity has been tested on 62 right and 59 left femora.

A hundred and fifteen right and 106 left dry, fully ossified radii have been studied to derive regression formulae for establishment of the total length of the radius from the length of the upper end taken to the lower level of insertion of the biceps brachii muscle on the radial tuberosity. The validity of the formulae which are statistically significant has been tested on 51 right and 56 left dry and fully ossified random radii.

All the regression formulae have a high degree of prediction, and are valuable in establishing the stature of an individual.
Some Crimonolgical and Psychiatric Aspects of Homicide in Iceland
Authors: Gudjonsson Gisli H. , Petursson Hannes
Published: July 2017

This paper investigates the relationship between some criminological and psychiatric aspects of homicide in Iceland for the period 1900–1979. During this period there were 45 homicide incidents, involving 52 victims and 47 offenders. 16 (34·0 per cent) of the offenders were considered to be psychiatrically ill or subnormal at the time of their offence and a further 17 (36·2 per cent) suffered from personality disorder, alcoholism or drug dependency. A relationship was found between psychiatric abnormality and such variables as day and time of offence, previous criminal record, method of killing, relationship between victim and offender, motive, and action after offence. These findings are generally consistent with previous homicide research.
How Breathing Technique Can Influence the Results of Breath-Alcohol Analysis
Authors: Jones A. W.
Published: July 2017

This paper reports experiments to test how a person's breathing technique can influence the concentration of ethanol and the temperature of end-expired breath samples. The experiments were performed with healthy men after they drank a moderate dose of ethanol and the concentration of ethanol in breath was determined by gas chromatography. The results were compared with control breaths, which were deep inspirations and forced expirations of room air, analysed within 2–3 minutes of the test-breath sample. With breath-holding (30 seconds) before expiration, the concentration of ethanol increased by 15.7 ± 2.24 per cent (mean ± SE) and the temperature of breath rose by 0.6 ± 0.09°C. Hyperventilating for 20 seconds, immediately before the analysis of breath, decreased the concentrations of ethanol by 10.6 ± 1.37 per cent and the breath temperature dropped by 1.0 ± 0.22°C. Keeping the mouth closed for 5 minutes (shallow breathing) increased expired ethanol concentration by 7.3 ± 1.2 per cent and the breath temperature rose by 0.7 ± 0.14°C. After a slow (20 second) exhalation expired ethanol increased by 2.0 ± 0.71 per cent but breath temperatures remained unchanged from control tests. My results suggest that the changes in expired-ethanol concentrations are partly caused by the rise or fall in the temperature of breath. But an equally important factor is the amount of time the breath spends in contact with the mucous membranes of the upper respiratory tract. A long contact time increases the concentration of ethanol and rapid ventilation lowers it. Regardless of the breathing technique tested, the results recovered to control values immediately the subjects began breathing normally again.
Schizophrenia and Anti-Social (Criminal) Behaviour—Some Responses from Sufferers and Relatives
Authors: Mackay R. D. , Wight R. E.
Published: July 2017

The involvement of schizophrenics in anti-social (criminal) behaviour is examined by means of a questionnaire survey. The results reveal that such behaviour is, for the most part, trivial and that in a high proportion of such cases the sufferers are not prosecuted but are removed to a hospital by the police or a social worker.
Assaults on Staff in a Locked Ward: Prediction and Consequences
Authors: Aiken G. J. M.
Published: July 2017

Violent incidents that resulted in injury to staff were recorded in a locked acute psychiatric admission ward of 17 beds. In 6 months 41 incidents occurred against 23 staff. Six incidents caused serious injuries and 21 caused significant injuries. Over half the incidents were thought to have been avoidable by the victims. A scale for rating arousal level was devised from the behavioural signs that occurred prior to the assault. High scores on this scale related to an increased chance of serious assault. There were changes in speech and movement prior to the assault in 80 per cent of incidents. However, changes in patients' postures and movements prior to the assault were significantly associated with serious injuries. The practical implications of these results are discussed from the point of view of those dealing directly with acutely disturbed patients.
Homicide: A Study at Siriraj Hospital, Bangkok
Authors: Tosayanond Songchat
Published: July 2017

The results of autopsies performed on homicide victims during a period of 10 years, 1972 to 1981, were studied. Post-mortem examination of 6080 unnatural deaths revealed that 468 (7.7 per cent) occurred as the result of homicide, with a male to female ratio of 9: 1. The most common age group was found to be between 20 and 39 years and the next most common 10 to 19 years. Homicidal cases involving victims over 60 years old were rare. The incidence of homicide was highest in the evening between 7.00–10.00 p.m., and the crime occurred more frequently in summer than winter. In this series a gun was the most commonly used weapon; 219 cases (46–79 percent) involved firearms. The majority of cases were the results of personal disputes and were not associated with heavy drinking. The causes of death were mostly injuries to brain and chest.
Detection of Cocaine in Rats from Analysis of Hair
Authors: Michalodimitrakis M.
Published: July 2017

The detection of benzoylecgonine in the hair of cocainetreated rats is studied with the use of RIA technique. The cocaine metabolite can be determined in whole hair of rats up to ten days after the last administration of the drug.

Benzoylecgonine can be detected in the hair of cocaine-treated rats with the use of the radioimmunoassay technique after sample extraction. After a period of ten days, cocaine metabolites could be detected under the conditions described in the experimental procedure. The concentrations of benzoylecgonine ranged between 23,94 and 47,56 ng/g.

The analysis of hair by means of a sensitive and specific method such as radioimmunoassay would be highly advantageous since hair samples are easily accessible, stable and retain the drug for long periods of time.
Wandering at Heathrow Airport by the Mentally Unwell
Authors: Weller M. P. I. , MRcPsych P. Jauhar
Published: July 2017

Over a two-year period, 24 patients were admitted from Heathrow airport to the catchment area psychiatric hospital, St. Bernard's, 19 under compulsion, after they had attracted attention whilst wandering aimlessly at Heathrow airport, as opposed to arriving or departing. Diagnostic and epidemiological data is presented, together with vignettes of three typical cases. Of these patients, 16 were suffering from schizophrenia and this overwhelming preponderance is considered, together with the fact that eight persons had previous admissions under similar circumstances.
Gamma-Glutamyl Transferase: Applications in Forensic Pathology: I: Study of Blood Serum Recovered from Human Bodies
Authors: Piette M. , Schrijver G. De
Published: July 2017

In order to appreciate more adequately chronic alcohol use by the deceased in the course of a medico-legal autopsy we studied the usefulness of a determination of gamma-glutamyl transferase (GGT) activity in cadaver serum. Some preliminary tests were performed to check the post-mortem stability of this enzyme, the influence of post-mortem haemolysis upon enzyme determination, the influence of the sampling site upon the enzyme activity and the suitability of vitreous humour as an alternative body fluid for GGT determination. Secondly, correlations between GGT activity and the degree of fatty liver degeneration and fibrosis (both possibly alcohol-induced tissue lesions) were searched for. Finally, a comparison was made between strictly selected groups of alcoholics and non-alcoholics.

We concluded that, keeping in mind the necessary precautions to avoid typical post-mortem fallacies, a GGT determination in cadaver serum provides a useful parameter for detecting chronic alcoholism at the forensic autopsy.
The Significance of Depression in the Mechanism of ‘Compulsive’ Shoplifting
Authors: Gudjonsson Gisli H.
Published: July 2017

The paper describes a case of a compulsive shoplifter who was treated successfully by behaviour therapy. The main objective of treatment was to increase time spent on self-rewarding activities where the patient was able to fulfil her need for excitement, challenge and purpose, while simultaneously reducing her ‘unacceptable’ activities (shoplifting, excessive housework). A theoretical model of compulsive shoplifting is presented and discussed. According to the model, low self-esteem provided the starting point for a chain of developments in which feelings of frustration, exploitation, resentment and lack of self-fulfilment became communicated indirectly through shoplifting activity.
Sudden Death Due to a Cardiomyopathy Predominantly Affecting the Right Ventricle—Right Ventricular Dysplasia
Authors: Smeeton W. M. I. , Smith W. M.
Published: July 2017

The right ventricle may be the source of potentially lethal arrhythmias. This paper presents a case of sudden cardiac death due to right ventricular dysplasia, a cardiomyopathy predominantly affecting the right ventricle. The clinical and pathological features of this unusual cardiomyopathy and its relationship to Uhl's anomaly and right ventricular dilated cardiomyopathy are discussed.
Forensic Usefulness of the Injury Severity Score
Authors: Okada Yasusei , Ishiyama Ikuo
Published: July 2017

This paper, based upon a case report, shows the forensic usefulness of the Injury Severity Score (ISS). The ISS is found to be of great use in deciding to what degree each injury is responsible for the death of a patient with multiple injuries.
The Bradford Fire Disaster
Authors: Sivaloganathan S. , Green M. A.
Published: July 2017

In May 1985 a football ground fire resulted in 50 deaths. All the bodies were severely burned. This paper provides an account of the planning and methods used in the initial investigation and assesses their value and the problems encountered.
Treatment for Offender Patients: How Should Success Be Measured?
Authors: Robertson Graham
Published: July 2017

The criteria used to judge the success of treatment for mentally ill (psychotic) patients are the same for offenders and non-offenders. For those offender patients detained as psychopaths, the incremental validity of the medical concept is dubious and recourse is often made to the use of the criminal criterion of reconviction in order to measure therapeutic effectiveness. One such study is reported here and others are reviewed. It is argued that reconviction is not a valid measure of psychiatric treatment and that the criteria used to judge therapeutic effectiveness in forensic psychiatry should not differ from those used in all other forms of psychiatric care.
Referrals to a New Regional Secure Unit — What Happens to Patients Refused Admission?
Authors: Bond Michael
Published: July 2017

The new Regional Secure Unit for the West Midlands, the Reaside Clinic, had a total of 85 patients referred for admission during the first year of operation, of whom 32 were considered unsuitable for admission. The characteristics and outcome of these patients are discussed, together with the implications for forensic psychiatrists, general psychiatrists and prison medical officers.