bluuebunny/crossref_metadata_2025 huggingface dataset:
Pitfalls of Frozen Section in Gynecological Pathology: A Case of Endometrial Tumor With Sex Cord–Like Elements
Authors: Cox Hecca Y. , Cracchiolo Bernadette , Galan Mark , Heller Debra
Published: February 2018

Endometrial stromal tumor with sex cord–like elements (ESTSCLE) is a rare entity that shares similar histological features with uterine tumors resembling ovarian sex cord tumors (UTROSCT). Differentiating the 2 entities involves ample sampling of the tissue to distinguish the percentage of sex cord components within the tissue, genetic studies, and immunohistochemical staining. Frozen section provides limited information for exclusion of either tumor; and the tumor is rare enough that the diagnosis may not be considered with the limited sampling; therefore, deferral of diagnosis to permanent sections may be appropriate.
Evaluating the use of appropriate anticoagulation with lenalidomide and pomalidomide in patients with multiple myeloma
Authors: Anderson Sarah M , Beck Bradley , Sterud Susan , Lockhorst Robin , Ngorsuraches Surachat
Published: February 2018

Background

Lenalidomide and pomalidomide are two immunomodulatory medications with the potential to improve outcomes for patients with multiple myeloma; however, a black box warning for venous thromboembolism exists.

Purpose

The purpose of this study was to assess overall adherence to guideline recommendations for anticoagulation therapy with lenalidomide and pomalidomide in multiple myeloma patients.

Methods

This retrospective study at an ambulatory oncology clinic utilized chart reviews from the calendar years 2013–2016. The primary endpoint was prescription of appropriate anticoagulation upon initiation of therapy based on a list of predetermined risk factors. Secondary endpoints included incidence of deep venous thromboembolism, pulmonary embolism, myocardial infarction, stroke, and major bleed; initial anticoagulant prescribed; and whether or not anticoagulation was prescribed for another disease state.

Results

A total of 130 patients met inclusion criteria: 70.8% (n = 92) and 29.2% (n = 38) were prescribed lenalidomide and pomalidomide, respectively. A total risk score of two was most common (n = 54, 41.5%). Aspirin 81 mg oral tablet was prescribed most often (n = 53, 40.8%), followed by no anticoagulation (n = 30, 23.1%). Overall, 27 patients (20.8%) were prescribed anticoagulation in accordance with National Comprehensive Cancer Network guidelines. Incidence of deep venous thromboembolism was the most common adverse event (n = 4, 3.1%), followed by major bleed (n = 1, 0.8%). No reports of pulmonary embolism, myocardial infarction, or stroke were documented.

Conclusions

Overall, a disparity exists between appropriate prescribing of prophylactic anticoagulation and current practice guidelines. However, documentation of thromboembolic events was lower than recorded in previously published literature.
Rapid Recovery of Liver Transplantation Recipients by Implementation of Fast-Track Care Steps: What Is Holding Us Back?
Authors: Biancofiore Gianni , Tomescu Dana Rodica , Mandell M. Susan
Published: February 2018

A body of scientific studies has shown that early extubation is safe and cost-effective in a large number of liver transplant (LT) recipients including pediatric patients. However, fast-track practices are not universally accepted, and debate still lingers about whether these interventions are safe and serve the patients’ best interest. In this article, we focus on reasons why physicians still have a persistent, although diminishing, reluctance to adopt fast-track protocols. We stress the importance of collection/analysis of perioperative data, adoption of a consensus-based standardized protocol for perioperative care, and formation of LT anesthesia focused teams and leadership. We conclude that the practice of early extubation and fast-tracking after LT surgery could help improve anesthesia performance, safety, and cost-effectiveness.
Life cycle cost and CO2 emission simulation models of apartment building projects using system dynamics
Authors: Lim Dong-Bum , Son Seunghyun , Kim Sunkuk , Park Junyoung
Published: February 2018

In recent years, interest in green industries, energy and resource conservation, and reduction of CO2 emissions has grown worldwide. There have been many attempts to reduce CO2 emissions in the construction field. However, adopting eco-friendly technologies in buildings may result in high investment costs at the initial stage of building projects, and budget limitations can consequently impact decision-making regarding green technology application. To overcome these problems, there have been studies to develop life cycle cost (LCC) and life cycle CO2 emissions (LCCO2) analysis models. However, these models reported so far lack verification of effectiveness of simulation results and are not well suited for practical application. Thus, a simulation model that is capable of selecting optimal alternatives for systematic analyses of cost-effective carbon reduction measures is desired and necessary. Accordingly, the purpose of this study is to use system dynamics to develop an LCC-based LCCO2 simulation model for whole life assessment of apartment building projects. The proposed model will be further developed into programmes that are able to select optimal alternatives for apartment building projects that could reduce LCCO2 while ensuring reasonable LCC.
Australian social work students: Balancing tertiary studies, paid work and poverty
Authors: Baglow Len , Gair Susan
Published: February 2018

It is commonly understood that enrolment in higher education means inevitable financial strain. In an online national survey in 2015, a sample of 2320 current students from 29 Australian social work programs reported on their experiences of juggling life, study and work.

Findings

This article details preliminary findings regarding the impact of low levels of income on the lives and study success of an Australian student cohort, and offers a considered comparison to relevant available data. Students in this study reported regularly going without necessities, and identified that a lack of finances and long hours in employment were adversely affecting their study experience. These problems became acute during compulsory field placements.

Applications

The purpose of this study was to illuminate social work students’ complex study realities in order to inform future education, policy and practice. The findings identify that for these students adverse outcomes including poverty and disruption to studies may be increasingly difficult to avoid. This situation may not be confined to this cohort or the Australian experience. There appears to be an urgent need for national bodies, universities and students to join together in advocating for increased support for tertiary social work students.
Secondary prevention care and effect: Total and low-density lipoprotein cholesterol levels and lipid-lowering drug use in women and men after incident myocardial infarction – The Tromsø Study 1994–2016
Authors: Hopstock Laila A , Eggen Anne Elise , Løchen Maja-Lisa , Mathiesen Ellisiv B , Njølstad Inger , Wilsgaard Tom
Published: February 2018

Background: Secondary prevention guidelines after myocardial infarction (MI) are gender neutral, but underutilisation of treatment in women has been reported. Design: We investigated the change in total and low-density lipoprotein (LDL) cholesterol levels and lipid-lowering drug (LLD) use after first-ever MI in a population-based study. Methods: We followed 10,005 participants (54% women) attending the Tromsø Study 1994–1995 and 8483 participants (55% women) attending the Tromsø Study 2007–2008 for first-ever MI up to their participation in 2007–2008 and 2015–2016, respectively. We used linear and logistic regression models to investigate sex differences in change in lipid levels. Results: A total of 395 (MI cohort I) and 132 participants (MI cohort II) had a first-ever MI during 1994–2008 and 2007–2013, respectively. Mean change in total cholesterol was −2.34 mmol/L (SD 1.15) in MI cohort I, and in LDL cholesterol was −1.63 mmol/L (SD 1.12) in MI cohort II. Men had a larger decrease in lipid levels compared to women: the linear regression coefficient for change was −0.33 (95% confidence interval [CI] −0.51 to −0.14) for total cholesterol and −0.21 (95% CI −0.37 to −0.04) for LDL cholesterol, adjusted for baseline lipid value, age and cohort. Men had 73% higher odds (95% CI 1.15−2.61) of treatment target achievement compared to women, adjusted for baseline lipid value, age and cohort. LLD use was reported in 85% of women and 92% of men in MI cohort I, and 80% in women and 89% in men in MI cohort II. Conclusions: Compared to men, women had significantly less decrease in lipid levels after MI, and a smaller proportion of women achieved the treatment target.
This must be the place (to commit a crime). Testing the law of crime concentration in Milan, Italy
Authors: Favarin Serena
Published: February 2018

The dense distribution of crime in a small number of micro places led to the formulation of a law of crime concentration applicable across cities and stable over time. This law has rarely been tested in Europe and has never been tested in Italy. In addition, there is a lack of extensive knowledge about its determinants. Therefore, the main objectives of this study are to test the presence and the stability of crime concentration in a different urban context and to explain this concentration. A street segment analysis and a group-based trajectory analysis were conducted to test the presence and the stability of crime concentration in the city of Milan (Italy), and negative binomial regression models were run to understand the main determinants of this concentration. The findings confirm the presence of crime concentration at street segment level, but only a few segments can be considered to be highly criminogenic over time. Social disorganization factors play an important role in explaining crime concentration, even though opportunity factors also coincide in this explanation. Despite their differences, cities around the world share the same crime concentration. The generalization of these findings is an important step in the development of common knowledge. Nevertheless, in Milan only a few segments are chronic hot spots. The stability pattern in the city needs to be further analysed using different methods. A theoretical integration approach considering both situational and social disorganization factors is promising in understanding why crime occurs in urban areas.
The Discourse of Digital Dispossession: Paid Modifications and Community Crisis on Steam
Authors: Joseph Daniel James
Published: February 2018

This article is a chronicle and analysis of a community crisis in digital space that took place on Valve Corporation’s digital distribution platform, Steam. When Valve and Bethesda (publisher and developer of Skyrim) decided to allow mods to be sold by mod makers themselves, there ensued a community revolt against the commodification of leisure and play. I put this crisis of play and work in dialogue with Harvey’s concept of “accumulation by dispossession,” firmly placing it within a longer history of disruptive capital accumulation strategies. I then conduct a discourse analysis of community members on reddit, as they make sense of and come to terms with this process of dispossession. Arising in the discourse was not class consciousness per se, but instead a pervasive feeling of helplessness and frustration as games, play, and leisure began to feel like work.
Research on an equal power allocation electronic differential system for electric vehicle with dual-wheeled-motor front drive based on a wavelet controller
Authors: Zhao Xuan , Yu Qiang , Yu Man , Tang Ziqiang
Published: February 2018

We propose an electronic differential system (EDS) based on a wavelet controller for electric vehicle with dual-wheeled-motor front drive. According to an analysis of current electronic differential strategies and vehicle driving dynamics, a new electronic differential strategy model of equal power allocation is proposed, and based on an analysis of the mathematical model of an interior permanent magnet synchronous motor, a new current controller based on the discrete wavelet transform is proposed using vector control. Based on A&D5435 hardware-in-the-loop simulation system and Carsim/Simulink, the test and simulation platform of the electric vehicle with dual-wheeled-motor front drive are established, and a vehicle performance simulation and test are performed under various driving conditions. The test and simulation results show that the equal power allocation EDS based on a wavelet controller for a front-wheel independent-drive electric vehicle proposed in this article shows excellent differential effects, stability, robustness, and vehicle handling stability.
Vascular ultrasound, the potential of integration of multiparametric ultrasound into routine clinical practice
Authors: Rafailidis Vasileios , Sidhu Paul S
Published: February 2018

Introduction

Ultrasound has traditionally been regarded as the first-line imaging modality for screening, diagnostic evaluation and monitoring treatment and disease progression of vascular pathology, including both the arterial and the venous branch of the vascular system. Albeit of its well-tolerated nature, wide availability and low cost, ultrasound above all, has the advantage of providing the clinician with clinically significant information related to both intraluminal irregularities and extravascular disease. Ultrasound has the potential not only to anatomically describe tissues but also to assess physiology by evaluating blood flow characteristics in real time.

Discussion

The already fundamental role of ultrasound has been even more expanded with the introduction of newer techniques like contrast-enhanced ultrasound, tissue-elastography and 3D ultrasound and the incorporation of research advances into clinical practice. The purpose of this review is to present and discuss some of the latest advances in the field of vascular ultrasound in attempt to illustrate how the adoption of multiparametric ultrasound into everyday clinical practice could address the patient's needs. Pathology and applications discussed include carotid and aortic disease, portal and peripheral venous abnormalities.

Conclusion

Widespread availability of modern technology in ultrasound devices has made the application of contrast-enhanced ultrasound, tissue elastography and 3D ultrasound feasible options, ready to contribute to the diagnostic performance of the ultrasonographic technique.
Clinical course and outcome in patients with severe dysphagia after lateral medullary syndrome
Authors: Kim Hyojun , Lee Ho Jun , Park Jin-Woo
Published: February 2018

Background

The objective of this study was to investigate the clinical course and final outcome in patients afflicted with severe dysphagia following a diagnosis of lateral medullary syndrome (LMS).

Methods

The patients with severe dysphagia after LMS admitted to a rehabilitation unit were included and their respective clinical data were prospectively collected. The criteria of ‘severe dysphagia’ was defined as the condition that showed decreased pharyngeal constriction with no esophageal passage in a videofluoroscopic swallowing study (VFSS) and initially required enteral tube feeding. The data included VFSS findings, types of diet and postural modification, penetration-aspiration scale (PAS) and functional oral intake scale (FOIS).

Results

A total of 11 patients were included and VFSS was performed every 2 weeks after stroke onset. Esophageal passage began to show at an average 34.7 ± 18.3 days, and the patients were able to begin consuming a partial oral diet with postural modification. It was 52.2 ± 21.8 days till they were advanced to a full oral diet. PAS and FOIS were significantly improved over time.

Conclusions

Patients with severe dysphagia after LMS were able to tolerate a partial oral diet at about 5 weeks following onset, and they were advanced to a normal diet after 10 weeks. This clinical course might help in predicting the prognosis, as well as assist in making practical decisions regarding a rehabilitation program.
Consistent Use of Assistive Devices for Patient Transfer Is Associated With Less Patient-Initiated Violence: Cross-Sectional Study Among Health Care Workers at General Hospitals
Authors: Pihl-Thingvad Jesper , Brandt Lars P. A. , Andersen Lars L.
Published: February 2018

This study investigated whether factors related to bodily contact between health care workers and patients were associated with patient-initiated violence. This cross-sectional study surveyed 496 Danish health care workers measuring patient-initiated violence, use of assistive devices, body mass index, physical exertion, frequency of patient transfers, psychosocial work environment, gender, age, and seniority. Associations were modeled using logistic regression analyses using patient-initiated violence as the outcome. Twenty-five percent of the respondents had experienced physical or verbal violence during the past year. Infrequent use of assistive devices, high physical strain, and severe obesity all significantly increased the risk of physical violence (risk ratio [RR] = 1.18, RR = 1.18, and RR = 1.16, respectively), whereas only the lack of assistive device use significantly increased the risk of verbal violence (RR = 1.13 and RR = 1.08). Consistent use of assistive devices appears to reduce the risk of patient-initiated violence. Managers should require the use of assistive devices when designing work processes for patient transfers.
Respiratory Structure and Function
Authors: Brinkman G. L. , Mich Detroit , Block D. L. , Mich Dearborn
Published: February 2018

Abstracts of papers from Annual Meeting of the American Thoracic Society held in conjunction with the Meetings of the National Tuberculosis and Respiratory Disease Association and the National Respiratory Disease Conference, Los Angeles, California, May 16-19, 1971.
Microseismic monitoring of a tight light oil reservoir: A case history in the Cardium Halo Play, Alberta
Authors: Duhault John L. J. , Eaton David W. , Kent Pedersen Per
Published: February 2018

The effectiveness of hydraulic-fracturing completions in a tight-oil play is investigated by detailed interpretation of microseismicity. The microseismic programs were acquired in the Cretaceous Cardium light oil sandstone reservoirs in Alberta, Canada. Events with magnitudes between [Formula: see text] and [Formula: see text] are located by downhole monitor wells to a maximum distance of 525 m, enabling inference of the fracture wing length, height, and azimuth based on event distribution. The fracture ports, one per stage, were located in an open-hole configuration that used external packers for zonal isolation. During completions, the ports were opened with ball-actuated frac sleeves. Event distributions indicated that, in some cases, fractures grew preferentially away from the Rocky Mountain deformation front. This inferred that fracture asymmetry is independent of the position of the monitoring array, indicating that it cannot be ascribed to observation bias and suggesting that the direction of fracture growth was dominantly influenced by the preexisting stress conditions in the reservoir. The distribution of microseismicity further indicates that isolated event clusters occur 30–50 m above the reservoir. These out-of-zone events are interpreted to have occurred on unpropped fractures. In comparison with gelled oil or foamed water, slickwater fracturing fluids are shown to produce more diffuse and scattered microseismic expression accompanied by better cumulative oil production. Taken together, the results of these studies indicate that the use of slickwater fracturing fluid, along with the reduced stage spacing and tighter interwell spacing, is expected to lead to higher initial production as well as higher estimated ultimate recovery.
Chronic Bacterial Infection in Cases of Dementia Præcox
Authors: Robertson W. Ford
Published: February 2018

I have to present the results of an inquiry into the possible importance of chronic bacterial infection as a factor in the causation of dementia præcox. My conclusions are based chiefly upon the study of thirty-two early cases in which it has been possible to make a sufficiently complete examination. I have also investigated by the same methods thirty cases of other forms of acquired insanity, and over 300 cases of nervous and other disorders in persons among the general population. I have to describe the chronic infections I have found in the cases of dementia præcox, and to endeavour to estimate their relation to the malady.
Artificial Insanity, chiefly in relation to Mental Pathology
Authors: Tuke Daniel Hack
Published: February 2018

Enumeration of physical symptoms (continued).—With regard to the contraction of the pupil which in the first instance takes place, it is doubtless due to the act of shortening the focal distance when gazing at a near object.∗ Dilatation succeeds, and continues even during the early stage of the nervous sleep, but after some time has elapsed, the pupils contract as in ordinary sleep. During both periods—that of dilatation and the subsequent contraction — the pupils, according to Mr. Braid, are insensible to light.
Tumours of the Brain in the Sane and the Insane
Authors: Boyd R.
Published: February 2018

In 206 cases of pulmonary phthisis, 132 in males and 74 in females, published in the “Ed. Med, and Sur. Journ.,” I found scrofulous tumours and tubercles in the brain in two males and two females.
Darwin on the Expression of the Emotions in Man and Animals
Authors: Shaw T. Claye
Published: February 2018

Mr. Darwin has called his book by the title of “The Expression of the Emotions in Man and Animals,” but he has gone into the mechanism of other conditions besides “Emotionls.” “Affirmation” and” Negation,” “Reflection,” “Meditation,” and “Helplessness,” are not necessarily associated with “Feeling,” and may more conveniently be called states of mind than emotions. If this had been better recognised it would have prevented the making of such an “antithesis” as Indignation on the one hand and Helplessness on the other. An indignant man is no doubt in an emotional condition, but a man who shrugs his shoulders in sheer help-lessness may be, and generally is, simply devoid of all emotion whatever.
Jean Jacques Rousseau: A Psychological Study
Authors: Hawkes J.
Published: February 2018

The life of the philosopher has for some minds a higher charm than that of a poet—the life of a practical worker a greater attraction than that of a student or dreamer—the career of an earnest living reality more than that of a mystic, or even of a professor of the ideal. The career of the natural phenomenon, whose name heads this article, embraced to a great extent all of these conditions. Born in an age when the dawn of a new creation was already beginning to climb over the hills by which men's minds were environed—at a time when the rude disentanglements, by processes new and strange, were shortly to make themselves felt among the believers in an old faith—when the first throes of the great moral volcano of modern times seemed to indicate but feebly its future terrible force—the mind of young Rousseau buds forth like some fragile blossom of spring pushing its sensitive shoots through the frozen snow on the mountains around his native town.
Sketch of the French Legislation Relative to the Insane
Authors: Foville M. Achille
Published: February 2018

The question of the revision of legislation in regard to the insane is, at this time, under consideration both in England and in France. In England Parliament has been occupied with various projects of law, results more or less direct of the parliamentary inquiry of 1877. In France the Government has charged a Commission composed of Senators, Deputies, Administrators, and Physicians, to study the improvements that might be introduced into this legislation.
Nervous Dulness in its Physical and Moral Aspects, and its Bearing on the Question of Capital Punishment
Authors: Kesteven Wm. Henry
Published: February 2018

It is only of late years, and that in a desultory manner, that what is here meant by nervous dulness has been recognised. A few words on the subject may not therefore be unacceptable, particularly as it has bearings on questions of social interest.
On the Effect of Prosperity and Adversity in the Causation of Insanity
Authors: Chapman T. A.
Published: February 2018

The subject of the causation of insanity has recently attracted considerable attention; and with the abundant material which the Commissioners in Lunacy are annually accumulating, we may expect by-and-bye to learn something more of this large and complicated subject.
Asylum Hospitals, with Plans
Authors: Greene Richard
Published: February 2018

The Commissioners in Lunacy have lately recommended the erection of detached hospitals for the treatment of infectious disease at most of the English County Asylums, and it would seem that at least twenty of these institutions are already equipped in this matter. These hospitals differ greatly as to size, form of construction, adjuncts, distance from the main building, and, in fact, in all their features. Some resemble villas rather than hospitals, others are attached by corridors to the asylum. The most of them are of one story only, but one or two are of two stories. Some are divided into blocks, others are in one continuous building. The causes of this endless variety are, firstly, that there are no model plans of asylum hospitals published, and, as far as I am aware, no plans published at all, if I except that lately built at the East Riding Asylum, described in this Journal for April, 1887; and, secondly, that these hospitals being for the most part small affairs, architects are rarely invited to send in plans, so that there is a total absence of the stimulus of competition.
3. German Retrospect
Authors: Ireland W. W.
Published: February 2018

Dr. G. Rabbas (“Zeitschrift für Psychiatrie” xli. Band, 3 Heft), following out the observations of Dr. Rieger, has, in a course of careful experiments, tested the capacity of the insane for reading in progressive dementia. He found that in general paralysis the power of reading was diminished, and in the end totally destroyed, and that this incapacity commenced at an early period of the disease. The words were given wrong or altered in a senseless manner, with a faint connection with the text read, whereas in functional insanity as well as senile dementia the power of reading was long retained even in cases where the mental fatuity seemed greater than in given cases of general paralysis. When maniacs could be induced to read they read on quickly without any regard to stops or beginnings of sentences, but they generally read correctly, without alteration of the words. This early loss of reading power in general paralysis, like the alteration in writing, is of great use for a differential diagnosis.
The First Maudsley Lecture
Authors: Crichton-Browne Sir James
Published: February 2018

Gentlemen,—I feel I owe the honour of having been selected to deliver this first Maudsley Lecture, not to any special fitness I possess to expone any of the more recent developments of that branch of medicine, the furtherance of which the lectureship is intended to promote, but to the fact that I am almost the last survivor of those who were associated with the founder of the lectureship in the early days of his professional career. While still a student at the University, Maudsley was revealed to me in a brilliant essay on Edgar Allan Poe, which was published in the Journal of Mental Science in April, 1860, and which, although too scathing and denunciatory of the ill-fated poet, as it now appears, was so rich in insight, originality and happy similitudes as to betoken unmistakably “the lighting of another taper at Heaven,” which was at that time Maudsley's way of describing the arrival of a new man of genius on the scene. A few years later I made Maudsley's personal acquaintance at the table of that gracefully-refined and highly-gifted physician and philanthropist, Dr. John Conolly, who afterwards became his father-in-law, and in the years following I can recall many memorable meetings with him at “The Lawn,” at Hanwell, in his rooms in Queen Anne Street, and in a restaurant in Soho, where, over frugal meals, he and I and Lockhart Robertson, and Broadbent and Harrington Tuke and Baron Mundy of Moravia, the zealous advocate of non-sequestration and family life and free air for the insane, held high discourse and adumbrated projects for the future of lunacy, some of which have taken shape since then, while others remain unrealised and perhaps unrealisable.
An Analysis of 200 Cases of Mental Defect
Authors: Middlemiss J. E.
Published: February 2018

The cases dealt with in the present paper came under review during the course of my duties as Medical Officer to the Leeds Committee under the Mental Deficiency Act. They comprise examples of the four varieties of mental defectives defined by that Act, viz., idiots, imbeciles, feeble-minded, and moral imbeciles, and include most of the clinical types described by writers on the subject. The commonly accepted division into primary and secondary groups has been adopted; a third group, containing cases which appear to combine the characteristics of both types, and a fourth group containing “doubtful” cases, in which the data are insufficient to allocate them definitely, being also added. It has seemed useful, too, to give columns showing the number of cases corresponding to the accepted clinical types, those complicated by epilepsy, those exhibiting pronounced stigmata of degeneration, as well as those showing a definite family history of neuropathic affections, tubercle, or alcohol respectively. It is obvious that many of these cases will figure under the several heads. The following analysis then shows the proportion of cases under each of these heads of the total number of cases examined, viz., 200:
2. Neurology
Authors: Cole Sydney J.
Published: February 2018

The author gives the results of his control measurements of sections from various cortical areas. He used a special block-holder, equipped with a scale, and rotatable, so that from one block of cortex seven or eight planes of section could be made, cutting the cortex at as many different angles. All the measurements were made at the apex of convolutions, where the axes of the majority of nerve-cells pass vertically into the white matter. The depth increments referable to obliquity are tabulated as percentages of the shortest measurement. He concludes that, using sections cut and mounted with extreme care to avoid undue obliquity, one may expect an error of something under 6 per cent., of which almost one half is due to difficulty in determining the line of demarcation between cortex and white matter. The fixing of this line is somewhat arbitrary, owing to the rather gradual and straggling manner in which the spindle-cells of the lowest cortical layer disappear as the white matter is reached.
5. Pathology
Authors: Stokes F. E.
Published: February 2018

The method employed consists of three stages: (1) The conversion of the total nitrogen into ammonia by the Kjeldahl process; (2) the conversion of the ammonia into pure aqueous solution; and (3) the calorimetric estimation of the ammonia in this solution by means of Nessler's solution. The result is expressed as “nitrogen number,” which denotes the number of hundredths of a milligramme in 1 c.c. of cerebro-spinal fluid. In general paralysis there is a high nitrogen number, which is marked towards the termination of the disease. It may be low in the early stages or in remissions. In mania the nitrogen number is always low—a factor of diagnostic importance in distinguishing between this disease and maniacal phases occurring in general paralysis. In imbecility, dementia præcox, paranoia, amentia and epilepsy the nitrogen number varies, but is usually low, and in terminal dementias it is very high. It was also found that density and nitrogen numbers run parallel to one another, with the exception of epilepsy, where high density obtains. The author emphasises the fact that choline does not occur in the cerebro-spinal fluid in mental diseases, and that ammonium salts only occur in the merest traces.
Some Observations on the Phenomena of Life and Mind
Authors: Dunn Robert
Published: February 2018

Life and mind, in their abstract nature or essence alike inscrutable to us, are problems which belong to the same category; for, in this world, we know nothing of life apart from an organism, and we have no manifestations of mind independently of a brain and nervous system. Here living organisms are required for the display of the vital phenomena, and a brain and nervous system for the manifestations of mind. Life has accordingly been defined as “the collective expression for a series of phenomena which take place exclusively in bodies that are organized,” and “mind as the functional manifestations of the living brain.” But then, and at the outset, it is to be remembered that in affirming sensation, emotion, thought, and volition to be functions of the nervous system, what is really maintained is this, that the vesicular matter of the encephalic ganglia furnishes the material conditions—the medium through which these mental phenomena are made manifest in this life. It may indeed be asked, Are not the physical forces of external nature, which underlie all vital phenomena, and the changing states of consciousness which constitute our mental life, as inscrutable to us in their nature or essence as are life and mind ? and it must be conceded that they are. Matter and force are coexistent, and are correlative. Nor can we conceive of the one but in association with, by, and through the other, any more than we can conceive of life, in our present state of existence, apart from an organism, or of thought independently of a living brain.
The Care and Treatment of the Insane Poor, with special reference to the Insane in Private Dwellings
Authors: Mitchell Arthur
Published: February 2018

In his address as President of the Medico-Psychological Association Dr. Robertson discusses the various modes of making public provision for the insane poor; and one of the three modes which he recommends is that of disposing of a certain number of them in private dwellings.
Clinical Cases illustrative of the value of the Thermometer as a means of Diagnosis in Diseases of the Nervous System
Authors: Gibson F. W.
Published: February 2018

Case 1.—S. E—, female. Admitted Jan. 22, 1866. Tried for wounding, with intent to murder, Dec, 1865. Found insane. She lived in a cellar with her husband and child. From the evidence given at the trial and from her own account, it appears that she wounded her child slightly with a razor in order to frighten her husband, who had treated her with great cruelty, into better behaviour. After she had been taken into custody it was found that “her mind was much shaken, and that she was the subject of delusions.”
A few Observations on the Treatment of a Certain Class of Destructive Patients, as pursued at the Colney Hatch Asylum
Authors: Christie Thomas Beath
Published: February 2018

I quite feel with the Superintendent of Colney Hatch Asylum, as he has said in his first paper, that a “dispassionate consideration of a subject” is the best course to pursue when seeking after “Truth.” Unhappily, stung and provoked by a reply, emanating from a gentleman who, though only an “assistant” physician, has evinced a fitness to attain a higher position, he has soon forgotten the position he started to uphold, and has launched out into an invective that is scarcely to be wished for in the pages of a Journal that lays claim to a scientific character.
On Aphasia or Loss of Speech in Cerebral Disease
Authors: Bateman Frederic
Published: February 2018

Aphasia is the term which has recently been given to the loss of the faculty of articulate language, the organs of phonation and of articulation, as well as the intelligence being unimpaired. The pathology of this affection is at the present time the subject of much discussion in the scientific world; the French Academy devoted several of their séances during the year 1865 to its special elucidation, and the Medical Journals of France and of our own country have lately contained a good deal of original matter bearing upon this obscure feature in cerebral pathology.
I. American Psychological Literature
Authors: Nicol Patrick
Published: February 2018

American Journal of Insanity, vol. xxv. July, 1868, to April, 1869.

October, 1868. No. 11.—“ Insanity and its Relations to Medicine by John Gray, M.D., &c. “History and Philosophy of Medical Jurisprudence,” by John Ordronaux, Professor of Medical Jurisprudence in Columbia College. “Last Wills-Unsound Mind and Memory.” “A Lecture on Gastric Epilepsy,” by G. E. Paget, M.D. “Case of Compound Fracture of the Skull, with Recovery,” by Edwin Hutchinson, M.D. BIBLIOGRAPHICAL: English Psychological Literature. Sltmma1'y: Obituary; “ Epileptiform Convulsions, following a Blow on the Head;” “Case of Epilepsy connected with Vesical Calculus, cured by Lithotomy.”., Thinking, Doing, Feeling.”
A Recent Trial for Murder
Authors: Needham Frederick
Published: February 2018

The circumstances of this case appear to me to be so interesting, in a psychological aspect, that I venture to place them at some length before the readers of the Journal.
The New Metropolitan Asylums
Authors: F. P.
Published: February 2018

In June, 1867, a new era was begun in the Poor Law system by Mr. Gathorne Hardy's Bill, which comprised arrangements for meeting the epidemic requirements of London, and for relieving the workhouses and lunatic asylums of the imbecile, idiotic, and chronic patients, not dangerous or destructive, but quiet in their habits, leaving behind merely the infirm poor and the acute and violent lunatics, for whom the accommodation was thought sufficient. There was also another clause providing a bevy of dispensaries, which however has not been carried out, though it was probably one of the most promising parts of the Bill. As regards the arrangements for epidemics, recent events have shown them to be inadequate; it must be said, however, that in 1867 the idea of meeting visitations of severe epidemics by temporary structures was not even in its infancy, otherwise we might have been spared such structures as Stockwell and Homerton Hospitals, which will never be filled or even half-filled in times of ordinary public health, and which are too small for great emergencies. A rapidly expansive system, as by temporary hospitals or by tents, capable of enlargement and of folding up and packing away when done with, is the proper plan for treating epidemics. What then is the proper one for quiet lunatics and imbeciles ?
The Study of the Human Mind from a Physiological View
Authors: Wilks Samuel
Published: February 2018

The scientific method of studying the phenomena of the human mind by founding it on a physiological basis, and thereby tracing the cerebral functions through the lower animals and uncultivated man, according to the plans adopted in other physiological investigations, must necessarily tend to modify or even change much that is contained in our received systems of psychology. In the hands of such men as Darwin and Huxley, the comparative method, when worked out in all its truthfulness, must necessarily bear good fruit, and be unaffected by any of the bias which the purely metaphysical method of the schools is apt to give to the investigation. The objection that it is degrading to compare the human being with the lower animals, or to take mankind in the mass, is of no value to the scientific investigator, who is merely seeking after truth, and knows that no researches of his can in any way affect man's history in the past or for the present; although they may afford many explanations of human conduct.
Necrophilism
Authors: Browne W. A. F.
Published: February 2018

The subject of cannibalism cannot be omitted from such an inquiry. The consideration of this revolting instinct and practice becomes imperative because there are grounds, derived both from history and psychology, for believing that cannibalism, either as a primitive or corrupted instinct, has at one time or other been universally prevalent, has characterised certain states or stages in the progress of every race. This proposition does not exclude the existence, either originally or in certain stages of progress, of purely vegetarian nations. We are so accustomed to regard modern communities in their civilised and mature condition, and in the same manner as the ancients fabled Minerva starting from the front of Jove, perfect, graceful, armed, that we forget that nations had beginnings, that their growth was from a mist or a myth which we cannot grasp, or that they emerged from barbarism so gross and degraded that we can scarcely realise its enormity. It would be a vain and futile task to establish by reference the proposition that a craving for human flesh, or, at all events, its use as food, preceded the habits and manners of civilised life, and we shall confine the allegation to our own progenitors as conveying a lesson at once to our pride and to our philosophy. Montalembert, after eloquently painting the striking and pleasing contrast between the aspect and social state of the west of Scotland, between 412 and 1867, perhaps the very spot in which these words are now written, says “Dion, Strabonius, St. John Chrysostom, and St. Jerome have emulated each other in painting the horrible cruelty, the savage and brutal habits of those inhabitants of North Britain, who, successively known under the name of Caledonians, Scots, or Picts, were most probably nothing more than the descendants of the British tribes whom Rome had not been able to subdue. All agree in denouncing the incestuous intercourse of their domestic existence, and they have even been accused of cannibalism.”
The Hallucinations of Mahomet and Others
Authors: Ireland William W.
Published: February 2018

To one who does not admit the divine mission of Mahomet it is very difficult to explain the pretensions of that remarkable man, and at the same time to uphold his sincerity. There have undoubtedly been instances where mere politicians have resorted to religious impostures as temporary expedients to advance their ends; for example, the woman whom Pisistratus got dressed up in the traditional costume of Pallas, and who conducted him back to Athens from exile, or the milk-white hind which followed Sertorius in Spain, and by means of which he was reputed to hold converse with the Gods. But a contrivance of this kind is a very different thing from the foundation of a religion which now numbers about a hundred and forty millions of votaries, and which possesses to this day a very singular power over the minds of its followers. By the persistent claim of being a messenger from God, after a struggle of twenty-one years Mahomet made himself master of the greater part of Arabia, and roused a mighty religious movement which continued after his death. In a few years more a number of wandering tribes, who had previously no more cohesion than the sands of their deserts, had run a mighty career of conquest, which bore them to the banks of the Loire and of the Oxus. It is generally admitted that men cannot excite in others feelings which are wanting in their own breasts. A man without honesty and destitute of religious faith could no more found a religious system like that of Islam than a man without an ear for music could compose an opera. The old notion that Mahomet was a mere impostor appears so difficult of belief that no one of any recognised skill in historical inquiry now upholds it. But it has always been a great difficulty to explain how Mahomet could in good faith say that he had seen the angel Gabriel, and heard voices from heaven calling him the Messenger of God, and revealing chapter after chapter of the Koran. It had long seemed to me that the question was beyond human solution, and that it might have been a very difficult one, even had the inquirer lived in Mecca or Medina during the time of Mahomet's mission.
Hallucinations in General Paralysis of the Insane, especially in Relation to the Localization of Cerebral Functions
Authors: Mickle Wm. Julius
Published: February 2018

In the following cases, visual or auditory hallucinations, or both, were more or less vivid and persistent. First the visual, and then the auditory, will be considered, together with the lesions of the respective supposed cortical centres.
Mental Experts and Criminal Responsibility
Authors: Tuke D. Hack
Published: February 2018

I wish in the first instance to lay clearly down what are the objects to be attained in regard to alleged insanity in criminal cases; in the second place I shall speak of what is the course pursued in England to reach those ends, and point out its inadequacy and inconvenience; and, thirdly, I shall suggest certain modifications, or rather radical changes in our present system, which I submit will act beneficially in securing the objects I lay down as those we ought to have in view. I am not, of course, speaking here of the duties of the Expert; his rôle is much more limited in its range; but I am placing myself in the position of one who heartily desires to answer the question: Can the present method of ascertaining Criminal Responsibility in our Courts of Law be improved ?
The Use of Atropine as a Sedative
Authors: Gasquet J. R.
Published: February 2018

The high place assigned by Dr. Ringer to atropine as a sedative and hypnotic has lately suggested to me to try it in the cases which are so much relieved by hyoscyamine. My experience has so far been too limited to pronounce definitely on its value; but it may be sufficient to induce other observers with more ample opportunities to give it a trial, and come to some definite conclusion as to its value. I have given it only in three cases: two of chronic mania with considerable violence and destructiveness, and the third of chronic insanity, characterised by vivid terrifying auditory hallucinations, which caused constant screaming and excitement. All three had been previously treated with hyoscyamine, and with the result of greatly quieting them. Two have now been taking the atropine for three months, and one for two months, in doses I shall presently mention, with occasional intermissions to test the action of the remedy. Comparing its action with hyoscyamine, it seems to me that it is less powerful than that alkaloid. The patients are less completely subdued and helpless: there are occasional outbursts of violence and excitement, though by no means so great as when atropine is not taken. Its effects seem to pass off more quickly, so that it needs to be given two or three times in the twenty-four hours. On the other hand, the patients are decidedly in a more natural and healthy condition; there is less stupor, oppression, and heaviness than under hyoscyamine. The pupils need generally not be dilated, but there is often much dryness of throat before the dose is reached, which quiets the patient. I ordered a solution of atropine in glycerine, of the strength of the liquor atropiæ P.B., on account of the risks from evaporation of the officinal preparation. I began with m. ij of this in each case, and have now pushed it in two cases to m x, and in the third to m vj twice a day. One case I treated for a while with belladonna, giving 3j of the tincture; but the atropine seems more uniform and convenient, especially as it can be administered without the patient's knowledge if necessary. I may remark that hyoscyamine is about fifteen times the price of atropine, which would be a matter of some importance in a large practice, if the action of the two drugs is not very different. I regret that I have had no acute case in which the alkaloid might be suitably tried since its use occurred to me. It might be worth trying whether the persistent use of atropine in full doses might not be useful as a curative agent in chronic mania, as it has sometimes been found to cure that cognate neurosis, exophthalmic goitre.