bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterizing Large-Scale Meteorological Patterns and Associated Temperature and Precipitation Extremes over the Northwestern United States Using Self-Organizing Maps
Authors: Loikith Paul C. , Lintner Benjamin R. , Sweeney Alex
Published: January 2017

The self-organizing maps (SOMs) approach is demonstrated as a way to identify a range of archetypal large-scale meteorological patterns (LSMPs) over the northwestern United States and connect these patterns with local-scale temperature and precipitation extremes. SOMs are used to construct a set of 12 characteristic LSMPs (nodes) based on daily reanalysis circulation fields spanning the range of observed synoptic-scale variability for the summer and winter seasons for the period 1979–2013. Composites of surface variables are constructed for subsets of days assigned to each node to explore relationships between temperature, precipitation, and the node patterns. The SOMs approach also captures interannual variability in daily weather regime frequency related to El Niño–Southern Oscillation. Temperature and precipitation extremes in high-resolution gridded observations and in situ station data show robust relationships with particular nodes in many cases, supporting the approach as a way to identify LSMPs associated with local extremes. Assigning days from the extreme warm summer of 2015 and wet winter of 2016 to nodes illustrates how SOMs may be used to assess future changes in extremes. These results point to the applicability of SOMs to climate model evaluation and assessment of future projections of local-scale extremes without requiring simulations to reliably resolve extremes at high spatial scales.
The Role of Low-Level, Terrain-Induced Jets in Rainfall Variability in Tigris–Euphrates Headwaters
Authors: Dezfuli Amin K. , Zaitchik Benjamin F. , Badr Hamada S. , Evans Jason , Peters-Lidard Christa D.
Published: January 2017

Rainfall variability in the Tigris–Euphrates headwaters is a result of interaction between topography and meteorological features at a range of spatial scales. Here, the Weather Research and Forecasting (WRF) Model, driven by the NCEP–DOE AMIP-II reanalysis (R-2), has been implemented to better understand these interactions. Simulations were performed over a domain covering most of the Middle East. The extended simulation period (1983–2013) enables us to study seasonality, interannual variability, spatial variability, and extreme events of rainfall. Results showed that the annual cycle of precipitation produced by WRF agrees much more closely with observations than does R-2. This was particularly evident during the transition months of April and October, which were further examined to study the underlying physical mechanisms. In both months, WRF improves representation of interannual variability relative to R-2, with a substantially larger benefit in April. This improvement results primarily from WRF’s ability to resolve two low-level, terrain-induced flows in the region that are either absent or weak in R-2: one parallel to the western edge of the Zagros Mountains, and one along the east Turkish highlands. The first shows a complete reversal in its direction during wet and dry days: when flowing southeasterly it transports moisture from the Persian Gulf to the region, and when flowing northwesterly it blocks moisture and transports it away from the region. The second is more directly related to synoptic-scale systems and carries moist, warm air from the Mediterranean and Red Seas toward the region. The combined contribution of these flows explains about 50% of interannual variability in both WRF and observations for April and October precipitation.
The Impact of Ocean Surface Currents on Sverdrup Transport in the Midlatitude North Pacific via the Wind Stress Formulation
Authors: Yu Zhitao , Metzger E. Joseph , Fan Yalin
Published: January 2017

A more complete wind stress τn formulation takes into account the ocean surface currents Vo, while the conventional wind stress τc popularly used in ocean circulation models is only a function of 10-m winds V10. An analytical solution is derived for the difference of Sverdrup transport induced by using τn instead of τc. A scaling analysis of the analytical solution indicates a 6% reduction of the Sverdrup transport in the North Pacific (i.e., the Kuroshio transport in the East China Sea) when Ekman velocity dominates the ocean surface currents. Because of the quadratic nature of wind stress, four nonlinear terms contribute equally to this difference: two vorticity torque terms and two speed gradient torque terms. A pair of 12.5-yr (July 2002–14) Hybrid Coordinate Ocean Model simulations that only differ in the wind stress formulation are used to test the analytical solution. The model results (2004–14) confirm that using τn instead of τc reduces the Sverdrup transport in the North Pacific by 8%–17% between 23° and 32°N. The reduction rate of the simulated 11-yr mean Kuroshio transport through the East Taiwan Channel and Tokara Strait is 8.0% (−2.5 Sv; 1 Sv ≡ 106 m3 s−1) and 12.8% (−4.8 Sv), respectively, in good agreement with the Sverdrup transport reduction rate, which is 7.4% (−2.6 Sv) and 15.4% (−6.3 Sv) at the corresponding latitude. The local effect of changing wind stress/wind work and Ekman transport due to the inclusion of Vo in the wind stress formulation is negligible compared to the Kuroshio volume transport change estimated in this study.
A Case of Premenstrual Distress: Bisexual Determinants of a Woman's Fantasy of Damage to Her Genital
Authors: Renik Owen
Published: January 2017

Case material is used to illustrate specific clinical application of the concept of primary femininity. Some contemporary contributions to the psychoanalytic theory of female psychosexual development are presented as complementary with, rather than contradictory to, more familiar, longstanding formulations that emphasize phallic strivings in women. In the clinical example reported, a fantasy of genital damage underlay a woman's premenstrual distress. Aspirations and concerns related to both aspects of her fundamental bisexuality participated in symptom formation and had to be investigated in order to achieve symptom relief. As the analytic work unfolded, it could be seen that the patient's awareness of her feminine aims served to keep her masculine aims out of awareness, and vice versa.
Novel Method for Laryngotracheal Reconstruction: Combining Single- and Double-Stage Techniques
Authors: Setlur Jennifer , Maturo Stephen , Hartnick Christopher J.
Published: January 2017

Objectives:

Traditional open techniques for laryngotracheal reconstruction are either single- or double-stage procedures. Some patients may benefit from the presence of a long, single-tube stent, such as an endotracheal tube, but their predicted need for a 2-stage procedure and a persistent tracheostomy is high. We describe a novel technique for airway reconstruction that combines the methods of both single- and double-stage procedures.

Methods:

We present a retrospective review of 4 patients. All patients underwent laryngotracheal reconstruction by a single surgeon. After the operation, the airway was stented with nasotracheal intubation. A small stent, fashioned from an endotracheal tube, was placed in the tracheostoma to keep it patent. The patients subsequently underwent extubation and replacement of the tracheostomy tube.

Results:

The study included 1 patient with grade 4 subglottic stenosis, 2 patients with grade 3 subglottic stenosis, and 1 patient with a posterior glottic scar. All were tracheostomy tube-dependent. Serial bronchoscopy was used to follow the patients for a minimum of 9 months after the operation. All 4 patients have since met the criteria for decannulation.

Conclusions:

This hybrid reconstruction merges the advantages of both the single- and double-stage procedures. It adds versatility to the surgical toolbox for airway reconstruction.
Chronic Secretory Otitis Media: Effects of Surgical Management
Authors: Gates George A. , Cooper J. C. , Avery Christine A. , Prihoda Thomas J.
Published: January 2017

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.
Bureaucrats, Cattle, and Public Policy
Authors: Picard Louis A.
Published: January 2017

The formulation of a policy on land use offers a clear example of the relationship between a bureaucracy and policy formulation. In much of the Third World, and particularly in many African countries, national and local government employees are to all intents and purposes the dominant socioeconomic elite in the country. This would suggest that those who are formulating and implementing a new policy such as that on land use may have the most to gain from the policy which is under examination.

Using data from the Southern African country of Botswana, this article examines the relationship between the socioeconomic status of the bureaucracy and the type of land tenure policy which is likely to result. Since the movement from communal to individual tenure of both grazing land and farm land is occurring throughout the African continent, the relationship between bureaucratic interests and public policy is of general interest beyond this specific case study.
The Role of the Medical Examiner in the Euthanasia Notification Procedure in the Netherlands
Authors: Cuperus-Bosma Jacqueline M , Van Der Wal Gerrit , Kostense Piet J , Van Der Maas Paul J
Published: January 2017

The objective of the study was to provide an insight into the role of the medical examiner in the euthanasia notification procedure in The Netherlands.

At the beginning of 1996 a representative group of 116 medical examiners was interviewed. The study found that there was a considerable variation in the way in which the medical examiners fulfilled their tasks. In all cases, after the physician-assisted death had taken place, the medical examiner investigated whether the attending physician had met the requirements for prudent practice, and in approximately 75% of the cases he reported his findings to the Public Prosecutor. In 78% of cases the attending physician was well known to the medical examiners, who were general practitioners, and in a third of the cases this influenced their assessment. Seventy-six per cent of the medical examiners, 61% of the members of the public prosecution and 47% of the physicians thought that it is the task of the medical examiner to review whether the requirements for prudent practice have been met by the attending physician.

In conclusion, further specification of the task of the medical examiner would appear to be beneficial to increase uniformity in the procedure. In particular, it should be determined whether it is the medical examiner's responsibility to review whether the requirements for prudent practice have been met. It should also be taken into consideration whether the position of the general practitioner medical examiner is sufficiently independent to make an objective report.
2. A Fatal Nail Gun Injury — An Unusual Ricochet?
Authors: Nadesan Kasinathan
Published: January 2017

An 18-year-old construction worker suddenly collapsed while handling a power-actuated nail gun and died shortly after. A neat, almost circular puncture wound was found on the front of his left chest. No fire-arm residues were detected on the surrounding skin. The police stated that it was an accidental injury, at a construction site, where a nail fired from a nail gun by the deceased had deflected off the wall and struck him on the front of the chest. Since the entry wound appeared to be a neat hole, and that too on the front of the left chest overlying the heart area, there was reluctance on the part of the pathologist to accept it as an accidental injury due to a ricochet. A visit to the scene, interrogation of witnesses, examination of the alleged tool and post-mortem X-ray of the deceased were undertaken prior to autopsy. A bent nail was found in the heart. The scene visit and the subsequent autopsy revealed that the nail took a roughly circular flightpath after it had struck the wall, all the while travelling with its pointed end directed forward. Within the body too, the nail maintained the same path.

Various medicolegal issues are discussed pertaining to nail-gun injuries. The importance of a visit to the scene, examination of the alleged tool, interrogation of witnesses and the X-ray of the body, all prior to autopsy, are emphasized. The conclusion was: accidental death due to the unusual ricochet of a nail.
A Controlled Trial of Iron Therapy in Sideropenia
Authors: Morrow J. J. , Dagg J. H. , Goldberg A.
Published: January 2017

It has been shown that there is a high incidence of latent iron deficiency (sideropenia) in the female population. To assess the role of this deficiency as a cause of symptoms a double blind trial of iron and placebo therapy was carried out on 20 sideropenic women presenting with symptoms.

The incidence of all the symptoms studied fell and there was no significant difference between iron and placebo in producing improvement.

A significant rise in haemoglobin level occurred only in response to iron therapy and this was reversed on cessation of iron. No significant changes in haemoglobin occurred in response to the placebo.

It has been concluded that while iron has no specific effect on the symptoms associated with sideropenia, it will produce a significant rise in haemoglobin level, reverse biochemical defects and, in a minority, prevent development of iron deficiency anaemia.
The Influence of Predominant Cell Type on the Management and Prognosis of Bronchial Carcinoma
Authors: Le Roux B. T.
Published: January 2017

Of 4,000 patients with bronchial carcinoma, the histology of the tumour was known in all but 5.8 per cent; nearly 48 per cent of tumours were squamous; 40 per cent were undifferentiated; 5 per cent were adenocarcinomata; in 17 patients the tumour was an alveolar cell carcinoma; in 56 patients submitted to exploratory thoracotomy the histology of the tumour was mixed. More than half the patients with adenocarcimoa and alveolar cell carcinoma were surgically managed.

Mediastinal glandular metastases from squamous or undifferentiated carcinoma demonstrated after pulmonary resection, did not preclude long survival. Operative mortality after pneumonectomy was relatively highest in those with an adenocarcinoma. There was evidence at necropsy of distant spread in more than 80 per cent of patients who died in the early post-operative period after pneumonectomy. One in every 3 patients who died from metastases in the first 2 years after pneumonectomy died with cerebral metastases.

Lobectomy in 65 per cent of patients was for squamous carcinoma, and was only slightly more common for undifferentiated carcinoma (18%) than for adenocarcinoma (15%). Long survival after lobectomy for squamous or undifferentiated carcinoma with glandular metastases was not uncommon.

Bronchial carcinoma in patients who presented without symptoms and with an abnormal routine chest radiograph was most often squamous, peripheral in type, and small. In this group the rate of resectability and of long survival were high and operative mortality was small.

A third of the patients with bronchial carcinoma, who denied ever having smoked, had squamous tumours. The incidence of adenocarcinoma in women, and those with hypertrophic pulmonary osteoarthropathy, was significantly higher.

The incidence of resectability with long survival in a small group of patients with alveolar cell carcinoma was surprisingly high.
Haemodynamic Effects of Different Beta Blockers in Angina Pectoris
Authors: Åström H. , Jonsson B.
Published: January 2017

Beta-blocking agents with partial agonist activity seem to reduce heart rate at rest slightly less than those without this property. Cardio-selective drugs have no effect on stroke volume at rest contrary to the non-selective ones which will reduce it somewhat. This difference is abolished during exercise. The only difference seen during work between different beta-blockers is the effect on the peripheral vascular resistance. The selective drugs lower the arterial pressure with unchanged resistance.
Flaccid Quadriparesis Due to Salmonella Enteritis
Authors: Reid Alison C. , Draper I. T.
Published: January 2017

A case of profound myopathy due to electrolyte disturbances secondary to salmonella enteritis is reported. The relationship between hypomagnesaemia, hypocalcaemia and parathyroid hormone secretion is also demonstrated.
Do Anticonvulsant Drugs Commonly Induce Osteomalacia?
Authors: Fogelman I. , Gray J. M. B. , Gardner M. D. , Beastall G. H. , McIntosh W. B. , Allam B. F. , Boyce B. F. , Boyle I. T. , Lawson D. H.
Published: January 2017

Twenty adult epileptic out-patients who had received anticonvulsant therapy for a mean duration of 15 years were assessed for clinical, biochemical, radioisotopic and bone biopsy evidence of osteomalacia. Occasional biochemical abnormalities were demonstrated but no individual subject was found to have osteomalacia. There is increasing evidence to cast doubt on the existence of a strong relationship between anticonvulsant drugs and osteomalacia. This evidence is reviewed and it is concluded that in the presence of adequate sunlight exposure anticonvulsant therapy alone is most unlikely to lead to osteomalacia in adults.
Severe Psychological Disturbance Resulting from Abuse of Nasal Decongestants
Authors: Blackwood G. W.
Published: January 2017

A case is reported in which a lady suffered long-term personality change, a paranoid psychosis of several months duration, and an acute delirium, secondary to abuse of Vicks Sinex Nasal Spray and Vicks Vaporub. The problems were reversible on withdrawal of these well used products which have not previously been reported to cause psychological distrubance.
Some Medical Aspects of the Darien Scheme: Was it Dengue?
Authors: McSherry J. A.
Published: January 2017

An account of an illness suffered by a Scots colonist on Darien in 1699 is reviewed and thought to describe Dengue.

The earliest description of Dengue was previously thought to have been published in 1780.
Use of a Radiometric Technique for Rapid Sensitivity Testing of Mycobacteria in Scotland: The First Year's Experience
Authors: Rayner A. , Harris G. , Croughan M. , Watt B.
Published: January 2017

We report the first year's experience of the use of a radiometric technique for sensitivity testing of mycobacterial isolates in Scotland. The techniques (using the Bactec 460 instrument) was much quicker than conventional methods (for example the mean time to obtain results for 60 strains of M.tuberculosis was 14.4 days, compared with 44.9 days for conventional methods). There was good agreement between results obtained by the two methods. Preliminary results also indicated the value of the radiometric technique for rapid isolation of mycobacteria from clinical samples (mean of 10.6 days with the radiometric technique compared with 26.7 days using egg media) although for optimal recovery, both techniques should be used in parallel.
A Psychiatric Liaison Service in a General Hospital Referrals and Their Appropriateness
Authors: Hall D.J.
Published: January 2017

Referrals to a liaison psychiatry service, based in a District General Hospital, were studied over a six month period. 190 [89%] of the 214 referrals were for assessment following an episode of deliberate self harm. An excess of these referrals were male [57%] and a large proportion particularly of the males [36%] were diagnosed as having a significant alcohol problem. Many were felt to have no significant psychiatric problem [31%], and a large proportion were discharged with no psychiatric follow-up [28%]. Patterns of diagnosis and disposal differed between the sexes. Referring junior medical staff when asked to give their opinions on the likely management and overall need for psychiatric referral of patients were found to reach reasonable agreement with the assessing psychiatrist, even without prior training, and to be more cautious in their assessment. In many centres the trend is towards selective referral of deliberate self harm patients, and this appears a safe and appropriate development which can be achieved without intensive training or major alterations to working patterns, and which will result in modest but important reductions in inappropriate referrals.
A Medical Audit and Patient Survey of Hysterectomies Performed for Menstrual Disorders
Authors: Roberts R.N. , Norman B.P. , Harrison C.G. , Heaton N.R. , Law J.K. , Wadehra V. , Younger H.M. , West C.P
Published: January 2017

The aim of the study was to carry out an audit of 283 hysterectomies performed for menstrual disorders over a one year period, and to determine the satisfaction of the women concerned towards their treatment. The medical records of these patients were examined, and they were each sent a questionnaire, 69% of which were completed and returned. The most common presenting symptoms were menorrhagia and dysmenorrhoea. In 53% of cases no clinical abnormality was postulated and in 31% of cases no pathological abnormality was found. The preoperative clinical and pathological diagnoses were in agreement for 59% of patients. Over 90% of women were satisfied with the management of their case by their GP and the gynaecology outpatient clinic. The use of patient-controlled analgesia systems was associated with better post-operative pain relief than intramuscular injections. Thirteen percent of patients required blood transfusion; 21% suffered some form of postoperative complication, most of which were minor. Ninety-four percent of the women were pleased that they had undergone hysterectomy, and 76% wished that they had had the operation sooner. It was concluded that hysterectomy is perceived positively by patients and should not necessarily be considered as a last resprt treatment for menstrual disorders.
Golf Related Head Injuries in Children: The Little Tigers
Authors: McGuffie A.C. , Fitzpatrick M.O. , Hall D.
Published: January 2017

Head injury is a major cause of morbidity in Western society and sport related incidents account for approximately 11% of all head injured patients attending Accident and Emergency Departments. 1 Golf was shown to be one of the sports most commonly associated with head injury requiring referral to a regional neurosurgical centre.2 Previous studies have demonstrated that it is predominantly children who sustain golf related head injuries which present either to an accident and emergency department3 or a regional neurosurgical centre.2 This study examines the number and pattern of golf related head injuries in children presenting to an accident and emergency department or requiring admission to the regional neurosurgical centre, over a three month period.
Blood Ordering Practices in Elective and Emergency Surgical Procedures
Authors: Patel R.S. , Richardson J.P. , Tait C. , Anderson J.R.
Published: January 2017

A retrospective study of preoperative blood ordering practices for 20 commonly performed elective and emergency general surgical procedures was carried out in a Glasgow teaching hospital. It was found that 50.6% of cross-matched blood was returned unused. This practice contributes to the wasteful outdating of blood held in cross match status but never used. As a result, the Minimum Blood Ordering Schedule has been developed to guide blood ordering in those operations where there is a realistic probability of transfusion (<30 %), and a group and screen is advocated for the remainder of procedures. In this way significant savings can be made in blood, laboratory technician's time and resources.
The Apparent Microheterogeneous Nature of the High-Sulfur Proteins of α-Keratins
Authors: Swart L. S. , Joubert F. J. , Strydom A. J. C.
Published: January 2017

The homogeneity of wool SCMK-B2 and mohair SCMK-B2, prepared according to the procedure of Gillespie, has been investigated. Moving boundary electrophoresis and gel filtration of the preparations revealed a single peak. Examination of the SCMK-B2 preparations by disc electrophoresis demonstrated the presence of various components. The preparations were each separated by chromatography on DEAE-cellulose into four subfractions. The aminoacid composition and tryptic peptide patterns of the subfractions were similar but certain characteristic differences were obvious.
Physiological Responses and Thermal, Humidity, and Comfort Sensations in Wear Trials with Cotton and Polypropylene Vests
Authors: Vokac Z. , Køpke V. , Keül P.
Published: January 2017

Relations were studied between skin temperature of the back as well as temperature and humidity inside clothing, and subjective estimates of thermal, humidity, and comfort sensations in 5 subjects wearing cross-country ski dress. The 2-h wear trials were performed in a climatic chamber at −2°C and simulated the actual circumstances under which such a dress is worn by alternating periods of intensive walking (20 min) on a treadmill with periods of resting (5–10 min). Each subject participated in 4 trials wearing alternately one of the 4 experimental, double-layer vests (double-cotton, cotton-polypropylene with cotton layer next to skin, same combination with polypropylene layer next to skin, double-polypropylene).

Skin temperature of the back was during the experiments systematically lower ( P<0.05) by about 1°C with the double-layer cotton vest than with the double-layer polypropylene vest. Since the physical parameters of the two fabrics were not identical, the findings cannot be definitely attributed to the inherently different properties of the fibers. No significant differences were found in the 4 experimental series either in other objective measurements (temperature and humidity of the microclimate, energy output, total amount of sweat, amount of sweat trapped in the vests) or in subjective estimates of thermal, humidity, and comfort sensations.

Gradual increase of skin temperature as well as of temperature and humidity (sweating) of the microclimate was recorded during walking periods. When walking was interrupted by a pause, both the temperature and humidity rose steeply, due to the cessation of bellows ventilation of the clothing, and fell again when walking was resumed. The thermal and humidity sensations on the back reported after the turning-points of the intermittent activity showed opposite direction of changes than those of the recorded parameters— i.e., decrease during pauses and increase after walking was resumed. It is possible that the perception of local sensations was affected by superimposed, central perception of changes in the amount of heat delivered from muscles to the brain receptors. The sensations of comfort seemed to be affected mostly by perception of “warmth” when walking and “cold” when resting.
Elastic Properties of Twisted Monofilaments
Authors: Żurek Witold , Cislo Romualda , Kowalska Ewa
Published: January 2017

Assuming that a twisted monofilament behaves like a twisted yarn, equations have been derived to predict the retraction of filaments when twisted and the strain remaining after loading has been removed. A comparison of experimental with calculated values shows the general applicability of the proposed equations.
Physical Chemistry of Crosslinking
Authors: Madan G. L. , Patel S. B. , Patel R. S. , Baddi N. T. , Mehta P. C.
Published: January 2017

Cotton fabrics were treated with different crosslinking agents under conditions found to be most favorable for chemiscrption of crosslinking molecules on cotton fibers. The effects of various factors such as period of chemisorption, temperature of drying and curing, concentration of crosslinking agents, pH, and nature of the catalysts on the physical properties of fabrics were investigated. The results show that chemisorption for a period of one hour is sufficient. Drying alone produces inferior properties of the fabrics compared to the fabrics which have been dried and cured. The results also indicate that the physical properties of the treated fabrics in the presence of sodium chloride are better than those obtained in the presence of magnesium chloride.
Limitations in Studying the Kinetics of Fabric Detergency
Authors: Schott Hans
Published: January 2017

The simplest expressions for the rate of removal of particulate soil from fabrics, including those for first-order kinetics, are described. Two factors militate against obtaining proportionality constants between a time function and a residual soil function which remain constant for long washing times, namely: redeposition, and heterogeneities in soil and fabric. Soil redeposition tends to lower the observed soil-removal rate. This effect can be eliminated by suitable experimental procedures. However, the inhomogeneities inherent in fabrics (fiber surface irregularities, variation in spaces between fibers and yarns) cause them to have sorption sites with a broad range of soil binding strengths. Variations in the size and shape of particles on artificial test fabrics and, for natural soil, in chemical composition as well, cause the particles to adhere to fabric substrates with bonds of different strengths. These heterogeneities produce a broad range of specific soil-removal rates whose values depend on the energies of adhesion of the particle-fabric complex. The most loosely held soil, with the highest removal rate constants, is washed off early so that the soil remaining on the fabric becomes progressively richer in the most tightly bound soil, with the smallest removal rate constants. Hence the average or observed rate constant for soil removal decreases during the washing process.
The Ideal Cotton-Fiber Strength and its Relation to Observed Strength, Maturity, and Fineness
Authors: Neelakantan P.
Published: January 2017

By taking into consideration the non-simultaneity of break of all fibers in a bundle, and also the uneven distribution of the applied load in a fiber, Lord's data on fiber fineness, maturity, and bundle strengths at zero and 1/8-in. gauge lengths on 37 cotton samples have been analyzed. It is shown that all cottons have the same ideal strength at these two gauge lengths, and that the zero and 1/8-in. gauge lengths are interrelated. It appears that the fiber fineness alone is able to account for the drop in strength as the gauge length increases to 1/8-in.
Belts in Open-End Yarns; Influence of Rotor Diameter and Statistical Distribution
Authors: Barella A. , Tura J. M. , Vigo J. P.
Published: January 2017

The influence of rotor diameter on separation between two successive belts, belt length, and belt nature were studied. It was concluded that when rotor diameter increases, both length of belt and belt separation increase, and the tightness of their coiling round the yarn core decreases. The study of statistical distributions of the considered parameters—belt separation, number of belts in a given length, and belt length—shows that the phenomenon follows the Gumbel law in the first case, the Poisson law in the second case, and the lognornal law in the third case.
Improving Immunization Coverage in Rural Areas of Ecuador: A Cost-Effectiveness Analysis
Authors: Sebastián Miguel San , Goicolea Isabel , Avilés Jaime , Narváez Mauricio
Published: January 2017

This study describes the costs and outcomes of two different immunization strategies used by the district level of the Ministry of Health carried out between 1993 and 1995 in Low-Napo area, Napo, Ecuador. One was centrally planned and managed by the District Hospital (DH) and the other planned and implemented together with community health workers (CHW). Immunization costs were estimated directly from survey records and communication of the Ministry of Health. Outcomes information was abstracted from the vaccination statistics of the Napo Province Health Department for 1993/1995. Community health workers strategy immunized 113 children with an average cost of US$32 per child. District Hospital strategy had an average cost of US$777.6 per immunized child. Thus, CHWs strategy is more effective and less costly than the DH strategy. This study shows that in order to maximize the cost-effectiveness of immunization, it is important to involve community participation in both planning and implementation. Continuous follow-up and evaluation of the immunization programme and further research on vaccine efficacy are necessary in order to maintain these results.
A Psychiatric Ward in an African District Hospital
Authors: van der Heide D H , Gernaat H B P E
Published: January 2017

In most African district hospitals there are no separate facilities for psychiatric patients. A former general medical officer describes how a ward for these patients was set up at a rural district hospital in Zimbabwe using the already available resources. The effects on the psychiatric care at the hospital and the district are illustrated by two case reports. It is concluded that psychiatric care integrated in primary healthcare, with due regard for the cultural aspects and with cooperation of local healers is feasible, provided that it is supported by additional diagnostic and treatment facilities at the district hospital.
Risk Factors for Severe Pneumonia in Children in Basrah
Authors: Hassan Mea'ad Kadhum , Al-Sadoon Imad
Published: January 2017

A case-control study was undertaken in Basrah Maternity and Children Hospital, Iraq. We studied 148 children who were admitted to hospital with severe pneumonia according to the World Health Organization (WHO) criteria and the controls were 250 children attending the out-patient department for non-severe respiratory infections. Significant risk factors were younger age (2–6 months), low parental education, smoking at home, prematurity, weaning from breast milk at <6 months, a negative history of diphtheria, pertussis and tetanus vaccination, anaemia and malnutrition.
Slow Improvement of Clinically-Diagnosed Dengue Haemorrhagic Fever Case Fatality Rates
Authors: Magpusao Nelma S , Monteclar Alan , Deen Jacqueline L
Published: January 2017

Dengue haemorrhagic fever (DHF) is recognized as a leading cause of hospitalization and death among children in many Southeast Asian countries. This study reviews the case fatality rates of DHF cases admitted to a referral hospital in Cebu (Philippines) over the past 5 years.

Information on patients 14 years old or younger admitted from 1 January 1997 to 31 December 2001 with the final clinical diagnosis of DHF was collated and analysed. Case fatality rates were compared before and after a standardized management protocol was implemented by the healthcare staff and after introduction of revisions to that protocol. The case fatality rate during the 2-year periods prior and after introduction of the management protocol decreased significantly from 197/2644 (7.45%) to 39/1182 (3.30%) ( P<0.01). Following the introduction of revisions to the protocol, the case fatality was reduced even further to 52/1697 (3.06%) ( P=0.7).

In this government hospital the introduction of a standardized management protocol for DHF was associated with a significant improvement in the case fatality rate of hospitalized children with clinically diagnosed DHF. However, compared with reports from hospitals in other dengue-endemic countries, the improvement has been slow. Possible ways to decrease fatality rates further have been identified.
Morbidity and Mortality following Induced Abortion in Nnewi, Nigeria
Authors: Ikechebelu J I , Okoli C C
Published: January 2017

We present a study of the maternal morbidity and mortality among 76 patients treated at the Nnamdi Azikiwe University Teaching Hospital, Nnewi for complications of induced abortion from January 1996 to December 2000. The total number of maternal admissions over this period was 5750, and illegal induced abortion was responsible for 1.3% of the admissions, with a mortality rate of 5.3% ( n=4) for induced abortion. This accounted for 21.1% of the total maternal deaths ( n=19) for the period. The mean age of the women was 20.6 years (range 15–34 years), 94.7% ( n=72) were unmarried, 93.5% ( n=71) were nulliparous and 76.5% ( n=58) were unemployed, 67.1% ( n=51) had had a mid-trimester termination at > 13 weeks gestational age. It is significant that 55.3% of the patients were teenagers and 45.1% of the mid-trimester abortions occurred in this group. Genital sepsis, haemorrhage, pelvic infection with peritonitis and abscess formation, uterine perforation, and gut injury were the major complications encountered.

This study demonstrates that induced abortion is still a major cause of maternal mortality in Nigeria. Integrated family health education, planned parenthood and contraceptive education, a mass literacy campaign and improvement of the existing national health services are recommended in order to ameliorate the problems of illegally induced abortion in Nigeria.
Use of Cholera Beds in the Delivery Room: A Simple and Appropriate Method for Direct Measurement of Postpartum Bleeding
Authors: Strand Roland T , da Silva Florinda , Bergström Staffan
Published: January 2017

Abundant obstetric bleeding is a predominant cause of maternal death, with the immediate postpartum period being the most critical time. Visual estimation of postpartum haemorrhage (PPH) often leads to severe underestimation and delay in treatment. Various methods have been developed in order to measure blood loss accurately, but none has proved appropriate in poor settings. The aim of this study was to present a method which is appropriate for measuring postpartum blood loss in a setting with limited resources.

Parturient women ( n=814) with active management of third stage of labour in Luanda, Angola were studied. Vaginal bleeding immediately after birth and during the first 2 hours postpartum was collected using a combination of a plastic sheet and a bucket below a cholera bed, in which the women rested during postpartum observation. Monitoring postpartum blood loss in the same way as cholera patients are monitored for loss of stool fluid was found to be a useful and practical way of measuring haemorrhage of parturient women after childbirth. The method described here is simple and appropriate, which makes it a good alternative to more costly methods in detecting and quantifying PPH.
Value of Fibreoptic Oesophago-Gastro-Duodenoscopy: Experience with 4000 Procedures at Kilimanjaro Christian Medical Centre, Moshi, Tanzania
Authors: Missalek W , Jones F , Mmuni K , Cutinha P
Published: January 2017

The paper presents the results of a retrospective study and the experiences with 4000 fibreoptic oesophago-gastro-duodenoscopies (EGD), which were performed at Kilimanjaro Christian Medical Centre (KCMC) between 1985 and 1989 in an open access service. Seventy per cent of all patients examined had abnormal findings with duodenal ulcer as the most frequent diagnosis (22%). Pyloric stenosis was seen in 6%, gastric ulcer in 5% and esophageal varices in 4% of all patients. High figures were found for carcinoma of the esophagus (4%) and malignancy of the stomach (5%). Gastritis was diagnosed in 11%.

We consider fibreoptic EGD a cost effective and appropriate technology. Because of its high diagnostic yield, we advocate its use in certain centres in developing countries.
Complications of Methods of Fracture Treatment used by Traditional Healers: A Report of Three Cases Necessitating Amputation at Ihiala, Nigeria
Authors: Ofiaeli R O
Published: January 2017

Three fracture cases treated by immobilization with bamboo sticks by traditional bone setters ended up with amputation in a rural hospital, two for gangrene and the third for diaphyseal sequestration. Venous occlusion, followed by interruption of arterial blood supply and immobilization in a dependent position are responsible for the gangrene. Overwhelming sepsis accounted for diaphyseal sequestration in the third patient.

These cases illustrate the need for more emphasis to be placed on primary surgical care, centred on rural hospitals, in the developing world.
Ectopic Pregnancy in Korle Bu Teaching Hospital, Ghana: A Three-Year Review
Authors: Baffoe Sarah , Nkyekyer K
Published: January 2017

A retrospective study of ectopic pregnancies seen in Korle Bu Teaching Hospital from January 1991 to December 1993 was conducted. The incidence was 39.5/1000 deliveries; patients with ectopic were not of lower parity than those with normal pregnancies. The incidence of historical predisposing factors was 11.08%, although findings at operation indicated a much higher incidence of previous pelvic inflammatory disease (PID). Dizziness/fainting and abdominal distension were more frequent than has been reported elsewhere. This was due to a very high incidence of ruptured ectopic pregnancies (98.1%) with mean volume of haemoperitoneum of 1.37 1. 16.3% of patients were misdiagnosed initially. The second commonest site of tubal pregnancy, after the ampullary region, was cornual. The case fatality rate was 27.9/1000, with more than half of the deaths occurring before or soon after arrival in hospital. In order to reduce the incidence of ruptured ectopic pregnancies we suggest, among other measures, that appropriate diagnostic facilities be provided.
International Criminal Prosecution of Physicians: A Critique of Professors Annas and Grodin's Proposed International Medical Tribunal
Authors: Meier Benjamin Mason
Published: January 2017

Society benefits from physicians who seek truth and healing for the good of humanity. Despite ethical admonishments to “do no harm,” however, physicians have caused some of the most appalling human rights abuses of the twentieth century. Physicians, alone or in concert with the state, have willfully abused their medical knowledge and debauched their profession in furtherance of human rights violations. Compounding their crimes, physicians often have been complicit in following oppressive regimes in abusive practices against their citizens. Ironically, it is their knowledge of this healing art that allows physicians to take part in this injurious conduct; and it is this knowledge that states seek to harness in buttressing violative policies. In fact, for nations bent on violating human rights, it is “much easier for governments to adopt inherently evil and destructive policies if they are aided by the patina of legitimacy that physician participation provides.”
What Lies Beneath: An Examination of the Underpinnings of Dietary Supplement Safety Regulation
Authors: Ziker Dana
Published: January 2017

In response to the increasing attention to the link between health and nutrition, a wealth of information—and misinformation—is becoming available, especially via the Internet. Consumers are advised to carefully assess the reliability of information they use to determine whether a product is safe. Meanwhile, regulators are sorting out the facts themselves, but despite the ever-increasing availability of scientific research, our evolving understanding of nutrition is still supplemented by our perceptions about risk.

The primary framework for the regulation of dietary supplements is the Dietary Supplement Health and Education Act of 1994 (“DSHEA”). Underlying DSHEA is the congressional intent to support two goals: “(1) to facilitate consumer access to dietary supplements, given that many dietary supplements are used by consumers to help them maintain and improve their health; and (2) to give the Food and Drug Administration (“FDA”) the authority to step in where safety problems arise and to ensure proper labeling.”
Functional Foods: What are They? How are They Regulated? What Claims Can Be Made?
Authors: Hahn Martin
Published: January 2017

Scientific studies continue to establish a strong relationship between constituents in foods and dietary supplements and certain diseases. The general population is inundated on a seemingly daily basis by media reports of new studies showing that a food or dietary supplement is useful in treating particular diseases or reducing the likelihood that a consumer will develop particular diseases. With increasing frequency, consumers are looking for foods and supplements to help manage and prevent the onset of disease.

Not surprisingly, the food and dietary supplement industries are responding by developing new products and repositioning old products efforts to help consumers manage their health. For example, yogurt used to be positioned only as a delicious component of a meal but now is also promoted for use in weight loss programs after a study showed that the calcium in dairy products is effective in weight loss.
Dietary Supplements: A Definition That is Black, White, and Gray
Authors: Onel Suzan
Published: January 2017

The Dietary Supplement Health and Education Act of 1994 (“DSHEA” or “the Act”) was a seminal event in the world of food and drug law. The Act took a controversial category of product traditionally regulated by FDA as either a food or a drug, depending upon the product claims and formulation, and created a new regulatory category called “dietary supplement” that was placed within the “food” definition. As such, products meeting the “dietary supplement” definition benefited in two significant ways, (1) dietary supplements could make “structure/function” claims traditionally within the realm of drug products; and (2) unlike food ingredients, dietary ingredients could be used in dietary supplements without being either approved food additives or generally recognized as safe (“GRAS”) ingredients. These legislative provisions significantly changed the legal, corporate, and consumer landscape, allowing products to enter the marketplace with broadbased claims without FDA premarket review or approval of the ingredients, formulation, or product claims.