bluuebunny/crossref_metadata_2025 huggingface dataset:
Lookit (Part 1): A New Online Platform for Developmental Research
Authors: Scott Kimberly , Schulz Laura
Published: January 2017

Many important questions about children’s early abilities and learning mechanisms remain unanswered not because of their inherent scientific difficulty but because of practical challenges: recruiting an adequate number of children, reaching special populations, or scheduling repeated sessions. Additionally, small participant pools create barriers to replication while differing laboratory environments make it difficult to share protocols with precision, limiting the reproducibility of developmental research. Here we introduce a new platform, “Lookit,” that addresses these constraints by allowing families to participate in behavioral studies online via webcam. We show that this platform can be used to test infants (11–18 months), toddlers (24–36 months), and preschoolers (36–60 months) and reliably code looking time, preferential looking, and verbal responses, respectively; empirical results of these studies are presented in Scott, Chu, and Schulz ( 2017 ). In contrast to most laboratory-based studies, participants were roughly representative of the American population with regards to income, race, and parental education. We discuss broad technical and methodological aspects of the platform, its strengths and limitations, recommendations for researchers interested in conducting developmental studies online, and issues that remain before online testing can fulfill its promise.
Kolte, R.R., Kambale, S.S., Gnanasekaran, G. & Janarthanam, M.K. (2016) Rediscovery and lectotypification of Lepidagathis clavata (Acanthaceae), a steno-endemic species from the northern Western Ghats, India. Phytotaxa 265 (3): 297–300.
Authors: KOLTE RUTUJA RAJENDRA , KAMBALE SHARAD SURESH , GNANASEKARAN GUNADAYALAN , JANARTHANAM MALAPATI KUPPUSWAMY
Published: January 2017

N/A
Landsat Identification of Tornado Damage by Land Cover and an Evaluation of Damage Recovery in Forests
Authors: Kingfield Darrel M. , de Beurs Kirsten M.
Published: January 2017

Multispectral satellite imagery provides a spaceborne perspective on tornado damage identification; however, few studies have explored how tornadoes alter the spectral signature of different land-cover types. In part 1 of this study, Landsat surface reflectance is used to explore how 17 tornadoes modify the spectral signature, NDVI, and “Tassled Cap” parameters inside forest (N = 16), grassland (N = 10), and urban (N = 17) land cover. Land cover influences the magnitude of change observed, particularly in spring/summer imagery, with most tornado-damaged surfaces exhibiting a higher median reflectance in the visible and shortwave infrared, and a lower median reflectance in the near-infrared spectral ranges. These changes result in a higher median Tasseled Cap brightness, lower Tasseled Cap greenness and wetness, and lower NDVI relative to unaffected areas. Other factors affecting the magnitude of change in reflectance include season, vegetation condition, land-cover heterogeneity, and tornado strength. While vegetation indices like NDVI provide a quick way to identify damage, they have limited utility when monitoring recovery because of the cyclical seasonal vegetation cycle. Since tornado damage provides an analogous spectral signal to that of forest clearing, NDVI is compared with a forest disturbance index (DI) across a 5-yr Landsat climatology surrounding the 27 April 2011 tornado outbreak in part 2 of this study. Preoutbreak DI values remain relatively stable across seasons. In the five tornado-damaged areas evaluated, DI values peak within 6 months followed by a decline coincident with ongoing recovery. DI-like metrics provide a seasonally independent mechanism to fill the gap in identifying damage and monitoring recovery.
Discerning “Flavors” of Drought Using Climate Extremes Indices
Authors: Crimmins Michael A. , Ferguson Daniel B. , Meadow Alison M. , Weiss Jeremy L.
Published: January 2017

Monitoring drought conditions in arid and semiarid regions characterized by high levels of intra- and interannual hydroclimatic variability is a challenging task. Typical drought-monitoring indices that are based on monthly-scale data lack sufficient temporal resolution to detect hydroclimatic extremes and, when used operationally, may not provide adequate indication of drought status. In a case study focused on the Four Corners region of the southwestern United States, the authors used recently standardized World Meteorological Organization climate extremes indices to discern intra-annual hydroclimatic extremes and diagnose potential drought status in conjunction with the simple metric of annual total precipitation. By applying data-reduction methods to a suite of metrics calculated using daily data for 1950–2014, the authors identified five extremes indices that provided additional insight into interannual hydroclimatic variability. Annual time series of these indices revealed anomalous years characterized by shifts in the seasonal distribution of precipitation and in the intensity and frequency of individual events. The driest 4-yr intervals over the study period, characterized by similar annual and interval total precipitation anomalies, represent dramatically different assemblages of index values, which are interpreted as different “flavors” of drought. In turn, it is expected that varying drought impacts on ecosystems, agricultural systems, and water resources would emerge under these different flavors of drought. Results from this study indicate that operational drought monitoring and historical drought assessments in arid and semiarid regions would benefit from the additional insight that daily-based hydroclimatic extremes indices provide, especially in light of expected climate change–driven changes to the hydrologic cycle.
Tropical Cyclones in Rotating Radiative–Convective Equilibrium with Coupled SST
Authors: Zhou Wenyu , Held Isaac M. , Garner Stephen T.
Published: January 2017

Tropical cyclones are studied under the idealized framework of rotating radiative–convective equilibrium, achieved in a large doubly periodic f plane by coupling the column physics of a global atmospheric model to rotating hydrostatic dynamics. Unlike previous studies that prescribe uniform sea surface temperature (SST) over the domain, SSTs are now predicted by coupling the atmosphere to a simple slab ocean model. With coupling, SSTs under the eyewall region of tropical cyclones (TCs) become cooler than the environment. However, the domain still fills up with multiple long-lived TCs in all cases examined, including at the limit of the very small depth of the slab. The cooling of SSTs under the eyewall increases as the depth of the slab ocean layer decreases but levels off at roughly 6.5 K as the depth approaches zero. At the eyewall, the storm interior is decoupled from the cooler surface and moist entropy is no longer well mixed along the angular momentum surface in the boundary layer. TC intensity is reduced from the potential intensity computed without the cooling, but the intensity reduction is smaller than that estimated by a potential intensity taking into account the cooling and assuming that moist entropy is well mixed along angular momentum surfaces within the atmospheric boundary layer.
Seasonality of the Observed Amplified Sahara Warming Trend and Implications for Sahel Rainfall
Authors: Vizy Edward K. , Cook Kerry H.
Published: January 2017

Prior results indicate an amplified annual mean warming trend over the Sahara, with temperature trends that are 2–4 times that of the tropical mean rate. Trend analysis is conducted using five atmospheric reanalyses and three observational datasets to better understand the seasonality and physical processes of this amplified warming and the implications for Sahel precipitation. The seasonality of the amplified warming is maximum during July–October with a minimum during June. Two processes related to the amplified warming are identified. A “dry process” supports amplified warming over the Sahara when there is limited latent heating and/or evaporation to cool the surface and distribute heat to the atmosphere. In this mechanism, the warming results from changes in the upward longwave and downward longwave fluxes that are tightly coupled to each other. The second, termed a “wet process,” occurs during the summer West African monsoon season. In this mechanism there are increases in the low- and midlevel atmospheric moisture over the Sahara that add to the surface warming by increasing the longwave downward radiation. This additional atmospheric moisture is transported over the Sahara because of a strengthening of the thermal low/Saharan high circulation system. A positive feedback mechanism is discussed in which enhanced moisture transport due to the stronger Saharan warming leads to increased Sahel rainfall that further strengthens the meridional temperature and height gradients by cooling the Sahel surface, further enhancing moisture transport into the region. Both processes contribute to the amplified warming, with the amplification being greater during the summer.
Foresight in Laryngology and Laryngeal Surgery: A 2020 Vision
Authors: Zeitels Steven M. , Blitzer Andrew , Hillman Robert E. , Anderson R. Rox
Published: January 2017

Laryngology and laryngeal surgery have been in the vanguard of minimally invasive human procedural interventions for approximately 150 years. The natural passages through the oral cavity, nose, and pharynx have provided an accessible gateway to the larynx that has allowed for rapid translation of a variety of diagnostic and therapeutic technologies. Trans-oral and transcervical laryngeal surgery have been further facilitated by progressive advancements in local, topical, intravenous, and general anesthesia. With rapid developments in engineering disciplines (ie, tissue, chemical, mechanical) and voice science, there are a variety of current and near-term opportunities to advance our field. This report represents a panel at the 2005 American Broncho-Esophagological Association meeting that sought to use present perspectives, combined with cutting-edge research insights, to provide foresight into key aspects of laryngology that we believe will be developed by the year 2020. We hope that aspiring laryngeal surgeons will find elements of this discussion valuable for devising a strategic roadmap for research initiatives in laryngology and laryngeal surgery.
Swedish Foreign Policy. A Response to Geopolitical Factors
Authors: Barnes Ian Ronald
Published: January 2017

Sweden is considered a nonaligned country. The author analyses the concepts of nonalignment and related theories to arrive at an exact definition of Swedish foreign policy. The second half of the article demonstrates how Sweden's current foreign policy is a logical outcome in the light of her history and geopolitical position vis-à-vis her regional and world environment. The author achieves this by following some of Rosenau's concepts of linkage theories.
How Does the Nuclear Arms Race Work?
Authors: Gray Colin S.
Published: January 2017

Many analysts are convinced that they understand how arms races work. However, very few arms race studies rest upon a disciplined use of historical data, or upon a willingness to consider seriously more than one or two of the more prominent candidates for the role of the driving factor in an arms race. This article suggests that any analysis of the dynamics of the nuclear arms race cannot afford to neglect the operation of the following factors: inter-state action-reaction processes; inter-armed service action-reaction processes; intra-armed service action-reaction processes; bureaucratic political games; the very individual structures and processes of each political system; military-industrial complexities; foreign policy goals and strategies: and finally, technological innovation. Synergistic combinations of the operation of the forementioned factors produce and sustain what we term arms races. Policy prescription for arms control, if it is to be relevant, must rest upon a deep understanding of the processes to be controlled. An appreciation of the true complexity of arms race phenomena is one important intellectual step towards the ability to control.
The Impact of Environment on the Productivity Attitudes of Intellectually Challenged Office Workers
Authors: YOUNG H. H. , BERRY GAYLE L.
Published: January 2017

Factors affecting the productivity of intellectually challenged office workers have not been systematically investigated. The impact of environment (lighting, noise, pleasant sounds, landscape, etc.) on the expressed productivity of 11 office workers engaged in decisionmaking, design, and/or creative work was explored in a realistic office setting. A novel feature in the experimental office environment was an “artificial window,” designed as a substitute for an outside window in an interior office, using motion picture loops of outdoor/nature scenes projected onto a back-projection screen. Matching nature sound or music could also be introduced as accompaniment. For long-term comfort and productivity, the artificial window was rated nearly as desirable as an outside window. Additional findings were that subjects preferred low-level music or nature sounds to a totally quiet office, and that introduction of these sounds could also block to some extent the undesirable effects of cyclic-pattern industrial noise. However, the introduction of music or nature sounds in concert with random-pattern noise, such as in a very noisy office, tended to accentuate the undesirable effects of the noise.
Alcohol and Speed-Accuracy Tradeoff
Authors: RUNDELL O. H. , WILLIAMS HAROLD L.
Published: January 2017

Performance on two auditory choice reaction time (RT) tasks was studied in a group of 12 subjects under the influence of graded doses of ethyl alcohol ranging from placebo to 1 g/kg body weight. Deadline procedures were employed in a side discrimination and a pitch discrimination task to permit the calculation of speed-accuracy tradeoff functions (accuracy versus RT). Accuracy declined as a function of dose, but alcohol did not significantly influence RT. Conversely, accuracy was not affected by task; but the pitch discrimination task required an average of 88 ms more time than the side task. Alcohol dose and task produced independent effects on the speed-accuracy tradeoff function. As dose increased, the slope of the tradeoff function declined; but slopes were equivalent for the two tasks. On the other hand, the x-intercept (where accuracy equals chance levels) was 90 ms greater for the pitch task than for the side task.
The Relationship between Flight Simulator Motion and Training Requirements
Authors: CARO PAUL W.
Published: January 2017

Flight simulator motion has been demonstrated to affect performance in the simulator, but recent transfer of training studies have failed to demonstrate an effect upon in-flight performance. However, these transfer studies examined the effects of motion in experimental designs that did not permit a dependency relationship to be established between the characteristics of the motion simulated and the training objectives or the performance measured. Another investigator has suggested that motion cues which occur in flight can be dichotomized as maneuver and disturbance cues, i.e., as resulting from pilot control action or from external forces. This paper examines each type cue and relates it analytically to training requirements. The need to establish such relationships in simulator design is emphasized. Future transfer studies should examine specific training objectives that can be expected to be effected by motion.
Effect of temperature and geometrical parameters on mechanical properties of pin-loaded fiber metal laminate joints
Authors: Zu Shiming , Zhou Zhengong , Zhao Yuan , Zhang Jipeng , Zhang Jiazhen
Published: January 2017

To investigate the effect of temperature and geometrical parameters on the mechanical properties of pin-loaded fiber metal laminate joints, experiments were performed by means of static tensile tests. The joints of varied width-to-diameter ratios ( W/ D = 2, 3, 4) and edge distance-to-diameter ratios ( E/ D = 1, 2, 3, 4) were experimentally investigated at room temperature. It was found that ultimate failure load increased with the increase of the ratio of W/ D or E/ D. The dominant failure mode was bearing failure. Shear-out and net-tension failures were more easily caused as the pin hole was located closer to the edge of the specimen. Also, to explore the effect of temperature on the bearing responses of fiber metal laminate joints, three typical joint configurations ( W/ D = 4, E/ D = 4; W/ D = 4, E/ D = 1; and W/ D = 2, E/ D = 4) were tested at high temperature, which ranged from 40℃ to 120℃. The test results clearly show that failure loads of joint decrease with the increase of the test temperature. The failure modes of the fiber metal laminate joints were predominantly affected by high test temperatures. The present work provides supporting information for the design of the fiber metal laminate joints.
The Effect on Dipyridamole on Platelet Aggregation and Adhesiveness
Authors: Gray G. R. , Wilson Patricia A. , Douglas A. S.
Published: January 2017

The effect of dipyridamole (Persantin) on platelet behaviour in human plasma and whole blood has been studied in three experimental systems. Added to plasma and whole blood in a concentration of 50 μg. per ml., dipyridamole inhibited platelet aggregation in a Chandler tube system, and ADP-induced clumping in a turbidimetric system. Adhesiveness of platelets to glass beads in a Hellem system was also decreased by the drug.

Oral administration in doses of 100 mg. 4 times per day suggests a trend in which ADP-induced clumping is lessened after therapy with the drug and one patient is recorded in whom a reduction in platelet adhesiveness to glass beads can probably be attributed to the drug.

The results of this trial coupled with those of previous workers suggest that clinical trials of dipyridamole in human arterial disease are indicated to define the place of this drug in the therapy of arterial disease.
Self Instruction versus Classroom Instruction
Authors: Lawrence Andrea D.
Published: January 2017

Classroom instruction and self-instruction are compared in terms of instructional functions—stimulus presentation, student response, confirmation of response, and branching.

Both the lecture method and self-instruction allow stimulus presentation in many variations by means of audiovisuals. Both allow student response, confirmation of response, and feedback to the teacher, though these are guaranteed to all students in self-instruction. Both allow branching—or slanting the presentation to the individual needs of the students, though self-instruction is particularly appropriate in this way. When working primarily within one format or the other, instruction can be improved by using a variety of audiovisual media to meet the requirements for stimulus presentation.

The lecture format can be enhanced by borrowing from self-instructional methods the desirable techniques of student response, confirmation, and, to some extent, branching.

But we must conclude that a variety of instructional methods is appropriate—because a variety of functions must be met. The logical plan is to combine methods and media to meet these needs most effectively and efficiently.
Sensitivity Patterns of Respiratory Type Haemophilus Influenzae from Purulent Sputum Specimens
Authors: Cargill J. Silvia , Saleh Violette F.
Published: January 2017

Of 50 strains of Haemophilus influenzae isolated from purulent sputum specimens, 100 per cent were fully sensitive to chloramphenicol, all of them being more sensitive than the Staphylococcus aureus (Oxford strain) control.

Only 36 per cent were fully sensitive to ampicillin, but the other 64 per cent were moderately sensitive; none were resistant.

Eighty four per cent were fully sensitive to tetracycline, 38 per cent to sulpha-methoxazole and 74 per cent to trimethoprim.

None of the strains were fully sensitive to penicillin or clindamycin. Only 32 per cent of strains were moderately sensitive to clindamycin and the rest were completely resistant. Reports that Haemophilus influenzae is sensitive to clindamycin are thought to be in error.

Conclusions are drawn from these results which might influence antibiotic treatment of exacerbations of chronic bronchitis.
Neisseria Catarrhalis Septicaemia in Acute Lymphoblastic Leukaemia
Authors: Burnett A. K. , Easton D. J. , Gordon A. M. , Rowan R. M.
Published: January 2017

A case of septicaemia due to Neisseria catarrhalis occurring in an immunosuppressed individual is described. The clinical syndrome closely resembled that of N. meningitidis septicaemia. The potential pathogenicity in the immunosuppressed patient, of organisms usually considered harmless is stressed.
Tourist Hepatitis in the West of Scotland
Authors: Chaudhuri A. K. R.
Published: January 2017

During the 6-year period (1971–76) 971 patients were admitted with acute viral hepatitis to different infectious diseases units in the West of Scotland. Of these, 30 (3 %) patients had tourist hepatitis. The majority (80 %) acquired the infection in the subcontinents of Africa and India or other tropical countries. The clinical spectrum of the illness in these patients ranged from mild to fulminant hepatitis. Fifteen patients were specifically asked about their immunisation history prior to their travel and none had had immunoglobulin prophylaxis against hepatitis. Normal human immunoglobulin prevents clinical hepatitis A and should be given to all prospective travellers to third world countries. In order to formulate a rational policy for prophylaxis, more data about the risk of contracting hepatitis in different countries is needed.
Self-Diagnosed Irritable Bowel Syndrome and Milk Intolerance in White and Non-White Doctors
Authors: Fowkes F. G. R. , Ferguson Anne
Published: January 2017

Doctors of different ethnic groups were asked to make a self-diagnosis of the irritable bowel syndrome and intolerance to cows' milk: 13.3 per cent of white and 18.1 per cent of non-white doctors thought they had the irritable bowel syndrome. In non-white males, aged 25 to 49 years, the irritable bowel syndrome was significantly associated with an awareness of milk intolerance (p<0.0001). The stated milk consumption of doctors who were milk intolerant was less than the consumption of those not affected by milk. Further studies of the irritable bowel syndrome and lactase deficiency in non-hospital based populations are recommended.
Ultrastructural Studies on the Peritoneum with Special Reference to Chronic Ambulatory Peritoneal Dialysis
Authors: Dobbie J. W. , Zaki M. , Wilson L.
Published: January 2017

Specimens of peritoneum from normal rat, mouse, man, uraemic patients and patients on chronic ambulatory peritoneal dialysis (C.A.P.D.) were examined by en face silver stained preparations and by electron microscopy. The ultrastructural features of the mesothelium and subjacent tissues in normal man, animal and uraemic patients were closely similar. Cellular degeneration and oedema were observed in the mesothelium of patients on C.A.P.D.
Pertussis in Pregnancy
Authors: MacLean D. W. , Calder Margaret A.
Published: January 2017

During the period July 1979 to April 1980 four pregnant women in one general practice were found to be suffering from pertussis. The diagnosis was based on clinical and serological evidence. The paper gives a clinical and bacteriological account of their progress and that of their babies. The possibility of pertussis occuring in expectant mothers at the present time is stressed.
Circadian Rhythms in Hypertension
Authors: Millar-Craig M. W. , Mann S. , Balasubramanian V. , Altman D. G. , Raftery E. B.
Published: January 2017

Continuous intra-arterial blood pressure recordings have been performed in 37 untreated ambulatory hypertensive subjects, who were investigated on an outpatient basis. Hourly data analysis demonstrated a circadian variation of both blood pressure and heart rate which were highest during the morning and fell during the late afternoon to reach a nadir during sleep. Prior to waking there was an increase in blood pressure, but not heart rate; however both blood pressure and heart rate increased briskly shortly after waking. Chronic therapy with oxprenolol (in 10patients) reduced daytime blood pressure, but had little effect during the night-time or early morning.
Direct Intercellular Communication in Health and Disease: An Overview
Authors: Green S. T.
Published: January 2017

Direct intercellular communication (cell to cell coupling) is a mechanism for the local transit of information between cells and supplements the endocrine and nervous systems. Electrophysiological, biochemical, histological and cell culture techniques have established the widespread existence of coupling in mammalian tissues, and the importance of the gap junction has been recognised. Information is carried in the form of ions and small molecules between cells, and sensitive apparatus exists within each cell for controlling the permeability of the junctional membrane.

The system may be important in the control and co-ordination of cellular metabolism and growth in the embryo and in adult tissues.

Disorders of direct intercellular communication may be important in the pathogenesis of some diseases, in particular cancer.
Amoebiasis as a Cause of Death in a Scottish Resident
Authors: Edlin G. P.
Published: January 2017

An elderly woman, resident throughout her life in Scotland presented with abdominal pain and diarrhoea. A provisional diagnosis of ulcerative colitis was made on sigmoidoscopy. At post mortem Entamoeba Histolytica was demonstrated in considerable numbers in the mucosal ulcers. It would appear though extremely rare that amoebiasis should be considered in the differential diagnosis of colonic ulceration.
Varicoceles—A Ten Year Retrospective Review
Authors: Ferrie B. G. , Hart A. J. , Kyle K. F.
Published: January 2017

A retrospective survey of men having ligation of varicoceles for infertility from 1969–79 was carried out. Out of 95 patients 71 were traced. The wives of 35 of the patients (48%) subsequently became pregnant while 36 (52%) did not. Almost 60 per cent of patients with a post-operative sperm count more than 40 million/ml achieved a pregnancy.

Approximately half the successful pregnancies were achieved within 2½ years but successful pregnancies continued until 5½years after operation.
Health Care Accommodation in Scotland
Authors: Maclachlan James
Published: January 2017

The Medical and Nursing Advisers of the Scottish Health Service, Common Services Agency, Building Division, advise upon the planning of health care accommodation. The overall spread of beds by function is given in a review of existing health care buildings in the year 1981. The numbers of hospital beds and of various groups of staff in the hospital and community services are calculated per 100,000 population so that any unusual disparity can be ascertained. One of the parameters for health building planning is fiscal control and so the cost per hospital in-patient week is tabulated for eight groups of specialities.

The appropriate responsibilities of the Regional Councils in Scotland in 1979 are considered along with the responsibilities of Health Boards because part of each Social Work Department's work is the provision of accommodation and social care for those in need as opposed to the National Health Service responsibility for the health care of those in hospital and in the community. An overall view of residential accommodation for those requiring medical treatment or social care is presented in tabular form. The views expressed are not necessarily those of the Common Services Agency.
C-Reactive Protein as a Predictor of Relapse in Asymptomatic Patients with Crohn's Disease
Authors: André C. , Descos L. , Vignal J. , Gillon J.
Published: January 2017

Comparison of the Crohn's Disease Activity Index (CDAI) with serum levels of the acute phase proteins during a 4-year study period of 50 patients with Crohn's disease has shown the serum C-reactive protein (CRP) to be a sensitive indicator of clinical status. Five patients are described in whom raised CRP levels reliably predicted relapse at a time when the patients were asymptomatic and the CDAI was normal. Measurement of serum CRP by radial immunodiffusion is cheap and simple, and if performed frequently in the follow-up of patients with Crohn's disease it may permit earlier, and therefore possibly more effective, treatment of relapse.
Juvenile Nasopharyngeal Angiofibroma—The Preferred Treatment
Authors: Lang D. A. , McKellar N. J. , Lang W.
Published: January 2017

Two cases of juvenile nasopharyngeal angiofibroma are discussed. The importance of pre-operative embolisation of this vascular tumour is emphasised as an important addition to the surgical treatment of the lesion.
Polyarteritis Group of Systemic Vasculitis — New Diagnostic Criteria
Authors: Leung A.C.T. , McLay A. , Mosley H. , Jones J.M. Boulton
Published: January 2017

We have used new diagnostic criteria to define patients with the polyarteritis nodosa (PAN) group of vasculitis. These were the combination of a necrotising glomerulitis without diffuse deposits of immunoglobulins or complement components in a patient presenting with systemic disease and multi-organ involvement. Twenty-two patients who fulfilled these criteria presented to our unit between 1975 and 1982. The diagnosis of PAN was confirmed by traditional histological criteria in eight. We anticipate that the use of these criteria will lead to earlier diagnosis and thereby improve the management of this potentially lethal disorder.
The Diagnosis of Acute Pancreatitis in the Presence of Hyperlipaemia
Authors: Garden O.J. , Dominiczak M.H. , Shenkin A. , Carter D.C.
Published: January 2017

A case of acute pancreatitis associated with severe hyperlipaemia is presented and the relationship of the two conditions discussed.
Leg Ulcer Infection with an Erythromycin-Resistant Streptococcus Pyogenes
Authors: Hardie R. , Hardie R.A.
Published: January 2017

The isolation of an erythromycin-resistant Streptococcus pyogenes from a leg ulcer is reported and its implications for antibiotic therapy discussed.
Aortic Stenosis Presenting with Predominant Right Heart Failure
Authors: Rodrigues E.A. , MacKay A. , de Bono D.P.
Published: January 2017

Two cases of severe aortic stenosis presenting with pure right heart failure and unimpressive cardiac murmurs are reported. Both responded well to aortic valve replacement. The mechanism of right heart failure is discussed as is the need for urgent surgery.
Hepatitis B in Adolescence and Middle-Age
Authors: Ho-Yen D. O. , Love W. C. , Follett E. A. C.
Published: January 2017

In 1983 304 serum samples, and in 1984 432 serum samples submitted to the Hepatitis Reference Laboratory, Ruchill Hospital, Glasgow were found to be positive for HBsAg by radio-immunoassay. Of these, 37 in 1983 and 50 in 1984 were from persons <18 years, while 38 and 46 respectively were from persons >39 years. This increase from 1983 to 1984 was due to more acute infections among males. In males <18 years, infections were related to drug abuse, whereas in men >39 years sexual transmission appeared to be the main source. Women >39 years may be at increased risk of infection from other members of the household. A finding of HBsAg in a person >39 years is as likely to be from an acute infection as from a carrier.
Fatal Outcome following Inhalation of Tipp-Ex
Authors: Macdougall I.C. , Isles C. , Oliver J.S. , Clark J.C. , Spilg W.G.S.
Published: January 2017

Recent measures to combat glue sniffing1,2 have led to a decrease in the availability of toluene-based glues. As a result, abuse of other more accessible solvents appears to have increased. Of particular concern are the halogenated hydrocarbons which are more likely to cause fatal cardiac arrhythmias than toluene3. We wish to report three cases presenting within a period of six months where death occurred following inhalation of Tipp-Ex, a seemingly innocuous preparation of 1,1,1-trichloroethane which is widely available in offices and schools.
Can Bone Marrow Transplantation Be Offered to More Patients in South East Scotland?
Authors: Craig J.I.O. , Hoyle C. , Yap P.L. , Parker A.C.
Published: January 2017

The number of patients with haematological malignancies and aplastic anaemia treated by allogeneic bone marrow transplantation in South East Scotland between 1983–1986 is apparently greater than that estimated by the Black Report in 1982. The potential for increasing the use of this effective therapy by using bone marrow donors from the extended family or national volunteer panels is discussed.
Saddle Embolus as First Presentation of Left Atrial Myxoma in a 14-Year-Old Girl
Authors: Leach W. J. , Pollock J. G.
Published: January 2017

A 14-year-old girl was brought to the A & E department minutes after collapsing while out walking minutes earlier. She had developed sudden, severe, cramping pain in her lower abdomen and both legs, and had been incontinent of urine. Earlier that day she had an episode of diarrhoea. The girl was previously in excellent health.
Simultaneous Bilateral Fractures of the Femoral Neck
Authors: Tail G.R.
Published: January 2017

An 80-year-old woman suffered bilateral simultaneous fractures of her hips. This is the first reported case in the elderly. Both hips were replaced by Thompson hemi-arthroplasties at the same operation, and the patient was discharged home.
Panhypogammaglobulinaemia Caused by Gold Therapy
Authors: Pearson S.L. , Stewart I.C. , Kellett R.J.
Published: January 2017

Gold compounds have been successfully used for over 50 years in the treatment of rheumatoid arthritis, but their mechanism of action is unknown. The main disadvantage is the frequent occurrence of side effects which often necessitate discontinuation of therapy.1 Recently, there have been reports of reduction in immunoglobulin levels in patients on gold treatment; we report a further case of hypoglobulinaemia associated with gold therapy and recommend that immunoglobulins be monitored prior to and during treatment.
Looking at Medical History: Vaccination
Authors: Haslam Fiona
Published: January 2017

Controversy with regard to medical procedures is not a new phenomenon. Two hundred years ago, vaccination against smallpox was both derided and acclaimed. The controversy engendered then can be “pictured” through the work of such graphic artists as James Gillray and Isaac Cruikshank.
Crescentic Glomerulonephritis: Experience of a Single Unit over a Five Year Period
Authors: Jeffrey R.F. , Gardiner D.S. , More I.A.R. , Junor B.J.R. , Briggs J.D.
Published: January 2017

Crescentic glomerulonephritis is a well defined pathological lesion occurring in a range of renal and systemic diseases. We have retrospectively reviewed the aetiology, clinical features and outcome in 60 patients presenting over a five and a half year period. Most patients were elderly (median age 61 years, range 16–84 years). The majority presented with severe renal impairment, 32 requiring dialysis at admission. The degree of glomerular crescent formation on biopsy was closely related both to initial dialysis dependence and the ensuing response to immunosuppression. Forty-three patients received immunosuppressive treatment. A beneficial response was seen in 40% of patients requiring dialysis, and in 88% of those with less severe renal impairment. A high early mortality was apparent (30% within three months), exclusively affecting elderly patients (all >60 years), with advanced renal failure (all dialysis dependent), the majority of whom (15 out of 18) had been immunosuppressed. The results suggest that the benefits of immunosuppression in this group may be outweighed by the complications of treatment.
Abscess Formation as a Complication of Chickenpox
Authors: Guthrie C.M.
Published: January 2017

Chickenpox is a common infectious disease of childhood. Skin lesions may occasionally become secondarily infected with bacteria. Large abscess formation is reported complicating a mild case of chickenpox in a previously healthy patient.
Impact of Angioplasty and Arterial Reconstructive Surgery on the Quality of Life of Claudicants
Authors: Pell J.P. , Lee A.J.
Published: January 2017

Claudicants usually die from concomitant conditions. Therefore, surgical interventions are aimed at improving quality of life, rather than survival. This study compared the impact of percutaneous transluminal angioplasty (PTA), arterial reconstruction and conservative management on quality of life. SF36 questionnaires were completed by 201 newly referred claudicants prior to treatment andsix months later. Multiple regression was used to compare the quality of life scores following the three treatments after adjustment for baseline scores, age, sex, site of disease and disease severity. Follow-up data were available on 81% of the 195 patients alive. Nineteen (10%) of these had undergone PTA and 19 (10%) reconstruction. All aspects of quality of lif e deteriorated following conservative treatment. PTA and arterial reconstruction produced significant improvements in both pain and physical functioning after adjustment for case-mix. Although unlikely to improve survival, PTA and arterial reconstruction are associated with significant improvements in quality of life.
Dr Francis Adams of Banchory (1796–1861)
Authors: Adam A.
Published: January 2017

Dr Francis Adams practised medicine in Banchory from 1819–1861. At that time there was no translation in English of the classic medical literature of the Greeks, Romans and Arabians. Almost entirely self-taught, and in spite of the demands of a large scattered practice, Dr Adams found time to remedy this deficiency.
Patterns of HIV Testing in Scotland: A General Practitioner Perspective
Authors: Ross J.D.C. , Goldberg D.J.
Published: January 2017

General practitioners are one ofthe largest groups who offer HIV testing but little is known about the patient group who present for HIV counselling and testing in primary care. This study describes the risk factors, positivity rate, temporal trends and demographic profile of patients presenting to their general practitioner for HIV testing in central Scotland. Of 8,466 tests taken 1% (84) were positive with an independent association between a positive result andage group, history of drug misuse, homosexuality andregion of testing. The majority of tests were performed in those who were at low risk and because ofpatient concern about HIV. No increase in the number of positive tests was apparent over the five-year study period. Variations between GP testingfor HIV occurs in different regions and may reflect the underlying HIV positivity rate. General practitioners performing HIV tests are well placed to educate their patients about HIV and encourage low risk sexual behaviour patterns.
The Antiphospholipid Syndrome
Authors: Muir A.
Published: January 2017

The antiphospholipid syndrome is now well established as an important, acquired prothrombotic disorder. Advances are being made in the understanding of the condition and the paradox of the in vitro anticoagulation, and the in vivo prothrombotic tendency. Newer and better assays for the diagnosis of antiphospholipid syndrome can be expected in the near future. Large, multi-centre, controlled trials to determine the optimum treatment of patients who test positive for the antiphospholipid syndrome, but have not suffered a thrombotic event, are required.
An Audit of Paediatric Audit in Scotland
Authors: Stone D. H. , Audish K.
Published: January 2017

We undertook a retrospective review of the Scottish Clinical Audit Project Register (SCAPR). This generated information on audit activities in Scotland relating to children aged 0–15 years over the period 1992 to 1997. All healthcare specialties (including dentistry) in both acute and community sectors were included. Of the 7,073 registered entries, 613 (9%) relating to children were identified. Greater Glasgow contributed a third of entries despite having only 18% of the child population. Over half the projects were conducted in secondary care settings and only 5% in primary care. Medicine and nursing appeared the most audit active professional groups. Our findings suggest that children (who comprise 19% of the Scottish population) are an under-audited group in Scotland. Secondary care (especially surgery) seemed over-represented and primary care under-represented as audit settings. We were unable to use the SCAPR to identify specific service deficiencies or improvements that may have been stimulated in the course of “closing the audit loop.” Future refinements to the way data are collected and recorded on the SCAPR will clearly require to address this shortcoming.
Isaac Israeli and His Book of Urine
Authors: Collins K.E. , Sussman M.
Published: January 2017

Isaac Israeli (c850–950), philosopher and physician was born in Egypt where he practised as an oculist before moving to Kairouan, in Tunisia, where he served as physician to the Caliph Ziyadat Allah and later to ‘Ubayd Allah al-Mahdi. His best known medical work Book of Fevers (Kitab al-Hummayat) was widely used as a medical text until the seventeenth century. This paper reviews Israeli's medical career through his Book of Urine (Kitab al-bawl), based on a fifteenth century Hebrew manuscript Sefer Hasheten (MS Hunter 477) in the Hunterian Collection of the University of Glasgow. This manuscript, most likely a translation from the original Arabic, describes the formation of urine and the value of visual examination of urine for the diagnosis and prognosis of disease. Israeli emerges as an outstanding physician and scholar who made a lasting contribution to Arab-Jewish medicine in its most productive period.
Medigap: Should Private Insurers Pay Public Rates and Who Should Make the Decision?
Authors: Caldie Edwin
Published: January 2017

The most complex issues in the field of healthcare policy can often be reduced to the simple question “who is going to pay?” Legislatures, whether at the state or national level, are generally the entity responsible for allocating healthcare costs. When a legislative body acts to allocate healthcare costs, it simultaneously amends a society-wide, interwoven web of regulation and incentives that is steeped in decades of tradition. Further, and perhaps more importantly, healthcare cost allocation affects each individual in our society on an intimate level. Medicare is one of the most controversial elements in this grand scheme of cost allocation policy.

Medicare serves approximately 37 million senior citizens in the United States. Of course, Medicare benefits are limited. With minor exceptions, Medicare fully covers only the first ninety days of hospitalization for an eligible citizen. After such period, a Medicare-eligible citizen may draw upon a non-renewable lifetime reserve, which provides Medicare hospitalization coverage for an additional sixty days.
If Roth Were a Doctor: Physician Reputation under the HCQIA
Authors: Montero Guillermo A.
Published: January 2017

Hospitals in the United States rely on peer review committees to make credentialing decisions and to conduct ongoing evaluations of all medical care, thereby ensuring the quality of the physicians they employ. Physicians, however, may be reluctant to serve on peer review committees for fear of retaliatory litigation. In response, and in an effort to improve the quality of healthcare in the United States, Congress passed the Health Care Quality Improvement Act of 1986 (“HCQIA”).

Congress designed the HCQIA to improve the quality of healthcare in two ways. First, it increased the effectiveness of peer review by providing review committees with immunity from lawsuits filed in response to professional review actions. Second, it authorized the Secretary of Health and Human Services (“HHS”) to create the National Practitioner's Data Bank (“NPDB”). Any disciplinary action taken by a review committee must, as a condition to immunity, be reported for listing in the NPDB.
Face Value: Challenges of Transplant Technology
Authors: Hartman Rhonda Gay
Published: January 2017

What is the value of a human face? It is a vexing question with no simple answer. The question, however, is no longer fanciful given the trajectory of biomedical science that simultaneously captures our imagination and challenges our essence. Essential to each of us and to the whole of humanity, the face is primal in its individuated image and identity. It is intrinsically connected with us in a way that defied question—until now, given the highly anticipated next step in transplant science and technology, facial transplantation. This Article examines the value of the face in this context, along with a range of related issues.

The human face has rich significance. It is intrinsic and instrumental to the ontology of a person. A portal for emotions and expressions, the face reveals an inner-self essential to identity and is inscribed with an inherent dignity of human life.
The Economics of Pharmaceutical Price Regulation and Importation: Refocusing the Debate
Authors: Vernon John A. , Golec Joseph H. , Hughen W. Keener
Published: January 2017

There is a great deal of misinformation surrounding the economics of pharmaceutical importation and price regulation. Among economists, the principles governing the relationships between prices, innovation, and pharmaceutical research and development (R&D) investment are incontrovertible. Unfortunately, faulty, non-economic analyses abound on these fundamental relationships, reinforcing economic illiteracy and leading to unfounded U.S. public policy.

Effective public policy debate requires that all parties to the debate be informed and aware of the potential costs and benefits associated with new policies, or changes in existing policies. This has not yet occurred for pharmaceutical importation and price regulation policy. Therefore, the purpose of this paper is to provide a positive (in contrast to a normative) economic analysis of pharmaceutical importation and price regulation.
Oy Canada! Trade's Non-Solution to “the Problem” of U.S. Drug Prices
Authors: Gilman Daniel
Published: January 2017

HORSTMAN: Mr. President, why did you block the reimportation of safer and inexpensive drugs from Canada which would have cut 40 to 60 percent off of the cost?

BUSH: I haven't yet. Just want to make sure they’re safe. When a drug comes in from Canada, I want to make sure it cures you and doesn't kill you.

KERRY: John, you heard the president just say that he thought he might try to be for it. Four years ago, right here in this forum, he was asked the same question: Can't people be able to import drugs from Canada? You know what he said? “I think that makes sense. I think that's a good idea” -- four years ago. Now, the president said, “I’m not blocking that.” Ladies and gentlemen, the president just didn't level with you right now again. He did block it, because we passed it in the United States Senate. We sent it over to the House, that you could import drugs.
Trojan Drugs: Counterfeit and Mislabeled Pharmaceuticals in the Legitimate Market
Authors: deKieffer Donald
Published: January 2017

Over the past five years, there have been over 140 reported incidents of counterfeit and mislabeled drugs being sold by legitimate pharmacies in the United States. Thousands of patients have consumed these medications, sometimes with dire consequences. The extent of counterfeits in the legitimate market, however, is unknown. It is certain that the detected incidents of fakes are a fraction of the total number of incidents.

How did these drugs wind up in the bloodstreams of unsuspecting patients? Despite elaborate safety precautions, strict regulations and battalions of enforcement personnel, the stream of phony pharmaceuticals continues unabated. This article will consider the practical and legal dimensions of trade in Trojan drugs.