bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cotton as an Electret
Authors: Weiss Louis C. , Thibodeaux Devron P. 
Published: January 2017

Research to enhance the storage of electrical charge in lint cotton led to imparting electret-like properties to cotton fibers. An electrostatic field introduced stored, oriented charges within a bundle of cotton fibers. The threshold values of temperature, time, and electric field for production of cotton electrets are defined, and specifications for measuring charge-density distribution are presented. The electret nature of the phenomenon is substantiated by findings that cotton fibers exposed to electric fields at elevated temperatures show long-term, charge-retention properties that are enhanced by short-circuiting. These fibers also display a tendency to a charge-polarity reversal after being removed from the electric field. Furthermore, the waxes native to the single fiber seem to be the basis of this new cotton property. These waxes are related to one of the best known electret materials—carnauba wax. A similar effect with analogous characteristics has also been produced in polyester fibers. With both fibers the effect is less than that possessed by ideal electrets.
A Simple Transfixion — Ligation Treatment of Haemorrhoids
Authors: Aina A O , Omo-Dare P 
Published: January 2017

The complications which may occur after existing haemorrhoidectomy procedures are enumerated. A new cost-effective operative procedure which requires minimal facilities and entails anal dilatation with simple transfixion-ligation of all primary and secondary haemorrhoids in one operating session is described. The preoperative and postoperative progress of 56 patients with 2nd to 4th degree haemorrhoids managed by transfixion-ligation of the individual haemorrhoids are presented and evaluated. Postoperative complications were few and mild. Pain and duration of hospitalization were consider-ably reduced and anal stenosis/fibrosis, faecal/ permanent flatus incontinence and recurrence of haemorrhoids were absent. The procedure is recommended for the treatment of all degrees of haemorrhoids especially in developing countries where patients' average income is low, hospitals have few experienced surgical personnel, inadequately equipped operating theatres and an insufficient number of beds.
Growing Up on an Appalachian Farm
Authors: Holston Ezra C. , Callen Bonnie 
Published: January 2017

Background Research on centenarians to date has focused on areas with a high population of centenarians. However, there is limited literature on centenarians’ perspectives about growing up on farms from the heartland of Appalachia in Eastern Tennessee. Purpose This qualitative descriptive study was designed to characterize the role of a farming childhood by exploring the viewpoints of community-dwelling centenarians who grew up on farms in south central Appalachia. Methods A qualitative descriptive design was used with a convenience sample ( n = 16). Cognitive status was determined with the Short Portable Mental Status Questionnaire. Demographic data were collected. Interviews were transcribed and analyzed with the Neuendorf method of content analysis. Results Main emerging themes were the farm, the family, and the environment. Conclusion The farm was at the center of these centenarians’ childhood, influencing their family, community relations, and social interactions, which provided lessons that they utilized throughout their long lives.
Rethinking Informed Consent: The Case for Shared Medical Decision-Making
Authors: King Jaime Staples , Moulton Benjamin W. 
Published: January 2017

In law, with rare exception such as legislative action, change is evolutionary and methodical. Unlike biomedical science where a breakthrough can quickly lead to dramatic changes in medical practice, legal precedent is more adherent and must evolve either through the legislative process or on a court by court basis in case law. Nevertheless, compelling evidence will pave the road to change within the law. Health care research conducted over the last three decades has produced a body of empirical evidence that suggests an overhaul of our current legal standards of informed consent is overdue.This article uses health services research to examine the fundamental assumptions of our current informed consent laws and propose legal reform. Much has been written on how to bring the law to bear on medical practice in order to improve patient rights and protect physicians, but far less has been done to bring the practice of medicine to inform our legal standards. Prior legal scholarship on informed consent has made arguments regarding reform from both ethical and legal perspectives; however, only a small few have incorporated clinical and health services research as well as ethical and legal principles to analyze informed consent.
The Mental Health Paradigm and the MacArthur Study: Emerging Issues Challenging the Competence of Juveniles in Delinquency Systems
Authors: Katner David R. 
Published: January 2017

Understanding the factors that impact a juvenile's adjudicative competence in delinquency and criminal proceedings today requires some familiarity with mental illness, mental retardation, and developmental immaturity. Current research and studies shed new light on these factors that juvenile advocates, prosecutors, judges, and policymakers must routinely confront. This article discusses some of the issues involved in competency determinations of juveniles awaiting trial; addressing both the more traditional factors, such as mental illness and mental retardation, and some of the more recent studies and literature identifying developmental immaturity as an emerging basis for challenging the competency of juveniles to stand trial.Juvenile justice systems routinely presume that adolescents accused of delinquent or criminal misconduct are competent to stand trial. Adults charged with criminal misconduct are also presumed to be competent. Competency requires that citizens accused of criminal misconduct understand the charges against them, have rudimentary understanding of the court process, be able to understand and answer questions posed to them by their counsel, and be able to make decisions about their trial such as whether to testify, and whether to accept or reject plea bargains.
My Computer, My Doctor: A Constitutional Call for Federal Regulation of Cybermedicine
Authors: Lewis Carmen E. 
Published: January 2017

Color it green. In a health care era driven by consumer demand, consumers are increasingly seeking Internet-based health services. Every day approximately seventy-three million Americans access the Internet in search of health information, with an average of six-million people seeking health advice. At present, a supply of over one-hundred thousand health-related websites serve the public’s demand for information and advice, with an average of one-thousand five hundred new sites added monthly. Surprisingly, consumers and students make up more than 30% of all healthrelated website users.4 From this union of cyberspace and the medical field, cybermedicine has emerged.What does cybermedicine encompass? Cybermedicine is “the science of applying Internet and global networking technologies to medicine and public health, of studying the impact and implications of the Internet, and of evaluating opportunities and the challenges for health care.” General use of the Internet under this definition encompasses exploration and exploitation of the Internet for consumer health education, patient self-support, and professional medical education and research.
Delivering Drugs to the Poor: Will the TRIPS Amendment Help?
Authors: Dutfield Graham 
Published: January 2017

Many of the diseases and health conditions that account for a large part of the disease burden in low- and middle-income countries are far less common in high-income countries. These burdens are primarily associated with infectious diseases, reproductive health, and childhood illnesses. Just eight diseases and conditions account for 29 percent of all deaths in low- and middle-income countries: TB, HIV/AIDS, diarrheal diseases, vaccine-preventable diseases of childhood, malaria, respiratory infections, maternal conditions, and neonatal deaths.Approximately 17.6 million people in low- and middle-income countries die each year from communicable diseases and maternal and neonatal conditions. Both the occurrence of and the death rates from such diseases and conditions are far lower in all high-income countries.Millions of people in developing countries die of diseases for which treatments exist that can relieve suffering and save, or at least prolong, people’s lives. High-profile pandemics like HIV/AIDS understandably attract considerable attention. Millions of people have died of this terrible disease - 2.6 million in 2003 and 2.8 million in 2005, of which Sub-Saharan Africa contributed 1.9 million and 2.0 million respectively. As the above quote makes clear, there are a whole host of diseases that have particularly devastating impacts on the poor.
Think Globally, Prescribe Locally: How Rational Pharmaceutical Policy in the U.S. Can Improve Global Access to Essential Medicines
Authors: Kesselheim Aaron S. 
Published: January 2017

Improving access to essential medicines in low- and middle-income countries (LMICs) has become a critical health policy issue. Millions more people die each year in poorer countries from diseases that are treated by pharmaceutical agents currently available in higher income nations. Recent medical innovation has tended to focus on problems affecting populations in developed countries and avoid those found exclusively or predominantly in LMICs. The etiology of these disparities is multifactorial, and can include high costs of products, inadequate cooperation between governments and aid agencies, rigid protection of intellectual property rights, and poor local health leadership regarding dissemination of products.Over the past two decades, there have been growing efforts to reduce global disparities in availability of essential medicines. At the forefront of these efforts have been international agencies such as the World Health Organization, or groups like Médicins Sans Frontières and Partners in Health, which have helped set international health priorities and sought to improve local health care delivery systems.
Reproductive Choices and Informed Consent: Fetal Interests, Women's Identity, and Relational Autonomy
Authors: Laufer-Ukeles Pamela 
Published: January 2017

In this Article, I describe and examine the severe shortcomings in women's autonomy in the context of reproductive choices in the medical arena. The reproductive choices I explore are those choices that involve gestation: abortion, fertility treatments, and interventions during pregnancy. Due to state and medical interests in the fetus, I describe how information conveyed to patients making reproductive choices is biased towards fetal interests, relies on female stereotypes, and is still conveyed with the objective authority of the medical profession. Moreover, reproductive choices implicate women's values and identity interests that reach beyond medical concerns, which are not part of the informed consent doctrine at all. The narrow, individualistic informed consent torts doctrine intended to protect patient autonomy does not do enough in this context to balance bias nor does it mandate discussion of important identity interests and values. Accordingly, I argue that when faced with reproductive choices, women are not provided the balanced and comprehensive information needed to promote their autonomy.In response to the breakdown in patient autonomy I describe, instead of leaving women alone to make choices or regulating in order to protect them from their choices, a broader framework for supporting reproductive choices should be established. In light of the interdependence of woman and fetus, as well as the broader social context shaping these decisions, I argue that a more contextual, relational perspective of autonomy should be the goal of informed consent in the context of reproductive choices. I suggest a number of reforms that aim to optimize patient autonomy from a relational perspective. I suggest a broad, deliberative doctor-patient consultation and legal reforms that create more balance between the pull towards intervention and fetal protection on the one hand, and non-intervention and protection of women's personal identity interests on the other.
Bridge to transplant or recovery in cardiogenic shock in a developing country
Authors: Villavicencio Mauricio A , Larraín Ernesto , Larrea Ricardo , Peralta Juan Pablo , Lim Jong S , Rojo Pamela , Donoso Erika , Gajardo Francesca , Hurtado Margarita , Rossel Víctor 
Published: January 2017

Background Durable mechanical support devices are prohibitively expensive in our health system and may be unsuitable for critically ill patients. CentriMag is an alternative bridge to transplantation or recovery. Methods We retrospectively reviewed 28 patients (23 males) aged 13–60 years who received CentriMag support. The etiology was ischemic in 13 (46%), dilated cardiomyopathy in 8 (29%), and others in 7 (25%). All patients were in Interagency Registry for Mechanically Assisted Circulatory Support class I, and 27 (96%) had multiorgan failure; 2 (7%) were post-cardiotomy and 12 (43%) had a previous cardiac arrest (mean arrest time 21 ± 17 min). Results Thirty-day post-implant survival was 79% (22 patients). Twenty (71%) patients were successfully bridged to transplantation or recovery. The mean support time was 40 days; 12 (43%) patients had >4-weeks’ support (longest was 292 days). Eight (29%) patients died on support. Complications included bleeding in 10 (36%) cases, immediate stroke in 4 (14%), and dialysis in 8 (29%). There was no stroke during subsequent support. Eighteen (64%) patients underwent transplantation, and 17 of them were discharged. Two (7%) patients recovered and were discharged. Two-year survival was 62% ± 10%. Mean follow-up was 21 months (total follow-up 579 months). Two (7%) patients died during follow-up. All survivors were in New York Heart Association class I. Conclusions CentriMag is useful for medium-term support for cardiogenic shock in a developing country. Support for >4 weeks is feasible. The stroke rate is low during support. The major drawback is prolonged intensive care unit stay.
Off-pump grafting does not reduce postoperative pulmonary dysfunction
Authors: Izzat Mohammad Bashar , Almohammad Farouk , Raslan Ahmad Fahed 
Published: January 2017

Objectives Pulmonary dysfunction is a recognized postoperative complication that may be linked to use of cardiopulmonary bypass. The off-pump technique of coronary artery bypass aims to avoid some of the complications that may be related to cardiopulmonary bypass. In this study, we compared the influence of on-pump or off-pump coronary artery bypass on pulmonary gas exchange following routine surgery. Methods Fifty patients (mean age 60.4 ± 8.4 years) with no preexisting lung disease and good left ventricular function undergoing primary coronary artery bypass grafting were prospectively randomized to undergo surgery with or without cardiopulmonary bypass. Alveolar/arterial oxygen pressure gradients were calculated prior to induction of anesthesia while the patients were breathing room air, and repeated postoperatively during mechanical ventilation and after extubation while inspiring 3 specific fractions of oxygen. Results Baseline preoperative arterial blood gases and alveolar/arterial oxygen pressure gradients were similar in both groups. At both postoperative stages, the partial pressure of arterial oxygen and alveolar/arterial oxygen pressure gradients increased with increasing fraction of inspired oxygen, but there were no statistically significant differences between patients who underwent surgery with or without cardiopulmonary bypass, either during ventilation or after extubation. Conclusions Off-pump surgery is not associated with superior pulmonary gas exchange in the early postoperative period following routine coronary artery bypass grafting in patients with good left ventricular function and no preexisting lung disease.
Lower limbs venous kinetics and consequent impact on drainage direction
Authors: Gianesini Sergio , Sisini Francesco , Di Domenico Giovanni , Secchiero Joel , Malagoni Anna Maria , Menegatti Erica , Gambaccini Mauro , Zamboni Paolo 
Published: January 2017

Background Literature concerning the lower limbs physiological venous haemodynamics is still lacking of reference velocity values and consequent impact on drainage direction. Aim of the present study is to assess the flow velocities in the different venous compartments, evaluating the possible Venturi effect role, thus finding clues for the identification of the physical model governing the flow direction. Methods Thirty-six lower limbs underwent a velocity and diameters echo-color-Doppler assessment in several anatomical point of analysis along both the deep and superficial venous systems. The investigation protocol included and compared two different manoeuvres to elicit the flow: manual calf compression/relaxation (CR) and active foot dorsiflexion (AFD). Both peak systolic (PSV) and time average velocities (TAV) were measured. Results The different venous segments demonstrated an overlap among the velocity values and the anatomical subdivision of the deep and superficial compartments. At the CR, TAV was 34 ± 12 cm/s in the deep venous system (N1), 15 ± 7 cm/s in the saphenous system (N2), 5 ± 2 cm/s in the saphenous tributaries (N3); PSV was 89 ± 35 cm/s in N1, 34 ± 16 cm/s in N2, 11 ± 4 cm/s in N3, p < 0.05. At the AFD, TAV was 33 ± 13 cm/s in N1, 15 ± 7 in N2, 9 ± 5 in N3; PSV was 83 ± 35 in N1, 32 ± 17 in N2, 15 ± 4 in N3, p < 0.05. A diameter decrease was reported from N1 to N3 ( p < 0.05). Conclusion This investigation provides evidences of the velocity decrease from the deepest to the most superficial compartments. These data introduce the Venturi effect as potential factor in the flow aspiration from the tributary to the deeper veins. The reported data represent a first step towards an objective evaluation of the physic laws governing the drainage. These values can constitute the basis for further investigations in pathological and post-procedural scenarios.
Congenital Angiodysplasia of the Lower Limb: The Klippel—Trenaunay Syndrome and Arteriovenous Fistulae
Authors: Lendorf Axel , Struckmann Jan , Strange-Vognsen Hans H. , Nielsen S. Levin 
Published: January 2017

During a 10-year period 13 patients were admitted on suspicion of congenital arteriovenous fistulae. Two patients turned out to have a Klippel-Trenaunay syndrome without evidence of arteriovenous fistula and two patients had agenesis of the venous drainage system. Evaluation by noninvasive methods for classification of this rare condition is of the microsphere injection technique before arteriography and venous emptying measurement before venography. From our experience only the microsphere technique is recommended to evaluate the severity of the shunting. The possibility of a partial excision of the angiodysplasia is the task of the surgeon facing the impossibility of radical operation. Therefore arteriograms should guide the surgeon in his attempt to reduce the hemodynamic consequence of shunting. Patients having a normal arteriogram should have a venogram before surgical exploration is attempted. In the series three patients turned out to have venous defects and removal of superficial varicosities would have aggravated the situation.
Effects of Micronization on Digestive Absorption of Diosmin
Authors: Johnston A. M. , Paul H. J. , Young C. G. 
Published: January 2017

Objective: To investigate the effect of diosmin particle size on the rate and extent of absorption and excretion of total radioactivity, following oral administration of micronized and non-micronized [14C]-diosmin to New Zealand White rabbits. Design: This study was conducted in a 2 x 12 cross-over design at a uniform target dose level of 10 mg/kg, and was conducted according to Good Laboratory Practice. The micronized formulation was prepared using a Microdismembrator II, and all prepared doses were suspended in 0.5% w/v aqueous methylcellulose at a target concentration of 5 mg/ml. Particle size analysis indicated that in the micronized formulation, 90% of particles were ≤2 <m, and in the non-micronized formulation, more than 75% of particles were ≥3 <m. Results: Analysis of percentage dose excreted via urine post-dose indicated a higher urinary output in the animals that received micronized diosmin (mean of 72% dose in both 0–48 h and 0–168 h) compared with means of 16% dose and 17% dose, respectively, in animals that received the non-micronized formulation. Statistical analysis showed these differences to be highly significant ( p < 0.0001), with no evidence of sequence or phase effects. Conclusion: Reduction of particle size of [14C]-diosmin when administered orally as a suspension to rabbits resulted in a marked increase in the proportion of the dose excreted in urine. This increase was considered to reflect an increased absorption of radiolabelled components from the micronized dose.
Differences Between Upper and Lower Limbs in Venous Endothelial Reactivity in Humans
Authors: Bailliart O. , Boudaoud L. , Bonnin Ph. , Sollier C. Bal Dit , Roussi J. , Carayon A. , Martineaud J. P. , Drouet L. O. 
Published: January 2017

Objective: To determine the variability of endothelial reactivity to venostasis in the upper and lower limbs of healthy subjects. Participants: Ten healthy volunteers were investigated twice, at an interval of 1-week. Main outcome measures: Plasma concentrations of substances released from endothelial cells were determined in each limb after 10 min of venostasis in a sequential manner. Tissue plasminogen activator (tPA), plasminogen activator inhibiting factor (PAI-1), thrombin–antithrombin complexes (TAT) and D-dimers (D-Di) were used as indicators of the thrombotic process and its reactions; angiotensin converting enzyme (ACE) and endothelin-1 (ET1) were related to endothelial cell activity involved in vascular tone regulation. Results: No difference was observed in endothelial cell recovery following venostasis after an interval of 1 week. A significant difference in endothelial cell release was found between the upper and lower limbs and between the right and left legs. Conclusions: Excellent reproducibility of measurements was observed. In keeping with the higher frequency of venous thrombosis in the lower limbs, the left leg seemed to be less reactive after venostasis, and the endothelium was more reactive in the upper than in the lower limbs.
Physiology of Lymphatic Oedema
Authors: Cossio J. A. Jimenez 
Published: January 2017

Objective: To describe the physiological mechanisms implicated in lymph formation and drainage, and the pathophysiology of lymphoedema. Design: Historical steps leading to the current understanding of the physiology and pathophysiology of lymph formation. Data extraction: Selection of relevant articles from the literature. Data synthesis: After a summary of the anatomical structures involved in the lymphatic system, the physiology of lymph formation and transport is described with special emphasis on recent hypotheses. The pathophysiology of lymphoedema is explained based on a combination of two factors: protein content and fluid movements within the lymphatic system. Conclusion: The pathophysiology of lymphoedema is currently better understood, even if some aspects remain unclear. This can lead to an improved therapeutic management of lymphoedema.