bluuebunny/crossref_metadata_2025_split huggingface dataset:
Some Fundamental Fracture Mechanisms Applicable to Advanced Filament Reinforced Composites
Authors: Mullin J. , Berry J.M. , Gatti A. 
Published: July 2017

The object of this study is to establish experimentally the critical fracture modes of an epoxy matrix in the vicinity of a break in a high modulus, high strength filament simulating the effect of tensile loading on unidirectional composites. Three distinct failure modes were observed to occur and the nature of these three modes is explained through an analysis of the stress state in the matrix. A single filament embedded in an epoxy novolac was used to examine the fracture process. The advantage of using this type of resin arises from its ability to be modified to varying degrees of crack sensitivity. The effects of varying gross strain rate were evaluated and the study was then extended to specimen configurations containing more than one filament. This approach permits the examination of the interaction of nearby filaments with localized fracture processes. Filaments of boron on tungsten (B/W) boron on Silica (B/SiO 2), boron carbide on B/W and tungsten wire were used with epoxy novolac (DEN 438).
Properties of Graphite Fiber Nonmetallic Matrix Composites
Authors: Dauksys R.J. , Ray J.D. 
Published: July 2017

Recent results of development and characterization of high perform ance graphite reinforced plastic composites are reviewed. Fabrication and characterization of epoxy matrix composites utilizing a variety of types and forms of high modulus graphite fibers as the reinforcement are discussed. Data relating interlaminar shear strength of composites to fiber surface condition and the effectiveness of fiber treatments to increase interlaminar shear strengths are reported. Graphite fibers in an increasing number of forms have been in vestigated as composite reinforcements. These forms include: con tinuous yarns of varying twist, short lengths of 10,000 filament tows, very long lengths (ca. 1000 feet) of tows, and continuous staple yarns of long (ca. 7 inch) fibers. A considerable range of average fiber proper ties is involved, such as moduli of 25 to 65x106 psi, tensile strengths of 150 to 450x103 psi, and densities of 1.4 to 2.0 g/cc.
Referrals for Psychiatric Reports: A Study on Solicitor to Psychiatrist Communication
Authors: Grant William 
Published: July 2017

Much of the communication between solicitors and psychiatrists is by letter. To determine what are the most important items (‘key items’) that should be included in a request for a psychiatric court report, questionnaires were sent to 20 psychiatrists, all of whom had experience in preparing psychiatric court reports. Then 150 requests for psychiatric court reports were studied and rated for the inclusion of key items. The referral letters rarely fulfilled the psychiatrists' requirements and in only 42 per cent was it clearly stated why a report had been requested. The study suggests that psychiatrists should explain more clearly to solicitors what information they require and solicitors need to be more aware of psychiatrists' requirements.
Antilibidinal Drugs and Mental Retardation: A Review
Authors: Clarke David J. 
Published: July 2017

A minority of people with mental retardation have sexual behaviour which is socially unacceptable or which brings them into conflict with the law. Such behaviour may be the result of ignorance about sexual matters, often best managed by counselling or by a behavioural approach. There are a small number of men with mental retardation and aberrant sexual behaviour who benefit from the prescription of an antilibidinal drug. Treatment with an antilibidinal drug alone reduces the intensity of sexual drive but does not alter its direction; concurrent sexual counselling or psychotherapy is often indicated. The various antilibidinal medications available are reviewed, with particular attention to reports which have described the treatment of people with mental retardation. Of the antilibidinals currently used, medroxyprogesterone acetate and cyproterone acetate are those for which there is most evidence of efficacy. Cyproterone acetate is preferable because it has a specific antiandrogenic action and fewer adverse effects. There is a need for controlled studies of antilibidinal drugs, with clearly defined inclusion criteria and adequate measures of both behavioural and attitudinal change.
Food Refusal in Prison
Authors: Larkin E. P. 
Published: July 2017

The prevalence of mental disorder amongst prisoners refusing food was studied by examining the prison records of a remand prison and a dispersal prison. Food refusal occurred predominantly in the remand prison. Less than one per cent of the annual remand population engaged in this behaviour. The results indicate that prisoners refusing food do so as a form of protest and that the prevalence of mental disorder among such prisoners is high. The majority respond to observation and counselling. Important indicators of psychosis are: (i) the inability of the prisoner to divulge reasons for his behaviour; and (ii) the refusal by the prisoner of both food and fluids. In such cases transfer to hospital for treatment may be urgently required.
An Approach to the Patient with Skin Disease
Authors: Olumide Yetunde Mercy 
Published: July 2017

We practise an integrated approach to the management of skin diseases, leprosy and sexually transmitted diseases because the latter diseases are still stigmatized and patients are unwilling to attend clinics so labelled. When approached by a patient with skin disease it is advisable to see the patient promptly, because any further delay encourages the use of assorted remedies which may lead to undesirable complications, physically, emotionally and financially. Since there is no health insurance scheme, it is also prudent to manage the patient as much as possible without admission to hospital and with minimal laboratory investigations, to save cost, so that the patient still has sufficient money to buy the required drugs. Family health workers treat patients at the primary health care (PHC) level. At this level, patients are managed by the use of specially prepared standing orders (SO), where checklists and flow charts are grouped by problems or complaints, to facilitate usage by an individual with minimal training in morphology. The SO presents, so far as is possible, the best treatment available for each condition, but which cannot be misused by the primary health care personnel. Before discussing the management of individual diseases, it is important for the reader to appreciate the milieu in which we practise which determines our approach to the patient with skin disease. Some of its features will be highlighted before the management of individual disorders is discussed.
Cutaneous Findings Associated with HIV Disease Including AIDS: Experience from Sub Saharan Africa
Authors: Pallangyo K J 
Published: July 2017

Cutaneous manifestations are common in patients with HIV infection and tend to be more frequent as immunodeficiency progresses. In the initial stage of HIV infection a transient maculopapular-rash may appear. During the otherwise asymptomatic phase that follows, patients may develop seborrhoeic dermatitis, persistent genital ulcer disease, pruritic papular eruption and/or a variety of scaling dermatoses. The most frequent skin tumour associated with HIV disease is Kaposi's sarcoma. Skin manifestations of adverse reactions to a variety of drugs occur more frequently in patients with HIV disease than in immunocompetent patients. In general most skin diseases that occur in association with HIV disease respond well to standard treatment regimens. However relapses, and/or recurrences are frequent in this group of patients.
Rhinomanometry for Preoperative and Postoperative Assessment of Nasal Obstruction
Authors: Gordon Andrew S.D. , McCaffrey Thomas V. , Kern Eugene B. , Pallanch John F. 
Published: July 2017

In this retrospective study we used active, anterior mask rhinomanometric methods to measure nasal resistance before and after surgery for nasal obstruction. The study group comprised 60 patients with nasal obstruction who had 63 preoperative and postoperative rhinomanograms and the control group contained 14 asymptomatic patients who underwent rhinomanometric studies before transnasal, transsphenoidal pituitary surgery. Before surgery the study group had significantly higher total and combined unilateral nasal resistances than either the control group before surgery (p < 0.05 and p < 0.01, respectively) or the study group after surgery (p < 0.0001 for both comparisons). Surgery normalized the nasal resistances of the study group in relation to the control group. A total nasal resistance greater than 1 cm H2O/L/sec or a unilateral resistance greater than 3.5 cm H2O/L/sec suggests clinically significant nasal obstruction. Airway narrowing and obstructive symptoms correlated with airway resistance in the preoperative patient, but symptoms did not correlate well with postoperative resistance.
Rhinomanometric Evaluation of Two Nasal Steroid Sprays in Rhinitis
Authors: Kohan Darius , Jacobs Joseph B. , Nass Richard L. , Gonzalez Sandra 
Published: July 2017

A prospective, randomized study comparing the effectiveness of two nasal steroid sprays, flunisolide and beclomethasone dipropionate, in the treatment of nasal obstruction associated with allergic or vasomotor rhinitis has been conducted at New York University Medical Center–Bellevue Hospital. All patients underwent routine history and physical examinations and a modified radioallergosorbent test. Paranasal sinus films were used to exclude patients with sinusitis. The Rhinotest microprocessor rhinomanometer was used to quantify pretreatment and posttreatment total nasal air flow and resistance during a period of 2 months. These findings were assessed in conjunction with the patients' subjective complaints. Results demonstrated that anterior rhinomanometric assessment of the nasal airway during inhalant therapy correlated well with the patients' own subjective impressions of nasal air flow. Both steroid inhalants were effective; however, flunisolide provided for earlier and more substantial symptomatic relief. Beclomethasone dipropionate had milder side effects.
Usefulness of 1000 Hz Tone‐Burst‐Evoked Responses in the Diagnosis of Acoustic Neuroma
Authors: Telian Steven A. , Kileny Paul R. 
Published: July 2017

The auditory brain stem response (ABR) has become widely recognized as a sensitive and cost‐effective screening modality in neuro‐otologic diagnosis. However, the audiometric characteristics of the test ear may obscure the interpretation of the click‐evoked ABR, particularly in the face of high‐frequency hearing loss. It is often unclear whether latency delays or absent responses are attributable to retrocochlear disease or simply to the magnitude of the patient's hearing loss. The acoustic click stimulus commonly used in ABR testing activates predominantly the basilar membrane in the 2000 to 4000 Hz range. Because many cochlear and retrocochlear processes are associated mainly with hearing loss in this range, we have found it helpful in selected cases to use 1000 Hz tone‐burst stimuli to circumvent the effects of elevated hearing thresholds on the ABR. In this article, our experience with the use of 1000 Hz nonlinearly gated tonebursts in 17 patients with acoustic neuroma is presented.
Percutaneous Endoscopic Gastrostomy and Jejunostomy for Long‐Term Feeding in Patients with Cancer of the Head and Neck
Authors: Shike Moshe , Berner Yitshal N. , Gerdes Hans , Gerold Frank P. , Bloch Abby , Sessions Roy , Strong Elliot 
Published: July 2017

Enteral feeding is often required in patients with cancer of the head and neck. Percutaneous endoscopic gastrostomies (PEGs) and Jejunostomies (PEJs) can facilitate enteral feeding in patients who require this treatment. The endoscopic technique allows for the placement of feeding gastrostomies and Jejunostomies without a surgical procedure and eliminates the need for nasal tubes for long‐term enteral feeding. Forty‐two patients with head and neck tumors were referred for placement of PEGs because of severe dysphagia induced by tumors, surgery, radiation, or chemotherapy. The procedure was performed in the gastroenterology suite. Patients were sedated with intravenous meperidine and diazepam, and local anesthetic with lidocaine was applied to the area of incision. Average procedure time was approximately 20 minutes. The procedure was successful in 39 patients in whom tubes were placed ranging in diameter from 15F to 22F. PEGs were placed in 36 patients with intact stomachs and PEJs in three patients with previous gastrectomies. The remaining three procedures were unsuccessful because of technical reasons. There were three localized skin infections, and all responded to antibiotic therapy. Neither peritonitis nor any other immediate complication occurred. In 16 nonhospitalized patients, the procedure was performed on an outpatient basis. After a mean followup of 4.5 ± 6 months of enteral feeding in the home, there was only one case of aspiration and subsequent pneumonia, and this case responded to antibiotics. No other long‐term complications were noted. Thus feeding gastrostomies and Jejunostomies can be placed safely and easily in patients with cancers of the head and neck by endoscopic methods without abdominal surgery. These tubes can be used for enteral feeding and eliminate the need for nasogastric tubes. They are better tolerated, are of a wider diameter, and have a reduced risk for migration, clogging, and aspiration‐related complications.
A Granulomatous Colitis of Dogs with Histologic Resemblance to Whipple's Disease
Authors: Van Kruiningen H. J. , Montali R. J. , Strandberg J. D. , Kirk R. W. 
Published: July 2017

A disease is described in Boxer dogs clinically characterized by an intractable, sometimes hemorrhagic chronic diarrhea. Nine cases were studied from one kennel. Pathologically the disease is defined as a granulomatous colitis. The histologic lesion is a distension of the lamina propria and submucosa of the colon and cecum with large pink staining macrophages, the majority of which are PAS positive, and some of which contain bacteria-like structures. Lymph nodes draining the cecum and colon contain similar macrophages. The macrophages, and their contents, are compared to those occurring in lesions of Whipple's disease of man. Whipple's disease is compared with Johne's disease of ruminants. Based on the histological and histochemical similarities between the granulomatous colitis of dogs and Whipple's disease of man a similar pathogenesis is postulated and similar therapy is suggested.
Clinical and Neuropathological Changes in Cattle Eating the Leaves of Macrozamia lucida or Bowenia serrulata (Family Zamiaceae)
Authors: Hall W. T. K. , McGavin M. D. 
Published: July 2017

Two steers were fed leaves of plants of the family Zamiaceae, one Bowenia serrulata and the other, Macrozamia lucida. Degenerative lesions were demonstrated in the nerve fibres of the fasciculus gracilis and the dorsal spinocerebellar pathways. Two naturally affected animals from an area where m. lucida was grazed were also examined, and in these, degenerative lesions of the fasciculus gracilis were found.
Biomechanical Comparison of Patellar Tendon Repairs in a Cadaver Model: An Evaluation of Gap Formation at the Repair Site with Cyclic Loading
Authors: Ravalin Richard V. , Mazzocca Augustus D. , Grady-Benson John C. , Nissen Carl W. , Adams Doug J. 
Published: July 2017

Background Ruptures of the patellar tendon are rare injuries. Surgical treatment for this injury is mandatory. Hypothesis Gap formation does not differ between the three patellar tendon repair techniques. Study Design Controlled laboratory study. Methods Twelve fresh-frozen cadaveric knees were used to compare three techniques of patellar tendon repairs. The standard suture repair used two Krackow sutures placed in the avulsed patellar tendon, passed through transpatellar drill holes, and secured with the knee in 30° of flexion. In the second group, suture repair was augmented with a No. 5 Ethibond suture. In the third group, suture repair was augmented with a 2.0 Dall-Miles cable. Testing was performed with the specimens mounted to a custom knee jig with the tibia free, simulating the knee moment of a 70-kg person. Each knee was then cycled 250 times at 0.25 Hz. Results Gap formation across the standard suture repair averaged 7.3 mm; across the suture augmentation and cable augmentation groups it averaged 4.9 mm and 3.5 mm, respectively. Conclusions Augmentation of patellar tendon avulsions can decrease gap formation at the repair site, allowing early mobilization. Clinical Relevance Gap formation seen in repair without augmentation could lead to clinical failure with resultant patella alta and extensor mechanism lag.
Prevention of Axillary Nerve Injury in Anterior Shoulder Reconstructions
Authors: McFarland Edward G. , Caicedo Juan Carlos , Kim Tae Kyun , Banchasuek Prachan 
Published: July 2017

Background Previous authors have suggested that the axillary nerve should be explored or palpated during all anterior shoulder stabilization procedures. Objective The goal of this study was to document the axillary nerve injury rate in a cohort of patients who had undergone anterior shoulder stabilization without axillary nerve dissection. Hypothesis Use of a subscapularis muscle-splitting approach by using a retractor along the scapular neck does not result in significant risk of injury to the axillary nerve, and exploration of the axillary nerve is not necessary using this approach. Study Design Prospective cohort study. Methods One hundred and twenty-eight anterior stabilizations were performed with a subscapularis muscle-splitting approach that has been previously described. In all cases a retractor was placed along the inferior scapular neck to protect the axillary nerve. The axillary nerve was not exposed or palpated in any case. All patients were evaluated on the 1st postoperative day and again within 10 days for symptoms of axillary nerve palsy, including sensory loss and return of muscle function. One patient (0.8%) had paresthesia in an axillary nerve distribution; recovery occurred without the need for electromyography or other interventions. There were no clinically detected cases of axillary nerve motor dysfunction. Conclusions Routine exposure of the axillary nerve is not necessary during anterior stabilization procedures using a subscapularis muscle-splitting approach if proper precautions are taken to protect the nerve. Other techniques of anterior stabilization may require exposure of the axillary nerve.
Improved Healing of Transected Rabbit Achilles Tendon after a Single Injection of Cartilage-Derived Morphogenetic Protein-2
Authors: Forslund Carina , Aspenberg Per 
Published: July 2017

Background Achilles tendon ruptures in humans might be treated more efficiently with the help of a growth factor. Cartilage-derived morphogenetic protein-2 has been shown to induce formation of tendon-like tissue. Hypothesis Cartilage-derived morphogenetic protein-2 has a positive effect on mechanical parameters for tendon healing in a rabbit model with Achilles tendon transection. Study Design Controlled laboratory study. Methods The right Achilles tendon of 40 rabbits was transected without tendon suture. Cartilage-derived morphogenetic protein-2 (10 μg) or vehicle control (acetate buffer) was injected locally 2 hours postoperatively. All tendons were tested biomechanically at 8 and 14 days, and treated tendons were histologically and radiographically evaluated at 56 days. Results At 14 days, both failure load and stiffness of treated tendons were increased by 35%. The treated tendons had significantly larger callus size at 8 and 14 days. Histologic and radiographic examination showed no signs of ossification in the treated tendons after 56 days. Conclusions A single injection of cartilage-derived morphogenetic protein-2 led to a stronger and stiffer tendon callus than that in the controls without inducing bone formation. Clinical Relevance Similar results from a larger animal model would suggest a possible future use of cartilage-derived morphogenetic protein-2 in the treatment of human Achilles tendon ruptures.
Efficacy of Cold Gel for Soft Tissue Injuries
Authors: Airaksinen Olavi V. , Kyrklund Nils , Latvala Kyösti , Kouri Jukka P. , Grönblad Mats , Kolari Pertti 
Published: July 2017

Background The use of cold treatment to limit edema, decrease pain, and induce effective muscle relaxation in soft tissue injuries is widespread. Purpose To compare the efficacy of a novel cold gel with that of a placebo gel in patients with a soft tissue injury. Study Design Prospective randomized double-blinded controlled study. Methods Seventy-four patients with sports-related soft tissue injury were randomly assigned to active cold gel (Ice Power) or placebo gel groups. The gel was applied four times daily on the skin for 14 days. Clinical assessment was made after 7, 14, and 28 days with use of visual analog scale ratings. Results Pain scores decreased from 59 to 30 during the first week, to 14 by the second, and to 7 by the end of study in the cold gel group. In the placebo group, pain scores decreased from 58 to 45, 26, and 13, respectively (significant difference). Patient satisfaction with treatment was 71 in the cold gel group and 44 in the placebo group (significant difference). Disability decreased significantly more rapidly in the cold gel group. Conclusions Cold gel therapy provided an effective and safe treatment for sports-related soft tissue injuries.
Treating Delusional Disorder: A Comparison of Cognitive-Behavioural Therapy and Attention Placebo Control
Authors: O'Connor Kieron , Stip Emmanuel , Pélissier Marie-Claude , Aardema Frederick , Guay Stéphane , Gaudette Gilles , Van Haaster Ian , Robillard Sophie , Grenier Sébastien , Careau Yves , Doucet Pascale , Leblanc Vicky 
Published: July 2017

Objective: Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophrenia and delusional disorder (DD). Clinical trials of DD have mostly compared CBT with either treatment as usual, no treatment, or a wait-list control. This current study aimed to assess patients with DD who received CBT, compared with an attention placebo control (APC) group. Method: Twenty-four individuals with DD were randomly allocated into either CBT or APC groups for a 24-week treatment period. Patients were diagnosed on the basis of structured clinical interviews for mental disorders and the Maudsley Assessment of Delusion Schedule (MADS). Results: Completers in both groups ( n = 11 for CBT; n = 6 for APC) showed clinical improvement on the MADS dimensions of Strength of Conviction, Insight, Preoccupation, Systematization, Affect Relating to Belief, Belief Maintenance Factors, and Idiosyncrasy of Belief. Conclusion: When compared with APC, CBT produced more impact on the MADS dimensions for Affect Relating to Belief, Strength of Conviction, and Positive Actions on Beliefs.