bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tropical Cyclones in Rotating Radiative–Convective Equilibrium with Coupled SST
Authors: Zhou Wenyu , Held Isaac M. , Garner Stephen T. 
Published: January 2017

Abstract
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.
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.
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.
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.
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.
The Ethics of Postmarketing Observational Studies of Drug Safety Under Section 505(o)(3) of the Food, Drug, and Cosmetic Act
Authors: Evans Barbara J. 
Published: January 2017

In 2007, Congress granted the Food and Drug Administration (FDA) new powers to order pharmaceutical companies to conduct drug safety studies and clinical trials in the postmarketing period after drugs are approved. The methodologies include observational studies that examine patients' insurance claims data and clinical records to infer whether drugs are safe in actual clinical practice. Such studies offer a valuable tool for improving drug safety, but they raise ethical and privacy concerns because they would entail widespread use of patients' health information in commercial research by drug manufacturers. This is the first article to explore the ethics of these section 505(o)(3) observational studies, so named after the section of the Food, Drug, and Cosmetic Act that authorizes them.Data access problems threaten to make the FDA's section 505(o)(3) study requirements unenforceable. Under existing federal privacy regulations, it appears highly unlikely that pharmaceutical companies will have reliable access to crucial data resources, such as insurance claims data and healthcare records, to use in these studies. State privacy laws present another potential barrier to data access. If pharmaceutical companies do manage to gain access to the needed data, this will raise serious privacy concerns because section 505(o)(3) observational studies do not appear to be covered by any of the major federal regulations that afford ethical and privacy protections to persons whose data are used in research.If the FDA's program of section 505(o)(3) observational studies fails because of the above problems, this failure will have a number of bad consequences: the public will be exposed to avoidable drug safety risks; taxpayers may be forced to bear the costs of having the FDA conduct drug safety investigations that would have been funded by drug manufacturers if data had been available; and, perhaps most troubling, the FDA may be forced to order postmarketing clinical trials to answer questions that could have been answered using observational studies. Problems with access to data for section 505(o)(3) studies thus could directly imperil human research subjects by forcing a needless over-reliance on risky postmarketing drug safety trials.This Article concludes by describing a promising new legal pathway for resolving these problems. Congress has provided the FDA a new set of powers that if skillfully exercised will allow the agency: (1) to facilitate pharmaceutical companies' appropriate access to data for use in section 505(o)(3) observational studies, (2) to impose strict ethical and privacy protections for persons whose data are used in these studies, and (3) to mobilize private-sector funding to generate much-needed evidence of the safety of FDA-approved drugs.
Low-Dose Guar Improves Diabetic Control
Authors: Jones D B , Lousley S , Jelfs R , Slaughter P , Carter R D , Mann J I 
Published: January 2017

Twenty diabetic outpatients (12 non-insulin-treated and 8 insulin-treated) were given guar granulate in a dose of 10 g daily for two months in order to study the effect on glycaemic control and lipid levels. Mean glycosylated haemoglobin levels (HbAlc%) fell from 11.1±2.0% pre-guar to 10.5 ± 2.2% (P< 0.001) after one month on guar and to 10.1±2.3% ( P<0.0001) after two months. Following discontinuation of guar, HbAlc% rose to 11.1±2.5% ( P<0.002). However, there were no significant changes in fasting blood glucose, 1 h postprandial blood glucose following a test meal, 24 h urinary glucose excretion or in lipid levels. Gastrointestinal side effects occurred in 4 patients during treatment with guar. Four patients reduced their dose of insulin and 2 patients reduced their dose of sulphonylurea therapy during this time because of symptoms suggestive of hypoglycaemia. We suggest that the low dose of guar used in this study may help improve glycaemic control in diabetic patients and that this may be achieved with a low incidence of gastrointestinal side effects.
Recurrent Varicose Veins
Authors: Juhan Claude , Haupert Serge , Miltgen Gilles , Barthelemy Pierre , Eklof Bo 
Published: January 2017

We report our experience of 93 patients with recurrent varicose veins. Doppler ultrasound and ascending phlebology were routinely performed, with descending or popliteal phlebography in some patients, as a means of evaluating recurrence. Early recurrence was found in a few cases due to incorrect diagnosis. Late recurrence, in the majority of cases, was due to incorrect surgery or the overlooking of gastrocnemius vein incompetence. In some cases deep reflux, soleal arch compression or left iliac vein compression was found to be a possible cause of recurrence. Extensive evaluation of the venous disorder and the ligation of every site of deep to superficial reflux are the first steps in preventing recurrence. The rules and pitfalls of surgical treatment are stressed. On recurrence, Doppler ultrasound is accurate in deep venous assessment and in demonstrating leaking perforators. Ascending phlebography is the method of choice in the investigation of the deep veins and in confirming perforating vein incompetence. We have used popliteal phlebography to demonstrate incompetence of the LSV junction, SSV junction, gastrocnemius vein and mid-thigh and popliteal fossa perforators. When necessary, surgery for recurrent varicose veins must be carefully carried out according to certain basic principles.
Is the ‘Normal’ Limb Normal in Unilateral Varicose Veins?
Authors: Sarin S. , Shields D. A. , Abu-Own A. , Scurr J. H. , Smith P. D. Coleridge 
Published: January 2017

Objective: To define venous function in the clinically normal limb of patients with unilateral primary varicose veins. Design: Prospective study using duplex scanning and photoplethysmography (PPG) as objective criteria of venous function. Setting: The Middlesex Hospital Vascular Laboratory, a teaching hospital centre of referral for the investigation of venous disease. Patients: Thirty patients with clinical unilateral primary varicose veins. Results: All clinically abnormal limbs had abnormalities on investigation. However, four of 30 patients (13%) also had abnormal duplex findings on the contralateral clinically normal limb, and six (20%) had abnormal PPG refilling times. A total of 26% clinically normal limbs could be demonstrated to have some abnormality of venous function using these two tests. Conclusions: We have shown that the contralateral, clinically normal limb cannot be assumed to be normal without full formal venous assessment.
Non-Invasive Methods of Measuring Venous Compliance
Authors: Davies A. H. , Magee T. R. , Hayward J. , Harris R. , Baird R. N. , Horrocks M. 
Published: January 2017

Objective: To compare two non-invasive methods of qualitative assessment of the long saphenous vein in terms of venous compliance. Design: Thirty-five long saphenous veins were examined. Compliance measurements have been calculated using: Method A in which an AV Impulse machine (Novamedix, UK) is used to generate a pulse wave in the long saphenous vein and the measurement of transit times are performed. Method B involves duplex ultrasound and venous occlusion of the long saphenous vein. Occlusive pressure measurements are used in both methods. Results: The mean vein compliance ratio measured in 35 long saphenous veins with the different methods was 0.23 (0.18–0.28) and 0.26 (0.22–0.30) using method A and B respectively. (Mean and (95% confidence interval)). The results show that a good correlation r = 0.91 and this was confirmed using methods of agreement. Conclusion: Both techniques give comparable results, however, the method involving Duplex is easier to perform. The research and clinical implications of these techniques remain to be assessed.
The Effects of Varicose Vein Surgery on the Venous Function of the Lower Limb
Authors: Moor P. S. , Travers J. P. , Makin G. S. 
Published: January 2017

Objectives: To assess the effect of varicose vein surgery on the venous function of the lower limb and to determine the ability of strain-gauge and photoplethysmography in discriminating between normal and abnormal venous function. Design: Prospective randomized trial with follow-up to 1 month postoperatively. Study group: Fifteen patients presenting for varicose vein surgery and 10 controls with no evidence of venous insufficiency. Interventions: Venous investigations were carried out preoperatively and at 1 month postoperative appointments. Main outcome measures: The effect of varicose vein surgery on lower limb venous function and the ability of plethysmography to distinguish normal from abnormal venous function. Results: Significant differences were found between pre- and postoperative venous refilling times (VRT) in patients attending for varicose vein surgery ( p><0.01). Significant differences were also found between control and case preoperative VRTs. No significant differences were found between pre- and postoperative, and case/control venous outflow (VO) and venous capacitance (VC) values. Conclusion: Varicose vein surgery improved the venous function in all of the lower limbs investigated. Photoplethysmographic venous refilling times were found to be a useful, reproducible measure, able to distinguish normal from abnormal venous function.