bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Surgeon Age and Experience With Congenital Heart Surgery Outcomes
Authors: Anderson Brett R. , Wallace Amelia S. , Hill Kevin D. , Gulack Brian C. , Matsouaka Roland , Jacobs Jeffrey P. , Bacha Emile A. , Glied Sherry A. , Jacobs Marshall L. 
Published: July 2017

Background—
Surgeon experience concerns both families of children with congenital heart disease and medical providers. Relationships between surgeon seniority and patient outcomes are often assumed, yet there are little data.

Methods and Results—
This national study used linked data from the American Medical Association Physician Masterfile and the Society of Thoracic Surgeons-Congenital Heart Surgery Database to examine associations between surgeon years since medical school and major morbidity/mortality for children undergoing cardiac surgery. Sensitivity analyses explored the effects of patient characteristics, institutional/surgeon volumes, and various measures of institutional surgeon team experience. In secondary analyses, major morbidity and mortality were examined as separate end points. We identified 206 congenital heart surgeons from 91 centers performing 62 851 index operations (2010–2014). Median time from school was 25 years (range 9–55 years). A major morbidity/mortality occurred in 11.5% of cases. In multivariable analyses, the odds of major morbidity/mortality were similar for early-career (<15 years from medical school, ≈<40 years old), midcareer (15–24 years, ≈40–50 years old), and senior surgeons (25–35 years, ≈50–60 years old). The odds of major morbidity/mortality were ≈25% higher for operations performed by very senior surgeons (35–55 years from school, ≈60–80 years old; n=9044 cases). Results were driven by differences in morbidity. In extensive sensitivity analyses, these effects remained constant.

Conclusions—
In this study of >200 congenital heart surgeons, we found patient outcomes for surgeons with the fewest years of experience to be comparable to those of their midcareer and senior colleagues, within the context of existing referral and support practices. Very senior surgeons had higher risk-adjusted odds of major morbidity/mortality. Contemporary approaches to training, referral, mentoring, surgical planning, and other support practices might contribute to the observed outcomes of junior congenital heart surgeons being comparable to those of more experienced colleagues. Understanding and disseminating these practices might benefit the medical community at large.
Severe Aortic Stenosis in Dialysis Patients
Authors: Kawase Yuichi , Taniguchi Tomohiko , Morimoto Takeshi , Kadota Kazushige , Iwasaki Keiichiro , Kuwayama Akimune , Ohya Masanobu , Shimada Takenobu , Amano Hidewo , Maruo Takeshi , Fuku Yasushi , Izumi Chisato , Kitai Takeshi , Saito Naritatsu , Minamino‐Muta Eri , Kato Takao , Inada Tsukasa , Inoko Moriaki , Ishii Katsuhisa , Komiya Tatsuhiko , Hanyu Michiya , Minatoya Kenji , Kimura Takeshi ,   on behalf of the CURRENT AS Registry Investigators
Published: July 2017

Background
Characteristics and prognosis of hemodialysis patients with severe aortic stenosis have not yet been well defined.

Methods and Results

The
CURRENT AS
(contemporary outcomes after surgery and medical treatment in patients with severe aortic stenosis) registry, a Japanese multicenter registry, enrolled 3815 consecutive patients with severe aortic stenosis. There were 405 hemodialysis patients (initial aortic valve replacement [
AVR
] group: N=135 [33.3%], and conservative group: N=270) and 3410 nonhemodialysis patients (initial
AVR
group: N=1062 [31.1%], and conservative group: N=2348). The median follow‐up duration after the index echocardiography was 1361 days, with 90% follow‐up rate at 2 years. The cumulative 5‐year incidence of all‐cause death was significantly higher in hemodialysis patients than in nonhemodialysis patients in both the entire cohort (71% versus 40%,
P
<0.001) and in the initial
AVR
group (63.2% versus 17.9%,
P
<0.001). Among hemodialysis patients, the initial
AVR
group as compared with the conservative group was associated with significantly lower cumulative 5‐year incidences of all‐cause death (60.6% versus 75.5%,
P
<0.001) and sudden death (10.2% versus 31.7%,
P
<0.001). Nevertheless, the rate of aortic valve procedure–related death, which predominantly occurred within 6 months of the
AVR
procedure, was markedly higher in the hemodialysis patients than in the nonhemodialysis patients (21.2% and 2.3%,
P
<0.001).

Conclusions

Among hemodialysis patients with severe aortic stenosis, the initial
AVR
strategy as compared with the conservative strategy was associated with significantly lower long‐term mortality risk, particularly the risk for sudden death, although the effect size for the survival benefit of the initial
AVR
strategy was smaller than that in the nonhemodialysis patients.
Brahmo Samaj, Unitarians and Canada: A forgotten chapter in Indo-Canadian religious history
Authors: Mullick Sunrit 
Published: July 2017

In the afternoon I had to speak at the Philosophical Club of the University [of Toronto] on "Present-day Currents of Religious Thought in India." It was a hard task to present the subject in an intelligible shape in one hour's discourse to a Canadian audience, and so it was a great gratification to me, when at the end of the lecture Dr. Abbott, President of the Club, observed that the discourse gave him a clearer grasp of the conditions of religious thought in India than he had heard from anything he had read or heard before, and Dr. Hume, Professor of Philosophy in the University, suggested in his short speech that an interchange of professors on the principle recently adopted by the German Emperor, might help India and Canada to understand each other better in the future. The same night I had to speak again at the Unitarian Club on "India and the Brahmo Samaj.... 1
Response of Reinforcing Wires to Compressive States of Stress
Authors: Herrmann Leonard R. , Mason William E. , Chan S.T.K. 
Published: July 2017

A theoretical investigation of the compressive response of a wire embedded in an elastic matrix is reported. In the first section con sideration is given to the beam-column behavior of an initially crooked wire embedded in a matrix which is subjected to a state of uniaxial stress. A plot of the effective stiffness of the wire as a function of the wire's initial crookedness is given. Secondly, con sideration is given to the possibility of buckling, within the matrix, of a compressively loaded straight wire. A plot of the buckling load of the wire as a function of the ratio of the wire's and matrix's shear moduli is given. Two procedures are developed for the pre diction of the lateral support offered to the wire by the matrix. Both procedures are developed by treating the matrix as a three- dimensional elastic solid, however, only the first of the two meth ods completely satisfies the displacement continuity requirements between the wire and the matrix. This research was supported under subcontract to the Stanford Research Institute, Menlo Park, California, under prime contract no. N123 ( 60530)-55641A with the U. S. Naval Ordinance Test Station, China Lake, California.
Prediction of Violence on a Psychiatric Intensive Care Unit
Authors: Eaton Scott , Ghannam Mohammed , Hunt Neil 
Published: July 2017

The aim of the present study was to identify patients who were at particular risk of violent behaviour, over a period of one month in a psychiatric high dependency unit, and to examine whether particular patients could be identified at admission who would subsequently be violent. Medical records, and other documents for 52 inpatients were included. Demographic, historical and clinical data available at admission were noted. All violent incidents were recorded and classified. Seventeen of 52 patients committed physical violence, usually to the staff. Most incidents were carried out by a small number of individuals. Identifying the violent, using variables available at admission, was not possible. The ward admitted a group with a subsequent high rate of violence. Prediction within this high-risk group was not possible. Measures aimed at preventing violence on a local secure ward should apply to all patients and should not be targeted just at those that would appear to be the most likely to be violent.
Detention of Elderly Psychiatric Inpatients under Section 5(2) of the Mental Health Act 1983
Authors: Salib Emab , Tadros George , Ambrose Angela , Allington Mark 
Published: July 2017

Emergency detention of elderly psychiatric inpatients appears to have attracted very little or no attention in published studies. In this retrospective review, all applications of sections 5(2) and 5(4) of the Mental Health Act 1983, detaining elderly inpatients in North Cheshire between 1985 and 1997 were reviewed. Forty-three percent of elderly inpatients under s.5(2) regained their voluntary status, while 57% were detained under another section by the end of the 72 hours (p<0.05). Duration in hospital prior to applying s.5(2), clinical diagnosis of functional mental illness and use of s.5(4) appear to increase the likelihood of converting s.5(2) into other sections. The high rate of non-conversion of s.5(2) in the elderly to s.2 or 3 may imply that in almost half of the cases, emergency detention may have been used to control isolated incidents of disturbed behaviour in otherwise co-operative patients. Educating doctors and nurses in guidance put forward by the Code of Practice (1993) remains, probably, the main key to a better use of emergency holding powers.
1. An Autopsy Case of Sudden Death in a Patient with Idiopathic Scoliosis
Authors: Hitosugi Masahito , Shigeta Akio , Takatsu Akihiro 
Published: July 2017

A 38-year-old woman with idiopathic scoliosis (right convex thoracic scoliosis, 78°; left convex lumbar curvature, 75°) died suddenly. Forensic autopsy and histopathologic examination revealed chronic congestive oedema, numerous cavities and atrophic changes of heart. These changes, including both respiratory changes and biventricular failure caused by hypoplastic cardiac changes, were due to a deformed thoracic cage. This case illustrates that not only abnormalities of respiratory function and cor pulmonare, but also hypoplastic cardiac changes, may cause sudden death in a patient with untreated scoliosis.
The Distinction between “Graphology” and “Questioned Document Examination”
Authors: Baxter P. G. 
Published: July 2017

A distinction must be drawn between the Various studies associated with the acts of writing, the preparation of documents by other means, and the examinations involved in determining the authorship of a given writing or the genuineness of a particular document. It is the object of this paper to define certain terms and to give a brief but factual history of the main disciplines involved, thereby making the distinction clear. The quantity of literature available on the subject of Graphology is enormous, whilst that on Questioned Document Examination is somewhat less. Obviously in a short communication such as this there will be omissions; however, a comprehensive list of references is given where the reader can select for study at length any particular aspect of this work.
Deaths Caused by Animals in Finland
Authors: Karkola K. , Möttönen M. , Raekallio J. 
Published: July 2017

An average of five people die annually in Finland of injuries caused by domestic animals. During the years 1957–68 the greatest number of deaths (30) was caused by horses, then by cows (18), and bulls (11). Dogs had killed 2 people and a cat and ram 1 person each. None of these deaths was a result of bites. Poisonous animals caused 22 deaths during the years 1936–68. Out of these 22, 20 were snake bites (the last one in 1961) and 2 were wasp stings (the last one in 1959). In 1969, a very unusual death was caused by pigs in Turku. A farmer was found dead in the pigsty among 12 pigs. He had lain there for about six hours. The autopsy showed that he had suffered from severe aortic stenosis. The viscera showed signs of cardiac failure. The pigs had gnawed the soft parts of the face, the eyes, all organs of the neck, and the genitals. Biochemical determination of histamine and serotonin proved that the wounds had been caused before death. Organs of the abdominal cavity had also been crushed. Bites and marks of pigs' feet were observed all over the body. Most likely, the man had fallen into the pigsty because of a heart attack. He had obviously been unable to move and was possibly unconscious when the pigs had savaged him.
Drug Abuse in Britain
Authors: James I. Pierce 
Published: July 2017

The pattern of drug abuse by young people in Britain over the past decade or so is described. The London heroin epidemic of the 1960s appears to have been checked by the 1968 regulations and the abuse of amphetamines has declined, with more cautious prescribing habits by British doctors. On the other hand, cannabis and lysergide misuse is more widely prevalent throughout the country. Unlike the U.S.A. there is no direct link between drugs and violence or major crime, although a proportion of drug takers are also delinquent. Similarly, there is no particular connexion between drugs and pornography. It is fashionable to consider that we live in a ‘permissive society’, but it may be more aptly described as a ‘rebellious society’ in which the great majority (but unfortunately not all) of young people is able to handle its emancipation responsibly.
The Heart's Response to the Portrayal of Violence
Authors: Carruthers Malcolm , Taggart Peter , Somerville Walter 
Published: July 2017

Observations have been made on the heart-rate and adrenaline and noradrenaline release in people watching films portraying violence. Contrary to the findings in other emotional situations, the heart-rate slowed during the films suggesting overactivity of the parasympathetic nerve-supply to the heart. Adrenaline excretion in the urine was increased, a finding usually connected with sympathetic overactivity. The suggestion is made that under the conditions of these observations, both sympathetic and parasympathetic overactivity are stimulated, the parasympathetic effect dominating the heart-rate.
The Dangerousness of Dangerousness
Authors: Shaw S. H. 
Published: July 2017

Summary The etymological problems of ‘dangerousness’ are considered. The fact that the concept is changing is pointed out, while some factors related to violent offenders are enumerated. The question of what sort of man serves a long sentence and the effect a long sentence has upon a man is raised, with particular emphasis upon groups of men and the idea of deterioration. Stress is placed upon the need for further research.
The Voluntary Act
Authors: O'Connor D. 
Published: July 2017

The importance of the actus reus in the analysis of criminal behaviour has only gained ground in recent years. The defence that the act complained of was involuntary raises directly the question ‘What is meant by voluntary conduct?’ In its earliest formulations the general acceptance of the doctrine of free will led to a ready acceptance of voluntary as simply meaning being a product of an exercise of the free will. More recent investigations, and in particular those following the development of ego psychology, have shown that the mechanism precedent to the operation of the will is of considerable complexity. Perception, cognition and evaluation of data must each be considered in an analysis of voluntary behaviour, so that what may seem voluntary may well flow from a defective capacity in any or all of these functions. The relationship between defective psychic functions such as those described and the pervasive concept of ‘insanity’ in the criminal law, it is suggested, may have led to the neglect of a study of voluntarism since many cases of psychic malfunction have displayed psychotic symptoms. It is argued that the distinction between self-induced and other-induced as a basis for attaching responsibility in law, as is strongly suggested in the cases, is unsatisfactory. The merit of the recent discussions of the nature of voluntary conduct is that the limitations of a pre-Freudian theory of conscious behaviour enshrined in McNaughton will be recognized within the debate on the nature of voluntary and, more particularly, involuntary conduct.
Identification of Bodies from Fires
Authors: Stevens P. J. 
Published: July 2017

Fire and associated injuries complicate the task of identification by: Making a body unrecognizable or difficult to identify visually; Destroying clothing and documents; Distorting or destroying external physical features such as hair, skin bearing scars, tattoos or other blemishes and skin from fingers (prints); Causing extensive loss of tissue such that whole members may be missing and internal organs completely destroyed. The most helpful means of identification of bodies from fires, therefore, tend to be: Personal property of metal or other fire-resistant material; X-rays; Dental evidence. The way in which the relative value of various means of identification is influenced by the special circumstances of each accident was demonstrated, and the problems that arise and the ways in which many are solved were exemplified by case histories of a number of aircraft accidents and house fire victims, the majority of which have been previously published.
Determination of the Time of Death by Continuous Post-Mortem Temperature Measurements
Authors: Simonsen Jørn , Voigt Jorgen , Jeppesen Niels 
Published: July 2017

In 20 cases with known times of death continuous post-mortem measurements of the temperature fall in brain, calf, liver, axilla and rectum of the bodies have been made, and, in addition, the environmental temperature has been recorded. The observations were not made under standardized conditions, and the clothing of the bodies was left untouched as far as possible. The measurements of the brain temperatures have given the greatest accuracy in determining the time of death; for temperatures above 25 °C the uncertainty was of the order of magnitude of ±2 1/2 hours, at lower temperatures greater. The other sites of measurement permitted less reliable estimates of the post-mortem time, but none of them were found to be appropriate beyond 20 hours after death. There is one factor which cannot be calculated. It is the temperature at the moment of death. All investigations show that it may vary enormously. In the present study the difference between the maximum and the minimum starting temperature ranges between 5 °C and 8 °C, dependent on the site of measurement. As the fall in temperature—irrespective of the site of measurement—during the first few hours post mortem is of the magnitude of 1 °C per hour, the above variation gives an inaccuracy which by far exceeds what can be achieved of greater accuracy by the aid of brain temperature measurements. For this reason the authors feel justified in concluding that the determination of the time of death will always be encumbered with great uncertainty, but that the most reliable estimate within the first 20 hours after death can be based upon the measurement of the brain temperature associated with an evaluation of the development of the signs of death. None of the other methods tested so far appears to have offered a greater reliability.
Legal Changes in Adolescent Psychiatry
Authors: Walshe-Brennan K. S. 
Published: July 2017

Juvenile crime has increased considerably in the past decade. The Police Federation and the Justices' Clerks' Society blame the Children and Young Persons Act 1969 and want the law changed for several reasons. The British Association of Social Workers, however, disagrees. In view of possible changes in the near future, the development of the 1969 Act is traced from World War II with comments on the social conditions then existing. The results of the legislature are discussed with particular reference to Certificates of Unruliness, accommodation difficulties and the role of psychiatry at the present time.
Further Observations on the Validity of Urine Alcohol Levels in Road Traffic Offences
Authors: Flanagan N. G. , Goff D. K. , Butt W. , Hadlow A. J. 
Published: July 2017

In a report which highlighted the decreasing deterrent effect of the breathalyser it was suggested that the police should use the breath test as a screen in high-risk situations. Urine and blood alcohol estimations were performed on 59 paired samples which had been collected under conditions that may be found in these situations. The statutory urine/blood conversion factor of 1·33 was applicable in only 2 of these cases. It is concluded that urine alcohol estimation is unreliable in these circumstances.
Alcohol Associated Mortality in Newcastle upon Tyne
Authors: Sunter J. P. , Heath A. B. , Ranasinghe H. 
Published: July 2017

An autopsy series consisting of 3421 cases over a five year period has been examined retrospectively in order to determine what proportion of the deaths was attributable in some direct way to either the acute or chronic effects of alcohol consumption. It was found that in 3·27 per cent of all deaths alcohol contributed materially to death. This represents 4·43 per cent of all male deaths and 1·57 per cent of all female deaths. The average age at death was 10 years lower in the alcohol associated group than in the autopsy population as a whole. In males of young middle age a particularly high proportion of deaths was associated with alcohol abuse.
The Brennan Case: Medicolegal Insanity?
Authors: McLean Angela M. , Harland W. Arthur 
Published: July 2017

The law of Scotland in regard to insanity induced by drink or drugs is considered in the context of the opinion of seven judges in Brennan's case. Reference is made to the views expressed in the English House of Lords decision in Majewski, also from seven judges. An assessment of legal insanity is given and some medical points noted. Tentative conclusions are suggested.
Deaths of Drug Addicts in London during 1970–4: Toxicological, Legal and Demographic Findings
Authors: Stevens Barbara C. 
Published: July 2017

138 deaths of persons aged 15–50 years with a Coroner's verdict of ‘Due to Addiction’ were found in the London area between 1.1.70–31.12.74: 107 were male and 31 female. Acute drug reaction to intravenous overdosage was the main cause of death in 68·5 per cent of cases, and only 5·6 per cent died of septicaemia. The annual numbers of deaths of addicts was highest in 1972 and now appears to be decreasing. The risk of addicts dying a sudden death in which their addiction was not the main cause but a contributory factor was demonstrated by a 10 per cent random sample of all other inquests, irrespective of verdict, during the same calendar period.
The Characterization of Motor Vehicle Body Fillers
Authors: Home Janet M. , Twibell J. D. , Smalldon K. W. 
Published: July 2017

The compositions of typical British motor vehicle body fillers are reviewed and a systematic scheme is presented for their characterization, which routinely employs sample colour and analysis by pyrolysis gas chromatography and occasionally employs X-ray fluorescence spectrometry in addition. Eighteen samples obtained from manufacturers were all distinguishable and, from the examination of 121 casework samples, the discriminating power of colour and pyrolysis gas chromatography was estimated to be at least 0·92. Twenty-three samples in the casework collection were all similar in colour and produced similar pyrograms. A brief examination of this large group of samples, by X-ray fluorescence spectrometry, indicated that inorganic analysis provided a useful increase in discrimination. The pyrolysis products of polythene were used to calibrate the retention scale of the gas chromatograms (in methylene units) and peak heights were recorded relative to the height of the largest peak (usually styrene). Using data recorded in this manner a computer based system was developed for the comparison of pyrograms and for establishing the evidential value of a particular analysis. It is suggested that a similar approach could be used for the interpretation of pyrograms from a wide variety of other materials.