bluuebunny/crossref_metadata_2025_split huggingface dataset:
Force Majeure (Legal Necessity): Justification for Active Termination of Life in the Case of Severely Handicapped Newborns after Forgoing Treatment
Authors: Leenen H. J. J. , Ciesielski-Carlucci Chris 
Published: July 2009

The health of newborns has always been subject to the natural lottery. When in the past a severely disabled baby was born, nature provided the “solution,” and the child did not survive. Medical technology has brought about a change; fetuses who would have died during pregnancy or newborns who once would have had little chance to survive are now kept alive. Although these technological advances do benefit many children, the dark side is that more severely handicapped babies are surviving.When a severely disabled baby is born, all persons concerned are faced with emotional difficulties as well as moral and legal dilemmas. Questions that arise include whether it is acceptable, morally and legally, to allow the severely handicapped newborn to die by forgoing treatment or by direct intervention.
In Vitro Fertilization: Regulations in Germany
Authors: Wiesing Urban 
Published: July 2009

In Germany — as probably worldwide — in vitro fertilization (IVF) has provoked disapproval, fears, and dread, but it also raises hope and gives feelings of pride and satisfaction in a new scientific achievement. Critics look for convincing argu- ments that could ban IVF completely or at least restrict it considerably. Some of the most important arguments are outlined below.The main aspect of IVF that was new to society was that conception could take place outside the female body. Although this fact has made a deep impression on us, no ethical relevance has been attributed to it. One must look further for arguments against IVF.
The Ethics Consultant and Ethics Committees, and their Acronyms: IRBs, HECs, RM, QA, UM, PROs, IPCs, and HREAPs
Authors: Schiedermayer David , La Puma John 
Published: July 2009

Much has been written about the role of hospital ethics committees. Ethics committees may have begun in Seattle in the early 1960s, but they were reified in. New Jersey by the Quinlan Court in the 1970s and thrived in the national bioethics movement of the 1980s.In this flurry of ethics activity, several new forms of ethics committees have evolved. New forms of ethics committees include patient care-oriented ethics committees (RM, QM, & QA). Many ethicists are familiar with mission-oriented ethics committees (IRBs & HECs). Such committees have taken on new roles, and Include PROs, IPCs, and HREAPs. In general, these committees are regulatory in nature and may often rely on rules and regulations to assess patient cases, research protocols, and health professional practices.
HMO Doctor – for Nonsmokers Only?
Authors: Herring Marvin E. , Erde Edmund L. 
Published: July 2009

When patients join a Health Maintenance Organization (HMO), they choose a primary care physician from among a set whose members are approved by a board according to preestablished criteria. To assist patients in making their choice of physician, the HMO provides them an information packet about each physician.Recently, a physician (let us call him Dr. Exchs) requested permission to include in the information packet about himself that he would not accept patients who smoke and would not continue the care of current patients who smoke. His poignant statement follows.
Distributive Justice and the Regulation of Fertility Centers: An Analysis of the Fertility Clinic Success Rate and Certification Act
Authors: Baker Doris J. , Paterson Mary A. 
Published: July 2009

The right to conceive and bear children has been protected both in law and in policy. Human society has from its earliest time valued children and defended procreation as a basic right.Modern health technology offers the possibility of conception to the estimated 2.5 million infertile couples who may wish to have children. For these persons, infertility treatment offers the hope of having children, an activity deemed basic and essential in human society.In general, the state has been reluctant to directly interfere in the reproductive decisions of individuals. However, the state may act to increase or reduce access to reproductive services in a variety of ways. For example, recent legislation regulating fertility clinics affects the distribution of assisted reproductive technology (ART) in the United States. The purpose of this paper is to describe this legislation, project its probable effects on the distribution of ART services, and analyze these effects based on distributive theories of justice.
Consultants and Committees: A Cooperative and Mutually Educational Enterprise
Authors: Loewy Erich H. 
Published: July 2009

It is logical that to function properly ethics committees must be properly trained, and I believe that Griener and Starch's paper in this issue of CQ is an important contribution to such a point of view and to this field. Although written from the Canadian perspective, the paper should find broad resonance in other settings. Differences between national medical settings are interesting but not critical to the point Griener and Starch make, i.e., ethics committees should be trained and should continue to be trained.Not all will agree on this position, because it rests on several presuppositions that not everyone will accept. According to such a thesis, ethics in general and medical ethics in particular has its own peculiar way of thinking, is based on a recognizable and acknowledged body of literature, and can be acquired by study. Further, such a view presupposes that persons who have acquired such a skill and broadened it by continual practice have developed an expertise lacking in others who have no familiarity with the field.
Misconduct and the Development of Ethics in the Biological Sciences
Authors: Reiser Stanley Joel 
Published: July 2009

A variety of cases of scientific misconduct have been documented since the 1980s among biological scientists. These cases have focused the attention of the public and scientific community on this behavior and made it the centerpiece of the concern about ethics in the biological sciences. In contrast, the ethics movement in clinical medicine, which arose in the 1960s, was not basically directed at the problems of wrong-doing. Instead it concentrated on the difficult ethical choices that had to be made In the practice of medicine.In this essay, I discuss the two movements. The attention given to misconduct In the biological sciences has become excessive and diverts its ethics movement from exploring and teaching about the difficult ethical decisions scientists must make in weighing obligations to self, science, and society. A more balanced and selective approach to developing an ethical framework in the biological sciences is needed.
Compassion, Reason, and Moral Judgment
Authors: Loewy Erich H. 
Published: July 2009

This paper will discuss the role of compassion in ethics in general and in healthcare ethics in particular. My thesis is that compassion:1) as Rousseau pointed out, is a natural trait common to all higher animals (human as well as nonhuman);2) can and does serve as one of the most important motivators and modulators of ethics in both theoretical and applied aspects;3) must be controlled by, and in turn control, reason if it is to serve its ethical as well as natural purposes; and4) as a natural trait has survival value and, by virtue of being a natural trait, cannot be an obligation although there may very well be an obligation to do all that is necessary to nurture and not crush this sentiment.
Legalizing Physician-Aided Death
Authors: Capron Alexander M. 
Published: July 2009

Physician aid in dying is a broader topic than euthanasia in that the latter usually refers to active euthanasia, while physician assistance also encompasses the issue of assisted suicide. Volumes could be and have been written on physician-assisted death. But my purpose here is to address a specific aspect of the topic: the policy implications with regard to proposed legislation on physician-aided death.Although the title's reference to physician assistance suggests a focus on the role of the professional, what people often take to be most important and at the heart of the topic is the issue of the patient's rights, usually seen as being manifested in four different ways. First is the right to a dignified death, as free from pain and suffering as possible. In crossing national boundaries and preceding the organization of the professions and the creation of societies, this right is viewed as one that ought to be recognized.
Informed Consent Revisited
Authors: Goldworth Amnon 
Published: July 2009

More than three decades after its introduction as a legal requirement for medical treatment in the clinical setting, informed consent continues to be viewed with skepticism as to its need or effectiveness. Some maintain that it is not required because the ordinary individual believes that doctors can be trusted to behave In the best interests of their patients. This issue will be discussed in a later portion of this article. Others are persuaded that informed consent is an unattainable ideal given the limited capacity of the ordinary individual to understand the relevant information. This view is supported by studies intended to show that satisfactory understanding on the part of patients cannot be achieved. In rebuttal, Apple-baum, Lidz, and Meisel observed that:Such statements are easily refuted by reference to studies of situations in which reasonable comprehension actually has been achieved. A sounder interpretation of all these studies might be that patients and subjects can attain a good level of understanding in many cases, but that several factors — including the manner in which disclosure is made as well as patients' limitations — may get in the way.
Prevalence of increased nuchal translucency in fetuses with congenital cardiac disease and a normal karyotype
Authors: Vogel Melanie , Sharland Gurleen K. , McElhinney Doff B. , Zidere Vita , Simpson John M. , Miller Owen I. , Allan Lindsey D. 
Published: July 2009

AbstractObjectivesOur aims were to estimate the prevalence of increased nuchal translucency in fetuses with a normal karyotype that were subsequently diagnosed with congenital cardiac disease on fetal echocardiography, and to assess whether there is a link between increased nuchal translucency and specific congenital cardiac malformations.MethodsWe reviewed all patients referred to King’s College Hospital and the Evelina Children’s Hospital in London for fetal echocardiography between January 1998 and December 2007. We investigated the proportion of chromosomally normal fetuses with congenitally malformed hearts in which nuchal thickness was increased, both overall and with specific defects.ResultsWe indentified 2133 fetuses with congenital cardiac disease by prenatal echocardiography. Of those, 707 were excluded due to abnormal karyotype, and 690 were excluded due to unknown karyotype. The remaining 736 were eligible for inclusion. Among 481 fetuses with documented congenital cardiac disease and normal chromosomes, making up 23% of the overall cohort, 224 had increased nuchal thickness defined as equal or greater than 2.5 millimetres, this being 0.47 of the inclusive cohort, with 95% confidence intervals from 0.42 to 0.51. These proportions were significantly higher than the expected proportion of the normal population, which was 0.05 (p < 0.001). The only diagnosis for which the proportion of fetuses with nuchal translucency measurement equal or greater than 2.5 millimetres was higher than the others was atrioventricular septal defect, with 0.62 of this cohort having abnormal values, with 95% confidence intervals from 0.47 to 0.77 (p = 0.038).ConclusionWe found that nearly half of prenatally diagnosed fetuses with congenitally malformed hearts, when examined ultrasonically in the first or early-second trimester, had increased nuchal thickness. We recommend, therefore, referral of all fetuses with increased nuchal translucency for fetal echocardiography.
Neuropsychological functioning of U.S. Gulf War veterans 10 years after the war
Authors: TOOMEY ROSEMARY , ALPERN RENEE , VASTERLING JENNIFER J. , BAKER DEWLEEN G. , REDA DOMENIC J. , LYONS MICHAEL J. , HENDERSON WILLIAM G. , KANG HAN K. , EISEN SETH A. , MURPHY FRANCES M. 
Published: July 2009

AbstractMany U.S. Gulf War-era veterans complained of poor cognition following the war. This study assessed neuropsychological functioning in veterans 10 years after the war through objective tests. 2189 Gulf War-era veterans (1061 deployed, 1128 non-deployed) were examined at 1 of 16 U.S. Veterans Affairs medical centers. Outcomes included neuropsychological domains derived from factor analysis and individual test scores. Deployed veterans performed significantly worse than non-deployed veterans on 2 of 8 factors (motor speed & sustained attention, analysis not corrected for multiple comparisons) and on 4 of 27 individual test variables (Trails A & B, California Verbal Learning Test – List B, and Continuous Performance Test sensitivity, with only Trails B surviving Bonferroni correction). Within deployed veterans, Khamisiyah exposure was negatively correlated with motor speed after controlling for emotional distress. Depressive symptoms and self-reported exposure to toxicants were independently and significantly associated with worse sustained attention. Other factors were also associated with self-reported exposures. The findings were not a result of differential effort across groups. Gulf War deployment is associated with subtle declines of motor speed and sustained attention, despite overall intact neuropsychological functioning. Evidence suggests that toxicant exposures influence both these functions, and depressive symptoms also influence attention. (JINS, 2009, 15, 717–729.)
A CLASS OF MIX DESIGN PROBLEMS: FORMULATION, SOLUTION METHODS AND APPLICATIONS
Authors: Wan Zhong , Teo K. L. , Kong LingShuang , Yang Chunhua 
Published: July 2009

AbstractIn this paper, we consider a linear program with only equality constraints but containing interval and random coefficients. We first address the linear program with interval coefficients, and establish some structural properties of this linear program. On this basis, a solution method is proposed. We then move on to consider the linear program with random coefficients. Using the chance constraint approach and a new approach, the satisfaction degree approach, we obtain the two respective deterministic equivalent formulations. Then the results and the numerical solution methods obtained for these two linear models are applied to the original linear problem which contains both interval and random coefficients. By way of illustration, we consider a practical problem, where the optimal mixing proportions need to be determined for the mix slurry in the production process of aluminium with sintering. This gives rise to a linear program with interval and random coefficients. Its deterministic equivalent formulations are presented. Preliminary numerical examples show that the proposed models and the solution methods are promising.
Selection of alfalfa cultivars adapted for tropical environments with repeated measures using PROC MIXED of SAS® System
Authors: de Assis G. M. L. , Ruggieri A. C. , Mercadante M. E. Z. , de Camargo G. M. F. , Carneiro Júnior J. M. 
Published: July 2009

Although alfalfa (Medicago sativa L.) is a leguminous herbage widely used in temperate regions as animal feed, there is not much research in tropical regions to develop cultivars adapted to these environmental conditions. The utilization of adapted cultivars with adequate management practices is important to improve productivity, quality and persistence of cultivated pastures. The objectives of this study were to verify the genetic variability among alfalfa cultivars and to rank them using mixed model methodology. A total of 35 alfalfa cultivars were evaluated in the rainy and dry seasons, from 1996 to 2000, in plots of 2.8 m2 in Sertãozinho, São Paulo, Brazil. The experimental design was a randomized complete block with three replications. Longitudinal data of dry matter yield were analyzed using PROC MIXED of SAS® System. Several covariance structures were tested and the spherical spatial structure was selected. The results show that the genetic variability was statistically significant only for the dry season. Moreover, the interaction among cultivars and harvests variance was highly significant for both seasons. The empirical best linear unbiased predictions of cultivar effects were obtained, allowing for the selection of the superior cultivars MH 15, 5715, SW 8210, Rio, High, 5888, Monarca, Victoria, Florida 77 and Falcon. Crioula, the most common cultivar in Brazil, showed low forage potential in Sertãozinho. Results indicate potential for use of more productive cultivars of alfalfa to produce animal feed in tropical environments.
Effects of restorative agroecosystems on soil characteristics and plant production on a degraded soil in the Georgia Piedmont, USA
Authors: Jacobsen K.L. , Jordan C.F. 
Published: July 2009

AbstractThis work presents the results of a three-year field study of agroecosystems designed to restore soil organic matter (SOM) to degraded soils of the Georgia Piedmont. The systems combine a suite of management practices previously demonstrated to increase SOM when studied individually, and examine the effects of these techniques when used in combination in a cropping systems context on soil characteristics, crop production and weed biomass. The systems' components include organic management, alley cropping with perennial legumes, conservation tillage, use of winter cover crops, straw mulch and two compost application rates. Vegetable crops grown were a rotation of okra, hot pepper and a corn and winter squash intercrop. The systems were not able to maintain soil C or N without the addition of compost. Systems incorporating alley cropping, organic management, conservation tillage and compost maintained soil C, and increased in soil C when mulch was not applied. In organic, conservation tillage without alley cropping, soil C did not change significantly, even with annual 44.8 Mg ha−1of compost additions. Patterns for soil N followed those of soil C. The study demonstrated that alley cropping can maintain and sequester soil C and N beyond organic conservation tillage alone, and more than conventionally tilled, chemically fertilized treatments. Crop yields did not vary by treatment due to high variation within treatments. Winter cover crop residue provided an effective weed barrier for 4 to 6 weeks in the spring, but additional hand weeding was required throughout the summer. The results of this systems-level study demonstrated interactions between management practices when used in combination that would not have been observed when studied individually. It also demonstrates that agroforestry techniques, conservation tillage and compost applications can increase soil C in degraded, clayey soils while they are in cultivation.
Using Ontology Fingerprints to Evaluate Genome-wide Association Results
Authors: Tsoi Lam , Boehnke Michael , Klein Richard , Zheng Jim 
Published: July 2009

AbstractWe describe an approach to characterize genes or phenotypes via ontology fingerprints which are composed of Gene Ontology (GO) terms overrepresented among those PubMed abstracts linked to the genes or phenotypes. We then quantify the biological relevance between genes and phenotypes by comparing their ontology fingerprints to calculate a similarity score. We validated this approach by correctly identifying genes belong to their biological pathways with high accuracy, and applied this approach to evaluate GWA study by ranking genes associated with the lipid concentrations in plasma as well as to prioritize genes within linkage disequilibrium (LD) block. We found that the genes with highest scores were: ABCA1, LPL, and CETP for HDL; LDLR, APOE and APOB for LDL; and LPL, APOA1 and APOB for triglyceride. In addition, we identified some top ranked genes linking to lipid metabolism from the literature even in cases where such knowledge was not reflected in current annotation of these genes. These results demonstrate that ontology fingerprints can be used effectively to prioritize genes from GWA studies for experimental validation.
Syntactic Development in Adolescents With a History of Language Impairments: A Follow-Up Investigation
Authors: Nippold Marilyn A. , Mansfield Tracy C. , Billow Jesse L. , Tomblin J. Bruce 
Published: July 2009

Purpose
Syntactic development in adolescents was examined using a spoken discourse task and standardized testing. The primary goal was to determine whether adolescents with a history of language impairments would differ from those with a history of typical language development (TLD). This is a companion study to one that examined these same adolescents 2 years earlier (M. A. Nippold, T. C. Mansfield, J. L. Billow, & J. B. Tomblin, 2008).

Method

The participants were 15-year-old adolescents with a history of specific language impairment (SLI;
n
= 102), nonspecific language impairment (NLI;
n
= 77), or TLD (
n
= 247). A sample of spoken discourse was elicited using a Peer Conflict Resolution (PCR) task and analyzed for mean length of T-unit, clausal density, and subordinate clause use. In addition, 2 subtests from the Clinical Evaluation of Language Fundamentals, Third Edition (E. Semel, E. H. Wiig, & W. A. Secord, 1995), Concepts and Directions and Recalling Sentences, were administered.

Results
On the PCR task, the TLD group outperformed the SLI and NLI groups on mean length of T-unit, clausal density, and nominal clause use, and the TLD group outperformed the NLI group on relative clause use. On the standardized testing, the TLD group outperformed the SLI and NLI groups, and the SLI group outperformed the NLI group. Correlation coefficients calculated between the nonstandardized and standardized measures of syntax were statistically significant and positive.

Conclusions
Speech-language pathologists may wish to employ the PCR task to examine syntactic development in adolescents as a supplement to standardized testing.
Refinement of Speech Breathing in Healthy 4- to 6-Year-Old Children
Authors: Boliek Carol A. , Hixon Thomas J. , Watson Peter J. , Jones Patricia B. 
Published: July 2009

PurposeThe purpose of this study was to offer a better understanding of the development of neuromotor control for speech breathing and provide a normative data set that can serve as a useful standard for clinical evaluation and management of young children with speech disorders involving the breathing subsystem.MethodSpeech breathing was studied in 60 healthy children, including 10 boys and 10 girls, each at ages 4, 5, and 6 years. A variable inductance plethysmograph was used to obtain volume changes of the rib cage, abdomen, and lung as well as temporal features of the breathing cycle.ResultsResults indicated that breathing behavior was influenced by height and age but not gender. Some speech breathing behaviors were found to be highly variable, whereas others were more systematic.ConclusionsThe data from this investigation demonstrate that the refinement of the speech breathing mechanism is gradual and presumably takes place from approximately 3–10 years of age. The rate of change associated with speech breathing parallels that observed in other subsystems of speech production.