bluuebunny/crossref_metadata_2025_split huggingface dataset:
A devastating case of purpura fulminans in a young adult seven years after a splenectomy
Authors: De Salvia Alessandra , Lanzara Guido , De Leo Domenico 
Published: February 2010

It is well known that asplenic patients can suffer immediate and long-term infective sequelae, most of all from capsulated bacteria, whereas appropriate immunization can reduce the incidence of post-splenectomy sepsis. We discuss the case of a young adult developing an overwhelming post-splenectomy sepsis (OPSS) due to streptococcus pneumoniae seven years after the splenectomy for a traumatic injury. Neither immunoprophylaxis nor antibiotic therapy, whose value is underlined by literature data and international guidelines, was ever administered, either by the hospital physicians or by the general practitioner.
Mental Capacity Act 2005 – what do doctors know?
Authors: Schofield C. 
Published: February 2010

The Mental Capacity Act 2005 was partially implemented in April 2007. Doctors should be aware of the Act and what implications it has on their clinical practice. This survey looked at the knowledge of physicians and psychiatrists regarding assessing capacity within the Act by means of a questionnaire. The results showed that 100% of physicians and 70% of the psychiatrists answered questions wrongly in the questionnaire. Also, 97% of physicians and 70% of psychiatrists did not have some aspects of knowledge about capacity. Statistically significant differences in responses between physicians and psychiatrists were in relation to their knowledge of the existence and implementation of the Act. Answers were related to active schizophrenia, weighing up pros and cons, and recent assessment of incapability in relation to being by definition incapable. This study shows that psychiatrists do slightly better in answering questions about the Mental Capacity Act 2005 and about capacity when compared with physicians, however both groups could improve their knowledge. With the full implementation of the Act in October 2007, this study shows the urgency and importance of training in the area of capacity for all doctors.
Referrals for expert psychiatric opinion on dangerous offenders: a survey of instructions regarding defendants liable on conviction to a statutory assessment of dangerousness
Authors: Bickle Andy , Stankard Paul 
Published: February 2010

The Criminal Justice Act 2003 (“the Act”) introduced significant changes to the sentencing of violent and sexual offenders. The Act brought in a statutory assessment of dangerousness which includes a statutory assumption of dangerousness (“SAD”) for certain repeat offenders. Previously, expert psychiatric witnesses have commented on whether a defendant demonstrated sufficient mental instability to warrant a discretionary life sentence. Under this regime, psychiatric evidence is adduced to the assessment of dangerousness, especially for the purpose of supporting or undermining a rebuttal of the statutory assumption. This study investigated how legal referrers are instructing psychiatrists in cases where on conviction there will be an automatic assumption that the offender is dangerous. The aim was to determine whether the requirements of the new law are being outlined to expert witnesses and how much notice is being given for the production of evidence. All referrals to a medium secure unit were surveyed over two years. Fifty-one referrals concerned defendants liable to the SAD on conviction. The majority of the SAD referrals (40 referrals = 78.4%) included no request to comment on risk or dangerousness. This figure did not fall over time as the Act became established. Only a small minority (5.9%) of instructions directed the psychiatrist to the relevant statutory provisions. On average, adequate notice appeared to be given for the production of evidence (45.6 days). In the authors' view, legal referrers should make more explicit the requirements of psychiatric evidence in such cases. New legislation currently before Parliament would amend further the sentencing of such offenders, but there would remain a statutory assessment of dangerousness as the basis of sentencing violent and sexual offenders. Psychiatrists wishing to act as expert witnesses should be aware of the contents of the statutory assessment and be prepared to liaise with legal counsel to clarify instructions.
Prisoners' insomnia: to treat or not to treat? Medical decision-making in places of detention
Authors: Elger Bernice S. 
Published: February 2010

Insomnia is a frequent reason for medical and psychiatric consultation in prisons. Medical decision-making in correctional health care should be based on the same principles as outside correctional institutions. In places of detention, principles should be balanced according to the same criteria as outside correctional institutions, while taking into account the unique harm-benefit ratios related to the specific context. The aim of this paper was to examine the existing attitudes and ethical issues related to decision-making about insomnia evaluation and treatment in places of detention. An analysis of the ethical issues and an evidence-based review of the consequences of different attitudes and treatments with regard to prison medicine were carried out. Insomnia is a public health problem and requires adequate evaluation and treatment to avoid more serious health consequences both within and outside correctional institutions. Insomnia treatment in places of detention is an ethical dilemma, but there is no evidence-based reason to avoid benzodiazepines in prison completely and to use only neuroleptics and antidepressants, which might represent more dangerous and less efficient treatment. In prison medicine, should we even treat insomnia? Widely accepted ethical strategies of decision-making indicate that we should. Institutional guidelines on insomnia should be based on ethically sound decision-making that takes into account the available evidence.
Cause of death in judicial hanging: a review and case study
Authors: Hellier Catherine , Connolly Robert 
Published: February 2010

The cause of death in judicial hanging is controversial and often attributed to `hangman's fracture' of the second cervical vertebra. Research has shown that such fractures are the exception in judicial hangings and the cause of death can be attributed to a range of head and neck injuries, particularly compression or rupture of the vertebral and carotid arteries leading to cerebral ischaemia. The rapidity of loss of consciousness and death is highly dependent upon knot positioning and the length of drop which has varied through the history of hanging as a capital punishment in the UK. The skeletal remains of Mr. George Kelly, wrongfully hanged for murder at Walton prison, Liverpool (1950) were exhumed, examined and are reported on herein. The first cervical vertebra was found to be fractured but no `hangman's fracture' of the axis – second cervical vertebra – was present. The hangman (Mr. Albert Pierrepoint) has been quoted as stating that the hanging of Mr Kelly took longer than `it should have' (Dernley and Newman, 1989) but no skeletal evidence of death by strangulation was found by the authors. Unconsciousness, if not death, would probably have been rapid due to vertebral artery damage as a result of the observed neck fracture, although this cannot be concluded with absolute certainty.
Pathology of firearm mortalities in the Niger Delta region of Nigeria: a study of 136 consecutive autopsies
Authors: Seleye-Fubara D. , Etebu E.N. , Bob-Yellowe E. 
Published: February 2010

A prospective autopsy study of firearms-related death was carried out by the authors in the Niger Delta region of Nigeria. The purpose of the study was to evaluate the pattern, frequency, and anatomical sites of wounds, also the cause of death and the age and sex distribution of victims. The autopsies were performed after being served with the coroner's inquest forms. In all cases standard autopsy procedures were adopted and reports issued. A total of 136 consecutive firearm deaths were autopsied. There were 122 (89.7%) males and 14 (10.3%) females, giving a male to female ratio of 8.7:1. The highest number of deaths, 95 (69.8%), occurred in the age group of 10–39 years with a peak of 51 (37.5%) deaths at 20–29 years. In 112 (82.4%) cases death occurred from homicidal gunshot wounds. The commonest targets of gunshot wounds were the head, 58 (42.6%); multiple anatomical sites, 30 (22.1%); chest, 16 (11.8%); abdomen, 11 (8.1%) and neck, 10 (7.4%). Haemorrhagic shock was the cause of death in 131 (96.3%) cases. Significant causes of traumatic death in the Niger Delta region of Nigeria are gunshot wounds and associated complications. Stringent laws on illegal firearms handling should be passed and enforced by the government to reduce the frequency of such deaths.
Homicide by organophosphorus compound poisoning
Authors: Kumar Lavlesh , Agarwal Swapnil Sudhirkumar , Chavali Krishnadutt H. , Mestri Shashidhar Channamallappa 
Published: February 2010

Pesticides are responsible for less than 1% of deaths from poisoning in the UK while various studies in India indicate that the figures range from 20% to a staggering 70% (Sharma, 1998). Organophosphorus compounds are reported to be the most commonly used substances for suicidal purposes (Dixit, 2007). Homicidal poisoning involving pesticides has always been rare owing to the disagreeable odour and taste rendered to them by their hydrocarbon solvents (Pillay, 2008). An unusual case of homicide using an organophosphorus compound is presented here. The body of a 28-year-old woman was brought for post-mortem examination at the mortuary of the Government Medical College and New Civil Hospital, Surat, Gujarat, India. It had been exhumed after forty-five days of burial under the supervision of a medical officer from the nearby primary health centre, the police and a magistrate. There was a history of marital discord between the deceased and her husband. Their ten-year-old daughter, who was the only witness to the incident, revealed later that her mother was struck by a wooden block and forcibly made to ingest some medicine. The ‘medicine’ was identified on chemical analysis as an organophosphorus compound (dichlorvos).
Challenges at the interface of working between mental health services and the criminal justice system
Authors: Hean Sarah , Warr Jerry , Staddon Sue 
Published: February 2010

Provision of mental health reports for defendants in contact with the criminal justice system is problematic. This paper explores factors that facilitate the flow of information on a defendant between the courts and the mental health services. It identifies key challenges to this information transfer from a court worker's perspective. It also explores potential mismatches in the expectations held by the criminal justice system and the mental health services of the timeframes in which reports should be delivered and examines the perceived usefulness of reports. In Part 1, questionnaires were distributed to a population of 2,107 court workers. In Part 2, monitoring forms were completed by court and health professionals on each report request made over a seven month period. Three key challenges to information transfer were identified: delays in report production, perceived inadequacies in the report content and report funding. Perceived timelines within which respondents believed reports should be delivered varied and there is a mismatch between the expectations of the two services. Perceptions on the usefulness of court reports also varied. Poor inter-agency communications are caused by lack of a clear, shared protocol outlining agreed timelines, report content and lines of responsibility relating to resource provision. Clear service level agreements are required between services to achieve clarity.
Occurrence of Injury during Officer Safety Training at Kent Police
Authors: Andrew J. , Henry T. , Coleman D.A. , Wiles J.D. 
Published: February 2010

There are limited data available on the injury occurrence associated with training in high-risk occupations. The aim of this investigation was to assess the injuries sustained during police training conducted by the Staff Safety Training Unit (SSTU), at Kent Police (Maidstone, Kent). Data were collected on 11,432 participants who undertook courses with the SSTU of Kent Police over a two-year period. Injury was defined as any occurrence resulting in physical damage to the body which required a ‘Hurt on Duty’ form to be submitted. In total 93 injuries occurred during the period, which equated to approximately four injuries per 1000 participants per year. The majority of injuries occurred during standard officer safety training (equating to ∼2.3% of the training population), compared to other courses run by the unit (risk of ∼0.1 to 0.2% of the training population). Unarmed defence and baton drills accounted for the highest number (∼49%) of injuries reported, with bruises, sprains and strains accounting for 67.6% of the total injuries. This study identifies the type, location and injury occurrence rates associated with officer (and other) training, and could potentially be used to inform future policy with regard to appropriate practice in training.
Ageing of modified wood. Part 1: Wetting properties of acetylated, furfurylated, and thermally modified wood
Authors: Bryne Lars Elof , Wålinder Magnus E.P. 
Published: February 2010

Abstract
The main objective of this work was to apply contact angle analysis to predict work of adhesion (W

a
) between some modified wood materials and certain thermoplastics and adhesives. Wetting properties, i.e., contact angles, were measured by the Wilhelmy method on both freshly prepared and aged veneer samples of unmodified and acetylated Scots pine, furfurylated radiata pine, and heat treated Norway spruce. The sessile drop method was used to measure contact angles on a phenol resorcinol formaldehyde, an emulsion polymer isocyanate, and a one-component polyurethane adhesive. Contact angle data were also collected from the literature on polyethylene, polyvinyl chloride, polymethyl methacrylate, polystyrene, and Nylon 6. Contact angle analysis based on the Chang-Qin-Chen model was then applied to determine so-called acid-base interaction parameters and W

a
between the wood samples and the selected thermoplastics and adhesives. Results show that the ageing process led to an increased hydrophobic character of unmodified, heat treated, and furfurylated wood samples. The freshly prepared acetylated wood samples had a pronounced hydrophobic character which remained approximately constant after ageing. The predicted W

a
between the wood and the adhesives was considerably higher than that between the wood and the thermoplastics. Furthermore, the predicted W

a
between the acetylated wood and both the thermoplastics and water was approximately unchanged when comparing the fresh and aged samples. In contrast, the ageing of all other wood samples resulted in a dramatic decrease of the wood-water W

a
and a moderate decrease of the wood-thermoplastics W

a
. The wood-adhesives W

a
, however, was unchanged for the unmodified and furfurylated wood when comparing the fresh and aged samples and even increased for heat treated and acetylated wood samples.
Non-ironic turning ironic contextually: Multiple context-determined irony in “The Story of an Hour”
Authors: Shen Dan 
Published: February 2010

Abstract
This article defines and discusses a type of irony that has eluded existing classifications, namely, “context-determined irony.” Although existing types of irony – whether called “verbal” or “situational” or modified by some other terms – are in varying degrees related to context, none of them is really context-determined. Compared with verbal or situational irony, “context-determined irony” generates more textual tension and semantic density due to the co-existence of the conventionally positive meaning and the contextually determined ironic meaning. It is revealed that such irony implicitly permeates Kate Chopin's “The Story of an Hour” (A lady of Bayou St. John, Houghton, Mifflin and Company, 1894), a textual analysis that is backed up by intertextual and extratextual considerations.
‘A proper synthesis of literary and linguistic study’: C. S. Lewis and a forgotten war
Authors: Williamson Karina 
Published: February 2010

Abstract
This article traces the long-running conflict between the interests of ‘Language’ and ‘Literature’ within English studies in Britain, using as springboard a letter from C. S. Lewis (then professor of Medieval and Renaissance Literature), to Angus McIntosh (then professor of English Language and General Linguistics). Written in 1961 when ‘Lang. & Lit.’ hostilities were at their height, the letter points two ways: back to old battles in Schools of English between philologists and literary scholars, historians and critics, and forward to continuing disputes about the contribution of linguistics to literary criticism. The main focus is on the period 1957–1977, before the impact of structuralism and poststructuralism diverted the attention of literary scholars, but during the development of stylistics as a method of analysing literary texts. McIntosh emerges as a pioneering figure in the struggle to achieve an effective integration of literary and linguistic studies.
A Quantitative Fabric Drape Evaluation System Using Image-Processing Technology, Part 2: Effect of Fabric Properties on Drape Parameters
Authors: Kown Eun Sook , Yoon Soon Young , Sul In Hwan , Kim Sungmin , Park Chang Kyu 
Published: February 2010

Abstract
A new quantitative fabric drape evaluation method using image-processing technology was published in Part 1 and submitted to the International Organization for Standardization as a revised international standard. In this research, the effects of fabric properties on drape parameters have been examined using the new drape evaluation system to verify the new method. Drape parameters include the number of drape nodes, the amplitude of the drape wave, and drape wavelength, as well as drape ratio (coefficient). The Kawabata Evaluation System (KES) was used to measure the mechanical properties of 60 woven fabric samples. Through correlation analysis, we found that tensile, bending, and shear properties of fabrics are closely related to each drape parameter. Some regression equations were derived to predict the drape ratio, the number of drape nodes, and the wave amplitude from the KES fabric properties. In all regression models, the bending hysteresis (2HB) of a fabric and its combined value with fabric weight (2HB/W) were observed to be the most significant factors.
Buchbesprechung
Authors: Voß Christian 
Published: February 2010

Zusammenfassung

The Konikovo Gospel. Konikovsko evangelie. Bibl. Patr. Alex. 268. Hrsg. von Jouko LINDSTEDT, Ljudmil SPASOV, Juhani NUORLUOTO. Helsinki 2008 (= Commentationes Humanarum Litterarum, 125), 439 + LXXXII S., ISBN 978-951-653-366-0
Buchbesprechung
Authors: Ibler Reinhard 
Published: February 2010

Zusammenfassung
PETROVA, ALENA, Überlegungen zu einer gattungsspezifischen Poetik des Raums an Textbeispielen der russischen Literatur des 19. Jahrhunderts. Frankfurt am Main: Peter Lang, 2008. 370 S. (Heidelberger Publikationen zur Slavistik. Literaturwissenschaftliche Reihe; 33). ISBN 3631555024, 978-3631555026
Diazoxide-responsive hyperinsulinemic hypoglycemia caused by HNF4A gene mutations
Authors: Flanagan S E , Kapoor R R , Mali G , Cody D , Murphy N , Schwahn B , Siahanidou T , Banerjee I , Akcay T , Rubio-Cabezas O , Shield J P H , Hussain K , Ellard S 
Published: February 2010

ObjectiveThe phenotype associated with heterozygous HNF4A gene mutations has recently been extended to include diazoxide responsive neonatal hypoglycemia in addition to maturity-onset diabetes of the young (MODY). To date, mutation screening has been limited to patients with a family history consistent with MODY. In this study, we investigated the prevalence of HNF4A mutations in a large cohort of patients with diazoxide responsive hyperinsulinemic hypoglycemia (HH).Subjects and methodsWe sequenced the ABCC8, KCNJ11, GCK, GLUD1, and/or HNF4A genes in 220 patients with HH responsive to diazoxide. The order of genetic testing was dependent upon the clinical phenotype.ResultsA genetic diagnosis was possible for 59/220 (27%) patients. KATP channel mutations were most common (15%) followed by GLUD1 mutations causing hyperinsulinism with hyperammonemia (5.9%), and HNF4A mutations (5%). Seven of the 11 probands with a heterozygous HNF4A mutation did not have a parent affected with diabetes, and four de novo mutations were confirmed. These patients were diagnosed with HI within the first week of life (median age 1 day), and they had increased birth weight (median +2.4 SDS). The duration of diazoxide treatment ranged from 3 months to ongoing at 8 years.ConclusionsIn this large series, HNF4A mutations are the third most common cause of diazoxide responsive HH. We recommend that HNF4A sequencing is considered in all patients with diazoxide responsive HH diagnosed in the first week of life irrespective of a family history of diabetes, once KATP channel mutations have been excluded.
Survey of Management of Children with Cleft Lip and Palate in Teaching and Specialist Hospitals in Nigeria
Authors: Olasoji Hector Oladapo , Hassan Abubakar , Adeyemo Wasiu L. 
Published: February 2010

Objective A national survey was conducted to obtain an overall view of the current management of children with cleft lip and/or palate in Nigeria. Method Questionnaires were sent to 44 identified cleft surgeons in all teaching and specialist hospitals in Nigeria. Results A total of 38 respondents returned completed questionnaires. The findings are as follows: (1) a majority of the surgeons (68.4%) are “low-volume operators,” undertaking 10 or fewer new cleft repairs annually; (2) 86.8% of the surgeons repair cleft lip at 3 to 4 months of age, and the most common (71%) unilateral cleft lip repair method is the rotation-advancement technique; (3) 50% of the surgeons use straight line repair for bilateral cleft lip; (4) a majority (79%) of the respondents close the soft and hard palates as a single procedure; 47.3% of respondents use the von Langenbeck technique, 21.1% use the double-opposing Z-plasty and 21.1%, the palatal pushback; (5) in the management of protruding premaxilla, 52.6% of the respondents choose adhesive tape; (6) procedures such as alveolar bone grafting, rhinoplasty, and surgical treatment for velopharyngeal incompetence are rarely done as part of cleft management; and (7) the interdisciplinary team approach is practiced by 21% of respondents. Conclusions Issues are raised regarding the current organization of cleft services. We hope the findings of this study will provide preliminary information needed for the eventual establishment of standard cleft management for children with cleft lip and palate deformity in Nigeria.