bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Proximal Weakness in a 10-Year-Old
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 10-year-old boy developed rapidly progressive weakness over the previous 4 years. Birth and development were normal until that point, when walking became difficult, then climbing stairs. By this time, he became wheelchair-bound. There was no family history for this condition. Physical Examination. Cranial nerves and cerebellar function were intact. Sensation was normal. Patient’s muscles were hypotonic, and his calves were enlarged. He was diffusely weak, with proximal predominance. He walked (with assistance) on his toes because of heel-cord tightness. There was a severe lordosis. DTRs were hypoactive and symmetric with no pathologic reflexes.
Mees’ lines and Distal Numbness
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Two months previously, an 18-year-old boy accidentally ingested an arsenic compound that he was using for taxidermy. His immediate symptoms were nausea and vomiting. Subsequently, he developed weakness of his legs and numbness distal to his knees. Family and personal medical history were negative. Physical Examination. Transverse white stria were present above the lunula of several nails (Mees’ lines). There was no weakness revealed by muscle testing. Sensation to all modalities was abnormal below his knees (including touch, vibration, and joint position). DTRs were symmetric and active in the upper extremities and absent in the lower extremities. Plantar responses were flexor. Nerves were normal to palpation.
Sacral Growth and Incontinence
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 25-year-old man with an external growth at the base of his spine, present since birth, was referred for premarital evaluation. A tap to this region would produce a tingling radiating to both posterior thighs. Sensation was otherwise intact. Patient was incontinent of urine, wearing a collecting device. Bowel function, erections, and ejaculations were normal, although his sperm count and motility were low. Medical history was otherwise normal. Physical Examination. A large midline sacral growth extended to include part of the right buttock. He was wearing a bag device. He had bilateral pes cavus, but no scoliosis. Pain sensation was decreased over the posterior thighs. Cranial nerves and cerebellar function were normal, and no motor impairment could be found. Knee jerks were hypoactive, with absence of all other DTRs. Plantar responses were flexor.
Scapular Winging Increased on Flexion
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 38-year-old man experienced right scapular pain radiating to his shoulder and elbow for 3 weeks. He became aware of abnormal prominence of his right scapula. There was no numbness or cervical pain. Medical history was negative. Physical Examination. At rest, the right scapula was winged with slight medial translocation and medial rotation of the inferior angle. The winging was accentuated by f01ward flexion of the arm and decreased on lateral abduction. There was no sensory loss. DTRs were hypoactive, symmetric, with no pathologic reflexes. There was no Homer’s sign.
Postlaminectomy Recurrence of Pain
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Eleven days before his initial examination, while working, a 57-year-old man developed sudden low back pain radiating to his right leg. He complained of knee weakness with numbness distal to it. There was no exacerbation on Valsalva’s maneuver. Medical history revealed left chest and arm pain, a negative cardiac evaluation, and a kidney problem requiring diuretics. Physical Examination. Cranial nerve and cerebellar function were normal. He had weakness of right knee extension and hip adduction, with touch sensation decreased over the lateral thigh, medial leg, and foot. The right knee jerk was absent, with other DTRs active. Plantar responses were flexor. Lasègue’s sign was present on the right.
Intrinsic Weakness Related to Stapling
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Over the previous year, a 35-year-old woman developed left wrist pain related to repeated pounding on a stapler. In the region exposed to this repeated trauma, the medial volar wrist, there was tenderness to pressure. In addition, she complained of multiple joint pain and finger weakness in that hand. She denied neck and elbow pain and change with Valsalva’s maneuver. Medical history was of low back pain only.
Painful Eruption and Weak Hip
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 74-year-old woman suffered from right low back pain radiating to her right thigh over the previous several months. She denied numbness and change on Valsalva’s maneuver. Weakness was evident only on crossing her right leg over the left. Bed rest for 2 weeks had no effect. Several weeks prior to this examination, a mildly painful vesicular eruption developed over the right thigh and buttock. Medical history revealed atrophy of the left arm since birth.
Positive “Dropped Ann Test”
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Eight months previously, a 73-year-old woman fractured the humeral lip of her left shoulder during a fall. Since then, she was unable to raise the arm above the horizontal plane. She had shoulder pain extending to her left trapezius muscle but no sensory loss. Her medical history was limited to angina, hypertension, and a benign tumor removed 2 years earlier.
Scapular Winging After Neck Tumor Excision
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Four months previously, a 60-year-old man awoke with “total paralysis” of his left arm. This resolved gradually in a proximal-to-distal pattern, clearing completely in 3 months. Shortly thereafter, a small tumor was noted on the left side of his neck. The growth was removed and found to be benign. Postoperatively, he immediately had difficulty in flexing and abducting his left arm. Medical history included a heart attack several years before.
Quadrilateral Space Lesion
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Seven weeks previously, an 80-pound piece of plywood fell 35 feet, striking the left shoulder of a 28-year-old construction worker. This resulted in slight separation of the glenohumeral joint, but no fracture. Initially, his fingers were paralyzed, with numbness from the medial upper arm to the medial two fingers. Function returned except for weakness of elbow extension. He denied neck pain or effect from Valsalva’s maneuver. Medical history was limited to splenectomy several years earlier because of a car accident.
Slow Evolution of Proximal Weakness
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 26-year-old man developed progressively severe leg weakness since the age of 10. No perinatal or infancy problems were noted. He had difficulty climbing stairs by 13 and needed a cane by the age of Patient had a 10th-grade education and was unable to hold a job because of his weakness and intellectual limitations. Three out of his four brothers had similar motor abnormalities. His four sisters and his parents were spared.
Thoracic Outlet Syndrome “Recurrence”
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
During the previous 4 years, a 51-year-old man complained of pain in his right arm with distal paresthesias. He developed curling of his fourth and fifth digits, and difficulty with fine finger movement. His pulse was decreased on that side. A diagnosis of thoracic outlet syndrome was made and scalenotomy performed. This was followed by transient improvement. Gradually, however, he noted cramping and progressive weakness with atrophy evident for 6 months. Elevation of his hand above his head occasionally led to numbness of his arm. There was no effect from Valsalva’s maneuver.
Gluteal Injection and Radiating Pain
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Two months previously, a 47-year-old woman was undergoing cervical traction for left arm pain. An intramuscular left gluteal injection caused immediate local soreness with radiation to the inguinal area, lateral thigh, and leg. Valsalva’s maneuver had no effect. She had weakness of the left knee. Medical history was limited to a benign right ovarian tumor. Physical Examination. Cranial nerve and cerebellar function were normal. There was no sensory or motor deficit. DTRs were active and symmetric, with no pathologic reflexes. There was no Lasègue’s sign.
Abdominal Pain with No Abdominal Pathology
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Patient is a 75-year-old woman with an 8-month history of upper abdominal pain, originally on the right but extending to the left. There was no skin eruption. Medical history included gall stones, pyelonephritis, right-sided sciatica (3 years ago), and collapsed vertebrae. Physical Examination. Cranial nerve and cerebellar function were intact. There was no weakness or sensory loss. DTR.s were hypoactive and symmetric, with no pathologic reflexes. Patient did not have Lasègue’s or Beevor’s sign.
Diabetes with Asymmetric Weakness
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
The patient was a 76-year-old woman with a 4-month history of weak grasp, especially on the right. She also felt finger numbness worse at night. For 7 years, she was paraparetic with distal pain and numbness. Medical history was of severe diabetes mellitus. Physical Examination. Intrinsic right hand muscles were atrophied, with decreased sensation of the medial three digits to the midpalm. On the left hand, the lateral thenar muscles were atrophied with sensory loss of the second digit. The lower extremities had proximal weakness and distal paralysis. All sensation was decreased in a stocking pattern with sparing of the lateral right thigh and leg. No DTRs could be elicited. Plantar responses were silent. The patient had no calf tenderness or plantar hyperpathia. Her nerves were normal to palpation.
Gunshot Wound of Leg
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Seven months ago, a 41-year-old man was wounded in the left leg. Shotgun pellets entered his medial calf in the posterior-to-anterior direction, with many remaining in situ. Skin grafts were required. Subsequently, he developed paresthesias of the fifth toe. Percussion at the wound elicited Tinel’s sign, which radiated to the plantar surfaces of the other toes. He also had difficulty curling his toes. Medical history included hip arthritis treated by left hip pinning, and attacks of low back pain radiating to the lateral left thigh, leg, and ankle.
Fractured Ankle Bone and Focal Atrophy
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Two years previously, a 34-year-old teacher hit the dorsum of her right ankle on her desk, fracturing a “small bone” between the maleoli. Several weeks later, her ankle was placed in a cast for 3 weeks. Since then, she noted dorsolateral foot pain distal to the maleolus. She denied weakness, numbness, back pain, or exacerbation by Valsalva’s maneuver. Medical history was negative.
Ear Pain, Hoarseness, and Facial Weakness
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Through an interpreter, a 69-year-old Chinese man described an itching sensation that evolved over the previous 4 weeks into left ear pain. Over the next several days, he developed hoarseness and facial weakness. He lost the ability to close his left eye and had difficulty swallowing (especially solids). Hiccoughs developed, and buzzing in his ear, decreased hearing, dizziness on arising, and leg weakness. There were no other prior medical problems.
Difficulty Relaxing Grip
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
As far back as he could recall, a 32-year-old man had difficulty relaxing his grip. This was intensified by exercise and cold but was unrelated to sleep or meals. By 17, he developed frontal baldness. No family history of precocious baldness, cataracts, or motor disease. Physical Examination. Patient’s strength and sensation were normal, with no notable atrophy. His DTRs were active, symmetric. Plantar responses were flexor. On percussion, his tongue remained ridged and thenar relaxation was delayed. He had difficulty releasing a handshake quickly. He had frontal baldness, but no cataracts or testicular abnormality.
Proximal Weakness and Frequent Pneumonia
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 28-year-old man had a 10-year history of progressive proximal weakness. He was normal until his midteens and even played team football. At the age of 15, however, during a hospitalization for schizophrenia, he started suffering calf cramps, which were treated with quinine. During the following years, his exercise tolerance decreased and proximal weakness progressed, especially in his hips. In the previous 4 years, he had four episodes of pneumonia, and pulmonary function tests documented decreased static lung volume. Family history was noncontributory.
Flail Anesthetic Posttraumatic Arm
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Three years previously, a 26-year-old cyclist was struck by a car. Initially, he was drowsy and confused, his right arm flail. CT scan indicated a left frontoparietal contusion. He became alert over the next several days on short-term steroid therapy. His right arm, however, remained flaccid and paralyzed. Electrodiagnostic studies at that time showed no motor function from C5 through T1 on volition and on peripheral stimulation. He later developed left focal seizures treated with phenobarbital, and lower gastrointestinal bleeding of unknown cause. Medical history prior to all this was negative.
Sudden Flaccid Hemiplegia
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
Four weeks previously, a 63-year-old right-handed man suddenly developed right-sided paralysis. There was no associated headache, loss of consciousness, pain, or loss of feeling. Medical history was negative. Physical Examination. There was a mild expressive aphasia. The patient was unperturbed but aware of his motor loss consisting of total flaccid right hemiplegia. There was no facial weakness and no hemianopsia. Sensation was intact. DTRs were active and symmetric, with plantar response flexor on the left and silent on the right. There was no cervical rigidity or Kernig’s sign. The heart rate was normal and regular, and the patient was normotensive. No cervical bruits were audible.
Paraplegia After Tethered Cord Surgery
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 45-year-old paraplegic patient was referred for complete neurologic evaluation by his lawyer several years after three lumbar laminectomies. For many years he had noticed insidious progression of gait difficulty and development of urinary incontinence. On evaluation, he was found to have a tethered spinal cord associated with a cystic lipoma. Three laminectomies were performed (between the ages of 39 and 40) with removal of the lipoma and freeing of the cord. Postoperatively, the patient was completely paraplegic and incontinent of urine. There were only patches of preserved touch in his legs and penis.
Postshunt Evaluation for Syringomyelia
Authors: Liveson Jay Allan 
Published: November 2023

Abstract
A 52-year-old woman had insidiously progressive right hemiparesis and hemianesthesia over several years. A diagnosis of syringomyelia was made and a shunt inserted surgically 1 year previously. Since then, there was no improvement in her status, although she complained of a heat sensation over her face. Medical history was otherwise negative.
Situation Theory and Causation
Authors: Koons Robert C 
Published: November 2023

Abstract
In their seminal book Situations and Attitudes (Barwise and Perry (1983)), Jon Barwise and John Perry introduced the basic elements of situation theory. These elements included: the existence of concrete parts of the world, called situations or situation-tokens, a realistic attitude toward abstract situation-types, and the use of a partial, non-classical semantics for the relationship between situation tokens and situation-types. Barwise and Perry made use of the strong Kleene tables of three-valued logic, making use of the three values true, false, and undefined.
An Overview
Authors: Koons Robert C 
Published: November 2023

Abstract
The notions of natural teleology and biological function play an increasingly significant role in contemporary philosophy, especially in recent theories of con tent and of knowledge. The twentieth century has been characterized by an intensifying of efforts at clarifying the logic, semantics, and metaphysics of teleology, rectifying the unfortunate neglect of the topic in modern philosophy since Leibniz. One of the most influential and attractive accounts was that of Charles Taylor, in his 1964 The Explanation of Behavior (Taylor (1964)).
Teleological Reliabilism
Authors: Koons Robert C 
Published: November 2023

Abstract
Gettier’s seminal article on justified true belief (Gettier (1963)) forced a re thinking of the conditions of knowledge. So-called external factors and analyses came to the fore. The distinction between knowledge and mere true opinion turns on the way in which the belief was formed and how it is sustained. If the formation and maintenance of the belief reliably tracks the truth, then the belief constitutes knowledge. Knowledge is reliably formed and maintained belief (Goldman (1979)).
Eudaemonism and the Objectivity of Value
Authors: Koons Robert C 
Published: November 2023

Abstract
The objective reality of value is a given of human experience. The task of philosophy is not to explain away the objectivity of value, but to reconcile the objective existence of value with four apparent problems. These four problems include two forms of “queerness” about objective values noted by J. L. Mackie, plus the problems of semantics and epistemology. Mackie argued that objective values would be queer, incapable of being integrated into a rationally coherent ontology, because, unlike all other facts, they (1) provide categorical reasons for acting, and (2) are intrinsically motivating. Many have noticed the philosophical problems inherent in postulating objective values, since they seem to be imperceptible and without definite location. Finally, the most serious problem of all is the semantic one: given that there are objective values, how do our thoughts and words become linked to one rather than another?
A Coherent Realism Is a Comprehensive Realism
Authors: Koons Robert C 
Published: November 2023

Abstract
A comprehensive form of realism, as exemplified by Plato, Aristotle, and Boethius, was the dominant school in Western philosophy from the time of Augustine until that of Scotus. Today, a comprehensive form of anti-realism, as exemplified by Rorty, Foucault, or Derrida, is at or near dominance in the academy. The transition from the first state to the last took place in four great waves: Occam, Bacon, Hume and the post-modernists. These waves correspond to the dismantling, one by one, of Aristotle’s four causes: formal, final, efficient, and material.
Introduction
Authors: Levin Susan B 
Published: November 2023

Abstract
Plato’s middle dialogues have received an extraordinary amount of attention, and much work has been done to illuminate his engagement with other philosophers and the sophists as he articulates a range of doctrines therein. Socrates, Parmenides, and Heraclitus are regularly identified as the key influences on Plato’s theory of Forms. According to the standard account, Plato continues Socrates’ quest—undertaken in opposition to the sophists—to articulate what objective standards in the arena of values consist in, and adds to this emphasis on values a strong concern with other entities, particularly those in the domain of mathematics. In addition, as Aristotle emphasizes, Plato departs from his teacher by insisting on the separate existence of the objective standards in question.
World Without End or Beginning
Authors: Kermode Frank 
Published: November 2023

Abstract
It is worth remembering that the rise of what we call literary fiction happened at a time when the revealed, authenticated account of the beginning was losing its authority. Now that changes in things as they are change beginnings to make them fit, beginnings have lost their mythical rigidity. There are, it is true, modern attempts to restore this rigidity. But on the whole there is a correlation between subtlety and variety in our fictions and remoteness and doubtfulness about ends and origins. There is a necessary relation between the fictions by which we order our world and the increasing complexity of what we take to be the ‘real’ history of that world.
Solitary Confinement
Authors: Kermode Frank 
Published: November 2023

Abstract
In this lecture, which is my last, I shall try to touch upon most of the themes proposed in the earlier ones, though I do not hope to provide in it the marvellous clue that would make all the rest useful and systematic. I could only do that if I were the master described in the poem, that ‘more severe, More harassing master’I have his programme but not his powers. ‘Life / As it is, in the intricate evasions of as’ is what I am talking about, as best I can; and I am glad that it was in my most recent talk that I discussed Sartre, who knew that fictions, though prone to absurdity, are necessary to life, and that they grow very intricate because we know so desolately that as and is are not really one. None of our fictions is a supreme fiction.
Instrumental Music, Charisma, and Church Leadership
Authors: Lange Barbara Rose 
Published: November 2023

Abstract
During one of the first services I attended at the IG, Brother Horváth declared, “We have a healthy, unified congregation. Now there are more of us ... thereis the problem of an assistant [helyettes ].” Commenting that “the Holy Spirit is not a municipal official,” he read Acts 13:r-5, which describes how God had distinguished Barnabas and Paul out of the Antioch congregation.
Conclusion
Authors: Lange Barbara Rose 
Published: November 2023

Abstract
As the IG congregations were meeting in the 1990s, an atmosphere of conflict permeated society. The violence in the Balkans to the south caused Hungarians to worry about ethnic tensions in their own country. Introducing a free market had drastic effects; when Roma became unemployed, some Magyars, impoverished themselves, objected to the fact that they got welfare payments from the government. The sociologist Zsuzsa Ferge warned that Hungary could become like the United States, where “society eventually divides in two.
Gender: Identifying and Managing Relevant Differences
Authors: Buckey Jay C 
Published: November 2023

Abstract
Although Mary Cleave was a fully trained and capable astronaut, she could not do extravehicular activity (EVA): There were no EVA suits small enough to fit her [1]. Similarly, although astronaut Wendy Lawrence was ready to go to the Mir space station on the Soyuz capsule, she wasn’t tall enough to fit safely within the capsule [2]. This problem, however, has not been limited to women. NASA astronaut Scott Parazynski also was ready to go to the Mir space station, but he was too big for the Soyuz capsule. Size and strength sometimes matter in the space program, and gender can influence both.
Preflight Preparation and Postflight Recovery: Preparation and Rehabilitation
Authors: Buckey Jay C 
Published: November 2023

Abstract
When the Greek explorer Odysseus returned from his long-duration voyage, only his dog recognized him. Even though his loved ones had yearned for a reunion with him, when Odysseus finally arrived home, his reentry into his previous life was not smooth. Odysseus had to work hard to establish a relationship with his son and dispose of the suitors who were pursuing his wife. He literally had to fight his way back to his former position.