Consent to treatment by minors attending accident and emergency departments: guidelines

The absolute right to refuse medical treatment, even if the reasons are irrational, is confined to competent adults. Children under 16 years can give legal consent to treatment in the absence of consent from those with parental responsibility. Children under 18 years do not, however, have an absolute right to consent, or refuse to consent, to treatment. The views of children assume increasing importance with age and maturity. Accident and emergency medical and nursing staff may face difficult decisions when children, or those with parental responsibility, refuse to consent to medical treatment. This paper presents guidelines designed to guide the decision making process in immediately or potentially life threatening conditions and in non-life-threatening conditions.     

Single-chip design of bit-error-correcting stack decoders

The design of a single-chip VLSI system to implement the Zigangirov-Jelinek sequential decoding algorithm for bit-error-correction is described and the dependence of performance on design parameters is discussed. By virtue of being self-contained, having few input and output pins, and processing stack elements once each clock cycle, the system should be capable of high-speed decoding. For constraint length 21, rate 1/2 codes, and 3-b soft decision detection, it is found that a system containing approximately 25000 stack cells reduces errors in a 3-dB signal-to-noise level environment, corresponding to 7.8% hard decision error rate, by two orders of magnitude. Higher decoding gain is obtained at lower noise levels through the use of a relatively long constraint length. The constraint length is not limited by the architecture. Chip area estimates needed to obtain prescribed decoded error rates and average decoding rates are also described and indicate that an effective system is potentially achievable with current technology     

Community-based behavioral training approaches for people with mental retardation and mental illness.

Reviews challenges associated with behavioral training approaches for individuals with mental retardation and mental illness in the community. Family and non-family facilitated training are considered. Professional practice issues are reviewed, and justification for multifactor behavioral assessment is offered. Future research directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fine physical mapping of Ph1, a chromosome pairing regulator gene in polyploid wheat

The diploid-like chromosome pairing in polyploid wheat is controlled by the Ph1 (pairing homoeologous) gene that is located on chromosome arm 5BL. By using a combination of cytogenetic and molecular techniques, we report the physical location of the Ph1 gene to a submicroscopic chromosome region (Ph1 gene region) that is flanked by the breakpoints of two deletions (5BL-1 and ph1c) and is marked by a DNA probe (XksuS1). The Ph1 gene region is present distal to the breakpoint of deletion 5BL-1 but proximal to the C-band 5BL2.1. Two other DNA probes (Xpsr128 and Xksu75) flank the region-Xpsr128 being proximal and Xksu75 being distal. The estimated size of the region is less than 3 Mb. The chromosome region around the Ph1 gene is high in recombination as the genetic distance of the region between 5BL-1 breakpoint and C-band 5BL2.1 (not resolved by the microscope) is at least 9.3 cM.     

Scabies associated with a bullous pemphigoid-like eruption

Intramuscular phenol neurolysis is a well-known procedure used to decrease spasticity and improve function in patients who have failed to respond to more conservative forms of intervention. Traditionally, this approach has been limited to spasticity reduction in limb muscles, and its use in managing spasticity of the facial muscles has not been described in the literature. This case report describes a new and previously unreported application of intramuscular neurolysis for managing severe unrelenting facial muscle spasticity in a postanoxic encephalopathic patient. Prior to the procedure, hypertonicity in the orbicularis oris muscle was so profound that it limited speech and affected cosmetic, hygienic, and nutritional status. After intramuscular phenol neurolysis of the orbicularis oris muscle, the patient's level of functioning improved.     

Management of rhesus isoimmunization by preimplantation genetic diagnosis

Intracranial osteolipomas are rare lesions which occur in the region of the tuber cinereum. All cases reported to date have been incidental autopsy findings. We describe a patient who presented with a variety of neurological symptoms and had a typical osteolipoma surgically removed.     

Nuclear Magnetic Resonance Studies of Silicon Carbide Polytypes

The ²⁹Si MAS NMR spectra of the 2H, 4H, 6H, and 3C polytypes of silicon carbide are presented. An attempt is made to correlate differences in the chemical shifts with local atomic environment. The results of the analysis of the spectra of pure polytypes are used as a basic for the interpretation of the spectra of mixed polytypes and a discussion of the crystallinity and impurity levels of different samples. Carbon-13 chemical shifts obtained from spectra of the same polytypes are also tabulated.     

The effects of patterned calorie-restricted diets on mammary tumor incidence and plasma endothelin levels in DMBA-treated rats

Chronic caloric restriction has been shown to inhibit mammary tumor promotion in the 7,12-dimethyl-benz[a]anthracene (DMBA) rat mammary tumor model. The objectives of this study were to determine (i) the effects of chronic caloric cycling (yo-yo dieting) on mammary tumor promotion by high fat diets and (ii) the effect of three dietary regimens +/- superimposed mammary tumor burden on plasma endothelin-1,2 (ET) levels. Female Sprague-Dawley rats were treated with DMBA (5 mg/rat) and divided into three dietary groups: ad libitum (AL) (containing 15% corn oil); 40% calorie restricted (CR) (containing 20% corn oil so consumption of fat was equivalent between AL and CR); a calorie cycled (CC) group fed alternatively AL and CR diets each 48 h period. After 10 weeks, tumor incidences were: AL, 63%; CR, 27%; CC, 57% (AL versus CR, P < 0.05; CC versus CR, P < 0.05; AL versus CC, NSD). ET levels (pg/ml plasma) were: AL, 16.0 +/- 6.54; CR, 32.31 +/- 0.34; CC, 23.44 +/- 5.04 (AL versus CR, P < 0.01; CC versus CR, P < 0.01; AL versus CC, P < 0.05). Plasma ET levels were independent of tumor incidence and tumor burden, but plasma ET levels were significantly increased in rats with a prior history of calorie restriction. As expected, maintained caloric restriction reduced mammary tumor incidence but intermittent caloric restriction (caloric cycling or yo-yo dieting) was without similar benefit.