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The upper arm has two muscle compartments: the anterior, which includes the biceps, and the posterior, which includes the triceps muscle.
The forearm has two major compartments: the anterior containing the flexor muscles, and the posterior containing the extensor muscles. The mobile wad creates the third compartment.
The upper extremity is perfused by branches from the deep and superficial brachial artery. The proximal brachial artery lies in the groove between the biceps and triceps muscles. Distally, it courses in front of the humerus. At the antecubital fossa, it runs deep to the bicipital aponeurosis and bifurcates into the radial and ulnar arteries, just below the elbow. The artery is surrounded by the two concomitant brachial veins, which run on either side of the artery.
The profunda brachial artery is a large branch arising from the proximal brachial artery distal to the teres major muscle and follows the radial nerve closely. It provides collateral circulation to the lower arm.
The basilic vein courses in the subcutaneous tissue in the medial aspect of the lower arm. At the midpoint, it penetrates the fascia to join one of the brachial veins.
The cephalic vein is entirely in the subcutaneous tissues, courses in the deltopectoral groove, and empties into the junction of the brachial and axillary veins.
In the upper arm, the median nerve lies in front of the brachial artery. It then crosses over the artery midway down the upper arm, where distally it lies posteromedial to the artery.
The ulnar nerve is behind the artery in the upper half of the arm. Midway down the arm, it pierces the intermuscular septum and courses more posteriorly, away from the artery, behind the medial epicondyle.
Above and below the knee amputations require basic anatomy knowledge of the muscle compartments, nerves, and arteries of the lower extremity.
The thigh has three compartments: anterior, posterior, and medial. The calf has four compartments: the anterior, lateral, or peroneal in addition to the deep and superficial posterior ones.
The lower extremity is perfused by the superficial and deep femoral artery. The superficial femoral artery continues as the popliteal artery after exiting the Hunter’s canal. The popliteal artery bifurcates into tibialis anterior artery and the tibioperoneal trunk. The tibioperoneal trunk gives the fibular artery and continues as the posterior tibial artery. The femoral and sciatic nerves provide innervation to the lower extremity.
This chapter is an inquiry about how punishment of perpetrators is related to reparation for the victims, drawing on specific examples from the African Great Lakes region. To date, the most well-known cases are the Lubanga case at the International Criminal Court(ICC) related to the Democratic Republic of Congo (DRC), and the Bemba case, where a former rebel leader and politician from the DRC was charged with war crimes and crimes against humanity committed in the Central African Republic (CAR). The International Criminal Tribunal for Rwanda (ICTR) cases for Rwanda have been exhaustively researched; less known is the Mau Mau court case brought by Kenyan Mau Mau victims in British courts. Finally, through the ICC and the International Crimes Division (ICD) of the High Court of Uganda, some of the crimes committed in Uganda are being tried, though only those of the Lord’s Resistance Army (LRA), and not those of government soldiers or officials.
This study explored counseling students’ attitudes toward beliefs and personal experience with complementary and alternative medicine (CAM) integration in counseling practices. A total of 113 clinical mental health counseling students completed a demographic questionnaire, the CAM use, and the Complementary and Alternative Medicine Beliefs Inventory. Data were analyzed using descriptive statistics, nonparametric Chi-Square testing, Mann–Whitney U test, and logistic regression analysis to determine the prevalence of CAM use, CAM beliefs, and predictive factors of CAM integration. The results indicated differences in ethnicity, gender, and age for CAM use, CAM beliefs, and predictors of attitudes toward CAM integration. Recommendations for counseling practice and education regarding CAM use and community-based health promotion were discussed.
In his seminal article on ‘John Locke and Anglican Royalism’, Mark Goldie warned scholars to beware axiomatic assumptions that ‘great philosophers only reply to leviathans and other sea monsters, and not to shoals of smaller, but no less dangerous fish’. With regard to Locke's Two Treatises of Government (1689), Goldie persuasively argued that Locke's motivation in dissecting Filmerian absolutism stemmed from dismay at the readiness with which ideas once regarded as extreme in the 1640s had seemingly achieved mainstream acceptance a generation later. In characteristically alliterative and succinct prose, Goldie emphasised the importance of recognising that multiple pens had produced ‘the suffocating plethora of polemic spawned by the triumphant Royalism of the Restoration’. Appearing three centuries after Oxford University's convocation had negatively defined the tenets of Restoration royalism by staging a public book-burning in July 1683 that consigned to the flames works endorsing popular sovereignty, contractual government, elective monarchy and rights of resistance, Goldie's article also drew attention to parallel events outside England. For Goldie, ‘nothing illuminates more the sectarian orientation of Restoration politics than the affairs of Scotland’, where sectarian strife and radical Presbyterianism ensured that ‘English religious rancour seems urbane by comparison’.
Pursuing Goldie's piscatorial imagery, this essay reconsiders a large fish in a relatively small pond: Sir George Mackenzie of Rosehaugh (c. 1636–91), often cited by Goldie as exemplifying late seventeenth-century Scots royalism. As well as serving as Charles II and James VII & II's lord advocate, Mackenzie sustained an extensive published output encompassing political theory, jurisprudence, moral philosophy, Scottish history, witchcraft, forensic rhetoric, witchcraft and imaginative literature, with the majority of his works republished in lifetime and posthumous editions. Among his contemporaries, Mackenzie's colleague at the Scots bar, Sir John Lauder of Fountainhall, acclaimed him as simply ‘the brightest man in the nation’ and, outside Scotland, Mackenzie's works were owned and cited by, among others, Abraham Cowley, William Davenant, John Dryden, John Evelyn, Johannes Graevius, John Locke, Samuel Pepys and William of Orange. In popular culture, however, Mackenzie's reputation remains the ossified prisoner of Presbyterian partisanship. Referred to as ‘Bluidy Mackenzie’ by Sir Walter Scott in The Heart of Midlothian (1818), the lord advocate's sobriquet became synonymous with the ‘Killing Times’ delineated in nineteenth-century Whig martyrologies which denounced the brutal suppression of Presbyterian nonconformists by servile Stuart sycophants.
Peripheral vascular injury (PVI) is a major concern in the Emergency Department (ED). According to the CDC, there were 33,594 mortalities related to firearms in 2014.1 There were 803,007 cases of aggravated assault that occurred in 2016. Nearly 24% of these (190,000) were performed with firearms and 16% (120,000) with cutting instruments.2 Inevitably, many of these result in damage to the vasculature, leading to blood loss and presentation to the ED. While some forms of injury are immediately life threatening and require emergent intervention, some present asymptomatically, which can lead to delayed or missed diagnoses. Emergency physicians should be well versed in the diagnosis, management, and disposition of these patients. This chapter will focus on the management of penetrating extremity trauma with vascular injury.
The use of cluster robust standard errors (CRSE) is common as data are often collected from units, such as cities, states or countries, with multiple observations per unit. There is considerable discussion of how best to estimate standard errors and confidence intervals when using CRSE (Harden 2011; Imbens and Kolesár 2016; MacKinnon and Webb 2017; Esarey and Menger 2019). Extensive simulations in this literature and here show that CRSE seriously underestimate coefficient standard errors and their associated confidence intervals, particularly with a small number of clusters and when there is little within cluster variation in the explanatory variables. These same simulations show that a method developed here provides more reliable estimates of coefficient standard errors. They underestimate confidence intervals for tests of individual and sets of coefficients in extreme conditions, but by far less than do CRSE. Simulations also show that this method produces more accurate standard error and confidence interval estimates than bootstrapping, which is often recommended as an alternative to CRSE.
To explore if better diet quality scores as a measure of adherence to the Australian Dietary Guidelines (ADG) and the Mediterranean diet (MedDiet) are associated with a lower incidence of hypertension and non-fatal CVD.
Prospective analysis of the 1946–1951 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH). The Australian Recommended Foods Score (ARFS) was calculated as an indicator of adherence to the ADG; the Mediterranean Diet Score (MDS) measured adherence to the MedDiet. Outcomes included hypertension and non-fatal CVD. Generalised estimating equations estimated OR and 95 % CI across quartiles of diet quality scores.
1946–1951 cohort of the ALSWH (n 5324), without CVD, hypertension and diabetes at baseline (2001), with complete FFQ data.
There were 1342 new cases of hypertension and 629 new cases of non-fatal CVD over 15 years of follow-up. Multivariate analysis indicated that women reporting better adherence to the ARFS (≥38/74) had 15 % (95 % CI 1, 28 %; P = 0·05) lower odds of hypertension and 46 % (95 % CI 6, 66 %; P = 0·1) lower odds of non-fatal CVD. Women reporting better adherence to the MDS (≥8/17) had 27 % (95 % CI 15, 47 %; P = 0·0006) lower odds of hypertension and 30 % (95 % CI 2, 50 %; P = 0·03) lower odds of non-fatal CVD.
Better adherence to diet quality scores is associated with lower risk of hypertension and non-fatal CVD. These results support the need for updated evidenced based on the ADG as well as public health nutrition policies in Australia.
The ratification of the Antarctic Treaty established a unique construct for human presence and activity in Antarctica. The designation of the continent for peace and science has inspired and informed the work of artists from across the world. This paper explores relationships between the Treaty and contemporary visual artists’ responses to Antarctica. Using data from interviews with scientists, cultural professionals and exhibition audiences, I explore the value to science and society of artists’ presence in Antarctica. I look at why in the last 2 years the number of artists being supported to work in Antarctica has declined and conclude with some observations on how this downward trend might be addressed.
Although the US Constitution is quite short, it is also quite old. The structures it called forth – including the presidency, the bicameral Congress, the Supreme Court – survive, even as their relationships have evolved. Its brief provisions have also spawned a complex body of jurisprudence on many issues that has shifted over more than two centuries; there are now more than 560 volumes of the official ‘US Reports’, that is, of cases decided by the US Supreme Court.1
This study investigates the effect of an abstract word training paradigm initially developed to treat lexical retrieval deficits in patients with aphasia on second language (L2) vocabulary acquisition. Three English–Spanish L2 learners (Experiment 1) and 10 Spanish–English L2 learners (Experiment 3) were trained on 15 abstract words within a context-category (e.g., restaurant) using a five-step training paradigm based on semantic feature analysis. In addition, 7 English–Spanish L2 learners were trained on either abstract or concrete words within a context-category (Experiment 2). Across all experiments, the majority of participants trained on abstract words showed improved production of the trained abstract words, as measured by a word generation task, as well as improvement on untrained concrete words within the same context-category (i.e., generalization). Participants trained on concrete words (Experiment 2) exhibited much smaller word production gains and no generalization to abstract words. These results parallel previous findings from aphasia research and suggest that this training paradigm can successfully be extended to L2 learning contexts, where it has the potential to be a useful tool in vocabulary instruction. We discuss the findings in terms of models of spreading activation and the underlying conceptual representations of abstract and concrete words in the L2 lexicon.
A piezoelectric biomedical microelectromechanical system (bioMEMS) cantilever device was designed and fabricated to act as either a sensing element for muscle tissue contraction or as an actuator to apply mechanical force to cells. The sensing ability of the piezoelectric cantilevers was shown by monitoring the electrical signal generated from the piezoelectric aluminum nitride in response to the contraction of iPSC-derived cardiomyocytes cultured on the piezoelectric cantilevers. Actuation was demonstrated by applying electrical pulses to the piezoelectric cantilever and observing bending via an optical detection method. This piezoelectric cantilever device was designed to be incorporated into body-on-a-chip systems.
Humanitarian actors sometimes have to decide whether to render assistance in situations that put them at risk of liability for aiding and abetting under international criminal law. This is the problem of the virtuous accomplice—the idea that knowingly contributing to the wrongdoing of others might, exceptionally, be the right thing to do. This article explains why the problem arises and clarifies its scope, before turning to criminal law in England and Wales and Germany to assess potential solutions. It argues that the best approach is to accept a defence of necessity—of justified complicity—and shows that such an argument works in international criminal law.
Depression is a clinically heterogeneous disorder. Previous large-scale genetic studies of depression have explored genetic risk factors of depression case–control status or aggregated sums of depressive symptoms, ignoring possible clinical or genetic heterogeneity.
We analyse data from 148 752 subjects of white British ancestry in the UK Biobank who completed nine items of a self-rated measure of current depressive symptoms: the Patient Health Questionnaire (PHQ-9). Genome-Wide Association analyses were conducted for nine symptoms and two composite measures. LD Score Regression was used to calculate SNP-based heritability (h2SNP) and genetic correlations (rg) across symptoms and to investigate genetic correlations with 25 external phenotypes. Genomic structural equation modelling was used to test the genetic factor structure across the nine symptoms.
We identified nine genome-wide significant genomic loci (8 novel), with no overlap in loci across symptoms. h2SNP ranged from 6% (concentration problems) to 9% (appetite changes). Genetic correlations ranged from 0.54 to 0.96 (all p < 1.39 × 10−3) with 30 of 36 correlations being significantly smaller than one. A two-factor model provided the best fit to the genetic covariance matrix, with factors representing ‘psychological’ and ‘somatic’ symptoms. The genetic correlations with external phenotypes showed large variation across the nine symptoms.
Patterns of SNP associations and genetic correlations differ across the nine symptoms, suggesting that current depressive symptoms are genetically heterogeneous. Our study highlights the value of symptom-level analyses in understanding the genetic architecture of a psychiatric trait. Future studies should investigate whether genetic heterogeneity is recapitulated in clinical symptoms of major depression.
However sophisticated or assertive a director or designer may be, it is the actor and his or her body that carry the ultimate authority in most kinds of theatre, especially in ‘live’ performance. ‘Liveness’ is a category debated in a number of the works reviewed this year, and evidence from the archive is always both invaluable and to be questioned. Nevertheless, the power of the actor to ‘fix’ posthumously an image of a character, assisted in this case by the photographer’s camera, is asserted in Angus McBean’s photograph of Richard Burton as Prince Henry in the Shakespeare Memorial Theatre’s 1951 production of Henry IV, Part Two, which forms the front cover of Shakespeare by McBean, edited by Adrian Woodhouse.
The morphology and growth habits of Evactinopora species of the Evactinoporidae (new family) are documented. This distinctive family of free-living bryozoans has a radial colony form at all growth stages. During a brief attachment phase on a hard substrate, the colony morphology grew as an expanding cone with vertical folds. Following detachment of the nascent colony from this hard substrate, it settled on soft sediment and the free-living expanding colony acquired a star-like form by producing slender outrigger rays. Continued growth produced a radial array of vertical vanes containing feeding autozooecia. The colony maintained a vertical orientation on soft sediment by means of outrigger rays and secretion of solid skeleton on the colony base that provided ballast. The radial growth pattern, outrigger rays, and vertical vanes developed as adaptive characters suitable for free-living life on soft sediment. North American species of Evactinopora are redefined and described taxonomically on the basis of zoarial and zooecial characters and a new species, Evactinopora mangeri, erected. The new family Evactinoporidae is established on the basis of the novel characters of early colony detachment from a hard surface, radial growth pattern through life, generation of outrigger rays, and growth of vertical vanes from the top of rays.