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Embolization of middle meningeal artery (EMMA) is a relatively new treatment for chronic subdural hematoma (CSDH). To date, an objective method that assesses or describes the extent of EMMA for the treatment of CSDH does not exist. Recently, the concept of a novel grading scale for EMMA in patients with CSDH has emerged. However, this has not been applied to a clinical case setting and inter-rater reliability has not yet been studied. The purpose of this study was to validate the grading scale in clinical practice and to assess for inter-rater reliability.
Materials and Methods:
We retrospectively examined consecutive patients who underwent EMMA for CSDH. Patients were included if the whole head angiogram from common carotid as well as external carotid arteries before and after EMMA were available in the arterial, capillary as well as venous phases. Two independent readers, each with more than 5 years of experience in independent practice, assessed the angiograms for the grading of EMMA and assigned a score ranging between 0 and 3. The grading score between the two readers were compared using Cohen’s Kappa score to assess the inter-rater reliability.
Results:
In 19 patients, we found that EMMA had no periprocedural morbidity and mortality. The number of cases in each EMMA grading score category are as follows: 0 n =1; 1 n =3; 2 n =1; and 3 n =10. There was substantial inter-rater reliability for the assessment of grading of EMMA (Kappa = 0.74).
Conclusions:
The novel EMMA grading scheme demonstrated substantial inter-rater reliability and appears promising.
Though the Hippocratic text On the Heart has garnered significant attention in the twentieth and twenty-first centuries from classicists, physicians and historians of medicine alike, no commentary on this important work currently exists. There remain, however, central questions of interpretation concerning a number of important points: in particular, how the author understands the structure and functioning of the heart.
The significance of this text for the history of cardiovascular medicine can be found first in its position as being radically advanced in its portrayal of the inner structure of the heart when compared with any other Hippocratic text. At the same time, the text falls dramatically short of the discoveries of the Alexandrian researchers who studied during the Hellenistic period—that is, around the same period as this text’s likely composition. In addition, this work contains the first extant description of the valves of the heart, and its detailed descriptions of a cuspid valve and the chordae tendineae have led several scholars to imagine that this text even contains evidence of either a systematic dissection of an animal heart or—what seems impossible outside of Alexandria, Egypt at that time—evidence of the dissection of a human heart.
This article intends to provide a full commentary on the text by consolidating, and in some cases correcting, previous interpretive attempts to understand an often referenced, and at times misinterpreted, ancient medical treatise.
This paper examines Master Lucas, a bell founder based in Venice who was active between the thirteenth and the fourteenth centuries. Through the examination of sixteen bells, some of which are no longer extant, the career of one of the earliest known Venetian bell founders can be traced. A catalogue of the bells describes their measurements, inscriptions and decorations. The distribution of his products to locations in Montenegro and central Italy demonstrate the importance of Venice as a bell casting centre in the Middle Ages. Written documents are cited to provide further information about Lucas’s life and some of the bells that he cast. Collation of this evidence sheds important light on the practices of bell casting in Venice around ad 1300.
Au sein de l’Organisation des États américains (OÉA),1 la Commission interaméricaine des Droits de l’Homme (CIDH) et la Cour interaméricaines des Droits de l’Homme sont les deux principaux organes chargés de veiller à la protection des droits de la personne dans les Amériques.2 Ces instances sont habilitées à instruire des recours individuels intentés contre des États membres et portant sur des allégations de violations de la Convention américaine relative aux Droits de l’Homme (CADH)3 et d’autres instruments interaméricains applicables.4 La présente chronique portera sur certaines décisions rendues par la cour pendant l’année 2022.
This paper examines the impact of trade-related technology diffusion from G7 countries to Latin America and East Asia on total factor productivity controlling for education, governance, and distance. We build on the trade and distance-focused strands of the technology diffusion literature and find that (i) total factor productivity (TFP) increases with education, trade, and governance (ETG) and declines with distance to the G7 countries; (ii) increasing Latin America's ETG to East Asia's level would double TFP, accounting for about 75% of the TFP gap between the two country groups; and (iii) South America's greater remoteness relative to Mexico's from the US and Canada significantly reduces its TFP and similarly for Singapore's greater remoteness from Japan relative to Hong Kong.
This paper develops a Heckscher−Ohlin model in which the effects on production structure of endowments and changes in trade policies depend in a continuous way on a country's degree of openness to trade. Its main contribution is to show semi-formally how the introduction of product differentiation causes the elasticities of output with respect both to factor endowments and to sectoral trade barriers to vary with import penetration (the share of foreign firms in home markets) and export orientation (the share of foreign markets in home-firm sales).
This article advances historical understandings of health, veterinary medicine and livestock agriculture by examining how, in mid-twentieth-century Britain, the diseases of livestock were made collectively knowable. During this period, the state extended its gaze beyond a few, highly impactful notifiable diseases to a host of other threats to livestock health. The prime mechanism through which this was achieved was the disease survey. Paralleling wider developments in survey practices, it grew from small interwar beginnings into a hugely expensive, wide-ranging state veterinary project that created a new conception of the nation’s livestock as a geographical aggregation of animals in varying states of health. This article traces the disease survey’s entanglements with dairy cows, farming practices, veterinary professional politics and government agendas. It shows that far from a neutral reflection of reality, surveys both represented and perpetuated specific versions of dairy cow health, varieties of farming practice and visions of the veterinary professional role. At first, their findings proved influential, but over time they found it harder to discipline their increasingly complex human, animal and disease subjects, resulting in unconvincing representations of reality that led ultimately to their marginalization.