Sexing North American Eskimo and Indian innominate bones with the acetabulum/pubis index

The acetabulum/pubis index was tested on American Eskimo and Indian samples of innominate bones to which sex had been assigned by visual inspection. The index alone sexed 91 and 89% of the Eskimo and Indian samples, respectively. Subsequent sorting of misclassified specimens with femur head diameter resulted in 96 and 99% rates of classification. The index and a measurement of ischial height were used in a discriminant function model which correctly identified the sex of 93% of the Eskimo and 92% of the Indian bones. Using femur head diameter to sort those specimens which were misclassified by their discriminant function score yielded classification rates of 96 and 98%. These results are compared to a range of 92 to 100% obtained with the index in earlier studies of American black and white pelvic bone samples.     

Term-limitation express

He is co-author of The American Presidency,and editor of The Politics of Interests.He has written extensively on term limits and rotation in office and related topics and commentaries.     

Has the erosion of the medical marketplace ended?

This paper updates tests of the validity of three models of medical price inflation: a standard model, in which changes in demand press against inelastic supply; a dynamic version of the standard model, in which high levels of insurance induce high rates of product innovation and development; and a model of increasing inefficiency, in which consumers have weak incentives to search out efficient suppliers. Earlier statistical support for the third model has weakened, which provides some evidence that the regulatory and competitive initiatives of the last decade are having their intended effects. But time series measures of medical prices upon which the statistical evidence relies have important methodological problems, so other types of evidence are useful. Trends in expenditure in other countries and in HMOs suggest that the most important explanation of medical price inflation is the dynamic version of the standard model, although the other models have some validity as well.     

The cost and value of second surgical opinion programs: a critical review of the literature

Second surgical opinion programs (SSOPs) have been used since 1972 by both public and private insurers to improve the patient's information and decision processes and to reduce operative risks and costs attributable to questionable and perhaps unnecessary operations. This article reviews the literature on SSOPs. It considers whether SSOPs are effective mechanisms for reducing health care costs, how SSOPs affect outcomes, how physician errors affect the value of SSOPs, and what nonconfirmation rates and rates of surgery indicate about the appropriateness of operations. Although the literature varies in quality, all the studies fall short in one or more of the following dimensions: an appropriate control group, a comprehensive definition of cost and outcomes, and sufficient duration and scale to measure changes and use of medical services in a general population. Thus, the value of SSOPs remains an open question.     

Chloroquine as a poison in murder. Report of fatalities after criminal or suicidal chloroquine administration

Presented is a case of murder by means of chloroquine, committed on a 36-year-old male. The wife of the deceased had confessed to have secretely administered chloroquine-containing tablets to her husband. She was lawfully sentenced to life-imprisonment. The toxicological findings of this case are compared to the results of two chloroquine suicide cases and discussed in the context of the referring literature. An additional case where chloroquine intoxication was doubtful is introduced because of the unusual circumstances under which it occurred.     

Supravital electrical excitability of muscles

A new method of postmortem electrical stimulation of muscles, measuring the force of the reaction against time, is presented. Preliminary investigations have yielded the following results: The maximum force of reaction in response to a definitive stimulation, measured by a sensitive force transducer, decreases in proportion to the post mortem interval. Using this method, the mechanical reactions of muscles by electrical stimulation can be demonstrated over a much longer postmortem period as these movements are visible. The duration of postmortem reaction of different muscles seems to be much more uniform than was previously assumed. Occasionally, reactions of the M. orbicularis oculi can be seen for the longest time. The basal muscular tonus changes relative to time. The time course of a single force reaction also changes relative to the postmortal interval: the reaction becomes slower. It has been theoretically established that measurement of influencing factors such as temperature and pH in the tested muscle will enable the time of death to be more precisely estimated.