Evaluation of pediatric skull fracture imaging techniques

Radiologic imaging is crucial in the diagnosis of skull fracture, but there is some doubt as to whether different imaging modalities can accurately identify fractures present on a human skull. While studies have been performed to evaluate the efficacy of radiologic imaging at other anatomical locations, there have been no systematic studies comparing various CT techniques, including high resolution imaging with and without 3D reconstructions to conventional radiologic imaging in children, we investigated which imaging modalities: high-resolution CT scan with 3D projections, clinical-resolution CT scans or X-rays, best showed fracture occurrence in a pediatric human cadaver skull by having an expert pediatric radiologist examine radiologic images from fractured skulls. The skulls used were taken from pediatric cadavers ranging in age from 5 months to 16 years. We evaluated the sensitivity and specificity for the imaging modalities using dissection findings as the gold standard. We found that high-resolution CT scans with 3D projections and conventional CT provided the most accurate fracture diagnosis (single-fracture sensitivity of 71%) followed by X-rays (single-fracture sensitivity of 63%). Linear fractures outsider the region of the sutures were more identifiable than diastatic fractures, though the incidence of false positives was greater for linear fractures. In the two cases where multiple fractures were present on the same anatomical skull location, the radiologist was less likely to identify the presence of additional fractures than a single fracture. Overall, the high-resolution and clinical-resolution CT scans had the similar accuracy for detecting skull fractures while the use of the X-ray was both less accurate and had a lower specificity.     

Racially conditional donation: the example of umbilical cord blood

While direction of donated tissue to family members has long been accepted, direction to members of specific racial groups has been opposed, on the basis that it is discriminatory and contrary to the ethos the institution of organ donation seeks to promote. It has, however, recently been proposed that racially conditional donation may provide a useful--and ethically acceptable--way to address the social inequalities and injustices experienced by certain cultural groups. This article examines the ethical, legal and cultural arguments for and against racially conditional donation, concluding that the practice is more likely to undermine the values of equity and justice than to promote them and that it may also lead to other unfavourable personal and social outcomes.     

Why are highly informed citizens sceptical of referenda?

Past work on attitudes toward the use of referenda finds that the most politically informed citizens are more sceptical of its use than their less informed counterparts. An intriguing tension presents itself in that those citizens who may be best equipped for referendum voting, the highly informed and politically sophisticated, are the least likely to support the use of this tool of direct democracy. Using data from Canadian Election Studies, we consider three explanations for relative referenda scepticism among political sophisticates. Our analyses provide evidence to support a confidence in government explanation and a concern for minority rights explanation, but not an incompetent public explanation – a curious finding considering the centrality of citizen competence in the theoretical literature on referenda.