Law's artefacts: Personal rapid transit and public narratives of hitchhiking and crime.

The West Virginia University (WVU) Personal Rapid Transit (PRT) system was built between 1971 and 1975 in Morgantown, West Virginia to be a prototype transportation system of the future. Envisioned as a hybrid of public and automotive transportation, the fully automated cars deliver passengers directly to their destinations without stopping at intervening stations. The PRT concept may be familiar to STS scholars through Latour's study of Aramis, a PRT in Paris that was never completed. This article recounts a history with the opposite ending: the successful realization of a PRT in West Virginia. Our account supplements existing ones, which explain the construction of the WVUPRT primarily as the product of geography and politics. While not denying these factors, we carve out an explanatory role for another influence: a public narrative about the dangers of hitchhiking and crimes that might ensue from that practice. In weaving together that narrative with the history of the WVUPRT, we show how public narratives of crime authorize technological infrastructure.

Finding the perfect match: Fingerprint expertise facilitates statistical learning and visual comparison decision-making.

Forensic feature-comparison examiners compare-or "match"-evidence samples (e.g., fingerprints) to provide judgments about the source of the evidence. Research demonstrates that examiners in select disciplines possess expertise in this task by outperforming novices-yet the psychological mechanisms underpinning this expertise are unclear. This article investigates one implicated mechanism: statistical learning, the ability to learn how often things occur in the environment. This ability is likely important in forensic decision-making as samples sharing rarer statistical information are more likely to come from the same source than those sharing more common information. We investigated 46 fingerprint examiners' and 52 novices' statistical learning of fingerprint categories and application of this knowledge in a source-likelihood judgment task. Participants completed four measures of their statistical learning (frequency discrimination judgments, bounded and unbounded frequency estimates, and source-likelihood judgments) before and after familiarization to the "ground-truth" category frequencies. Compared to novices, fingerprint examiners had superior domain-specific statistical learning across all measures-both before and after familiarization. This suggests that fingerprint expertise facilitates domain-specific statistical learning-something that has important theoretical and applied implications for the development of training programs and statistical databases in forensic science. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Comparison of clinical estimations and radiological measurements in the context of paediatric cervical masses: How accurate are we?

OBJECTIVES: Cervical masses represent a common presentation to the paediatric ENT outpatient clinic. Despite their high prevalence, few represent an underlying malignant pathology. Currently, there is no universally accepted algorithm for management of such cases in the United Kingdom. Local guidance often centres around clinical interpretation of size when determining the need for investigation. With such emphasis placed on size, the authors sought to investigate the accuracy of physician palpation and in turn explore the validity of common referral pathways. METHODS: A retrospective methodology was used to address the research objective. All paediatric ultrasound scans conducted during a 24-month period were reviewed to compare the clinical and radiological assessments of diameter. A 2 tailed paired student's t-test was selected to evaluate the differences between the two measurements and ultimately assess clinician accuracy. RESULTS: 753 paediatric cervical ultrasound scans were conducted during the 2-year period. Initial analysis identified three discrete ultrasonographically diagnostic groups: lymph nodes (n = 532), non-lymph node masses (n = 162) and normal anatomy (n = 59). Further analysis of clinical estimation and radiological measurement demonstrated a statistically significant difference (p < 0.02) for the lymph-node group. A statistically significant difference was not demonstrated within the non-lymph node group (p = 0.66). When clinician assessment resulted in a value outside of what was considered accurate, lymph node sizes were predominantly overestimated (62/91, 68%). Conversely, non-lymph node masses where the clinical measurement was not within 5 mm of the ultrasound measurement were more commonly underestimated in size (11/45, 55%) but this was not statistically significant. CONCLUSIONS: Our study demonstrates a statistically significant tendency for clinicians to overestimate paediatric cervical lymphadenopathy. Calliper measurement may further improve accuracy of assessment.

High-risk basal cell carcinoma excision in primary care: a retrospective observational study of compliance with NICE guidance.

OBJECTIVES: To assess compliance with 2010 National Institute for Health and Care Excellence (NICE) guidance on cancer services relating to the management of basal cell carcinomas (BCC) in the community, where except in specific circumstances it is recommended that only low-risk BCCs should be excised routinely. DESIGN AND SETTING: A retrospective observational study of the histopathology reports of BCC excisions received from primary care in two district general hospitals in the South of England. One hundred consecutive BCC excisions were analysed from each hospital. OUTCOME MEASURES: The numbers of high-risk BCCs excised in primary care according to histological subtype, anatomical site and age and if these excisions were compliant with NICE 2010 guidance. Completeness of excision and mention of BCC on histology request were secondary outcomes. RESULTS: Histologically high-risk subtypes were present in 32% (64/200) of BCCs excised in the community. Only 17/64 were excised by general practitioners (GPs) who were accredited to do so. Non-compliance regarding anatomical site occurred in 16% of samples; only one was non-compliant regarding patient age. There was a high overall rate of complete excision (94.5%) with variation in presence of the term BCC on histology request forms. CONCLUSIONS: NICE 2010 guidance relating to BCC excision in primary care was not followed in a considerable number of cases. Compliance with NICE 2010 guidance depends on the ability to recognise high-risk BCCs clinically and manage appropriately. It also shows that despite close supervision by secondary care, there are still failures of compliance.GP training in identification of subtypes of BCC might be improved, as well as an increase in numbers of GPs accredited to carry out high-risk BCC excisions. Difficulty in diagnosing high-risk histological subtypes of BCC preoperatively should be considered in any future revision of NICE guidance.

Forensic bitemark identification: weak foundations, exaggerated claims.

Several forensic sciences, especially of the pattern-matching kind, are increasingly seen to lack the scientific foundation needed to justify continuing admission as trial evidence. Indeed, several have been abolished in the recent past. A likely next candidate for elimination is bitemark identification. A number of DNA exonerations have occurred in recent years for individuals convicted based on erroneous bitemark identifications. Intense scientific and legal scrutiny has resulted. An important National Academies review found little scientific support for the field. The Texas Forensic Science Commission recently recommended a moratorium on the admission of bitemark expert testimony. The California Supreme Court has a case before it that could start a national dismantling of forensic odontology. This article describes the (legal) basis for the rise of bitemark identification and the (scientific) basis for its impending fall. The article explains the general logic of forensic identification, the claims of bitemark identification, and reviews relevant empirical research on bitemark identification-highlighting both the lack of research and the lack of support provided by what research does exist. The rise and possible fall of bitemark identification evidence has broader implications-highlighting the weak scientific culture of forensic science and the law's difficulty in evaluating and responding to unreliable and unscientific evidence.

A surfeit of science: The "CSI effect" and the media appropriation of the public understanding of science.

Over the past decade, popular media has promulgated claims that the television program CSI and its spinoffs and imitators have had a pernicious effect on the public understanding of forensic science, the so-called "CSI effect." This paper analyzes those media claims by documenting the ways in which the media claims that CSI "distorts" an imagined "reality." It shows that the media appropriated the analytic stance usually adopted by science advocates, portraying the CSI effect as a social problem in science communication. This appropriation was idiosyncratic in that it posited, as a social problem, a "surfeit" of knowledge and positive imagery about science, rather than the more familiar "deficits." In addition, the media simultaneously appropriated both "traditional" and "critical" PUS discourses. Despite this apparent contradiction, the paper concludes that, in both discourses, the media and its expert informants insist upon their hegemony over "the public" to articulate the "reality" of forensic science.

Randomized controlled trial on the effect of coaching in simulated laparoscopic training.

BACKGROUND: The effect of coaching on surgical quality and understanding in simulated training remains unknown. The aim of this study was compare the effects of structured coaching and autodidactic training in simulated laparoscopic surgery. METHODS: Seventeen surgically naive medical students were randomized into two groups: eight were placed into an intervention group and received structured coaching, and nine were placed into a control group and received no training. They each performed 10 laparoscopic cholecystectomies on a virtual reality simulator. The surgical quality of the first, fifth, and 10th operations was evaluated by 2 independent blinded assessors using the Competency Assessment Tool (CAT) for cholecystectomy. Understanding of operative strategy was tested before the first, fifth, and 10th operation. Performance metrics, path length, total number of movements, operating time, and error frequency were evaluated. The groups were compared by the Mann-Whitney U test. Proficiency gain curves were plotted using curve fit and CUSUM models; change point analysis was performed by multiple Wilcoxon signed rank analyses. RESULTS: The intervention group scored significantly higher on the CAT assessment of procedures 1, 5, and 10, with increasing disparity. They also performed better in the knowledge test at procedures 5 and 10, again with an increasing difference. The learning curve for error frequency of the intervention group reached competency after operation 7, whereas the control group did not plateau by procedure 10. The learning curves of both groups for path length and number movements were almost identical; the mean operation time was shorter for the control group. CONCLUSIONS: Clinically relevant markers of proficiency including error reduction, understanding of surgical strategy, and surgical quality are significantly improved with structured coaching. Path length and number of movements representing merely manual skills are developed with task repetition rather than influenced by coaching. Structured coaching may represent a key component in the acquisition of procedural skills.

Endoscopic versus laparoscopic management of noninvasive upper tract urothelial carcinoma: 20-year single center experience.

PURPOSE: We compare the outcomes of endoscopic surgery to laparoscopic nephroureterectomy for the management of specifically noninvasive upper tract urothelial carcinoma. MATERIALS AND METHODS: A retrospective database review identified consecutive patients with clinically noninvasive upper tract urothelial carcinoma who underwent endoscopic surgery (59, via ureteroscopic ablation or percutaneous resection) or laparoscopic nephroureterectomy (70) at a single center during 20 years (1991 to 2011). Overall survival, upper tract urothelial carcinoma specific survival, upper tract recurrence-free survival, intravesical recurrence-free survival, progression-free survival and renal unit survival were estimated using Kaplan-Meier methods, with differences assessed using the log rank test. RESULTS: Median age and followup were 74.8 years and 50 months, respectively. Overall renal preservation in the endoscopic group was high (5-year renal unit survival 82.5%), although this came at a cost of high local recurrence (endoscopic surgery 5-year recurrence-free survival 49.3%, laparoscopic nephroureterectomy 100%, p <0.0001). For G1 upper tract urothelial carcinoma, endoscopic surgery 5-year disease specific survival (100%) was equivalent to that of laparoscopic nephroureterectomy (100%). However, laparoscopic nephroureterectomy demonstrated superior disease specific survival to endoscopic surgery for G2 disease (91.7% vs 62.5%, p = 0.037) and superior progression-free survival for G3 disease (88.9% vs 55.6%, p = 0.033). CONCLUSIONS: For G1 upper tract urothelial carcinoma, endoscopic management can provide effective oncologic control and renal preservation. However, endoscopic management should not be considered for higher grade disease except in compelling imperative cases or in patients with poor life expectancy as oncologic outcomes are inferior to those of laparoscopic nephroureterectomy.

Forensic culture as epistemic culture: the sociology of forensic science.

This paper explores whether we can interpret the notion of 'forensic culture' as something akin to what Knorr-Cetina called an 'epistemic culture'. Can we speak of a 'forensic culture', and, if so, how is it similar to, or different from, other epistemic cultures that exist in what is conventionally called 'science'? This question has important policy implications given the National Academy Science's (NAS) recent identification of 'culture' as one of the problems at the root of what it identified as 'serious deficiencies' in U.S. forensic science and 'scientific culture' as an antidote to those problems. Finding the NAS's characterisation of 'scientific culture' overly general and naïve, this paper offers a preliminary exploration of what might be called a 'forensic culture'. Specifically, the paper explores the way in which few of the empirical findings accumulated by sociologists of science about research science seem to apply to forensic science. Instead, forensic science seems to have developed a distinct culture for which a sociological analysis will require new explanatory tools. Faithful sociological analysis of 'forensic culture' will be a necessary prerequisite for the kind of culture change prescribed by external reformist bodies like the NAS.

Long-term endoscopic management of upper tract urothelial carcinoma: 20-year single-centre experience.

UNLABELLED: Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Endoscopic management of small, low-grade, non-invasive upper tract urothelial cell carcinoma (UTUC) is a management option for selected groups of patients. However, the long-term survival outcomes of endoscopically-managed UTUC are uncertain because only four institutions have reported outcomes of more than 40 patients beyond 50 months of follow-up. Moreover, there is significant variance in the degree of underlying UTUC pathology verification in some of these reports, which precludes an analysis of disease-specific survival outcomes. The present study represents one of the largest endoscopically managed series of patients with UTUC, with a long-term follow-up. The degree of verification of underlying UTUC pathology is one of the highest, which allows a grade-stratified analysis of different outcomes, including upper-tract recurrence-free survival, intravesical recurrence-free survival, renal unit survival and disease-specific survival. These outcomes provide further evidence suggesting that endoscopic management of highly selected, low-grade UTUC can provide effective oncological control, as well as renal preservation, in experienced centres. OBJECTIVE: • To report the long-term outcomes of patients with upper tract urothelial cell carcinoma (UTUC) who were treated endoscopically (either via ureteroscopic ablation or percutaneous resection) at a single institution over a 20-year period. PATIENTS AND METHODS: • Departmental operation records were reviewed to identify patients who underwent endoscopic management of UTUC as their primary treatment. • Outcomes were obtained via retrospective analysis of notes, electronic records and registry data. • Survival outcomes, including overall survival (OS), UTUC-specific survival (disease-specific survival; DSS), upper-tract recurrence-free survival, intravesical recurrence-free survival, renal unit survival and progression-free survival, were estimated using Kaplan-Meier methods and grade-stratified differences were analyzed using the log-rank test. RESULTS: • Between January 1991 and April 2011, 73 patients underwent endoscopic management of UTUC with a median age at diagnosis of 67.7 years. • All patients underwent ureteroscopy and biopsy-confirmation of pathology was obtained in 81% (n = 59) of the patients. In total, 14% (n = 10) of the patients underwent percutaneous resection. • Median (range; mean) follow-up was 54 (1-223; 62.8) months. • Upper tract recurrence occurred in 68% (n = 50). Eventually, 19% (n = 14) of the patients proceeded to nephroureterectomy. • The estimated OS and DSS were 69.7% and 88.9%, respectively, at 5 years, and 40.3% and 77.4%, respectively, at 10 years. The estimated mean and median OS times were 119 months and 107 months, respectively. The estimated mean DSS time was 190 months. CONCLUSIONS: • The present study represents one of the largest reported series of endoscopically-managed UTUC, with high pathological verification and long-term follow-up. • Upper-tract recurrence is common, which mandates regular ureteroscopic surveillance. • However, in selected patients, this approach has a favourable DSS, with a relatively low nephroureterectomy rate, and therefore provides oncological control and renal preservation in patients more likely to die eventually from other causes.

Single screw fixation in stable and unstable slipped upper femoral epiphysis.

The aim of this single centre retrospective study was to assess the outcome of patients after the fixation of slipped upper femoral epiphysis (SUFE) using a single cannulated screw. Thirty-eight slips, 28 stable and 10 unstable were treated with single in-situ screw fixation. The minimum follow-up was 1 year. The overall adverse outcome in terms of avascular necrosis (AVN), chondrolysis and revision surgery for slip progression was 18%, which was considered satisfactory. Slip progression of more than 10° was higher in the unstable when compared with the stable group but not statistically significant. Two out of the nine satisfactorily fixed unstable slips required revision surgery as opposed to none in the stable group. The incidence of AVN in the unstable group was 20%. There were no cases of AVN in the stable group. The adverse outcome in terms of AVN, chondrolysis and revision surgery for slip progression was significantly higher in the unstable group. In our study, results of single screw fixation for SUFE were found to be satisfactory as shown by earlier studies with the unstable SUFEs as expected having a poorer outcome when compared with the stable SUFEs.

The vision in "blind" justice: expert perception, judgment, and visual cognition in forensic pattern recognition.

Many forensic disciplines require experts to judge whether two complex patterns are sufficiently similar to conclude that both originate from the same source. Studies in this area have revealed that there are a number of factors that affect perception and judgment and that decisions are subjective and susceptible to extraneous influences (such as emotional context, expectation, and motivation). Some studies have shown that the same expert examiner, examining the same prints but within different contexts, may reach different and contradictory decisions. However, such effects are not always present; some examiners seem more susceptible to such influences than do others--especially when the pattern matching is "hard to call" and when the forensic experts are not aware that they are being observed in an experimental study. Studying forensic examiners can contribute to our understanding of expertise and decision making, as well as have implications for forensic science and other areas of expertise.

Cultural consequences of miscarriages of justice.

Social science scholarship has tended to focus more on the causes than the consequences of miscarriages of justice. Within the literature on consequences, the overwhelming emphasis has been on individual consequences: psychological and material impacts on the wrongly convicted individual and, in some cases, other indirectly impacted individuals such as family members of the wrongly convicted and victims of the true perpetrator's future crimes. Some attention has been devoted to social harms, the impact of miscarriages of justice on the broader society within which they are situated, such as the undermining of the legitimacy of the criminal justice system. This paper focuses on what are called here cultural consequences of miscarriages of justice: the way in which some high-profile miscarriages of justice can shape the public's beliefs about some of the most basic "facts" about crime, such as the nature, prevalence, or even existence of certain categories of crime and the types of individual who tend to perpetrate particular types of crime. In this way, the paper argues, miscarriages of justice may have hitherto underexplored consequences: reshaping, based on false premises, the public's belief about the very nature of crime itself. This paper discusses three cases studies of miscarriages of justice that for varying periods of time created widespread false beliefs about the nature of crime in large segments of the public. The paper concludes by noting that the "righting" of these false beliefs was in most cases fortuitous. This suggests that unexposed miscarriages of justice may still be shaping popular beliefs about the nature of crime, and aspects of the public's current conception of crime may yet be based on false premises.

On the preliminary psychophysics of fingerprint identification.

For a century, the matching of images of fingerprints has been used for forensic identification. Despite that history, there have been no published, peer-reviewed studies directly examining the extent to which people can correctly match fingerprints to one another. The results of three experiments using naïve undergraduates to match images of fingerprints are reported. The results demonstrate that people can identify fingerprints quite well, and that matching accuracy can vary as a function of both source finger type and image similarity.