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Under these circumstances we must consider next only the rapid rewarming with light cradle or electrically heated sleeping bag blood pressure 90 over 50 buy cheap digoxin on-line. It was evident that the temperatures which can be developed by this means are not sufficient for heat therapy sheer heart attack buy generic digoxin on line. Besides this hypertension of the knee buy generic digoxin 0.25mg on line, the wall of the foot-section of the sleeping bag is only partly heated; on the outer sides it remains completely cold blood pressure 4080 best 0.25 mg digoxin. As long as no improvement and strengthening of the heating equipment of the sack is carried out, the sleeping bag can be considered only as a substitute for wrapping in warm covers. With warming by light one might expect severe local vessel expansion with danger of collapse. Actually the subjects often complained of dizziness and nausea after reaching consciousness if the treatment lasted longer than 15 minutes. I n these cases it is indicated to switch off the light cradle and to pack the subject with covers. Apart from this it must be remembered that during unconsciousnessthe subject should be protected against direct contact with the lamps by means of covers, otherwise burns could occur during clonic-tonic convulsions. This suggests that "short waves" be employed to supply heat, since it was shown in animal experimentation that by this means it is possible to bring about a thorough warming of the whole animal, which leads to a recovery of the animal with puzzling rapidity. We did not have the proper equipment for a thorough warming of a human being by this means. Above all, it is necessary to advise against a practical application of this method, since there exists the danger of prolonged burning even in full consciousness, as the result of cold anaesthesia, even if the treating physician carefully tries to avoid this. The severe d a c u l t y in breathing as well as the formation of foam before the mouth, which reminded one of incipient lung oedema, seemed to indicate oxygen therapy. Death After Cooling in Water Practical and Theoretical Considerations Reports to the effect that those who have been rescued at sea are imperilled for a considerable time after rescue has aroused special attention. It has been reported especially that sudden cases of death occurred as much as 20 minutes to 90 minutes after rescue, and that in mass catastrophes these sudden deaths could amount to mass-dying (rescue collapse). Bleeding in the rewarming periphery, break-downs of neural and humoral correlations and similar ideas have been brought up. In contrast to this our experiments give a relatively simple explanation of cold-death under these conditions. With the exception of a single case, a total irregularity of the heart chamber could be definitely demonstrated in all cases of cooling under 30" C. The exception was an experiment on an intoxicated subject, which is to be gone i n 6 more fully below (see see. V I I) Furthemore heart-death was established clinically in all cases of death observed b y zcs. These were cases in which it was specially noted that the neck and the back of the head lay deep in the water. I n all remaining cases breathing outlasted the clinical chamber cessation by as much as 20 minutes. I n part this was "normal, much decelerated breathing," in part an angonal form of gasping. As already referred to , an auricular flutter could be demonstrated cardiographically during the irregularity. In cases in which a special cooling of neck and back of head had existed before death, the autopsy showed a: mr7ced brain oedema, a tight filling of the general brain cavity [Hirngefaesse] blood in the spinal fluid as well as blood in the Michaelisrhomboid. The heart findings warrant our taking a certain attitude toward the question of rescue collapse. Death occurred relatively quickly after removal from the water, which may be compared with rescue. It is to be noted, however, in the first place, that almost certainly a much larger number of deaths would have been observed if an active heat therapy had not almost regularly been coupled directly with the completion of the experiment; in the second place, that in such cases there would have been very much longer intervals. We have already called attention repeatedly to the after-cooling following the experiment.

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It cannot be satisfactorily conducted in an atmosphere where it is gauged and tested by operating or production standards hypertension occurs when buy discount digoxin 0.25 mg on line. Basic scientific research should not blood pressure chart who cheap digoxin generic, therefore hypertension herbs buy digoxin 0.25 mg fast delivery, be placed under an operating agency whose paramount concern is anything other than research arrhythmia vertigo effective digoxin 0.25mg. The decision that there should be a new and independent agency was reached by each of the committees advising in these matters. Much medical progress, for example, will come from fundamental advances in chemistry. Separation of the sciences in tight compartments, as would occur if more than one agency were involved, would retard and not advance scientific knowledge as a whole. These principles are as follows: (1) Whatever the extent of support may be, there must be stability of funds over a period of years so that long-range programs may be undertaken. They should be persons of broad interest in and understanding of the peculiarities of scientific research and education. Only through such responsibility can we maintain the proper relationship between science and other aspects of a democratic system. The usual controls of audits, reports, budgeting, and the like, should, of course, apply to the administrative and fiscal operations of the Foundation, subject, however, to such adjustments in procedure as are necessary to meet the special requirements of research. Basic research is a long-term process-it ceases to be basic if immediate results are expected on short-term support. Methods should therefore be found which will permit the agency to make commitments of funds from current appropriations for programs of five years duration or longer. Continuity and stability of the program and its support may be expected (a) from the growing realization by the Congress of the benefits to the public from scientific research, and (b) from the conviction which will grow among those who conduct research under the auspices of the agency that good quality work will be followed by continuing support. Military Research As stated earlier in this report, military preparedness requires a permanent, independent, civilian-controlled organization, having close liaison with the Army and Navy, but with funds direct from Congress and the clear power to initiate military research which will supplement and strengthen that carried on directly 35 under the control of the Army and Navy. As a temporary measure the National Academy of Sciences has established the Research Board for National Security at the request of the Secretary of War and the Secretary of the Navy. This is highly desirable in order that there may be no interruption in the relations between scientists and military men after the emergency wartime Office of Scientific Research and Development goes out of existence. The Congress is now considering legislation to provide funds for this Board by direct appropriation. I believe that, as a permanent measure, it would be appropriate to add to the agency needed to perform the other functions recommended in this report the responsibilities for civilian-initiated and civilian-controlled military research. The function of such a civilian group would be primarily to conduct long-range scientific research on military problems-leaving to the Services research on the improvement of existing weapons. Some research on military problems should be conducted, in time of peace as well as in war, by civilians independently of the military establishment. It is the primary responsibility of the Army and Navy to train the men, make available the weapons, and, employ the strategy that will bring victory in combat. The Armed Services cannot be expected to be experts in all of the complicated fields which make it possible for a great nation to fight successfully in total war. There are certain kinds of research-such as research on the improvement of existing weapons-which can best be done within the military establishment. However, the job of long-range research involving application of the newest scientific discoveries to military needs should be the responsibility of those civilian scientists in the universities and in industry who are best trained to discharge it thoroughly and successfully. It is essential that both kinds of research go forward and that there be the closest liaison between the two groups. Placing the civilian military research function in the proposed agency would bring it into close relationship with a broad program of basic research in both the natural sciences and medicine. The establishment of the new agency, including a civilian military research group, should not be delayed by the existence of the Research Board for National Security, which is a temporary measure. Nor should the creation of the new agency be delayed by uncertainties in regard to the postwar organization of our military departments themselves. Clearly, the new agency, including a civilian military research group within it, can remain sufficiently flexible to adapt its operations to whatever may be the final organization of the military departments. National Research Foundation It is my judgment that the national interest in scientific research and scientific education can best be promoted by the creation of a National Research Foundation.

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The Regulated Area description for item 22 arteria testicularis cheapest generic digoxin uk, ``Monte Foundation Fireworks' arteria pudenda interna buy digoxin us, would be revised to clarify the safety zone will be in the navigable waters around and under the Capitola Pier blood pressure medication hair loss purchase digoxin 0.25 mg visa. The three new fireworks events would be listed in Table 1 of this section as item 31 arteria iliolumbalis purchase generic digoxin canada, ``Fourth of July Fireworks, City of Benicia,' item 32, ``Fourth of July Fireworks, City of Vallejo,' and item 33 ``Berkeley Winter on the Waterfront Fireworks. The Coast Guard believes it is beneficial to include these additional fireworks displays in the list of reoccurring permanent regulations to increase public awareness of when safety zones would be enforced in these marine areas. Regulatory Analyses We developed this proposed rule after considering numerous statutes and Executive orders related to rulemaking. Below we summarize our analyses based on a number of these statutes and Executive orders and we discuss First Amendment rights of protestors. Regulatory Planning and Review Executive Orders 12866 and 13563 direct agencies to assess the costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits. This regulatory action determination is based on the limited duration and narrowly tailored geographic areas of the safety zones. Although this rule restricts access to the waters encompassed by the safety zones, the effect of this rule will not be significant because the local waterway users will be notified via public Notice to Mariners to ensure the safety zones will result in minimum impact. The entities most likely to be affected are waterfront facilities, commercial vessels, and pleasure craft engaged in recreational activities. We have analyzed this proposed rule under that Order and have determined that it is consistent with the fundamental federalism principles and preemption requirements described in Executive Order 13132. Also, this proposed rule does not have tribal implications under Executive Order 13175 (Consultation and Coordination with Indian Tribal Governments) because it would not have a substantial direct effect on one or more Indian tribes, on the relationship between the Federal Government and Indian tribes, or on the distribution of power and responsibilities between the Federal Government and Indian tribes. In particular, the Act addresses actions that may result in the expenditure by a State, local, or tribal government, in the aggregate, or by the private sector of $100,000,000 (adjusted for inflation) or more in any one year. Though this proposed rule would not result in such an expenditure, we do discuss the effects of this rule elsewhere in this preamble. Environment We have analyzed this proposed rule under Department of Homeland Security Directive 023­01, Rev. A preliminary Record of Environmental Consideration supporting this determination is available in the docket. We seek any comments or information that may lead to the discovery of a significant environmental impact from this proposed rule. Protest Activities the Coast Guard respects the First Amendment rights of protesters. If you submit a comment, please include the docket number for this rulemaking, indicate the specific section of this document to which each comment applies, and provide a reason for each suggestion or recommendation. We encourage you to submit comments through the Federal eRulemaking Portal at A above, this proposed rule would not have a significant economic impact on any vessel owner or operator for the following reasons: (i) this rule will encompass only a small portion of each affected waterway for a limited period of time for each fireworks event, and (ii) the maritime public will be advised in advance of these safety zones via Notice to Mariners. Under section 213(a) of the Small Business Regulatory Enforcement Fairness Act of 1996 (Pub. The Coast Guard will not retaliate against small entities that question or complain about this proposed rule or any policy or action of the Coast Guard. Collection of Information this proposed rule would not call for a new collection of information under the Paperwork Reduction Act of 1995 (44 U. The authority citation for part 165 continues to read as follows: Authority: 46 U. A barge located approximately 700 feet off of the San Francisco Municipal Pier at Aquatic Park. Increases to a 500-foot radius upon commencement of the first fireworks display and remains in effect until after the conclusion of the second fireworks display. This review was initiated within two years of the completion of the previous review. Comments will be available for public inspection Monday through Friday, except for legal holidays, from 9 a. Please be aware that comments and other submissions from members of the public are made available for public viewing without changes.

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One surely is not mistaken in supposing that none of the defendants prehypertension blood pressure chart cheap digoxin 0.25mg, even if he has ever such great experience as a medical man interleukin 6 arrhythmia cheap digoxin 0.25mg with visa, a t that time thought without exception of all the possibilities which we have to consider now prehypertension medication buy cheap digoxin on-line, when for many months we have had to search for the legal basis of the whole problem of human experiments hypertensive retinopathy purchase digoxin cheap online, and have had to think of all eventualities. According to his sentiment, at that time each physician and research man said to himself: I f the experimental subject agrees to the experiment, everything is all right. For this always appeared to the physicians to be the highest principle: An experiment is legal if the experimental subject agrees to it, provided that t,he physician observes the necessary care when performing the experiment. As proved here by this trial, there exists in no country a written law regulating the legal conditions of experiments on humans. On the other side, however, the human experiment is such a far-reaching and often such an indispensable matter that one might speak of an unwritten law, which generally and tacitly is accepted and acknowledged by the whole world. Counsel for some of the defendants have demonstrated to the Tribunal in their document books the opinion of the whole world on this unwritten law, in the most varying degrees, from the absolutely harmless to the absolutely deadly experiment, and has certainly thereby compiled valuable material which is suitable for forming the basis of a codification of this unwritten medical law and to show safe future roads for the development of justice in this sphere. Lacking a written law, the physician and research man even today can only recognize the conventional legal concept as a rule for his conduct as expressed in international medical literature. As far a s one can see, international medical literature up to date nowhere represents the opinion that the consent of a prisoner is ineffective because, by reason of his imprisonment, he had no free will. On the contrary, in many cases it has taken an important step forward, and had frequently, without meeting any opposition, reported on experiments performed on prisoners whose consent was not regarded as essential. Many experiments, some of which were reported on here in Court, and some of which are described in the documents submitted by the defense, demonstrate clearly that obviously the opinion prevails everywhere that in the case of prisoners, in particular those who have been sentenced to death, the consent of the prisoner to the experiment can be replaced by the permission of the authorities, even in the case of experiments which were very dangerous and where fatalities occurred in more or less large numbers. The published reports also talk about the number of deaths in the experiments described, some slightly camouflaged but to a large extent openly, without the research worker or the reader realizing that murderous actions were being reported, because otherwise the reaction would have been a completely different one. The question becomes particularly acute if these experiments were carried out in a totalitarian state or during a total war. It is not the point in this connection whether a dictatorial regime is desirable or should be rejected, nor whether a war as such appears to be criminal (for example because it will be judged as an aggressive war later on); the attitude that, under such exceptional conditions as exist in a dictatorship or total war, even life-endangering experiments on human beings may perhaps be more justified than under normal conditions i s obviously based on the thought that the state governed by dictatorship can and will ask for greater sacrifices, from criminals too, especially during total war. As a matter of fact the following thought appears to have occurred t o many a defendant during this trial: During a total war the state asks everybody to be ready at any time to serve a t the front, and during the aerial war every woman and every child at home is exposed daily and every hour to mortal danger;many a citizen would therefore think it unsatisfactory if a criminal, who is burdened with heavy guilt or may even have committed a crime punishable with death, remains free from all danger. Evidence Testimony Page Extracts from the testimony of prosecution witness Eugen Kogon-Extracts from the testimony of prosecution exper witness Dr. They were told that it was a harmless affair; that the people would get additional food. The camp administration chose people arbitrarily from among the prisoners, whether they were criminals, or political prisoners, or homosexuals. Intrigue among the prisoners themselves also played a role in the selection, and occasionally people came for whom there was no special reason, but they came into the experiments. From the fall of 1943, approximately, the camp leaders did not want to keep the responsibility for the selection of experimental subjects. Doctor Ding himself no longer viished to have verbal instructions from Mrugowsky to carry out the experiments, but he demanded written orders. Then, the officials of the Reich Criminal Police Office in Berlin twice selected 110 and 99 people in Buchenwald, who were made available for the experiments. In the last period, people were selected from various concentration camps and prisons in Germany. I n addition to this, political *Complete testimony is recorded in mimeographed transcript, 6, 7, 8 Jan. Were all of these experimental subjects condemned to death, who were experimented on i n Block 468 A. I do not know of a single case in which anyone came to the experimental station in Block 46 because he had been condemned to death. Once in the case of four Russian prisoners of war, it was claimed that they were to be shot, but there was no judgment, no sentence. They belonged to the category of Russian prisoners of war, of whom about 9,500 were shot, hanged, or strangled in Buchenwald. Were any special considerations or favors granted to the experimental subjects who survived these experiments?

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