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Articles 6151 - 6180 of 12732
Full-Text Articles in Medicine and Health Sciences
A Call To Excellence In Patient Experience, Geoffrey A. Silvera
A Call To Excellence In Patient Experience, Geoffrey A. Silvera
Patient Experience Journal
In this address, the incoming associate editor describes his early experience with the Patient Experience Journal (PXJ) and issues a call to action to the PXJ community. In the call to action, the PXJ community is asked to build upon our collective history of scholastic and practical excellence. The combination of practical relevance and methodological rigor in our contributions will help to ensure a future in which patient experience is paramount in health service delivery conversations. In addition, gaps in the patient experience literature and emergent opportunities for theoretical and practical contributions are recommended.
Patient Experience: Driving Outcomes At The Heart Of Healthcare, Jason A. Wolf Phd
Patient Experience: Driving Outcomes At The Heart Of Healthcare, Jason A. Wolf Phd
Patient Experience Journal
There is no longer a question that patient experience matters in healthcare today. It matters for those that are cared for and served and matters to all those working each and every day to provide the best in care at all touch points across the healthcare continuum. With this recognition, there too needs to be a change in mindset about patient experience itself. When addressing the topic of patient experience, the conversation is about something much broader than the “experience of care”, as identified in the triple aim. The idea of experience reflects our biggest opportunity in healthcare, where experience …
The Rise And Fall Of Human Dissection In Hellenistic Alexandria, Ellie H. Barany
The Rise And Fall Of Human Dissection In Hellenistic Alexandria, Ellie H. Barany
Young Historians Conference
Classical and Hellenistic Greece were known to be a hub of scientific research. However, the potential for scientific discovery was limited by dominating religious beliefs. Advancements in the study of human anatomy were inhibited by religious taboos that prevented the practice of human dissection. These taboos took hold of Greek society, with a consequence of exile to anyone who violated them. The exception however, is in Hellenistic Alexandria under the rule of the Ptolemaic Kings, Soter and Philadelphus. This paper examines the factors under which the Greek scientist Herophilus was allowed to practice systematic human dissection, as well as the …
To What Extent Did Blood Transfusion Systems And Technologies Modernize During World War Ii?, Hannah J. Leblanc
To What Extent Did Blood Transfusion Systems And Technologies Modernize During World War Ii?, Hannah J. Leblanc
Young Historians Conference
This investigation will explore changes in blood transfusion during World War II (1939-1945). Medical technology and collection systems for whole blood and blood plasma in particular will be examined. The focus of this investigation will be the United States, but Great Britain will also be mentioned due to its close blood transfusion-related interactions with the United States during this period. Additionally, blood transfusion prior to World War II and in modern times will also be considered in this investigation to provide context and to allow assessment of modernization during the war. However, artificial blood substitutes will not be considered, nor …
Effects Of Vocal Fold Nodules On Glottal Cycle Measurements Derived From High-Speed Videoendoscopy In Children, Rita R. Patel, Harikrishnan Unnikrishnan, Kevin D. Donohue
Effects Of Vocal Fold Nodules On Glottal Cycle Measurements Derived From High-Speed Videoendoscopy In Children, Rita R. Patel, Harikrishnan Unnikrishnan, Kevin D. Donohue
Electrical and Computer Engineering Faculty Publications
The goal of this study is to quantify the effects of vocal fold nodules on vibratory motion in children using high-speed videoendoscopy. Differences in vibratory motion were evaluated in 20 children with vocal fold nodules (5–11 years) and 20 age and gender matched typically developing children (5–11 years) during sustained phonation at typical pitch and loudness. Normalized kinematic features of vocal fold displacements from the mid-membranous vocal fold point were extracted from the steady-state high-speed video. A total of 12 kinematic features representing spatial and temporal characteristics of vibratory motion were calculated. Average values and standard deviations (cycle-to-cycle variability) of …
Bachelor Of Liberal Studies Degree Option For Pre-Dental Undergraduates At Bowling Green State University, David Westmeyer
Bachelor Of Liberal Studies Degree Option For Pre-Dental Undergraduates At Bowling Green State University, David Westmeyer
Honors Projects
Admission to professional school programs has become more competitive than ever. There are a lot of applicants with competitive GPAs and test scores. These “numbers” are no longer adequate for professional school matriculation. Admissions teams are now also looking for well-rounded students who have shown a commitment to service, leadership positions, commitment to their field of interest, and more. Students who are aware of these expectations become extremely busy attempting to fulfill all of these requirements.
One of the most difficult aspects of my dental school journey was to select an appropriate major. If I were able to redo my …
Preoperative Assessment Clinic Reduces Total Joint Arthroplasty Case Cancellations, Angelica Adriano
Preoperative Assessment Clinic Reduces Total Joint Arthroplasty Case Cancellations, Angelica Adriano
Doctor of Nursing Practice Final Manuscripts
The purpose of this evidence-based project was to reduce the rate of elective total joint arthroplasty case cancellations by implementing a nurse practitioner-led Preoperative Assessment Clinic (POAC), in the orthopedic department of a major southern California Veterans Affairs (VA) hospital. Retrospective data collected in a 12-month time period showed a surgical cancellation rate of 22%. Reasons for delays or cancellations included: medical instability, abnormal labs and/or studies, patients requiring referral to specialists, dental clearance, patient-initiated cancellations, and active infections. The POAC reduced the rate of case cancellations at 1 year to 17% and at 2 years to 9%. Lost revenue …
Isolation Frequency And Susceptibility Pattern Of Non-O1 And Non-O139 Vibrio Cholerae In A Tertiary Health Care Laboratory, 1999-2012, S Irfan, N Fasih, N K. Ghanchi, Erum Khan
Isolation Frequency And Susceptibility Pattern Of Non-O1 And Non-O139 Vibrio Cholerae In A Tertiary Health Care Laboratory, 1999-2012, S Irfan, N Fasih, N K. Ghanchi, Erum Khan
Department of Pathology and Laboratory Medicine
In the past decade the importance of non-O1 and non-O139 strains of Vibrio cholerae has been highlighted globally. This study aimed to evaluate the frequency and antimicrobial susceptibility profile of non-O1 and non-O139 V. cholerae in Pakistan. Data of stool specimens yielding growth of non-O1 and non-O139 V. cholerae isolated at a national referral laboratory from 1999 to 2012 were retrospectively analysed and evaluated for resistance to ampicillin, tetracycline, chloramphenicol, co-trimoxazole and ofloxacin. A total of 95 800 stool samples submitted over 1999-2012 yielded 3668 strains of V. cholerae, of which 6% were non-O1 and non-O139 V. cholerae. A high …
Grant Writing In Higher Education, Amos Bean
Grant Writing In Higher Education, Amos Bean
Muskie School Capstones and Dissertations
The primary aim of this capstone was to elicit feedback from public health and grant writing practitioners and funders in order to gather data that can be used to supplement teachings and readings for a course in the Muskie School of Public Service Masters in Public Health (MPH) graduate program. Two overarching questions served as the basis for this endeavor. The primary question for public health and grant writing practitioners was, “What are the most important lessons you have learned that you think graduate students who are writing their first proposals should know?” The primary question for funders was, “What …
Beyond The Millennium Development Goals: An Evaluation Of The War On Hiv / Aids In Kenya, Robert G. Nyaga
Beyond The Millennium Development Goals: An Evaluation Of The War On Hiv / Aids In Kenya, Robert G. Nyaga
Theses and Dissertations
HIV/AIDS remains a threat to Kenya and other developing nations. This thesis aimed at assessing the HIV/AIDS situation in Kenya by examining the knowledge of Kenyans towards infection and spread HIV/AIDS, attitudes towards people living with HIV/AIDS, involvement of community opinion leaders in the HIV/AIDS campaigns, sharing of HIV/AIDS information, and government efforts to control HIV/AIDS. A sample of Kenyans (N= 103) was surveyed and asked to respond to several scales assessing each of the above items. Quantitative and qualitative methods reveal the knowledge and attitudes portrayed by Kenyans and show that, although much has been achieved, there is need …
The Use Of Hydrotherapy In Labor To Promote Physiologic Labor, Nicolette Johnson
The Use Of Hydrotherapy In Labor To Promote Physiologic Labor, Nicolette Johnson
Honors Theses
The pain of labor is well understood, yet, very difficult to treat. This is secondary to the fact that each woman’s perception of pain varies as it is influenced by many different factors. According to Lowedermilk, Perry, Cashion, & Alden, (2012) how the woman perceives pain is “influenced by a variety of physiologic, psychological, emotion, social, cultural and environmental factors” (p. 387). A nurses’ role is to act as a patient advocate and with that entails maintaining the patient’s comfort throughout the labor process. In order to do so, a nurse must be able to assess the patient from not …
Genetic Candidate Variants In Two Multigenerational Families With Childhood Apraxia Of Speech, Peter Beate, Ellen M. Wijsman, Alejandro Q. Nato Jr., University Of Washington Center For Mendelian Genomics, Mark M. Matsushita, Kathy L. Chapman, Ian B. Stanaway, John Wolff, Kaori Oda, Virginia B. Gabo, Wendy H. Raskind
Genetic Candidate Variants In Two Multigenerational Families With Childhood Apraxia Of Speech, Peter Beate, Ellen M. Wijsman, Alejandro Q. Nato Jr., University Of Washington Center For Mendelian Genomics, Mark M. Matsushita, Kathy L. Chapman, Ian B. Stanaway, John Wolff, Kaori Oda, Virginia B. Gabo, Wendy H. Raskind
Biochemistry and Microbiology
Childhood apraxia of speech (CAS) is a severe and socially debilitating form of speech sound disorder with suspected genetic involvement, but the genetic etiology is not yet well understood. Very few known or putative causal genes have been identified to date, e.g., FOXP2 and BCL11A. Building a knowledge base of the genetic etiology of CAS will make it possible to identify infants at genetic risk and motivate the development of effective very early intervention programs. We investigated the genetic etiology of CAS in two large multigenerational families with familial CAS. Complementary genomic methods included Markov chain Monte Carlo linkage …
Health Behaviors And Their Correlates Among Participants In The Continuing To Confront Copd International Patient Survey, Hana Müllerová, Sarah H. Landis, Zaurbek Aisanov, Kourtney J. Davis, Masakazu Ichinose, David M. Mannino, Joe Maskell, Ana M. Menezes, Thys Van Der Molen, Yeon-Mok Oh, Maggie Tabberer, Meilan K. Han
Health Behaviors And Their Correlates Among Participants In The Continuing To Confront Copd International Patient Survey, Hana Müllerová, Sarah H. Landis, Zaurbek Aisanov, Kourtney J. Davis, Masakazu Ichinose, David M. Mannino, Joe Maskell, Ana M. Menezes, Thys Van Der Molen, Yeon-Mok Oh, Maggie Tabberer, Meilan K. Han
Preventive Medicine and Environmental Health Faculty Publications
Background and aims: We used data from the Continuing to Confront COPD International Patient Survey to test the hypothesis that patients with COPD who report less engagement with their disease management are also more likely to report greater impact of the disease.
Methods: This was a population-based, cross-sectional survey of 4,343 subjects aged ≥ 40 years from 12 countries, fulfilling a case definition of COPD based on self-reported physician diagnosis or symptomatology. The impact of COPD was measured with COPD Assessment Test, modified Medical Research Council Dyspnea Scale, and hospital admissions and emergency department visits for COPD in the prior …
Measures Of Resident Burnout, Empathy And Emotional Intelligence As A Function Of Years In Post-Graduate Training, Kevin Weaver Do, Amy B. Smith Phd, Marna R. Greenberg Do, Mph, Facep, Elaine A. Donoghue Md, Robert D. Barraco Md, Mph, Joann Quinn Phd, Jennifer Macfarlan, Bernadette Glenn-Porter Bs, Bryan G. Kane Md, Jeanne L. Jacoby Md
Measures Of Resident Burnout, Empathy And Emotional Intelligence As A Function Of Years In Post-Graduate Training, Kevin Weaver Do, Amy B. Smith Phd, Marna R. Greenberg Do, Mph, Facep, Elaine A. Donoghue Md, Robert D. Barraco Md, Mph, Joann Quinn Phd, Jennifer Macfarlan, Bernadette Glenn-Porter Bs, Bryan G. Kane Md, Jeanne L. Jacoby Md
Department of Pediatrics
No abstract provided.
How Recipient Age Affects Long Term Survivability In Heart Transplantation Patients, Daniel Baker
How Recipient Age Affects Long Term Survivability In Heart Transplantation Patients, Daniel Baker
Honors Theses
Heart transplantation is very traumatic for the human body. It involves physically taking out an organ that is vital for normal function and replacing it with an organ that is foreign to the body. However, it is sometimes thought that this is a very well known and well-researched procedure, when the reality is that the very first heart transplant took place less than 50 years ago by Dr. Christiaan Banard (Brink & Hassoulas, 2009). During the last 50 years many breakthroughs have been discovered and the procedure has been vastly helped by the rise of immunosuppressant’s and new surgical technology, …
Verification And Quantification Of Surface Electromyographic (Emg) Activity Of The Masseter Muscle, Kelsey Bowles
Verification And Quantification Of Surface Electromyographic (Emg) Activity Of The Masseter Muscle, Kelsey Bowles
Honors Theses
Purpose: The goal of the present study is to develop and evaluate an automated technique for measuring biting and chewing related surface electromyographic (EMG) activity of the masseter muscle.
Methods: Data from 28 neurologically healthy participants between the ages of 18-40 were selected for this study. The procedure for collecting the bite/chew data consisted of the participant biting down and chewing three small breath mints while an EMG sensor recorded the masseter muscle activity. A five-step Matlab-based algorithm was created to accurately identify onsets and offsets of each bite and chew event.
Results: Compared to manual measurements using standard …
Boosting Education While Boosting The Immune System, Mandy Hendricks Rn Msn Ocn, Cathy Cerami Rn, Bsn, Ocn
Boosting Education While Boosting The Immune System, Mandy Hendricks Rn Msn Ocn, Cathy Cerami Rn, Bsn, Ocn
Patient Care Services / Nursing
No abstract provided.
Improving Patient Care Through Nursing Informatics, Mandy Hendricks Rn, Msn, Aocns, Roberta Werkeiser Rn, Ocn, Alfonsina Zolynski Rn, Ocn
Improving Patient Care Through Nursing Informatics, Mandy Hendricks Rn, Msn, Aocns, Roberta Werkeiser Rn, Ocn, Alfonsina Zolynski Rn, Ocn
Patient Care Services / Nursing
No abstract provided.
Secreted Herpes Simplex Virus-2 Glycoprotein G Alters Thermal Pain Sensitivity By Modifying Ngf Effects On Trpv1, Jorge Rubén Cabrera, Abel Viejo-Borbolla, Antonio Alcamí, Francisco Wandosell
Secreted Herpes Simplex Virus-2 Glycoprotein G Alters Thermal Pain Sensitivity By Modifying Ngf Effects On Trpv1, Jorge Rubén Cabrera, Abel Viejo-Borbolla, Antonio Alcamí, Francisco Wandosell
Dartmouth Scholarship
Genital herpes is a painful disease frequently caused by the neurotropic pathogen herpes simplex virus type 2 (HSV-2). We have recently shown that HSV-2-secreted glycoprotein G (SgG2) interacts with and modulates the activity of the neurotrophin nerve growth factor (NGF). This interaction modifies the response of the NGF receptor TrkA, increasing NGF-dependent axonal growth. NGF is not only an axonal growth modulator but also an important mediator of pain and inflammation regulating the amount, localization, and activation of the thermal pain receptor transient receptor potential vanilloid 1 (TRPV1). In this work, we addressed whether SgG2 could contribute to HSV-2-induced pain. …
Epigenetic Profiles Signify Cell Fate Plasticity In Unipotent Spermatogonial Stem And Progenitor Cells, Ying Liu, Eugenia G. Giannopoulou, Duacheng Wen, Ilaria Falciatori, Oliver Elemento, C. David Allis, Shahin Rafii, Marco Seandel
Epigenetic Profiles Signify Cell Fate Plasticity In Unipotent Spermatogonial Stem And Progenitor Cells, Ying Liu, Eugenia G. Giannopoulou, Duacheng Wen, Ilaria Falciatori, Oliver Elemento, C. David Allis, Shahin Rafii, Marco Seandel
Publications and Research
Spermatogonial stem and progenitor cells (SSCs) generate adult male gametes. During in vitro expansion, these unipotent murine cells spontaneously convert to multipotent adult spermatogonial-derived stem cells (MASCs). Here we investigate this conversion process through integrative transcriptomic and epigenomic analyses. We find in SSCs that promoters essential to maintenance and differentiation of embryonic stem cells (ESCs) are enriched with histone H3-lysine4 and -lysine 27 trimethylations. These bivalent modifications are maintained at most somatic promoters after conversion, bestowing MASCs an ESC-like promoter chromatin. At enhancers, the core pluripotency circuitry is activated partially in SSCs and completely in MASCs, concomitant with loss of …
A Review On The Respiratory System Toxicity Of Carbon Nanoparticles, Maricica Pacurari, Kristine L. Lowe, Paul B. Tchounwou, Ramzi Kafoury
A Review On The Respiratory System Toxicity Of Carbon Nanoparticles, Maricica Pacurari, Kristine L. Lowe, Paul B. Tchounwou, Ramzi Kafoury
School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)
The respiratory system represents the main gateway for nanoparticles’ entry into the human body. Although there is a myriad of engineered nanoparticles, carbon nanoparticles/nanotubes (CNPs/CNTs) have received much attention mainly due to their light weight, very high surface area, durability, and their diverse applications. Since their discovery and manufacture over two decades ago, much has been learned about nanoparticles’ interactions with diverse biological system models. In particular, the respiratory system has been of great interest because various natural and man-made fibrous particles are known to be responsible for chronic and debilitating lung diseases. In this review, we present up-to-date the …
The Valuable Oncology Nurse Preceptor, Donna Colabroy Rn, Msn, Ocn, Ccm, Maura Price Rn, Bsn, Ocn
The Valuable Oncology Nurse Preceptor, Donna Colabroy Rn, Msn, Ocn, Ccm, Maura Price Rn, Bsn, Ocn
Patient Care Services / Nursing
No abstract provided.
Sharing Local Public Health Services Across Jurisdictions: Comparing Practice In 2012 And 2014, Kusuma Madamala, Susan Zahner, Roger Brown
Sharing Local Public Health Services Across Jurisdictions: Comparing Practice In 2012 And 2014, Kusuma Madamala, Susan Zahner, Roger Brown
Frontiers in Public Health Services and Systems Research
Objective: Describe cross-jurisdiction service sharing (CJS) by local and tribal health departments (LHD) in Wisconsin in 2014 compared to 2012.
Design: An online survey of 91 LHD directors in Wisconsin was conducted. Results were compared to the results of a 2012 survey. Characteristics of CJS arrangements and differences in results by population size, geographic region, and governance type were described. Standardized proportion differences (h) were estimated using the arcsin transformation. Confidence intervals were estimated using unconditional exact confidence intervals for the difference of proportions.8 A forest plot of the estimates and confidence intervals was generated to visualize change in …
Trends In Clinical Billing By Local Health Departments, J. Mac Mccullough
Trends In Clinical Billing By Local Health Departments, J. Mac Mccullough
Frontiers in Public Health Services and Systems Research
Background: Billing for clinical services is perceived to be increasingly important for local health departments (LHDs). Yet very little evidence exists regarding the frequency and relative financial importance of clinical billing revenues.
Purpose: The purpose of this study is to report on trends in the frequency and financial scope of clinical billing by LHDs from 2008 to 2013.
Methods: The study used data from the 2008, 2010, and 2013 National Association of City and County Health Officials Profile report surveys. Per capita revenues from clinical billing and percent of total LHD revenues from clinical billing were calculated. …
Tuberculosis And Local Health Department Expenditures On Tuberculosis Services, Michelle P. Yip, Betty Bekemeier
Tuberculosis And Local Health Department Expenditures On Tuberculosis Services, Michelle P. Yip, Betty Bekemeier
Frontiers in Public Health Services and Systems Research
Background: Although tuberculosis (TB) morbidity and mortality have decreased in recent decades, challenges exist regarding disproportionate distributions of TB among specific populations and geographic areas. Inconsistent local health department (LHD) funding for TB programs poses difficulties for LHDs to sustain resources and personnel that predisposes communities to risks of future outbreaks of TB and drug-resistant TB diseases.
Purpose: This study examined relationships between annual TB incidence rates and LHD expenditures on TB-related services to elucidate potential impacts of TB incidence on LHD TB spending.
Methods: This dataset included county-level TB incidence data with comparable, annual (2000–2010) TB-related service expenditures for …
The Cost Of Public Health Services, F. Douglas Scutchfield Md
The Cost Of Public Health Services, F. Douglas Scutchfield Md
Frontiers in Public Health Services and Systems Research
Paying for public health services is and remains a consistent concern among local health departments. The data on the impact of the 2008 recession on public health nationally demonstrated the problems with maintaining staff and services in the face of a declining resource base. This capacity to provide funding for provision of public health services has prompted a number of mechanisms to provide support for dealing with revenue shortfalls. The papers in this issue of Frontiers in PHSSR continue to echo that concern of how best to deal with loss of funding, measuring it and developing tools to ascertain the …
Assessment Of Red Blood Cell Distribution Width As A Prognostic Marker In Chronic Lymphocytic Leukemia, Monika Podhorecka, Dorota Halicka, Agnieszka Szymczyk, Arkadiusz Macheta, Sylwia Chocholska, Zbigniew Darzynkiewicz
Assessment Of Red Blood Cell Distribution Width As A Prognostic Marker In Chronic Lymphocytic Leukemia, Monika Podhorecka, Dorota Halicka, Agnieszka Szymczyk, Arkadiusz Macheta, Sylwia Chocholska, Zbigniew Darzynkiewicz
NYMC Faculty Publications
Red blood cell distribution width (RDW) is a quantitative measure of the variability in size of circulating erythrocytes. It was recently reported that RDW is a prognostic factor for infection diseases, cardiovascular and pulmonary diseases, as well as some neoplasms. Moreover, RDW is remarkably strong predictor of longevity, including all causes of death, for adults aged 45 years and older. To explain this occurrence it was proposed that persistent IGFs/mTOR signaling is one of the factors that play a role in affecting the RDW and mortality.The above observations induced us to analyze the prognostic role of RDW in chronic lymphocytic …
The Westerville Naturals Baseball Team & Otterbein Health And Sport Sciences, Student Project, Kenleigh J. Immel, Jason Combs, Adam Collier, Taylor Lindsey, Christian Brett
The Westerville Naturals Baseball Team & Otterbein Health And Sport Sciences, Student Project, Kenleigh J. Immel, Jason Combs, Adam Collier, Taylor Lindsey, Christian Brett
Senior Year Experience Student Projects
We had the privilege to give back to our community in the form of manual labor. The Westerville Naturals baseball team needed a hand moving gravel in order to store a shed behind their field. The team provided a gator to transport the gravel from the parking lot to the field. The objective was to scoop shovels full of gravel into the back of the gator. We took multiple trips to load the five tons of gravel and transport it to the new location. Once moved, the sheds needed a facelift so it was decided to paint the sheds. We …
Genetic Association Of Deleted In Colorectal Carcinoma Variants With Breast Cancer Risk: A Case-Control Study., Xinghan Liu, Xijing Wang, Sidney W. Fu, Zhijun Dai, + 9 More
Genetic Association Of Deleted In Colorectal Carcinoma Variants With Breast Cancer Risk: A Case-Control Study., Xinghan Liu, Xijing Wang, Sidney W. Fu, Zhijun Dai, + 9 More
Medicine Faculty Publications
Deleted in colorectal carcinoma (DCC), a netrin-1 dependence receptor, is correlated with cell progression, migration, and adhesion. Evidence indicated that DCC was frequently down-regulated in many cancers. However, the association of DCC with breast cancer remains uncertain. We conducted a case-control study to investigate the impact of three DCC gene variants (rs2229080, rs7504990, and rs4078288) on breast cancer susceptibility in Chinese women. This study included 560 breast cancer patients and 583 age-matched healthy controls from Northwest China. The three gene variants were genotyped via Sequenom MassARRAY. Odds ratios (ORs) and 95% confidence intervals (CIs) were utilized to evaluate …
Did Garin And Bujadoux Actually Report A Case Of Lyme Radiculoneuritis?, Gary P. Wormser, Vanessa Wormser
Did Garin And Bujadoux Actually Report A Case Of Lyme Radiculoneuritis?, Gary P. Wormser, Vanessa Wormser
NYMC Faculty Publications
A 1922 report by Garin and Bujadoux is widely regarded as describing the first case of neurologic Lyme borreliosis. Although the patient reported had a tick bite followed by the development of a rash and radiculoneuritis, there were a number of highly atypical features, raising the question of whether the patient, in fact, had neurologic Lyme borreliosis. The paper may not deserve the historic recognition that it has received.