The History of Pediatric and Adult Hearing Screening.

OBJECTIVES/HYPOTHESIS: To document the history of hearing seeing in children and adults. STUDY DESIGN: A literature search in all languages was carried out with the terms of hearing screening from the following sources: Pub Med, Science Direct, World Catalog, Index Medicus, Google scholar, Google Books, National Library of Medicine, Welcome historical library and The Library of Congress. METHODS: The primary sources consisting of books, scientific reports, public documents, governmental reports, and other written material were analyzed to document the history of hearing screening. RESULTS: The concept of screening for medical conditions that, when found, could influence some form of the outcome of the malady came about during the end of 19th century. The first applications of screening were to circumscribe populations, schoolchildren, military personnel, and railroad employees. During the first half of the 20th century, screening programs were extended to similar populations and were able to be expanded on the basis of the improved technology of hearing testing. The concept of universal screening was first applied to the inborn errors of metabolism of newborn infants and particularly the assessment of phenylketonuria in 1963 by Guthrie and Susi. A limited use of this technique has been the detection of genes resulting in hearing loss. The use of a form of hearing testing either observational or physiological as a screen for all newborns was first articulated by Larry Fisch in 1957 and by the end of the 20th century newborn infant screening for hearing loss became the standard almost every nation worldwide. CONCLUSIONS: Hearing screening for newborn infants is utilized worldwide, schoolchildren less so and for adults many industrial workers and military service undergo hearing screening, but this is not a general practice for screening the elderly. LEVEL OF EVIDENCE: NA Laryngoscope, 131:S1-S25, 2021.

Fighting Prejudice and Absorbing Refugees From Nazism: The National Committee for the Resettlement of Foreign Physicians, 1939-1945.

In the 1930s and 1940s, the medical profession reacted with hostility and erected formidable barriers to refugee physicians from Nazi-dominated Europe who sought to practice medicine in the United States. Yet, refugee physicians ultimately succeeded, with 77% of them working as doctors by 1945 and 98.6% by 1947. Although physician skills are readily transferable, and the United States had a genuine need for doctors after World War II drew 55 000 physicians into the military, refugee physicians' success can be attributed to the courageous physician leaders who lobbied on their behalf and the creation of the National Committee for the Resettlement of Foreign Physicians-an organization that helped immigrant physicians pass licensing examinations, identify locations for employment, and overcome barriers to integration into American society.

Artificial intelligence based writer identification generates new evidence for the unknown scribes of the Dead Sea Scrolls exemplified by the Great Isaiah Scroll (1QIsaa).

The Dead Sea Scrolls are tangible evidence of the Bible's ancient scribal culture. This study takes an innovative approach to palaeography-the study of ancient handwriting-as a new entry point to access this scribal culture. One of the problems of palaeography is to determine writer identity or difference when the writing style is near uniform. This is exemplified by the Great Isaiah Scroll (1QIsaa). To this end, we use pattern recognition and artificial intelligence techniques to innovate the palaeography of the scrolls and to pioneer the microlevel of individual scribes to open access to the Bible's ancient scribal culture. We report new evidence for a breaking point in the series of columns in this scroll. Without prior assumption of writer identity, based on point clouds of the reduced-dimensionality feature-space, we found that columns from the first and second halves of the manuscript ended up in two distinct zones of such scatter plots, notably for a range of digital palaeography tools, each addressing very different featural aspects of the script samples. In a secondary, independent, analysis, now assuming writer difference and using yet another independent feature method and several different types of statistical testing, a switching point was found in the column series. A clear phase transition is apparent in columns 27-29. We also demonstrated a difference in distance variances such that the variance is higher in the second part of the manuscript. Given the statistically significant differences between the two halves, a tertiary, post-hoc analysis was performed using visual inspection of character heatmaps and of the most discriminative Fraglet sets in the script. Demonstrating that two main scribes, each showing different writing patterns, were responsible for the Great Isaiah Scroll, this study sheds new light on the Bible's ancient scribal culture by providing new, tangible evidence that ancient biblical texts were not copied by a single scribe only but that multiple scribes, while carefully mirroring another scribe's writing style, could closely collaborate on one particular manuscript.

Moses Maimonides and Judah Halevi on order and law in the world of nature, and beyond.

The concept of order, expressed by a number of forms of the Arabic root n.z.m., was of paramount importance in the natural philosophy of medieval Jewish thinkers, far more important than the related concept of law. Moses Maimonides walked a very tight rope between the order that is present in the cosmos, and which testifies to its intelligent Creator, and some minor streaks of apparent disorder, which indicate that the universe is not an eternally self-maintaining entity ruled only by necessity. Judah Halevi was mostly concerned with hierarchical levels of increasing order: a basic orderliness, which describes the cosmos, and a higher level of order, which applies to the Jewish people.

Illuminating Genetic Mysteries of the Dead Sea Scrolls.

The discovery of the 2,000-year-old Dead Sea Scrolls had an incomparable impact on the historical understanding of Judaism and Christianity. "Piecing together" scroll fragments is like solving jigsaw puzzles with an unknown number of missing parts. We used the fact that most scrolls are made from animal skins to "fingerprint" pieces based on DNA sequences. Genetic sorting of the scrolls illuminates their textual relationship and historical significance. Disambiguating the contested relationship between Jeremiah fragments supplies evidence that some scrolls were brought to the Qumran caves from elsewhere; significantly, they demonstrate that divergent versions of Jeremiah circulated in parallel throughout Israel (ancient Judea). Similarly, patterns discovered in non-biblical scrolls, particularly the Songs of the Sabbath Sacrifice, suggest that the Qumran scrolls represent the broader cultural milieu of the period. Finally, genetic analysis divorces debated fragments from the Qumran scrolls. Our study demonstrates that interdisciplinary approaches enrich the scholar's toolkit.

"The Vienna Protocol: Medicine's confrontation with continuing legacies of its Nazi past,".

This letter to the editor describes a symposium on The Vienna Protocol and the legacy of the Pernkopf atlas, which took place as part of the annual Neuberger Holocaust Education week, in Toronto, Canada, on 10. November 2019.

DOUBLINGS BETWEEN BEWILDERMENT AND ENLIGHTENMENT: READING FREUD WITH HEINE ON THE TROUBLED IDENTITY OF HIRSCH-HYACINTH.

The present paper examines Freud's collapse of Heine's poignantly observed multi-cultural narratives in discerning the joke's mechanism of doubling as it progresses from initial bewilderment to momentary enlightenment. In so doing, Freud opens the door to examination of the complex Jewish cultural identity he and Heine share, as represented by the fictional character, "Hirsch-Hyacinth". Hirsch-Hyacinth is a caricature of the "marginal man" in his doubled orientation between and within conflicting aspects of self, a condition reflecting oscillation between idealization, derogation, awareness and dissociation, conditioned by internalization of societal prejudice and traumatization. Freud's tightly focused demonstration of psychoanalytic method upon the Heine joke sample proceeds toward two forms of revelation. The first illustrates the universal applicability of psychoanalytic method. The second signals the individual's ongoing reckoning with the particularities of subjective psychological experience as embedded in identification with large group assumptions of social reality.

[Not Available]. / Histoire de la pneumologie dans l'antiquité (partie 1).

Medicine owes many to Hippocrate, but pneumology traces its origin back to antiquity, from Mesopotamia to ancient Rome. Regarding prehistory: if viscera of this period have not been kept, some bones were. Since Neanderthals, it is then possible to study osteoarticular pathologies (often chronic arthrosis). But no evidence of tuberculosis was found (all thoracic kyphosis are not tuberculosis). Tuberculosis probably appears during the Neolithic age, because of high concentration of population. In ancient times, pneumology was of course not a real medical specialty. However, respiratory illness already constituted a big part of antique medical practice. The purpose of the physician in antiquity was to establish a diagnosis, a prognostic and to propose a treatment. Prognostic revealed to be of great importance in ancient times, since therapeutic efficacy was limited. Contemporary physicians often neglect this part of their practice. In ancient times, physicians also tried to gradually eliminate magic-religious aspects in taking care of the patients. This review will propose a journey from Mesopotamia to ancient Egypt (and its medical papyrus). Very few sources are available concerning medicine in pre-Columbian cultures. However, it is well known that shamans had, besides their religious competences, a great pharmacopoeia. Because of these very few sources, this topic will not be added to this article. Little is known in Europa about chinese medicine before the Jesuit mission in China during the 17th and 18th centuries. Yet, chinese medicine grew in parallel with European's one. Some relevant elements of this medicine will hereafter be shown.

The power of the kashrut: older but shorter. The impact of religious nutritional and hygienic rules on stature and life expectancy of Jewish conscripts in the early 19th century.

BACKGROUND/OBJECTIVES: We test the impact of several demographic, economic and social factors on stature in an early nineteenth century environment. SUBJECTS/METHODS: We use a database of conscripts from the period 1818-1860 of a rural province in The Netherlands (Drenthe). This area had a rather high biological standard of living. This database of 413 conscripts contains information about family structure, family rank order, height, tax income, occupation and age of death. Conscripts came from two communities: one from a particular village (Oosterhesselen) and the other was Jewish conscripts that came from the countryside of the province. RESULTS: Our statistical analysis shows a positive significant relationship between family size and height, which confirms the resource dilution theory. Remarkably, the sign of the relation between family size and life expectancy is inverse. Other factors such as the potato crisis and income had the expected effect on conscript heights. The community effect was strong. Jewish conscripts were much shorter than their counterparts. Access to nutrition, the specific food laws and other factors can explain this difference. CONCLUSIONS: An increasing sibship size had a negative impact on body height but positive effects on life expectancy when adulthood was reached. Specifically for the Jewish community was the positive effect of the death of the father on conscript height. The mechanisms behind this phenomenon are unclear and open for further research.

Sanitary Conditions in the Ghetto of Nyíregyháza, and the Temporary Jewish Hospital. / A nyíregyházi gettó egészségügye és az ideiglenes zsidó kórház.

In April 1944 a ghetto was organized in the center of the town Nyíregyháza (East-Hungary). The ghetto proved to be 17 580 people's temporary residence for a whole month. The major problem was to ensure hygienic circumstances and prevent epidemics in the overcrowded area. A temporary hospital worked in the orthodox synagogue with a personnel consisting of 6 Jewish pharmacist and 39 doctors. The hospital functioned 35 days visited by daily ca. 100 people. During the period 254 patients were recorded, their average age was 58 years and they mostly suffered in chronic illnesses. The hospital was regarded as a shelter by a good number of patients. During the evacuation of the ghetto the increased stress and brutality caused a lot of deaths and abortions. Within this single month 32 people died and 10 was bom in the ghetto. At the same time during the war and also still in the afterwar period the lack of deported or killed Jewis physicians caused severe problems in the public health of the town and the whole county.

Jewish Medical Ethics.

BACKGROUND: Jewish medical ethics is a term coined by the late Lord Rabbi Immanuel Jacobovits in the mid-20th century. Its principles and emphases differ in some significant ways from the currently accepted axioms in Western secular ethics. The emphasis is lesser on autonomy and more on the value of human life and on communitarianism. The Israel Patient's Rights Law reflects these differences from the Western norms.

[Philo of Alexandria and his views on health and sickness]. / Gesundheit und Krankheit bei Philo von Alexandrien.

Philo of Alexandria, Torah scholar and philosopher of religion, (c. 20 BC to 50 BCE) is the first Middle Platonic philosopher whom we know through his own works. His thinking was determined by the two antitheses of God and world, and virtue and vice. The Logos (divine reason) mediates between the transcendent God and the earthly world. His thoughts on health and illness and on the possibilities and limitations of medicine are testimony to his comprehensive philosophical education as well as to his belief in God as ruler of the world and of human life. He saw human health as the reward for self-control for which one was best prepared by the classical education programme. Self-control and physical exercise were therefore, in his view, possible guarantors of health, and a coach potentially more important than a physician. Illnesses, if they result from the loss of self-control, may point to the necessity for penitence. Philo therefore saw virtuousness as the safest precondition for a healthy and cheerful life. That the life forces increase during youth and diminish in old age is part of destiny. Similarly, illness can be brought about by strokes of fate. If illness occurred in this or any other way, medicine was there to help and its success or failure depended on divine providence. Like Jesus Sirach, the Jewish scholar who taught around a hundred years earlier, Philo did not think it sinful to use medical help if one was ill, seeing that God himself had made natural remedies available. He compared the importance of physicians for their patients to that other professionals have in people's lives. Philo did not provide a compendium on the work of the physician, but he gave indications, on nutrition for instance, or on the use of laxatives and fragrances, or that complaints can be necessary stages of recovery. Philo also asked himself whether physicians were always obliged to tell patients the truth. The only case of illness he described in sufficient detail was one of leprosy, which he diagnosed in accordance with Leviticus 13:2. Philo saw physicians as helpers of God, who was the Lord of life and who would therefore decide on the fate of the healthy and sick. Faith in God, Philo thought, was vital if one was to cope with life's ups and downs. Only the wicked had to fear death, however, while the souls of the righteous returned to heaven after death.

[Truth telling to patients--A discussion of Jewish sources (corrected)].

Defining truth and truth-telling to patients are central topics in philosophy, law, and psychology, with many implications in medicine. In the last hundred years, with the transition from paternalistic medicine to a system in which the patient's autonomy is emphasized, the decision on the quantity and quality of medical information to be disclosed to the patient has become more complicated and requires careful consideration and special sensitivity on the part of the doctor. The Israeli Patients' Rights Act (1996] established guidelines for medical staff about telltting the truth to patients with occasional special authority delegated to the doctor to decide for the benefit of the patient at his discretion and with the approval of the institutional ethics committee, but in practice there are difficulties in implementing the Law. This article reviews a selection of sources from Jewish tradition throughout the ages that deal with truthtelling or concealing the truth in medical contexts and other contexts. Sources are drawn from the Bible, Mishna-Talmud, and halachic Literature, from which.conclusions can be drawn regarding this issue. In our opinion, these sources yield messages and values that are also relevant to the modern medical world. This is especially true in a multi-cultural environment such as Israel that requires the physician to consider the patient's background and to communicate information in accordance with his/her will, in an efficient and sensitive manner.

[Medicine, physicians and medical ethics in Jewish tradition through the ages].

Medicine has always had a place of honor in the Jewish heritage. Since Biblical times, the sources of Judaism have valued the physician's activities and seen them as a partnership with God's deeds. Later, in the times of the Mishna and the Talmud, a model of scholars evolved who were not only learned sages but also had extensive medical and scientific knowledge. Their dealings with various issues in medical ethics were the basis for deliberation on questions that appeared throughout history on the advancement of medical science. The various sources from this period show the sages' sensitivity regarding the subject of human life, saving lives and the importance of the availability of medicine for all segments of the population. During the years following the completion of the Talmud, the medical profession was common among the Jews and they excelled in this field. Jewish doctors left behind a Legacy of values in medicine. Hebrew was considered a significant Language in the medical field and was cited in various medical texts such as in the book written by Vesalius, the "father" of modern anatomy. The rapid progress of medicine poses new challenges in bioethics. There is a need for physicians with extensive medical knowledge along with an understanding of ethical issues in order to offer solutions to new situations. Knowledge of the Jewish literature throughout the ages on a variety of subjects and the essential values which are their foundation can contribute to the modern discussion on biomedical questions. This is even more important in Israeli society where many of the laws are formed based on Jewish values. Engagement with Jewish medical ethics can help in educating physicians to have the ability to contribute to public debate and legislation in a way that would balance between the values and needs which an ethical issue raises.

[The day-to-day routine in hospitals--standards and conflicts, based on the example of the Rothschild spital in Vienna around the year 1900]. / Alltag im Krankenhaus--Normen und Konflikte am Beispiel des Wiener "Rothschild-Spitals" um 1900.

The juxtaposition of official regulations and letters of complaint from Vienna's Rothschild Hospital shows, beyond the rhetoric and euphemisms of hospital reports, how lively and diverse day-to-day life was in a Jewish hospital around the year 1900. The letters of complaint query the official hospital rules and show that ideal and reality did not always coincide. Often, religious questions were at the root of the critique--such as doubts as to whether kosher dietary laws were adhered to--or conflicts between the agents involved, be they individuals or groups, patients, nurses, physicians or administrative staff. As part of this process, power structures, social hierarchies, patient rights and gender issues were called into question and renegotiated.

[At the Grundlsee. Alfons Paquet's note on his visit to Sigmund Freud in September 1930]. / Am Grundlsee. Eine Aufzeichnung Alfons Paquets über seinen Besuch bei Sigmund Freud im September 1930.

1930. This hitherto unknown account by A. Paquet, a writer from Frankfurt and at that time secretary of the Goethe-Prize, revolves around Freud's self-description as a "conscious Jew" who nevertheless eschewed categorization, as well as around psychoanalysis as an invidious, though necessary form of creative destruction.