legaljustice4john.com
The Shaken Baby Syndrome Myth
renamed "Abusive Head Trauma" or "Non-Accidental Injury"

WAS

SBS: EVERTHING IS BROKEN

* SBS began as an unproven theory and medical opinions, now discredited by biomechanical engineering studies
* No DIFFERENTIAL DIAGNOSIS done to eliminate other causes, abuse assumed without evidence
* Shaken Baby diagnostic symptoms not caused by shaking
* Child protective agencies snatch children, destroy families based on medical accusations without proof of wrong-doing
*Poor or deceptive police investigations, falsified reports, perjured testimony threaten legal rights, due process
* Prosecutors seek "victory", over justice; defense attorneys guilty of ineffective counsel, ignorance, lack of effort
* Care-takers threatened, manipulated, in order to force plea bargains, false confessions
* A fractured criminal justice system--a big piece for the rich, a small piece for the poor, and none for alleged SBS cases.

1. SBS "MYTH" WEBSITE SUMMARY 
2. ARTICLE ABOUT PEDIATRIC ACADEMY SBS FRAUD

3. SUMMARIZED HISTORY OF THE SHAKEN BABY SYNDROME THEORY
4. POLICE ASSAULT: PROTESTING FOR A POLYGRAPH --DJT


Related websites/ important people and projects ShakenBabySyndrome/Vaccines/YurkoProject
CHRISTINA ENGLAND: BOOK
"Shaken Baby Syndrome or Vaccine Induced Encephalitis-- Are Parents Being Falsely Accused?" by Dr Harold Buttram, with Christina England (WEBSITE)
Evidence Based Medicine and Social Investigation:
EBMSI conferences, resources and information Articles and Reports
VacTruth: Jeffry Aufderheide; The SBS conection and other dangerous or deadly side effects of vaccination 

Vaccinefraud.com/The true, suppressed history of the smallpox vaccine fraud and other books:
Patrick Jordan
On SBS:
Sue Luttner, must-read articles and information on Shaken Baby Syndrome: her resources link
The Amanda Truth Project: Amanda's mother speaks out at symposium
Tonya Sadowsky


SUBJECT: SHAKEN BABY SYNDROME AND BIOMECHANICAL EVIDENCE DISPROVING IT
SBS: Biomechanics--Dr.Uscinski

http://www.jpands.org/vol9no3/uscinski.pdf

Journal of American Physicians and Surgeons Volume 9 Number 3 Fall 2004
Ronald Uscinski, M.D.

TheThreshold of Injury
The Shaken Baby Syndrome

In 1971, Guthkelch hypothesized that subdural hematomas could be caused by manually shaking an infant, without the head impacting any surface. One year later, Caffey alluded, in a paper describing .parent-infant traumatic stress syndrome. (PITS), to manual shaking causing intracranial injury in the form of subdural hematoma and cerebral contusions in infants. Two further papers by Caffey over the next two years emphasized shaking as a means of inflicting intracranial bleeding in children.

After publication of these papers, shaken baby syndrome became widely accepted as a clinical diagnosis for inflicted head injury in infants. However, in 1987 and again in 2003, careful laboratory investigations based on the known biomechanics of head injuries showed that human beings cannot achieve the necessary accelerations for causing intracranial injury in infants by manual shaking alone, but that impact is required. Moreover, after more than 33 years, despite numerous reports of series of case studies, an actual witnessed incident in which an infant sustained an intracranial injury as a result of shaking alone has yet to be documented.

As is true in other scientific disciplines, knowledge of medicine should, and generally does, advance in two distinct ways. The first is clinical observation of various physical and physiologic manifestations of disease processes, with an attempt to verify underlying etiologic, anatomic, and physiologic principles. The second is laboratory investigation of both normal and abnormal (or disease) processes, in an attempt to arrive at underlying mechanisms. Ideally, both should aim to discover treatment principles.

Biomechanical Considerations

Our understanding of trauma to living tissue is derived from both clinical observation and laboratory experimentation. While there is a physiologic response to trauma, the initiating event of necessity must involve mechanical disruption of living tissue. Hence, force is applied to living tissue in such amount and manner as to result in disruption. In the physical universe, as described by classical Newtonian physics, force is the product of mass and acceleration. Insofar as living tissue has mass and undergoes motion, these laws apply. The study of the principles of disruption of tissue is referred to as biomechanics, and an understanding of trauma to the nervous system or any other body system necessitates some understanding of this discipline.

It is significant that in all four previously cited original papers regarding the hypothesis of shaking, both Guthkelch and Caffey refer to a single paper by Ommaya published in 1968 as a biomechanical justification for this concept. Therefore, it is important to understand what was attempted and accomplished by Ommaya.

Carrying forward work by physicist A.H. Holbourn, Ommaya had formulated and demonstrated the concept of an injury threshold for neural tissue. If achieving this threshold required force, it is understood that this force must be the product of mass and acceleration, and specifically, rotational acceleration, or acceleration involving the head moving through an arc.

Moreover, previous work had demonstrated that this threshold force represented a constant factor and was related to the inverse of the mass of the individual brain raised to two-thirds power. Scaling of injury thresholds to individual brains was theoretically possible and, to an extent, experimentally verified. It is important to understand that mass is a physical property, and other factors, such as age, gender, and even species, are irrelevant. Building upon this work, Ommaya had recognized that for a given mass of brain, the critical factor in determining injury would be rotational acceleration.

As Ommaya and other clinical neurosurgeons observed, people who sustained whiplash injuries to the neck in motor vehicle accidents sometimes also exhibited symptoms referable to altered brain function such as altered sensorium, diplopia, and even occasional intracranial bleeding.

Working with the U.S. Department of Transportation, Ommaya devised an experiment to measure more precisely the amount of rotational acceleration necessary to reach the threshold of injury. A contoured fiberglass chair was built, mounted on wheels, and placed on tracks with a piston behind it. Rhesus monkeys were strapped into the chair with their heads free to rotate. The piston then impacted the chair, simulating a rear-end motor vehicle collision.

The experiment was photographed with a high-speed camera, enabling calculations of generated rotational accelerations. Measuring the arc of the head rotating and accelerating around the neck, Ommaya was able to demonstrate that a rotational acceleration of 40,000 radians/sec was sufficient to cause concussion in the animal subjects. Ommaya was able to produce intracranial injury in 19 of the animals, with 11 of them also demonstrating neck injury. Then, using the scaling parameters, he estimated that less rotational acceleration would be required to produce concussion in the larger human brain, perhaps on the order of 6,000 to 7,000 radians/sec .

It is significant to note that whereas this experiment showed, qualitatively, that rotation alone could indeed produce intracranial injury, it was not shown quantitatively that human beings could generate the required rotational acceleration by manual shaking. Nonetheless, this critical omission was not addressed until 19 years later. At that time it was shown quantitatively that impact was required to generate adequate force. Guthkelch, Caffey, and others either were not aware of, or disregarded, this critical missing piece of information. In the intervening years, and even up to the present, numerous references are made to infants sustaining inflicted brain injury by manual shaking.Yet no laboratory proof of this possibility has ever been put forth. In fact, the available experimental evidence, beginning as far back as 1943, addressed directly in 1987 and reproduced in 2003, seems to indicate the contrary.

Conclusions

Clinical observation and scientific experimentation and verification should complement one another. More than 30 years after the original hypothesis of shaken baby syndrome, this does not appear to have happened.

With regard to treatment of cranio-cerebral trauma, the differentiation between accidental and inflicted injury is of limited practical importance: injuries are injuries. For social purposes, however, the distinction is critical.

While the desire to protect children is laudable, it must be balanced against the effects of seriously harming those who are accused of child abuse solely on the basis of what is, at best, unsettled science.

Ronald Uscinski, M.D., F.A.C.S., is a neurosurgeon practicing in the Washington, D.C., area. He has consulted and testified as an expert witness for the defense in cases involving alleged child abuse, both pro bono and for time compensation. He has never consulted or testified for the prosecution, because no prosecuting entity has ever contacted him. Address correspondence to: 18111 Prince Philip Drive, Olney, MD 20832, ruscinski@juno.com.

REFERENCES

1. Guthkelch AN. Infantile subdural haematoma and its relationship to whiplash injuries. BMJ 1971;2(759):430-431.

2 Caffey J. The parent-infant traumatic stress syndrome. Am J Roentgen 1972;114:217-228.

3 Caffey J. On the theory and practice of shaking infants. Am J Dis Child 1972; 24:161-169.

4 Caffey J. The whiplash shaken infant syndrome: Manual shaking by the extremities with whiplash-induced intracranial and intraocular pleadings, link with residual permanent brain damage and mental retardation. Pediatrics 1974;54;396-403.

5 Duhaime A, Gennarelli T, Thibault L, et al. The shaken baby syndrome.a clinical, pathological, and biomechanical study. J Neurosurg 1987;66:409-415.

6 Prange M, Coats B, Duhaime A, Margulies S. Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants. J Neurosurg 2003;99:143-150.

7 Ommaya AK. Whiplash injury and brain damage. JAMA 1968;204:75-79.

8 Holbourn AH. Mechanics of head injuries. Lancet 1943;4(Oct 9):438-441.

9 Holbourn AH. The mechanics of brain injuries. Br Med Bull 1969 1945;622:147-149.

10 Ommaya AK, Hirsch AE, Harris E, et al. Scaling of experimental data on cerebral concussion in subhuman primates to concussive thresholds in man. In: Proceedings of the 11th Stapp car crash conference of automotive engineers, NewYork; 1967.

11 Ommaya AK, Yarnell P. Subdural hematoma after whiplash injury. Lancet;2:237-239.

SBS:A Clinical, pathological, and biomechanical study
J Neurosurg. 1987 Mar;66(3):409-15.
The shaken baby syndrome. A clinical, pathological, and biomechanical study.
Duhaime AC, Gennarelli TA, Thibault LE, Bruce DA, Margulies SS, Wiser R.

Because a history of shaking is often lacking in the so-called "shaken baby syndrome," diagnosis is usually based on a constellation of clinical and radiographic findings. Forty-eight cases of infants and young children with this diagnosis seen between 1978 and 1985 at the Children's Hospital of Philadelphia were reviewed. All patients had a presenting history thought to be suspicious for child abuse, and either retinal hemorrhages with subdural or subarachnoid hemorrhages or a computerized tomography scan showing subdural or subarachnoid hemorrhages with interhemispheric blood. The physical examination and presence of associated trauma were analyzed; autopsy findings for the 13 fatalities were reviewed. All fatal cases had signs of blunt impact to the head, although in more than half of them these findings were noted only at autopsy. All deaths were associated with uncontrollably increased intracranial pressure. Models of 1-month-old infants with various neck and skull parameters were instrumented with accelerometers and shaken and impacted against padded or unpadded surfaces. Angular accelerations for shakes were smaller than those for impacts by a factor of 50. All shakes fell below injury thresholds established for subhuman primates scaled for the same brain mass, while impacts spanned concussion, subdural hematoma, and diffuse axonal injury ranges. It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.

Med Sci Law. 2003 Oct;43(4):317-33
Can shaking alone cause fatal brain injury? A biomechanical assessment of the Duhaime shaken baby syndrome model.
Cory CZ, Jones BM.

Medical Engineering Research Centre, Cardiff School of Engineering, Cardiff University, The Parade, PO Box 925, Cardiff CF24 0YF. Cory@cardiff.ac.uk

A biomechanical model of a one-month old baby was designed and tested by Duhaime and co-workers in 1987 in an attempt to assess the biomechanics of the shaken baby syndrome (SBS). The study implied that pure shaking alone cannot cause fatal head injuries, a factor which has been applied in criminal courts. In an attempt to test the validity of the model a preliminary study was undertaken in which a replica was constructed and tested. The broad description of the design and construction of the Duhaime model allowed for variations and therefore uncertainties in its reproduction. It was postulated therefore that differences in certain parameters may increase angular head accelerations. To further investigate this observation, an adjustable replica model was developed and tested. The results indicated that certain parameter changes in the model did in fact lead to an increase in angular head acceleration. When these parameter changes were combined and an injurious shake pattern was employed, using maximum physical effort, the angular head acceleration results exceeded the original Duhaime et al. (1987) results and spanned two scaled tolerance limits for concussion. Additionally, literature suggests that the tolerance limits used to assess the shaking simulation results in the original study may not be reliable. Results from our study were closer to the internal head injury, subdural haematoma, tolerance limits. A series of end point impacts were identified in the shake cycles, therefore, an impact-based head injury measure (Head Injury Criterion - HIC) was utilized to assess their severity. Seven out of ten tests conducted resulted in HIC values exceeding the tolerance limits (critical load value, Stürtz, 1980) suggested for children. At this present stage the authors conclude that it cannot be categorically stated, from a biomechanical perspective, that pure shaking cannot cause fatal head injuries in an infant. Parameters identified in this study require further investigation to assess the accuracy of simulation and increase the biofidelity of the models before further conclusions can be drawn. There must now be sufficient doubt in the reliability of the Duhaime et al. (1987) biomechanical study to warrant the exclusion of such testimony in cases of suspected shaken baby syndrome.

Rigid-body modelling of shaken baby syndrome
Proc Inst Mech Eng [H]. 2005;219(1):63-70
Rigid-body modelling of shaken baby syndrome.
Wolfson DR, McNally DS, Clifford MJ, Vloeberghs M.

Institute of Biomechanics, University of Nottingham, Nottingham, UK.
Email: SBS-Rigid-body modelling

Recent reassessment of the literature on the shaken baby syndrome (SBS) has revealed a lack of scientific evidence and understanding of all aspects of the syndrome. In particular, studies have been unable to clarify the mechanisms of injury, indicating that impact, rather than shaking alone, is necessary to cause the type of brain damage observed. Rigid-body modelling (RBM) was used to investigate the effect of neck stiffness on head motion and head-torso impacts as a possible mechanism of injury. Realistic shaking data obtained from an anthropometric test dummy (ATD) was used to simulate shaking. In each study injury levels for concussion were exceeded, though impact-type characteristics were required to do so in the neck stiffness study. Levels for the type of injury associated with the syndrome were not exceeded. It is unlikely that further gross biomechanical investigation of the syndrome will be able to significantly contribute to the understanding of SBS. Current injury criteria are based on high-energy, single-impact studies. Since this is not the type of loading in SBS it is suggested that their application here is inappropriate and that future studies should focus on injury mechanisms in low-energy cyclic loading.


Dianne Jacobs Thompson  Est. 2007
Also http://truthquest2.com (alternative medicine featuring drugless cancer treatments)
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