bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the emergence of the postverbal sin1
先 in Cantonese
Authors: Zhou Yang
Published: March 2018

Sin1
先 as a function word in contemporary Cantonese encodes a number of grammatical and pragmatic meanings. As its most prominent feature in syntax, it predominantly occurs in the postverbal position while indicating the meaning of ‘first’. This paper explores the emergence of the postverbal sin1
先 ‘first’ in Cantonese. We first examine the word order typology on the element for ‘first’ in the languages and dialects of southern coastal China. In this linguistic area, the postverbal elements for ‘first’ in Chinese dialects are contact-induced by Tai-Kadai and Hmong-Mien languages; whereas sin1
先 ‘first’ in the mainstream Cantonese shows a stronger tendency to be placed in the postverbal position than its counterparts in other Chinese dialects. We then discuss the word order and semantic changes of sin1
先 from 1820s to 1960s based on Cantonese historical materials. Besides the pressure of language contact, the formation of the postverbal sin1
先 ‘first’ has been further triggered by the semantic motivation to formally differentiate the ‘precedent-subsequent’ polysemy within sin1
先 itself. In short, the emergence of the postverbal sin1
先 ‘first’ in Cantonese has been a two-stage process, dually driven by external and internal causes, respectively.
The working class left behind? The class gap in life satisfaction in Germany and Switzerland over the last decades
Authors: Lipps Oliver , Oesch Daniel
Published: March 2018

The 1990s and 2000s were a gloomy period for Germany’s working class, hit by mass unemployment, welfare retrenchment and wage stagnation. We examine whether the growing economic disparity between the top and the bottom of Germany’s class structure was accompanied by a widening class gap in life satisfaction. We analyse whether there is a social class gradient in life satisfaction and whether, over the last decades, this class gradient increased in Germany, relative to the comparison case of Switzerland. We use panel data for Germany (1984–2014) and Switzerland (2000–2015) and check the robustness of our results by replicating our analysis with the pooled German and Swiss samples of the European Social Survey (2002–2014). In both countries, respondents in higher classes report substantially higher life satisfaction than those in lower classes. The class gap is twice as large in Germany than in Switzerland. In Germany, the class gap in life satisfaction narrowed between 1984 and 1990, strongly widened between 1990 and 2005 and then decreased again after 2010. In Switzerland, the class gap did not follow a clear time trend, but remained basically constant. In Germany, differences in unemployment risks and household income account for half of the class gap and its evolution over time.
Identification of hand motion using background subtraction method and extraction of image binary with backpropagation neural network on skeleton model
Authors: Fauziah  , Wibowo E P , Madenda S , Hustinawati
Published: March 2018

Capturing and recording motion in human is mostly done with the aim for sports, health, animation films, criminality, and robotic applications. In this study combined background subtraction and back propagation neural network. This purpose to produce, find similarity movement. The acquisition process using 8 MP resolution camera MP4 format, duration 48 seconds, 30frame/rate. video extracted produced 1444 pieces and results hand motion identification process. Phase of image processing performed is segmentation process, feature extraction, identification. Segmentation using bakground subtraction, extracted feature basically used to distinguish between one object to another object. Feature extraction performed by using motion based morfology analysis based on 7 invariant moment producing four different classes motion: no object, hand down, hand-to-side and hands-up. Identification process used to recognize of hand movement using seven inputs. Testing and training with a variety of parameters tested, it appears that architecture provides the highest accuracy in one hundred hidden neural network. The architecture is used propagate the input value of the system implementation process into the user interface. The result of the identification of the type of the human movement has been clone to produce the highest acuracy of 98.5447%. The training process is done to get the best results.
SCRAM: a pipeline for fast index-free small RNA read alignment and visualization
Authors: Fletcher Stephen J , Boden Mikael , Mitter Neena , Carroll Bernard J
Published: March 2018

Small RNAs play key roles in gene regulation, defense against viral pathogens and maintenance of genome stability, though many aspects of their biogenesis and function remain to be elucidated. SCRAM (Small Complementary RNA Mapper) is a novel, simple-to-use short read aligner and visualization suite that enhances exploration of small RNA datasets.

Availability and implementation

The SCRAM pipeline is implemented in Go and Python, and is freely available under MIT license. Source code, multiplatform binaries and a Docker image can be accessed via https://sfletc.github.io/scram/.

Supplementary information

Supplementary data are available at Bioinformatics online.
GenomeDISCO: a concordance score for chromosome conformation capture experiments using random walks on contact map graphs
Authors: Ursu Oana , Boley Nathan , Taranova Maryna , Wang Y X Rachel , Yardimci Galip Gurkan , Stafford Noble William , Kundaje Anshul
Published: March 2018

Motivation

The three-dimensional organization of chromatin plays a critical role in gene regulation and disease. High-throughput chromosome conformation capture experiments such as Hi-C are used to obtain genome-wide maps of three-dimensional chromatin contacts. However, robust estimation of data quality and systematic comparison of these contact maps is challenging due to the multi-scale, hierarchical structure of chromatin contacts and the resulting properties of experimental noise in the data. Measuring concordance of contact maps is important for assessing reproducibility of replicate experiments and for modeling variation between different cellular contexts.

Results

We introduce a concordance measure called DIfferences between Smoothed COntact maps (GenomeDISCO) for assessing the similarity of a pair of contact maps obtained from chromosome conformation capture experiments. The key idea is to smooth contact maps using random walks on the contact map graph, before estimating concordance. We use simulated datasets to benchmark GenomeDISCO's sensitivity to different types of noise that affect chromatin contact maps. When applied to a large collection of Hi-C datasets, GenomeDISCO accurately distinguishes biological replicates from samples obtained from different cell types. GenomeDISCO also generalizes to other chromosome conformation capture assays, such as HiChIP.

Availability and implementation

Software implementing GenomeDISCO is available at https://github.com/kundajelab/genomedisco.

Supplementary information

Supplementary data are available at Bioinformatics online.
Extended state observer-based back-stepping control for hypersonic reentry vehicle with input constraints
Authors: Chen Chen , Ma Guangfu , Lyu Yueyong , Guo Yanning
Published: March 2018

This paper investigates the attitude-tracking control problem of hypersonic reentry vehicle in cases of multiple uncertainties, external disturbances and input constraints. The controller design is based on synthesizing the extended state observer (ESO) into a back-stepping control technique. This control-oriented model is formulated with mismatched and matched uncertainties. They reflect the total disturbances that group different types of aerodynamic uncertainties and external moment disturbances. In order to improve the system robustness, a sigmoid function-based ESO is first proposed. This will estimate the total disturbance and is equipped with a controller. The sigmoid smooth function is also introduced for the purpose of handling the input constraints. This will approximate saturation and guarantee that the control input is bounded. Error states between the actual control input and the desired control input are integrated to compensate for the saturation effect. Following this, the stability of the closed-loop system is proved within the Lyapunov theory framework. Several simulations are then investigated to illustrate the effectiveness of the proposed constrained attitude control scheme.
Solving polynomial systems via homotopy continuation and monodromy
Authors: Duff Timothy , Hill Cvetelina , Jensen Anders , Lee Kisun , Leykin Anton , Sommars Jeff
Published: March 2018

We study methods for finding the solution set of a generic system in a family of polynomial systems with parametric coefficients. We present a framework for describing monodromy-based solvers in terms of decorated graphs. Under the theoretical . that monodromy actions are generated uniformly, we show that the expected number of homotopy paths tracked by an algorithm following this framework is linear in the number of solutions. We demonstrate that our software implementation is competitive with the existing state-of-the-art methods implemented in other software packages.
Beyond Acculturation: Multiculturalism and the Institutional Shaping of an Ethnic Consumer Subject
Authors: Veresiu Ela , Giesler Markus
Published: March 2018

Prior consumer research has investigated the consumer behavior, identity work, and sources of ethnic group conflict among various immigrants and indigenes. However, by continuing to focus on consumers’ lived experiences, researchers lack theoretical clarity on the institutional shaping of these individuals as ethnic consumers, which has important implications for sustaining neocolonial power imbalances between colonized (immigrant-sending) and colonizing (immigrant-receiving) cultures. We bring sociological theories of neoliberal governmentality and multiculturalism to bear on an in-depth analysis of the contemporary Canadian marketplace to reveal our concept of market-mediated multiculturation, which we define as an institutional mechanism for attenuating ethnic group conflicts through which immigrant-receiving cultures fetishize strangers and their strangeness in their commodification of differences, and the existence of inequalities between ethnicities is occluded. Specifically, our findings unpack four interrelated consumer socialization strategies (envisioning, exemplifying, equipping, and embodying) through which institutional actors across different fields (politics, market research, retail, and consumption) shape an ethnic consumer subject. We conclude with a critical discussion of extant scholarship on consumer acculturation as being complicit in sustaining entrenched colonialist biases.
Public Health and Pharmacy in the United States
Authors: Levin Bruce Lubotsky , Hanson Ardis , Hurd Peter D.
Published: March 2018

In 1988, the Institute of Medicine’s Committee for the Study of the Future of Public Health closely examined public health programs and the coordination of services across US government agencies and within state and local health departments. Its subsequent report, The Future of Public Health, defined both the substance and the mission of public health, reifying a community-based prevention and promotion foci with the larger societal goal of healthy neighborhoods and lifestyles. This chapter examines the evolution and organization of the United States public health system, including local, state, national, and tribal health systems, as well as the roles public health and pharmacy play in the respective education and practice of each discipline.
Epidemiology
Authors: Hanson Ardis , Levin Bruce Lubotsky
Published: March 2018

Epidemiology, a basic science of public health, is a quantitative discipline based on probability, statistics, research methodologies, and disease etiology, to examine what factors cause, exacerbate, and/or prevent disease (morbidity) and death (mortality). Epidemiology can increase our understanding of at-risk populations, meet selected needs for addressing specific disease states or physical/mental/substance use disorders, identify services utilization, and potentially drive policy. Hence, a basic understanding of the principles and applications of epidemiological vocabulary, methods, and theoretical frameworks is essential for the practicing pharmacist. This chapter examines the core functions of epidemiology, provides a brief history of the field and subspecialties in epidemiology, and frames epidemiology at the national and international levels. In addition, the chapter discusses the distinct vocabularies, measures, methods, and studies commonly employed by epidemiologists.
Pharmacists’ Roles in the Increase of Health Literacy Among Patients
Authors: Bleidt Barry A , Coleman Carmita A , Rabionet Silvia E , Hanson Ardis
Published: March 2018

Many of the challenges people face in today’s society have their origins in the early years and experiences of life, including problems with words, numeracy, and problem-solving. Layer onto these problems the need to successfully navigate today’s complex health care setting, and patients who have low health literacy and numeracy experience significant problems affecting their utilization of health care services. This chapter frames health literacy as a major public health problem, particularly its impact on patient care and its effects on health promotion and disease prevention efforts. It also addresses the roles of pharmacists, from identifying low health literacy patients and providing interventions to recommending individualized tools to assist in the everyday care of these patients.
Breast Cancer Screening: Evidence and Recommendations
Authors: Wernli Karen J. , Bowles Erin J.
Published: March 2018

Breast cancer screening in the United States was first recommended to women in 1976. Over the past decade, mammography screening has changed from film screen mammography to primarily digital mammography, which, as of 2016, accounts for over 97% of all mammograms performed in the United States. Several systematic reviews, which have included results from up to 9 randomized clinical trials from the United States, Europe, and Canada, have demonstrated a reduced risk of breast cancer mortality associated with breast cancer screening. Potential harms from breast cancer screening include false-positive mammograms (which may lead to unnecessary additional imaging and benign breast biopsies), overdiagnosis, and radiation exposure. This chapter summarizes evidence from randomized controlled trials for mortality benefit; current society and task force recommendations for mammography screening; evaluation of the evidence; risk–benefit analysis; and supplemental screening in high-risk women.
Breast Cancer Metastatic Imaging
Authors: McDonald Elizabeth S. , Elmi Azadeh , Mankoff David A.
Published: March 2018

This chapter reviews appropriate indications for advanced imaging, such as PET/CT, in the evaluation of breast cancer. An informed imaging approach is based on primary tumor size and pathological characteristics, as well as patient symptoms that may indicate a higher likelihood of metastatic disease. When evaluation for metastatic disease is indicated, survey imaging with CT, bone scintigraphy, abdominal MRI, brain MRI, and/or PET/CT can be used to establish disease burden, and to identify a biopsy target for pathological confirmation. We emphasize the evolving role of FDG PET/CT in this chapter, including basic principles of PET imaging, followed by a short section on image interpretation. Finally, the concept of using imaging as a response biomarker is introduced.
One-View Asymmetry
Authors: Levesque Paul H. , Sheiman Laura
Published: March 2018

This chapter, appearing in the section “Asymmetry, Mass, and Distortion,” will discuss the presence of tissue asymmetry visualized only on one view. The distribution of fibroglandular tissue is extremely variable and unique from one patient to another; however, in most patients the parenchyma is usually distributed within the breasts symmetrically in a “mirror-image” fashion. Areas of tissue density (asymmetry) may be seen that are only visualized on the craniocaudal (CC) or mediolateral oblique (MLO) view. In the majority of patients, this finding represents superimposed normal tissue, or islands of normal parenchyma. Occasionally, underlying benign lesions may present as a tissue asymmetry. Rarely, a one-view asymmetry may represent a malignancy. This section will discuss the imaging features (including mammography, tomosynthesis, and ultrasound assessment), clinical features, differential diagnosis, and management suggestions for one-view asymmetries.
Two-View Asymmetry
Authors: Valencia Elizabeth M. , Lee Christoph I.
Published: March 2018

This chapter reviews key imaging features, protocols, pitfalls, differential diagnoses, and management recommendations for a two-view asymmetry. A focal asymmetry is a small amount of fibroglandular dense tissue seen on two views that is asymmetric compared to the contralateral breast. A global asymmetry is defined as a large focal asymmetry that extends beyond one breast quadrant. A developing asymmetry is defined as a focal asymmetry that is new, denser, or larger when compared to prior mammograms. In general, an asymptomatic global asymmetry is considered a normal variant. In contrast, a developing asymmetry should be evaluated with greater suspicion. Topics discussed in the chapter are superimposition, global asymmetry, developing asymmetry, and triangulation.
Non-Mass Enhancement on MRI
Authors: Lam Diana L. , Rahbar Habib
Published: March 2018

Breast cancer presents on MRI as an enhancing finding on post-contrast T1-weighted images that is distinct from normal background parenchymal enhancement (BPE), and these enhancing lesions can be further described as a focus, mass, or non-mass enhancement (NME). Each enhancing lesion, with the exception of a focus, can be described further with specific morphological features that are defined by the ACR BI-RADS Atlas. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations of a focus of enhancement and non-mass enhancement on MRI. Topics discussed include distinguishing a focus from normal BPE, benign versus suspicious features of a focus, NME characterization, and kinetic enhancement curves.
Amorphous/Indistinct Calcifications (Group)
Authors: Wang Lilian
Published: March 2018

Amorphous calcifications are calcifications that are sufficiently small and/or hazy that a more specific morphological classification cannot be made. Historically, such calcifications were referred to as “indistinct” calcifications. The likelihood of malignancy and the management of amorphous calcifications largely depend on their distribution. This chapter, appearing in the section on calcifications, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnosis with radiology–pathology correlation, and management recommendations for amorphous/indistinct calcifications in a group. Topics discussed include spot magnification views for characterization, role of distribution in BI-RADS assessment, and pathological entities, including fibrocystic change, milk of calcium, atypical ductal hyperplasia (ADH), and ductal carcinoma in situ (DCIS).
Nipple Discharge
Authors: Winkler Nicole S.
Published: March 2018

Nipple discharge refers to expressible or spontaneous drainage of fluid from one or more duct orifices of the nipple. Discharge indicates excess fluid secretion into one or more ducts that will drain through an unobstructed duct orifice onto the nipple skin. The fluid content and appearance are important as they have clinical implications. Nipple discharge that is clear or bloody, unilateral (typically uniductal) and spontaneous (fluid discharges without breast or nipple compression) is considered suspicious for malignancy, though most cases are due to benign papillomas. This chapter, appearing in the section on nipple, skin and lymph nodes, reviews the key clinical features, associated imaging findings, imaging protocols and pitfalls, differential diagnoses, and management recommendations for patients presenting with nipple discharge. Topics discussed include clinical evaluation of nipple discharge, sonographic evaluation of ducts and nipple, ductography, intraductal mass, and papilloma.
Nipple Abnormalities
Authors: Winkler Nicole S.
Published: March 2018

New nipple retraction and new nipple inversion can be secondary to malignancy, post-surgical change, inflammation, or infection. Paget disease of the nipple is characterized by an inflammatory response of the nipple epidermis to malignant cells extending from ductal carcinoma in the lactiferous sinus. A mass arising within the nipple is rare and usually a variant of a papilloma arising in the nipple (nipple adenoma). This chapter, appearing in the section on nipple, skin, and lymph nodes, reviews the key clinical features, associated imaging findings, imaging protocols and pitfalls, differential diagnoses, and management recommendations for patients presenting with nipple retraction. Topics discussed include imaging features of nipple retraction, both benign and malignant causes of nipple retraction, Paget disease of the nipple, and masses occurring in the nipple.
Skin Calcifications
Authors: Freer Phoebe E.
Published: March 2018

Dermal and epidermal calcifications in the breast are extremely common and are typically benign, of no clinical significance, and are unrelated to breast cancer. If the radiologist attempts to do a mammographically guided needle localization for surgical excisional biopsy of calcifications that are not recognized to be in the dermis, it is possible that the patient may proceed to surgical biopsy with no calcifications seen in the excised specimen. Therefore, it is important to recognize dermal calcifications as such at the time of screening or diagnostic imaging. This chapter reviews the key imaging and clinical features of skin calcifications that may be encountered either incidentally on breast imaging or on diagnostic imaging when a patient has been recalled from screening for grouped calcifications. Topics discussed include obtaining tangent views to accurately diagnose skin calcifications, as well as how to recognize calcifications on tomosynthesis.
Cyst/Abscess Aspiration
Authors: Falomo Eniola T.
Published: March 2018

Aspiration is the process of draining a fluid-filled structure, such as a cyst or an abscess, and is typically performed under ultrasound guidance. Cyst aspiration can be done for symptomatic relief (in patients with associated pain or tenderness), and for cases of presumed cysts with sonographic features that are not entirely diagnostic of a cyst. In the latter case, aspiration is performed to help distinguish between a complicated cyst and a solid mass. This chapter, appearing in the section on interventions and surgical procedures, reviews the procedural protocols and pitfalls, clinical management, and imaging follow-up involved in a cyst or abscess aspiration procedure. Topics discussed include indications for performing a cyst or abscess drainage procedure, procedural steps, post-procedure follow-up, and appropriate management of complex masses.
Depression as a Recurrent, Progressive Illness
Authors: Post Robert M.
Published: March 2018

Clinical Highlights and summary of Chapter• Episodes of depression and bipolar illness progress in two ways:faster recurrences as a function of number of prior episodes, andgreater autonomy (decreased need for precipitation by stressors(Episode Sensitization)• Recurrent stressors result in increased reactivity to subsequent stressors(Stress sensitization) and bouts of stimulant abuse increase in severity with repetition(Stimulant-induced behavioral sensitization)• Each type of sensitization cross-sensitizes to the others and drives illness progression• Each type of sensitization involves specific memory-like epigenetic processes as well as nonspecific cellular toxicities• Childhood onset depression and bipolar illness have a more adverse course than adult onset illness and are increasing in incidence via a cohort (year of birth) effect• As opposed to genetic vulnerability, each type of sensitization can be prevented with appropriate clinical intervention and prevention, which should lessen illness severity and progression• Seeing depression and bipolar disorder as progressive illnesses changes the therapeutic emphasis away from acute treatment and instead to long term prophylaxis• Preventing recurrent depressions will likely protect the brain, the body, and the personWord count with Named refs = 6,417>Depression and bipolar disorder are illnesses which tend to progress with each new recurrence. Stressors, mood episodes, and bouts of substance abuse each sensitize (show increased reactivity) upon their repetition and cross-sensitization to the others. These sensitization processes appear to have a memory-like and epigenetic basis, in some instances conveying lifelong increased vulnerability to illness recurrence and progression. Greater numbers of episodes are associated with faster recurrences, lesser need for stress precipitation, cognitive dysfunction, pathological changes in brain, treatment refractoriness, and loss of many years of life expectancy, predominantly from cardiovascular disease. Such a perspective emphasizes the need for greater awareness of higher incidence of psychiatric and medical comorbidities in the United States compared to many European countries, and the need for earlier intervention and more sustained long term prophylaxis to prevent illness progression and its adverse consequences on brain and body.
Diagnostic Dilemmas
Authors: Strain James J. , Casey Patricia , Tyrer Peter
Published: March 2018

This chapter describes the universal problems with the issue of diagnosis for the psychiatric disorders. Taxonomies, DSM-5 and ICD-10, ICD-11, are symptom driven with no biological markers. This is in contrast to medical disorders which years ago began to derive their diagnoses on the basis of mechanisms of action, and guided diagnosis where it could be done by biological markers. This means in psychiatry there are not “zones of rarity” between diagnoses and there is considerable symptom overlap among the diagnosis. Research attempts to improve this condition are explored: (1) Research Domain Criteria (RDoC) and (2) genetic studies. The concept that depression is a systemic disorder and not just a mental disorder is enhanced with our increasing understanding of the biology underlying the disorder and its effects on the body.
An Updated Electronic Health Record (EHR) for Depression Management
Authors: Strain Jay J. , Shenoy Akhil , Strain James J.
Published: March 2018

Depression is a ubiquitous illness for which primary care is now on the front line, providing care to millions of patients. Identifying these patients and providing adequate care is beyond the capabilities of our current medical approach. New algorithms from research and unique techniques based on new technologies now exist for optimizing our current Electronic Health Records (EHR) into a powerful support tool for psychiatric patient care. This chapter examines the theories, biopsychosocial techniques, ongoing research, technologies, and protocols from other areas of Medicine that have been successful in capturing and evaluating patient status and guiding medical care. These concepts are modeled into how primary care colleagues can receive automated guidance and psychiatry can be referred those cases which require specialist intervention. A multimodality paradigm for an enhanced EHR which minimizes primary care physician efforts and maximizes identification, escalating management, and tracking of psychiatric patient care is proposed.
Facial Weakness
Authors: Shaibani Aziz
Published: March 2018

Unilateral or bilateral facial weakness is an important manifestation of many neuromuscular disorders; some of them are as simple as Bell’s palsy, while others are as serious as Guillain-Barré syndrome (GBS). Facial weakness can be easily mimicked, and therefore, psychogenic etiology should always be kept in mind. Peripheral facial weakness affects all functions and parts, while central weakness may save the upper face and may affect emotional and voluntary functions differentially. Botulinum toxin injection has become a common cause of facial palsy, therefore detailed history is crucial. Examination of the sensory and motor systems is important to define the type and cause. Imaging and electrodiagnostic testing are often needed in the diagnostic process.
Myotonia
Authors: Shaibani Aziz
Published: March 2018

Myotonia is a slow relaxation phase after normal contraction. Patients report dystonia as muscle stiffness and sometimes pain. They usually adapt to it well. Falls due to myotonia may lead to accidents. Examination for percussion myotonia should be part of neuromuscular examination. Percussion of the thenar muscles with the reflex hammer is the most productive method. Electrically silent myotonia is a sign of Brody myopathy. Myotonia may be incidentally discovered during electromyography (EMG). The most important task is to differentiate between myotonia from paramyotonia clinically and electrically. There has been a significant understanding of the underlying channelopathies lately. Severe myotonia respond well to mexiletine.
Effects of Exercise on Mental Health
Authors: Olex Stephen , Olex Krista
Published: March 2018

While the beneficial effects of exercise on the body are well established, there is now substantial evidence that physical activity has significant benefits on brain function and mental health as well. Physical activity including aerobic exercise, resistance exercise, yoga, and Tai Chi can influence mental health through numerous mechanisms on multiple levels, ranging from the microscopic to the level of human connection. A large body of clinical data suggests that exercise has beneficial effects on mood and cognition. While the evidence is strongest for the effects of aerobic exercise on cognitive dysfunction and depression, there is promising data in the use of aerobic exercise in other populations with mental illness as well as for the use of the other types of movement for mental health. Clinicians should be aware of physical activity as a powerful tool in their clinical toolbox with the potential for tremendous benefit on mind and body.
Acupuncture and Chinese Medicine
Authors: Yang Jingduan , Monti Daniel A.
Published: March 2018

Chinese medicine uniquely relates specific mental and physical functioning to corresponding energetic channels called meridians that are associated with internal organs. Qi balance is described in terms of Yin and Yang. Human beings are considered healthy when the Qi circulating in each meridian is balanced in forces of Yin and Yang, sufficient in amount, and moving freely in the correct direction. As one of the major treatment modalities of Chinese medicine, acupuncture is the oldest and most commonly used medical procedure in the world. Acupuncture has been used alone or integrated with Western medicine to treat a variety of psychiatric conditions, such as depression, anxiety, insomnia, pain, and addiction. The literature to support the use of acupuncture is encouraging for some psychiatric problems but too limited to draw definitive conclusions. This chapter reviews the basis for acupuncture and describes current research indicating its use, particularly in psychiatric disorders.
Hypnosis and Biofeedback as Prototypes of Mind–Body Medicine
Authors: Stoner Marie
Published: March 2018

Hypnotizability is a strong moderator for treatment outcome in patients with psychiatric disorders. Hypnosis is able to reduce distress and pain in short procedures and has been particularly useful in cancer procedures. Gut-directed hypnotherapy for irritable bowel syndrome has shown substantial results for structured short-term scripted treatment. Biofeedback for hypertension is successful when clinical practice guidelines identifying patient characteristics are followed. Heart rate variability biofeedback shows promise as a technique to directly target self-regulatory mechanisms. Innovative use of real-time functional magnetic resonance imaging neurofeedback is showing promise for altering neural patterns underlying diverse disorders such as clinical depression and chronic pain. Obsessive-compulsive disorder and eating disorders patients may be selectively responsive to hypnotic suggestion. This chapter reviews the basis of hypnosis and related approaches to the management of patients with psychiatric conditions.
Functional Neuroimaging: A Transformative Tool for Integrative Psychiatry
Authors: Alavi Abass , Newberg Andrew B.
Published: March 2018

Functional neuroimaging with positron emission tomography (PET), single photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) can be highly useful in the evaluation and management of patients with psychiatric disorders. PET and SPECT imaging typically evaluate cerebral metabolism and blood flow, respectively, and can determine patterns associated with different disorders such as depression or schizophrenia. PET and SPECT imaging can also evaluate neurotransmitter changes such as dopamine or serotonin associated with different psychiatric disorders. fMRI is an excellent tool for studying the effects of psychiatric disorders on specific brain processes related to cognition and mood. fMRI activations studies allow researchers to present various stimuli to a subject in order to determine how the brain reacts and whether psychiatric disorders are associated with different brain reactivity patterns. Functional neuroimaging with PET, SPECT, and fMRI can be highly useful in the investigation of the mechanism of action of integrative therapies for psychiatric disorders.
Commonly Encountered Sleep Disorders
Authors: Doghramji Karl
Published: March 2018

Complaints related to sleep and wakefulness are some of the most commonly encountered in clinical settings. This chapter reviews specific sleep disorders including insomnia disorder, hypersomnolence disorder, narcolepsy, obstructive sleep apnea hypopnea syndrome, central sleep apnea syndrome and selected parasomnias (nonrapid eye movement sleep arousal disorders and rapid eye movement sleep behavior disorder). These disorders are some of the best characterized and commonly comorbid with other medical and psychiatric disorders. Their defining characteristics, diagnostic modalities, and treatment options are summarized. Topics covered in this chapter include narcolepsy, cataplexy, insomnia, restless legs syndrome, periodic limb movement disorder, obstructive sleep apnea, central sleep apnea, hypersomnolence.
Cognitive Interventions: Brain Training and Rehabilitation
Authors: Swirsky-Sacchetti Thomas , Rider Robert L.
Published: March 2018

The research pertaining to two types of cognitive interventions is reviewed. Brain training, which utilizes a variety of computer based approaches, is designed to improve normal performance by developing cognitive skills. Cognitive remediation is designed to improve performance in the face of acquired deficits. Such programs are designed to help patients with existing mild cognitive impairment or dementia. Although not uniform, there is mounting evidence that these interventions have a beneficial effect. However, research also suggests the beneficial effect of such programs is often limited to the specific type of task trained, with generalization to real-life performance more questionable. Patients improve specific cognitive domains that do not necessarily correlate with improvements in activities of daily life. The findings and limitations of current research are discussed along with directions for future research.
Integrative Treatment of Anxiety
Authors: Rakel Birgit
Published: March 2018

Anxiety and anxiety disorders are among the most common complaints of people in all populations. Fear and anxiety are similar, but fear relates to immediate threats while anxiety refers to anticipation of future threats. Patients with anxiety symptoms frequently seek integrative approaches to help reduce their symptoms. Medications such as benzodiazepines are useful in certain anxiety conditions but have a number of side effects and may be addictive. Dietary influences can have a significant effect of augmenting or alleviating anxiety. Gut microbiota may play an important role in anxiety and other emotions. Mind–body techniques such as meditation or mindfulness programs have been shown to significantly reduce anxiety symptoms. Several supplements such as kava kava, lavender, and chamomile may also have anti-anxiety effects. This chapter reviews the current data on the use of integrative therapies in psychiatric symptoms and disorders.
Centromere Fissions, Complementary Isochromosomes, Telomeric Fusions, Balancing Supernumerary Chromosomes, Neocentromeres, Jumping Translocations, and Chromothripsis
Authors: McKinlay Gardner R. J , Amor David J
Published: March 2018

This chapter reviews a number of very rare chromosomal rearrangements: centromere fissions, complementary isochromosomes, telomeric fusions, balancing supernumerary chromosomes, neocentromeres, jumping translocations, and chromothripsis. Centromere fission results when a metacentric or submetacentric chromosome splits at the centromere, giving rise to two stable telocentric products. The Robertsonian fission reverses the fusion that had originally generated it. Telomeric fusion leads to a 45-chromosome count. With the balanced complementary isochromosome carrier, two stable exactly metacentric products are generated. A balancing small supernumerary marker chromosome contains material deleted from the normal homolog. A supernumerary chromosome lacking a normal centromere can become stable and functional due to the generation of a neocentromere. In jumping translocations, a segment can move from one chromosome to two or more recipient chromosomes. Chromothripsis takes complex rearrangement to a yet more complex level. The reproductive risks associated with each are noted.
Sex Chromosome Aneuploidy and Structural Rearrangement
Authors: McKinlay Gardner R. J , Amor David J
Published: March 2018

There are four major sex chromosome abnormalities due to complete aneuploidy. Otherwise unassisted, infertility is practically inevitable in XXY Klinefelter syndrome and 45,X Turner syndrome. The other two conditions, XXX and XYY, apparently have little effect on fertility; furthermore, they are not discernibly associated with any increased risk for chromosomally abnormal offspring. This chapter first discusses these classic pure sex chromosomal aneuploidies. Then, deletion/duplication states of the X and Y chromosomes are reviewed, whether large and known since classical cytogenetics, or those only having come to light due to the power of twenty-first century molecular karyotyping. Recurrence risks are considered both for those who (if fertile, naturally or via in vitro fertilization) might themselves have such an abnormality, and for normal parents having had an affected child.
Chromosomal Disorders of Sex Development
Authors: McKinlay Gardner R. J , Amor David J
Published: March 2018

Chromosomal sex is, for the most part, congruently XX female and XY male. The XX and XY embryo are built on a fundamentally similar outline plan, and only as development proceeds do certain modifications evolve. If at any point in this sequential process some genetic instruction is faulty, inappropriate, or cannot be acted on, the direction of anatomical sexual development may proceed imperfectly or completely incongruently. This chapter reviews the conditions of ambiguous/incomplete/indeterminate development of the internal and external genitalia, where the basis of this is a chromosome abnormality, usually of the X or the Y chromosome. The key role of the SRY male-determining gene in a number of these conditions is noted. The de novo or familial origin of these disorders is discussed, with particular reference to possible risks of recurrence.
The Global Epidemiology of Drug Use in Prison
Authors: Carpentier Chloé , Royuela Luis , Montanari Linda , Davis Philip
Published: March 2018

This chapter provides an overview of drug use in prison. It is centered on illicit drug use in Europe, where the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been collecting aggregated data from various sources for 15 years. It also reviews, based on published literature, data from the four other global regions. A total of 59 studies from 31 countries in the five world regions were included for analysis. Results show that the prevalence of drug use varies greatly between studies. Lifetime prevalence of any illicit drug use in prison ranges between 2% to 76% worldwide with, in most cases, cannabis being the most frequently reported substance. More recent (past-month) illicit drug use is reported by <1% to 65% of inmates, while <1% to 39% report injecting illicit drugs during their stay in prison. Alcohol use in prison is reported in a few studies only, varying between 2% to 77% while the prevalence of current tobacco smoking ranges between 4% to 90%. In general, available data are scarce and patchy, especially outside Europe, with large variations in methodology relating to sampling strategy and measurement. This heterogeneity hampers comparison and may, in part, account for the wide range of prevalence estimates. Comparable methods and measures of drug use and its consequences in prison populations are needed to facilitate international comparisons and provide the sound information needed for development and implementation of drug interventions in various prison settings across the globe.
Drug Use in Prisoners and Hepatitis
Authors: Winter Rebecca J. , Hellard Margaret E.
Published: March 2018

A corollary of the high proportion of people who inject drugs cycling through prisons worldwide is the accompanying high prevalence of viral hepatitis, particularly hepatitis C (HCV). Prisons have the potential to either escalate or interrupt the transmission of viral hepatitis: prisons that do not provide access to even basic prevention programs are high-risk environments for viral hepatitis transmission. In contrast, prisons can also reduce prevalence through testing and treatment programs. This chapter provides an overview of the global prevalence and incidence of HCV and hepatitis B (HBV) in prisons and the occurrence of known transmission vectors, including injecting drug use, tattooing and other body modification practices, and unprotected sexual intercourse. It discusses policy and practice options to reduce the risk behaviors associated with HCV and HBV transmission, prevent transmission through vaccination, and potentially expand viral hepatitis treatment in prisons using new directly acting anti-viral medication, and the prospect of treatment as prevention.
Harm Reduction in Prisons
Authors: Snow Kathryn , Levy Michael
Published: March 2018

Interventions intended to minimize the harms of injecting drug use, particularly drug overdose and exposure to blood-borne viruses, have a long history of implementation in some community settings but are frequently unavailable in prisons. The denial of harm reduction measures to prisoners who inject drugs violates their right to non-discriminatory healthcare, as well as other facets of international human rights law. Evidence is available from several programs in diverse settings which demonstrates that it is possible to implement many harm reduction interventions in prisons, that such programs can reduce the risk of drug-related harms, and that concerns regarding unintended negative consequences of such programs are often unfounded. This chapter provides an overview of the key harm reduction measures relevant to the prison setting, with a particular focus on the provision of sterile injecting equipment to prisoners via needle and syringe exchange programs, and on the provision of the opioid antagonist naloxone as first-line treatment for opioid overdose to people while in prison and on leaving prison. The chapter reviews the legal basis for providing these and other harm reduction measures to prisoners, outlines the evidence that supports specific interventions, and highlights topics on which further research is needed.
Jaws
Authors: Anbarasu Arangasamy , Lane Jack I.
Published: March 2018

Section 5 focuses on the Jaw. Various aspects are considered such as the anatomy, dentition, cysts of the jaw, benign tumours, and malignant tumors.
Evaluation of Intranasal Flap Perfusion by Intraoperative Indocyanine Green Fluorescence Angiography
Authors: Geltzeiler Mathew , Nakassa Ana Carolina Igami , Turner Meghan , Setty Pradeep , Zenonos George , Hebert Andrea , Wang Eric , Fernandez-Miranda Juan , Snyderman Carl , Gardner Paul
Published: March 2018

BACKGROUND

Vascularized intranasal flaps are the primary reconstructive option for endoscopic skull base defects. Flap vascularity may be compromised by injury to the pedicle or prior endonasal surgery. There is currently no validated technique for intraoperative evaluation of intranasal flap viability.

OBJECTIVE

To evaluate the efficacy of indocyanine green (ICG) near-infrared angiography in predicting the viability of pedicled intranasal flaps during endoscopic skull base surgery through a pilot study.

METHODS

ICG near-infrared fluorescence endoscopy was performed during endoscopic endonasal surgery for skull base tumors. Intraoperative and postoperative data were collected regarding enhancement of the flap body and pedicle. Fluorescence was rated qualitatively. Postoperatively, flap perfusion was evaluated via MRI-contrast enhancement in addition to clinical outcomes (cerebrospinal fluid leak and endoscopic flap appearance).

RESULTS

Thirty-eight patients underwent ICG fluorescence angiography. Both the body and pedicle enhanced in 20 patients (53%), while the pedicle only enhanced for 12 patients (32%), the body only for 3 (8%), and neither for 3 (8%). When both the pedicle and body enhanced with ICG, the rate of postoperative MRI contrast enhancement was 100% and the rate of flap necrosis was 0%. The sensitivity and specificity of flap pedicle ICG enhancement for predicting postoperative flap MRI enhancement were 97% and 67%, respectively. Two of 3 patients without enhancement developed flap necrosis.

CONCLUSION

ICG fluorescence angiography of intraoperative flap perfusion is feasible and correlates well with outcomes of postoperative MRI flap enhancement and flap necrosis. Additional study is needed to further refine the imaging technique and optimally characterize the clinical utility.