bluuebunny/crossref_metadata_2025 huggingface dataset:
Insider attack detection in database with deep metric neural network with Monte Carlo sampling
Authors: Go Gwang-Myong , Bu Seok-Jun , Cho Sung-Bae
Published: January 2022

Role-based database management systems are most widely used for information storage and analysis but are known as vulnerable to insider attacks. The core of intrusion detection lies in an adaptive system, where an insider attack can be judged if it is different from the predicted role by performing classification on the user’s queries accessing the database and comparing it with the authorized role. In order to handle the high similarity of user queries for misclassified roles, this paper proposes a deep metric neural network with strategic sampling algorithm that properly extracts salient features and directly learns a quantitative measure of similarity. A strategic sampling method of heuristically generating and learning training pairs through Monte Carlo search is proposed to select a training pair that can represent the entire dataset. With the TPC-E–based benchmark data trained with 11,000 queries for 11 roles, the proposed model produces the classification accuracy of 95.41%, which is the highest compared with the previous models. The results are verified through comparison of quantitative and qualitative evaluations, and the feature space modelled in the neural network is analysed by t-SNE algorithm.
Using habitat suitability information from across a species range to inform understudied ecosystems
Authors: Hurtado Cindy M , Burton A Cole
Published: January 2022

Knowledge of habitat suitability (HS) is required for effective conservation planning, yet it can be difficult to obtain. In the absence of local HS information, managers often use studies from other areas to guide their decisions, typically without local validation. We tested the hypothesis that HS is consistent across a species range, and thus reliably extrapolated to understudied sites. We focused on the puma, Puma concolor, a widely distributed large carnivore of conservation and management importance. We conducted a meta-analysis of 41 studies to calculate a mean effect size for six of the most common predictor variables used in mammal HS research. Using the estimated effect sizes in a regression model which included all six variables, we created a new HS model for pumas in an understudied site, the Tumbesian Region (TR). We contrasted predictions from this range-wide model with those from three more regionally specific HS models: a model developed in the Caatinga, Brazil (Caatinga model), a model considering only tropical studies (tropical model), and a model using only studies from the United States and Canada (temperate model). We used puma detection rates from camera trap surveys across the TR to validate model predictions. Although mean effect sizes of habitat predictor variables varied across puma range, all models provided useful predictions of HS for pumas in the TR (area under the receiver operating characteristic curve [AUC] > 0.64). Unexpectedly, the temperate model was best at predicting puma HS in the TR (AUC: 0.77; rs = 0.3), followed by the range-wide model (AUC = 0.73; rs = 0.29). The tropical and Caatinga models had lower predictive accuracy (AUC = 0.68; rs = 0.28 and AUC = 0.64; rs = 0.23, respectively). The accuracy of the tropical model improved when the area of potential recent puma extirpation was excluded from the validation data set. These results highlight that although HS for P. concolor varies across the species range, information collected across a wide range of sites may be better than only locally or regionally specific information for informing HS in understudied sites (e.g., for habitat protection, restoration areas). Given the pressing need for actions to address widespread biodiversity declines, existing knowledge can be used to predict HS to data-poor regions and inform conservation planning while also motivating model validations and targeted data collection.
Gauging Historical Forest Surveys: Recalibrating the Legacy of the Brandis Hypsometer
Authors: Karns Jameson , Wohlers David
Published: January 2022

During the nineteenth century, the European field of forestry was transmitted through expanding colonial empires and networks that sought to inventory and monetize overseas woodlands. Encountering new environments and terrain, the nineteenth century British Empire discovered that existing surveying and enumeration methods were poorly suited for colonized territories. This was particularly true of British India, which spanned from modern-day Pakistan to Myanmar. Designed for European forests, forestry instruments in the nineteenth century performed poorly abroad. With the assistance of Syed Mir Mohsin Hussain, Dietrich Brandis—a German scientist and one of the first Inspectors General of Forests in British India—reconstituted a European hypsometer to address some of these challenges. The collaboration between the two men resulted in the Brandis hypsometer. For the subsequent half century, the hypsometer became a principal forestry device throughout the British Empire and the United States. Despite the widespread adoption of the device, critics challenged the operability and accuracy of the Brandis hypsometer. Using computer-aided design and modern fabrication techniques has allowed for a reexamination of this historic device. The authors’ investigation supports critics’ claims and suggests a degree of nuance for researchers relying on data produced by the device.
COVID-19 wastewater surveillance implemented in the Tokyo 2020 Olympic and Paralympic Village
Authors: Kitajima Masaaki , Murakami Michio , Iwamoto Ryo , Katayama Hiroyuki , Imoto Seiya
Published: January 2022

Wastewater-based epidemiology was implemented in the Olympic and Paralympic Village to better understand COVID-19 incidence. SARS-CoV-2 RNA was detected in a number of wastewater samples even when no positive individual was identified in the corresponding areas. Wastewater-based epidemiology can be a useful tool to control infections at mass gatherings.
Progressive, Cutaneous Nodules in an Immunocompromised Patient
Authors: Fida Madiha , Abu Saleh Omar M.
Published: January 2022

Mycobacterium chelonae is one of the rapidly growing nontuberculous mycobacteria. It can cause localized and disseminated cutaneous infections, especially in immunocompromised individuals. Cutaneous lesions are typically painful and nodular, and they present most commonly on the lower extremities. Diagnosis of M chelonae infection is made by culturing the organism from the tissue biopsy specimen. Treatment generally depends on the location and severity of the infection and the underlying immune status of the patient. Treatment typically is a course of combination therapy with 2 to 4 agents, followed by several months’ therapy with 1 to 2 agents. Tobramycin is the aminoglycoside of choice.
Cutaneous Clue to a Fever of Unknown Origin
Authors: Sia Irene G. , Wieland Carilyn N.
Published: January 2022

Sweet syndrome is an uncommon inflammatory disorder with main features of fever, edematous and reddish plaques, neutrophilia, and the histologic finding of diffuse dermal neutrophilic infiltrates. Patients with Sweet syndrome may have multisystem involvement with neutrophilic infiltration of other organs, and Sweet syndrome may affect the joints, gastrointestinal system, and central nervous system. The 2 major diagnosis criteria are 1) acute onset of painful, tender, and erythematous plaques or nodules and 2) histopathologic evidence of neutrophilic dermal infiltrates without vasculitis. First-line therapy for Sweet syndrome is systemic corticosteroids, which will promptly improve symptoms and skin lesions.
Program Development
Authors: Kang Tammy I. , Mahoney Daniel P. , Weaver Meaghann S. , Remke Stacy S.
Published: January 2022

Pediatric palliative care (PPC) represents a dynamic, maturing field. The exponential growth of PPC programs over the past two decades provides insight into lessons learned for successful program design, development, implementation, and now sustainability. Originally, the PPC experiential narrative was focused primarily on programmatic planning with key efforts toward establishing administrative buy-in, identifying key community and institutional stakeholders, and transforming vision plans into tangible day-to-day work. With the maturation of PPC programs, the conversation has shifted toward advanced programmatic implementation and sustainable development. This chapter provides an overview of PPC programmatic development, clinical and academic work implementation, and core mission sustainability.
Advance Care Planning Along the Care Continuum
Authors: Mullin Jonathan , Burgess Rachael , Baker Justin
Published: January 2022

Advance care planning has been defined as a process of understanding and sharing values, goals, and preferences regarding current and future medical care, which occurs among patient, family, and healthcare providers. Advance care planning allows children, families, and providers to think ahead about future medical care, including care at the end-of-life. This process commonly includes discussions of resuscitation preferences, medical technologies, location of care (including hospice), and legacy-making, and it can also include discussions of organ donation and autopsy. Advance care planning offers care providers the ability to provide anticipatory guidance and partner with parents and patients to implement goal-concordant care in serious illness in pediatrics. These discussions merit a deliberate and compassionate patient- and family-centered approach.
Anticipatory Grief and Bereavement
Authors: Snaman Jennifer M. , Akard Terrah Foster , Morris Sue E. , Wiener Lori
Published: January 2022

Grief is a universal process among children with serious illness and their parents and family members. The grieving process often begins at time of diagnosis, continues throughout the illness, and into bereavement. The death of a child is a devastating event that results in grief that is long-lasting. Parents, siblings, extended family members, friends, members of the care team, and the wider community are all affected by the loss and may require support. Grief can result in different psychological, spiritual, or physical manifestations, and there are many cultural, spiritual, and/or religious familial aspects to grief that must be considered. Interdisciplinary care providers should be aware of the factors associated with anticipatory grief and bereavement as well as supportive interventions that can be provided throughout the disease process, at the end of life, and following the child’s death.
Oncological Illnesses
Authors: McCarthy Sarah , Pyke-Grimm Kimberly A. , Feraco Angela M.
Published: January 2022

Oncological illnesses in childhood include leukemias, lymphomas, brain tumors, and extracranial solid tumors arising from tissues such as muscle, neural tissue, and internal organs. Cancer prevalence, types of cancers that predominate, and typical prognoses for these cancers differ substantially from adult-onset cancers. Yet, as for adults, cancer remains one of the most life-threatening childhood illnesses. Cancer and cancer treatment may alter every aspect of a family’s daily life and anticipated future. This altered reality applies even to children who are likely to live a long life after being diagnosed with cancer. Children with cancer and their families face high symptom burdens, uncertainty, and the possibility of death or long-term poor health from cancer or complications of cancer treatment. Ideally, interdisciplinary palliative care promotes physical, emotional, social, and spiritual well-being. Core tenets of PPC within oncology include systematic symptom assessment and intervention, facilitation of patient and family-centered communication, and developmentally informed advance care planning. As such, palliative care is a necessary component of state-of-the-art childhood cancer care throughout the illness trajectory. Clinicians who care for children with cancer are at risk for work-related distress. In addition to caring for patients and families, interdisciplinary palliative care teams may facilitate reflection and meaning-making to promote clinician resiliency.
Phenomenology of Paraphilia
Authors: Lehne Gregory K.
Published: January 2022

Understanding the psychological experience of individuals who have a paraphilia is critical when it comes to assessing and treating such individuals. The specificity of the sexual content and the intensity of the sexual motivation distinguish the paraphilias. This information is gradually revealed to an individual over the life history, as reflected in mental imagery, fantasies, and rehearsal, as well as behavioral experience including situations of sexual arousal. The content has an influence on the course of the life history, including self-concept and the lifestyle the individual develops. Paraphilias may be ego-dystonic or ego-syntonic. There are patterns of experiences, explanations, rationalizations, and justifications that are commonly found in men with a paraphilia; paraphilias are less common and less studied in women.
Neuropsychological Findings in Sexual Offenders
Authors: Gosselin Anik , White Kristen
Published: January 2022

This chapter summarizes the findings on neurocognitive functioning among sexual offenders (SO). It demonstrates the importance of differentiating between subtypes of SO based on victim type, offense type, and paraphilic interest by showing a remarkable decrease in variance in neuropsychological findings when subgroups were examined separately. Recently, research has focused on comparing nonoffending individuals endorsing pedophilia to pedophilic SO in order to disentangle the sexual preference from the offending behavior in ways that previous studies including only sexual offenders could not. The chapter is therefore organized in terms of studied populations and comparison groups. It examines in order the prevalence of school difficulties and learning disorders among SO, intelligence, and neuropsychological findings. In addition, the chapter reviews findings on subgroups of sexual offenders.
The Neurobiology of Sexual Behavior and the Paraphilias
Authors: Saleh Fabian M. , Bradford John M. , Taylor Jacob , Fedoroff J. Paul
Published: January 2022

This chapter analyzes the biological underpinnings of male sexual behavior. Research in human sexual behavior has been primarily focused on the effects of pharmacological agents, especially those acting on the serotonergic system and agents that affect the production and action of sex hormones. More recently, brain-imaging studies have increased the understanding of the brain regions and circuits that may underlie sexual desire, arousal, and behavior. The chapter reviews some of these studies, with particular emphasis on the role of the mesolimbic reward system in influencing sexual behavior. In addition to discussing neurobiological contributors to the intensity of the sexual drive, it also describes some work that suggests an association between certain neuroimaging findings and pedophilia. For many years, there has been an understanding of the role of sex hormones in human sexual behavior. Sexual drive and sexual behavior in general are dependent on the levels of these sex hormones. In general terms, androgens are important for the maintenance of sexual behavior in males.
Violence Risk Assessment
Authors: Pinals Debra A. , Tillbrook Chad E. , Mumley Denise L. , Kruse Kathleen L.
Published: January 2022

This chapter examines violence risk assessments of sex offenders. The impact of a clinician providing an assessment of an individual's risk of violence, just like assessment of risk of sexual re-offending, can be great, influencing determinations that may result in loss of liberty and even death. Overlap often exists between the need to assess risk factors related to harmful sexual behaviors and the need to assess risk of future violence. As the two lines of research in sex offender risk assessment and violence risk assessment continue to expand, clinicians in the position of assessing risk among sex offenders will also need to maintain an awareness of the literature related to general violence risk assessment. The chapter reviews research and current knowledge related to general violence risk assessment and its overlap with mental illness, and delineates approaches to violence risk assessments based on current understanding of risk factors.
Boundary, Harassment, and the #MeToo Era
Authors: Farrell Helen M. , Saleh Fabian M.
Published: January 2022

Physicians and treatment providers strive to help their patients, the community, and each other. Boundaries have been a foundation of professionalism in psychology and psychiatry. Much previous literature on the topic has focused on the maintenance of professionalism and respect between provider and patient. In a rapidly shifting culture, however, it is imperative that the discussion broaden to promote integrity and respect among colleagues. Harassment has been on the forefront of people’s minds over the past few years, and there is much to be understood about its prevalence in medicine. Both the accusers and the accused are at risk of victimization and career devastation, whether it is through harassing acts or false reporting. The #MeToo era has ushered in much-needed conversations and awareness around this issue, but it has led to some unintended consequences. Through continued attention, reflection, and problem-solving, physicians have the opportunity to minimize the risk for victimization while providing support for one another.
Evaluating LGBT Individuals Who Have Committed Sexual Offenses
Authors: Tabashneck Stephanie , Judge Abigail M.
Published: January 2022

This chapter identifies special considerations in the forensic evaluation of sexual and gender minorities lesbian, gay, bisexual, and/or transgender (SGM) individuals who have committed sexual offenses. Factors relevant to SGM sex offenders include at least three considerations. First and foremost is the potential significance of sexual and/or gender identities on risk assessment. This includes how these variables may inform static and dynamic risk factors and how they are measured by available risk assessment tools. Second, this population experiences significant stigma and discrimination, which may potentially affect disclosure during forensic interview. Finally, evaluators are also often tasked with making treatment recommendations in addition to an evaluation about the likelihood of sexual recidivism. Competent and affirmative treatment for sexual and gender minorities will produce more informed and effective treatment recommendations, yet this competence is not widespread among forensic evaluators.
Cellulitis and erysipelas
Authors: Glaser Katherine S. , Tomecki Kenneth J.
Published: January 2022

This chapter explores the clinical presentation, microbiology, and treatment of cellulitis and erysipelas. Erysipelas is a superficial skin infection limited to the upper dermis and superficial lymphatics with a distinct clinical presentation. The legs are the most commonly affected site, but erysipelas can occur anywhere on the body. Meanwhile, cellulitis is a type of acute bacterial skin and skin-structure infection (ABSSSI) that involves the deep dermis and extends into the subcutaneous tissue. Clinically, cellulitis presents as a unilateral, ill-defined, erythematous, firm plaque in conjunction with the four cardinal signs of inflammation: rubor, calor, dolor, and tumor. Skin manifestations are often preceded by fever, chills, and malaise. Though there are notable differences between erysipelas and cellulitis, the treatment is similar and typically based on disease severity and presence of purulence. Systemic antimicrobial therapy is the treatment of choice for cellulitis/erysipelas. In addition to antimicrobial therapy, local measures including immobilization and elevation as well as supportive measures such as warm compresses can hasten recovery and alleviate symptoms.
Atypical pneumonia
Authors: File Thomas M.
Published: January 2022

This chapter addresses atypical pneumonia. The term “atypical pneumonia” was first termed over 60 years ago to describe cases of pneumonia caused by an unknown agent(s) and which appeared clinically different from pneumococcal pneumonia. Although the original classification of atypical and typical pneumonia arose from the perception that the clinical presentation of patients was different, recent studies have shown there is excessive overlap of clinical manifestations of specific causes which does not permit empiric therapeutic decisions to be made solely on this basis. Thus, the designation of “atypical pneumonia” is controversial in relationship to scientific and clinical merit; and many authorities have suggested that the term “atypical” be discontinued. However, the term remains popular among clinicians and investigators and remains prevalent in recent literature regardless of its clinical value. Moreover, options for appropriate antimicrobial therapy for the most common causes are similar, which is considered “justification” by some to lump these together. Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are the most common causes of “atypical” pneumonia. Treatment of atypical bacterial in the spectrum of community-acquired pneumonia (CAP) has been controversial and is related to several issues which include the relevance of terminology, imprecise diagnostic methods at present, and perceived contradictory results of published evidence.
Aspiration pneumonia
Authors: Gibb Jean , Goetz Matthew Bidwell
Published: January 2022

This chapter studies aspiration pneumonia, which refers to infectious consequences of inhalation of relatively large volumes of material (macro-aspiration). Although healthy persons frequently aspirate small volumes of pharyngeal secretions during sleep, the development of pneumonia after such micro-aspiration is normally prevented by mechanical and immunological responses. Pneumonia arises when these host defenses fail to limit bacterial proliferation either because of micro-aspiration of highly virulent pathogens to which the host lacks specific immunity or because of macro-aspiration of lower or higher virulence organisms. Aspiration may be clinically obvious, as when acute pulmonary complications follow inhalation of vomited gastric contents. Such acute chemical pneumonitis is often referred to as Mendelson's syndrome. On the other extreme, so called “silent aspiration,” as occurs in persons with neurological impairment who lack cough responses, is often followed by the indolent onset of infectious pneumonia consequent to the inhalation of the composite of aerobic and anaerobic microorganisms normally resident in the oropharynx.
Empyema and bronchopleural fistula
Authors: Bolton Charlotte E. , Shale Dennis J.
Published: January 2022

This chapter discusses empyema and bronchopleural fistula (BPF). Infection of the pleural space leading to empyema formation, and the importance of clearing infection and pus from this space, has been recognized since ancient times. Parapneumonic effusions are classified as simple or uncomplicated, complicated, and empyema, based on the appearance and biochemical characteristics of aspirated fluid, which supports the clinical impression of a continuum of disease. This classification has clinical utility in that, during the early acute phase, with free-flowing fluid, treatment is simpler than in the more chronic fibropurulent stage associated with multiple loculations and the need for greater interventional therapy. Empyema may be defined as the presence of organisms and numerous host defense cells, neutrophils, in the pleural fluid, or, more narrowly, as pus apparent to the naked eye. BPF may be caused by an empyema or may be associated with empyema formation following surgery, penetrating lung injuries, or a lung abscess.
Biliary infection
Authors: Chandra Raghav , Rege Robert V.
Published: January 2022

This chapter explores the pathogenesis, diagnosis, and treatment of infections of the gallbladder and bile ducts. Bacterial infections of the biliary tract range from simple biliary colonization to fulminant, life-threatening infections requiring prompt diagnosis and treatment. Acute cholecystitis is a common disorder that manifests as acute inflammation of the gallbladder. The pathogenesis of this disease involves obstruction of the cystic duct by an impacted gallstone at the gallbladder neck with resulting inflammation. Acute ascending cholangitis refers to inflammation and infection of the intra- and extrahepatic biliary tree. While bacterial infection secondary to an obstructed gallstone or stricture is the most common etiology, cholangitis can result from parasitic infections, autoimmune diseases, and chemical irritants. The pathogenesis of acute cholangitis involves a combination of factors including ductal obstruction, injury to the biliary epithelium, and the presence of bacteria in bile.
Pyogenic liver abscess
Authors: Wong Patricia , Herlong H. Franklin
Published: January 2022

This chapter studies pyogenic liver abscess. First described by Hippocrates around 400 BC, pyogenic liver abscess is an uncommon hepatic infection, but is associated with significant morbidity and healthcare costs. With the advent of imaging techniques that allow for prompt diagnosis, potent antibiotics, and effective drainage procedures, the mortality from pyogenic liver abscess has declined dramatically over the past several decades. Pyogenic liver abscesses result from seeding of the liver from biliary tract disorders, portal vein pyemia, direct extension, hematogenous spread, or hepatic trauma. Rarely, abscesses develop after arterial embolization or radiofrequency ablation of hepatic tumors. Most patients with pyogenic liver abscesses appear acutely ill with fever and right upper quadrant pain. However, in elderly, debilitated patients, clinical signs may be minimal, potentially delaying diagnosis. The diagnosis of pyogenic liver abscess is made through radiographic imaging and aspiration and culture of abscess material. Meanwhile, the mainstay of treatment of pyogenic liver abscess is systemic antimicrobial therapy in combination with drainage.
Viral encephalitis
Authors: Halperin John J. , Irani David N.
Published: January 2022

This chapter focuses on viral encephalitis—typically evidenced by fever, headache, and changes in nervous system function. Neurologic symptoms range from mild somnolence to coma, from focal deficits to seizures. Differentiating encephalitis from meningitis from encephalopathy can be challenging; determining whether it is due to a specific virus, bacteria, or fungus can be lifesaving. Encephalitis, involving inflammation of the brain parenchyma, typically directly alters brain function by either impairing functions normally mediated by the damaged area or triggering seizures from it. When the inflammation affects the brainstem, or substantial portions of the cerebral hemispheres, level of consciousness is depressed, up to and including coma. Virtually all viruses that cause encephalitis have developed highly specialized mechanisms to invade the central nervous system (CNS).
Neonatal infection
Authors: Gallagher Patrick G. , Baltimore Robert S.
Published: January 2022

This chapter concentrates on neonatal infections, which are classified according to time and mode of onset in three categories: prenatal, perinata (early onset), and nursery-acquired (late onset). It explains that infections that begin within the first month of life are considered neonatal, but many intensive care units for neonates provide continuing care for infants several months of age with complex problems that are the result of prematurity and complications of neonatal disorders. It also mentions neonatal nursery-associated infections that may occur in infants up to a year or more of age. The chapter analyzes bacterial infections that set in substantially before birth that usually result in a stillbirth due to rapidly dividing high-grade pathogens. It also looks at the difficulty in distinguishing infections that are acquired shortly prior to birth from those acquired as a result of contact with maternal vaginal, fecal, or skin flora during delivery.
Dialysis-related infection
Authors: Mariuz Peter
Published: January 2022

This chapter focuses on the treatment of infections related to dialysis access devices. It looks at the types of access devices for dialysis, which include catheters that are available for hemodialysis and differ according to the duration of use. It also mentions the arteriovenous (A-V) fistula as an anastomosis of the radial artery to the cephalic vein and an A-V graft that uses a tube made of polytetrafluoroethylene to make the A-V connection. The chapter describes two types of hemodialysis (HD) catheters: non-cuffed, non-tunneled, for acute use, and cuffed, tunneled catheters for chronic use. It discusses how infections remain a common cause of death among patients receiving long-term dialysis and a leading cause of hospitalization.
Campylobacter
Authors: Acheson David W. K.
Published: January 2022

This chapter focuses on Campylobacter, which is a motile, non-spore-forming gram-negative rods. It explains how Campylobacter is recognized as a very common cause of gastrointestinal (GI) infection in humans in many parts of the world. It also recounts how Campylobacter organisms were first isolated in the early 1900s from aborted sheep fetuses and then from stool in the 1970s. The chapter describes members of the genus Campylobacter as a major enteric pathogen for humans, which include Campylobacter jejuni, Campylobacter coli, Campylobacter fetus, Campylobacter upsaliensis, and Campylobacter lari. It points out C. jejuni as the most frequently associated with GI disease and C. fetus as the usual cause of systemic infection in debilitated patients.
Clostridium
Authors: Forster Derek
Published: January 2022

This chapter examines the genus Clostridium, which contains many species of bacteria that cause human diseases. It analyzes how Clostridium can produce some of the deadliest toxins ever discovered and describes distinctive infections of Clostridium that includes botulism, tetanus, gas gangrene, and food poisoning from Clostridium perfringens. It also examines clostridia that are obligate, anaerobic, spore-forming bacilli and are ubiquitous in the environment, in soil and marine sediment. The chapter mentions botulism as a rare but potentially fatal disease caused by Clostridium botulinum bacteria, which produce botulinum toxin, one of the most potent bacterial toxins ever described. It talks about tetanus as a neurologic disorder characterized by muscle spasms.
Corynebacteria
Authors: Ramírez-Ronda Carlos H. , Ramírez-Ramírez Carlos R.
Published: January 2022

This chapter investigates Diphtheria as an acute, infectious, preventable, and sometimes fatal disease caused by Corynebacterium diphtheriae. It highlights the infection caused by Diphtheria, which is usually localized to the upper part of the respiratory tract or the skin and gives rise to local and systemic signs. It explains that the systemic signs of infections are the result of a toxin produced by the microorganisms multiplying at the site of infection, which particularly affect the heart, the peripheral nerves, or the kidneys. This chapter describes the worldwide distribution of Diphtheria into four biotypes: gravis, intermedius, mitis, and belfanti. It mentions epidemic and endemic diphtheria that occur in temperate climates and under poor socioeconomic conditions, where crowding is common and where many persons are either not immunized or inadequately immunized.
Staphylococcus
Authors: Bradley Suzanne F.
Published: January 2022

This chapter looks at the treatment of staphylococcal infection that is dependent on the site involved, the severity of infection, and the antibiotic susceptibility pattern of the organism causing the infection. It discusses the most serious staphylococcal infections that are caused by coagulase-positive staphylococci and coagulase-negative staphylococci, which may be life threatening. It also describes Staphylococcus aureus as a highly invasive pathogen that spreads hematogenously to many organs and leads to metastatic foci of infection. The chapter investigates coagulase-negative staphylococci, which are generally healthcare-associated infections that require the presence of prosthetic material to gain a foothold and cause infection. It explains staphylococci's quick propensity to develop resistance to antibiotics.
Viridans streptococci
Authors: Brusch John L.
Published: January 2022

The Streptococcus viridans group of bacteria have long been recognized as a major cause of subacute bacterial endocarditis. However, the wide variation in pathogenesis and presentation of the diseases produced by different strains of this group have been long underappreciated. These infections are a growing problem among the immunosuppressed adult and pediatric age groups. This chapter focuses on the pathological mechanisms, clinical presentations, and treatment of various S. viridans infections especially those caused by S. angiosus.
Tularemia
Authors: Neeman Kari , Snowden Jessica N.
Published: January 2022

This chapter talks about francisella, which are small, aerobic, catalase-positive, pleomorphic, gram-negative intra- and extracellular coccobacilli. It describes four recognized subspecies of F. tularensis: tularensis (Type A), holarctica (Type B), mediasiatica, and novicida. It also analyzes F. tularensis Type A, which has been described as the more virulent of the subspecies and is found predominantly in North America. The chapter looks at F. tularensis Type B that exists throughout the northern hemisphere. It examines Tularemia as a zoonotic infection that can infect a wide variety of invertebrates, such as the dog tick (Dermacentor variabilis) and wood tick (Dermacentor andersoni), and vertebrates, such as rabbits, muskrats, prairie dogs, and other rodents.
Miscellaneous gram-negative organisms
Authors: Kumar Sampath , Singh Kamaljit
Published: January 2022

Most gram-negative infections are caused by organisms in the Enterobacteriaceae or the Pseudomonas genus, and a few are caused by a heterogeneous group of miscellaneous gram-negative organisms. Acinetobacter is a member of the family Moraxellaceae, which includes A. calcoaceticus, A. lwoffii, and A. baumannii as the most commonly reported in the clinical literature. Achromobacter spp. are widely distributed in soil and water, and they may be part of the normal flora of the lower gastrointestinal tract. The chapter describes the genus Alcaligenes, which consist of gram-negative rods or cocci that are oxidase positive and obligate aerobes. A. faecalis as the most commonly isolated species in the clinical laboratory.
Sporotrichum
Authors: Greenfield Ronald A.
Published: January 2022

This chapter describes sporotrichosis as a subacute or chronic fungal infection caused by Sporothrix schenckii and related species that are widely distributed in nature. Sporotrichosis occurs commonly in cutaneous or lymphocutaneous forms that result from direct inoculation by the pathogen and in a variety of extracutaneous forms. In addition, primary sporotrichotic pneumonia is acquired by inhalation of these pathogenic fungi, and musculoskeletal or osteoarticular sporotrichosis is a result of direct inoculation into tendons, bursae, and joints due to hematogenous dissemination, which may result in disseminated cutaneous sporotrichosis and/or infection of a variety of unusual sites, including the meninges. The chapter details the testing, evaluation, and treatment of patients presenting with sporotrichosis.
Papillomavirus in oro-genital infection
Authors: Eron Lawrence J.
Published: January 2022

This chapter covers human papillomaviruses (HPV), which cause more than 10,000 cases of squamous cell carcinoma (SCC) of the cervix and more than 4,000 deaths annually each year in the United States. HPV is the third most common cancer in women worldwide, and HPV also causes genital warts and other subclinical disease, making it the most common sexually transmitted disease in the United States with as many as 20 million infections. The National Health and Nutrition Examination Survey (NHANES) study reported a 25% prevalence of HPV DNA from vaginal swabs of 20- to 24-year-olds. HPV produces persistent infection that is subclinical and easily transmitted via intercourse, and 80% of sexually active people become infected during their lifetime.
Tissue nematodes
Authors: Michelow Ian C. , Blatt Daniel B.
Published: January 2022

This chapter discusses tissue-dwelling nematodes, which are among the neglected tropical diseases that frequently cause debilitating illness in the most marginalized communities of the world. Invasive nematode infections tend to result in eosinophilia and elevated serum immunoglobulin E. Because even with normal blood tests parasitic diseases cannot be ruled out, diagnostic considerations must be focused on understanding the invading parasite's geographic distribution and its prevalence in endemic areas, incubation periods, and clinical manifestations. The chapter discusses trichinellosis, which is caused by Trichinella spp. It also describes Wuchereria bancrofti, Brugia malayi, Onchocerca volvulus, and Loa loa, which are four of the filarial species capable of infecting humans and that cause most tissue invasive nematode diseases worldwide.
Malaria
Authors: Fairley Jessica K. , Wu Henry M.
Published: January 2022

Malaria remains a life-threatening parasitic infection endemic throughout much of the world, with 228 million infections worldwide and 405,000 deaths due to malaria in 2018, and with the majority of these deaths among African children. Malaria is one of the most common causes of fever in returned travelers and recent immigrants to nonendemic countries. Malaria is a mosquito-borne protozoal infection caused by Plasmodium spp. It is carried by Anopheles spp. mosquitos. A high index of suspicion is critical when evaluating patients with febrile illness following travel to malarious areas, especially those endemic for P. falciparum. Proper treatment of malaria requires knowledge of the infecting species and where it was acquired, since drug resistance patterns, especially to chloroquine, vary geographically.
Antimicrobial agent tables
Authors: Parente Diane , Cunha Cheston B.
Published: January 2022

This chapter provides five tables of antimicrobial agents, grouped according to class, listing their generic and brand names, major toxicities and drug–drug interactions, along with recommended dosages for both adult and pediatric patients. Adult dose interval adjustments for patients with kidney disorders and reduced creatinine clearance are provided, as is dose adjustment for those on either peritoneal dialysis or hemodialysis.
Complexity in Clinical Practice
Authors: Silveira José , Rockman Patricia
Published: January 2022

This chapter illustrates the role of complexity in clinical practice. Implications for clinical judgment and decision making are discussed. The constraints that complexity imposes on the accuracy of clinical assessments are operationalized. Clinicians’ causal formulations are often either wrong or incomplete. The ways in which complexity contributes to this and to clinical uncertainty are explored. Properties of complexity particularly relevant to mental disorders, their assessment and treatment, are illustrated using clinical examples. Two common ways in which clinicians formulate impressions in mental health are critiqued. The chapter helps clinicians appreciate the complexity inherent to mental health care and reduce their vulnerability to confusing this with their own limitations.
Phronesis (Practical Wisdom)
Authors: Kroll Jerome , Mason Perry C.
Published: January 2022

Phronesis, classically defined by Aristotle as knowledge of what is good and what is bad for humans, is best understood as practical wisdom, that is, the wisdom of action. The main difficulties in possessing phronesis and acting on it are that both human goods and ills come in degrees (so that it is hard to tell how much of the one is enough and how much of the other is too much) and that the goods frequently compete with each other (so that it is hard to determine which to pursue at the expense of the other). In the end, phronesis amounts to sound judgment and intuition in identifying the specific goods to be pursued and the ills to be combated in a given context. In the context of psychiatric practice, the goods and ills must be preeminently those for the patient, mainly the goods of mental health and the ills of mental disorder. But in addition to facing competing goods and subtly varying degrees of goods and ills, the psychiatrist also faces both nonmedical goods and ills and other persons to be taken into account—family members, translators, and consultants, sometimes embodying cultural attitudes different from those of the psychiatrist, as well as such nonpersons as their clinics or health maintenance organizations, insurance companies, and governmental agencies. A look at several cases of community psychiatric practice reveals the complexities that require seasoned phronesis for successful treatment.
Gratitude
Authors: Jans-Beken Lilian
Published: January 2022

Gratitude has been omnipresent in religious, spiritual, and philosophical ideologies since ancient times. All these ideologies believed that gratitude contributes to the well-being of individuals, to strong relationships between people, and to societal cohesion, and it is seen as an essential part of living a meaningful life. In positive psychology, gratitude is viewed as a general tendency to recognize small to large benefits, to experience sufficiency, and to acknowledge anything in the world, both human and nonhuman, with grateful emotion; expression of this emotion promotes one’s own well-being and the well-being of others; also called mature gratitude. An important aspect of mature gratitude as a contributor to well-being is the ability to be grateful for broken belongings, hurtful people, or any other kind of adversity. Health and well-being cannot be understood merely by analysis of the individual psychopathological symptoms but by the synthesis of all domains of mental health, each of which is associated with gratitude: physical well-being, psychological well-being, and social well-being. Gratitude contributes more or less to each of these areas. In clinical practice, gratitude can play a positive role regarding several diagnoses, including burnout, addiction, chronic pain, and bereavement. This chapter illustrates the effect gratitude has on the mental health of people with these serious conditions. Mature gratitude plays a vital role in preventing people from experiencing depression, anger, and anxiety because of suffering. It teaches people a better and more adaptive way to embrace their hardship.
Cancer Risk from Pediatric Computed Tomography
Authors: Lee Christoph I.
Published: January 2022

This chapter provides a summary of a landmark study in radiology. How much radiation do children receive from computed tomography and what is the cancer risk from this radiation exposure? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study overview, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.
Chronic Illness, Death, and Dying in Modern Times
Authors: Hallenbeck James L.
Published: January 2022

This chapter examines the issues of chronic illness, death and dying in the United States. It explains that how people get sick today and how society responds to sickness have changed dramatically. While significant differences remain between developed and developing countries in terms of causes of death, the trend seems irreversible: Illnesses and deaths associated with infectious and parasitic causes are on the wane, and chronic, degenerative illnesses such as cancer and dementia are increasing. Also discussed are the history of hospice and palliative care in the United States. The author provides a glimpse of likely future challenges for this evolving field of medicine.
Stigma Reduction in Postsecondary Settings
Authors: Szeto Andrew C. H. , Lindsay Brittany L.
Published: January 2022

This chapter describes the disturbing growth of mental health problems that have occurred within the postsecondary sector, including colleges, universities, and technical institutes. The chapter then explores some initiatives in postsecondary institutions to address mental illness stigma, including the use of mass media, programs targeting mental illness stigma, and the stigma of suicide. There is a particular focus on holistic approaches to addressing mental health, which both directly and indirectly addresses stigma at multiple levels within the postsecondary setting. The chapter concludes with recommendations for postsecondary institutions to sustain stigma reduction on their campuses and further address mental health as a holistic concept.
Reducing the Stigma of Mental Illness in First Responders
Authors: Milliard Beth
Published: January 2022

First responders, including police officers, firefighters, and emergency medical service personnel, are often exposed to high-stress and potentially traumatic situations. The ability to both recognize mental health problems among first responders and minimize stigma is critical to enable timely and appropriate access to services. This chapter details a number of programs that have been developed to reduce the stigma of mental illness in first responder organizations. The research suggests that multiple types of programs are needed because no one program will fit all groups, but continued efforts to prioritize mental health and implement proactive mental health programs and leadership training will lead to a reduction of stigma.
Naming the Problem
Authors: Black Donald W.
Published: January 2022

This chapter details the process of diagnosis and assessment of antisocial personality disorder (ASPD). The first step in evaluating patients is to construct an accurate history through a careful interview. Because lab tests, x-rays, and brain scans have little, if any, diagnostic value—aside from their capacity to rule out medical problems—the patient’s history is the most important basis for diagnosing ASPD. The chapter then considers mental status examination (MSE), the psychiatrist’s equivalent of the physical examination, and personality and cognitive testing. When the history has been pieced together, the time comes to consider potential explanations for the patient’s chief complaint and current problems, a process that results in the differential diagnosis, a set of possibilities ranked from most to least probable. Ultimately, psychiatric diagnosis carries several important functions and can help guide troubled patients to make important changes in their life.