bluuebunny/crossref_metadata_2025 huggingface dataset:
A computational model of the discovery of writing
Authors: Sproat Richard
Published: February 2018

This paper reports on a computational simulation of the evolution of early writing systems from pre-linguistic symbol systems, something for which there is poor evidence in the archaeological record. The simulation starts with a completely concept-based set of symbols, and then spreads those symbols and combinations of these to morphemes of artificially generated languages based on semantic and phonetic similarity.

While the simulation is crude, it is able to account for the observation that the development of writing systemsex nihiloseems to be facilitated in languages that have largely monosyllabic morphemes, or that have abundant ablauting processes. We are also able to model what appears to be two possible lines of development in early writing whereby symbols are associated to the sounds ofallmorphemes linked to a concept (as seems to have been the case in Sumerian), versus just one morpheme linked to a concept (as seems to have been the case in Chinese). Finally, the model is able to offer an account of the apparent rapid development of writing in Mesopotamia that obviates the need to posit a conscious invention of writing, as proposed by Glassner.

The proposed model thus opens a new approach to thinking about the emergence of writing and its properties, something that, as noted above, has scant direct archaeological evidence.

The software is released open-source on GitHub.
Early Thai orthography
Authors: Diller Anthony
Published: February 2018

Orthographic complexity in Thai is traced diachronically to account for non-linear relationships in the current writing system. As a result of orthographic conservatism over a period of phonological change, an earlier direct phoneme-grapheme isomorphism has shifted to a complex configuration with abstract reinterpretation. What were originally segmental graphemes have acquired hierarchical functions in suprasegmental tone marking. However, aspects of this account have been challenged. A debate has arisen regarding the origins of Thai writing. An early inscription with consistent use of tone marks has been deemed a fake, causing a local uproar. This inscriptional debate is described in some detail as it provides a context appropriate for examining more general questions raised byShare & Daniels (2016)and others regarding multi-dimensional hierarchical depth in orthographic systems. Central to Thai orthographic depth is the claim that early Thai writers marked phonemic tone.
Sustainable nutrition.
Authors: Gustafson D. I.
Published: February 2018

A new paradigm - 'sustainable nutrition' - has emerged where distinct streams of scientific discourse are beginning to overlap: in global change, environmental science, agriculture, food security, nutrition, sustainable development and public health. A broadening of perspective has accompanied this new way of thinking, which holistically considers overall food system performance, as measured by economic, environmental, societal, nutrition and health outcomes. This systems approach includes analysis of entire food supply chains: beginning with the production of essential agricultural inputs, animal and crop farm operations, fisheries and aquaculture, processing, storage, distribution, preparation, consumption and ending with waste disposal. The burgeoning scientific literature on this topic is reviewed here, which points to four actions that are needed to achieve sustainable nutrition: (1) carefully define terminology and agree upon quantifiable measures, metrics and methods of assessing the status of sustainable nutrition; (2) bridge the gap between the ability to characterize national-scale food system performance and the diet and health of individuals, by gender, age and socio-economic status; (3) better coordinate and resource the efforts now underway at local and regional levels that attempt to enhance sustainable nutrition; and (4) facilitate consensus-building across the full spectrum of food system stakeholders on the trans-sectoral, ethically based policies and other interventions that are needed across entire food supply chains in order to attain sustainable nutrition.
Finding hope
Authors: Milona Michael
Published: February 2018

This paper defends a theory of hope according to which hopes are composed of a desire and a belief that the object of the desire is possible. Although belief plus desire theories of hope are now widely rejected, this is due to important oversights. One is a failure to recognize the relation that hope-constituting desires and beliefs must stand in to constitute a hope. A second is an oversimplification of the explanatory power of hope-constituting desires. The final portion of the paper uses an enhanced understanding of the psychology of hope to make progress on normative questions about hoping well.
Induced phenylamide accumulation in response to pathogen infection and hormone treatment in rice (Oryza sativa)
Authors: Morimoto Noriko , Ueno Kotomi , Teraishi Masayoshi , Okumoto Yutaka , Mori Naoki , Ishihara Atsushi
Published: February 2018

Rice plants accumulate various specialized metabolites, including phenylamides, in response to pathogen attack. We prepared 25 phenylamides, and developed a method of analyzing them by multiple reaction monitoring with liquid chromatography coupled with tandem mass spectrometry. We analyzed phenylamides in rice leaves infected with Cochliobolus miyabeanus and Xanthomonas oryzae. The phenylamides induced included benzoyltryptamine, cinnamoyl-, p-coumaroyl-, feruloyl-, and benzoylserotonins, cinnamoyl and benzoyltyramines, feruloylagmatine, and feruloylputrescine. Some of the phenylamides exhibited antimicrobial activity against C. miyabeanus and X. oryzae, indicating that they are phytoalexins. Treatment with jasmonic acid, salicylic acid, 6-benzylaminopurine, and ethephone also induced phenylamide accumulation. The compositions of the induced amides varied depending on the plant hormone used, and cinnamoyltryptamine, cinnamoylserotonin, and cinnamoyltyramine were not induced by the plant hormones. These findings suggest that several plant hormones and additional factors are involved in phenylamide accumulation in response to pathogen infection in rice.
Comparative effects of ethylene inhibitors onAgrobacterium-mediated transformation of drought-tolerant wild watermelon
Authors: Malambane Goitseone , Nonaka Satoko , Shiba Hiroshi , Ezura Hiroshi , Tsujimoto Hisashi , Akashi Kinya
Published: February 2018

Ethylene (C2H4), a phytohormone that is produced in response to both abiotic and biotic stresses, is an important factor influencing the efficiency of Agrobacterium-mediated transformation. In this study, effects of various ethylene inhibitors on the efficiency of Agrobacterium-mediated genetic transformation in drought-tolerant wild watermelon was comparatively examined. Consequently, in comparison to the application of chemical inhibitors such as AgNO3 and aminoethoxyvinylglycine (AVG), lower ethylene level was observed when the infecting Agrobacterium contained a gene for 1-aminocyclopropane-carboxylic acid (ACC) deaminase (acdS), which cleaves ethylene precursor ACC into α-ketobutyrate and ammonia. GUS histochemical and spectrophotometric enzyme assays showed that acdS was more effective in enhancing gene transfer than the chemical ethylene inhibitors. Efficiency of transgenic shoots formation was higher in acdS- and AVG-treated explants. These observations demonstrated that controlling the ethylene level during co-cultivation and shoot formation, particularly using the acdS-harboring Agrobacterium, is advantageous for enhancing the transformation efficiency in this plant.
Silencing of lncRNA ZFAS1 inhibits malignancies by blocking Wnt/β-catenin signaling in gastric cancer cells
Authors: Xu Weiran , He Liang , Li Ying , Tan Yan , Zhang Fan , Xu Hong
Published: February 2018

Gastric cancer is a common malignancy with high mortality. Long noncoding RNA (lncRNA) zinc finger antisense (ZFAS)1 is upregulated in gastric cancer specimens compared with the para-carcinoma tissues. The silencing of ZFAS1 inhibited the growth, proliferation, cell cycle progress, migration, invasion and epithelial-mesenchymal transition (EMT), and enhanced the sensitivity to cis-platinum or paclitaxel in SGC7901 cells, as evidenced by the expression changes of proliferating cell nuclear antigen, Cyclin D1, Cyclin E, Cyclin B1, E-cadherin, N-cadherin, vimentin, matrix metalloproteinase (MMP)-2 and MMP-14. The ZFAS1 also activated the Wnt/β-catenin signaling. Subsequently, the ZFAS1 knockdown-induced the inhibition of migration, invasion, EMT and resistance to chemotherapeutic reagens was reversed by the overexpression of β-catenin. In summary, the silencing of ZFAS1 inhibited the growth, proliferation, cell cycle progress, migration, invasion, EMT and chemotherapeutic tolerance by blocking the Wnt/β-catenin signaling in gastric cancer cells.
Supersaturated Sparse Graphs and Hypergraphs
Authors: Ferber Asaf , McKinley Gweneth , Samotij Wojciech
Published: February 2018

A central problem in extremal graph theory is to estimate, for a given graph H, the number of H-free graphs on a given set of n vertices. In the case when H is not bipartite, Erd̋s, Frankl, and Rödl proved that there are 2(1+o(1))ex(n, H) such graphs. In the bipartite case, however, bounds of the form 2O(ex(n, H)) have been proven only for relatively few special graphs H. As a 1st attempt at addressing this problem in full generality, we show that such a bound follows merely from a rather natural assumption on the growth rate of n ↦ ex(n, H); an analogous statement remains true when H is a uniform hypergraph. Subsequently, we derive several new results, along with most previously known estimates, as simple corollaries of our theorem. At the heart of our proof lies a general supersaturation statement that extends the seminal work of Erd̋s and Simonovits. The bounds on the number of H-free hypergraphs are derived from it using the method of hypergraph containers.
Dizziness
Authors: Adams Andrea C.
Published: February 2018

Patients frequently complain of “dizziness” and use this term to describe various symptoms. It can be difficult to obtain an accurate history of the symptoms, especially with the time constraints that clinicians often face. The symptom of dizziness requires taking an open-ended history. Direct questions often suggest symptoms to the patient and can lead to a wrong diagnosis.
Cognitive Loss
Authors: Adams Andrea C.
Published: February 2018

This chapter discusses dementia, memory loss, and other cognitive dysfunction. Dementia is diagnosed when cognitive or behavioral symptoms interfere with the ability to function at work or at usual activities. This represents a decline from previous levels and is not explained by delirium or major psychiatric disorder. The criteria for dementia include a minimum of 2 of the following cognitive or behavioral impairments: 1) impaired ability to acquire and remember new information, 2) impaired reasoning and handling of complex tasks, 3) impaired visuospatial abilities, 4) impaired language functions, and 5) changes in personality, behavior, or comportment.
Spells
Authors: Adams Andrea C.
Published: February 2018

Spells are transient disorders that indicate reversible alterations in neuronal excitability. Transient disorders can affect the central or peripheral nervous system and can be generalized or focal. Examples of generalized transient disorders are generalized seizures, syncope, concussion, and cataplexy. Examples of focal transient disorders are focal seizures, transient ischemic attacks, migraine, transient mononeuropathies, paresthesias, muscle cramps, and tonic spasms.
Pain
Authors: Adams Andrea C.
Published: February 2018

Pain can be categorized as neuropathic, nociceptive, or idiopathic. This chapter discusses neuropathic pain, which is pain caused by dysfunction of the nervous system. Nociceptive pain is the result of tissue damage that may or may not include damage to the nervous system. Idiopathic pain encompasses several poorly understood pain disorders that are not associated with tissue damage and includes many pain disorders that have been considered psychogenic in origin. Pain is the number 1 reason that patients seek medical attention. It is an alarm mechanism warning of tissue damage and potential danger.
Cerebrovascular Disease
Authors: Adams Andrea C.
Published: February 2018

Transient ischemic attack (TIA) is an episode of focal neurologic dysfunction (brain, spinal cord, or retina) caused by ischemia. The clinical symptoms usually last less than 1 hour, and there is no evidence of acute infarction. Central nervous system infarction is defined as cell death attributable to ischemia with clinical, neuroimaging, and/or neuropathologic evidence of permanent injury. In the absence of imaging and pathologic evidence, clinical stroke is established by the persistence of symptoms for 24 hours. Silent infarction, discovered by imaging, has no known symptoms but remains an important issue in secondary stroke prevention.
Efficacy and Safety of a Paired Sedation and Ventilator Weaning Protocol for Mechanically Ventilated Patients in Intensive Care
Authors: Katz Jeffery , Greenberg Steve
Published: February 2018

The chapter entitled examines the efficacy of pairing daily sedation awakening trials (SAT) with daily spontaneous breathing trials (SBT) in intensive care unit (ICU) patients on a mechanical ventilator. Three-hundred thirty-six ICU patients requiring mechanical ventilation for > 12 hours and eligible for a ventilator weaning trial were included. The authors compared the number of ventilator-free days in patients who received an SBT alone versus an SAT + SBT. Patients in the intervention group (SAT + SBT) spent a mean of 3.1 more days liberated from the ventilator when compared to the control group. Medical ICU patients undergoing paired SAT + SBT may experience improved outcomes versus those with SBT alone.
Prone Positioning in Severe Acute Respiratory Distress Syndrome
Authors: Coppadoro Andrea , Foti Guiseppe
Published: February 2018

The PROSEVA trial shows improved survival with prone positioning in patients affected by moderate/severe ARDS. Prone positioning resulted effective in patients with moderate/severe ARDS persisting after a 12–24 hours stabilization period, admitted to centers with proven experience with prone position. Patients were ventilated with protective ventilation (6 ml/kg) and a PEEP of about 10 cm H2O. Prone position sessions lasted for at least 16 hours, and patients randomized to prone position were kept supine only if their PaO2/FiO2 consistently improved. Improved survival was not associated with improvement in pH, PaCO2, or PaO2; therefore a “response” to prone position is not necessarily a marker of improvement. Incidence of complications did not differ significantly between the two groups, except for cardiac arrests, which was higher in the supine group.
Positive End-Expiratory Pressure Setting in Adults with ALI and ARDS
Authors: Scott J. Aaron , Moitra Vivek
Published: February 2018

The ExPress Trial examined the role of a positive end-expiratory pressure (PEEP) strategy targeting increased alveolar recruitment versus minimal alveolar distension in the treatment of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Although lung protective ventilation in ALI and ARDS showed significant mortality benefit, the optimal PEEP strategy was unclear. The primary outcome of the study was 28 day mortality. Secondary outcomes included ventilator-free days, organ failure–free days, and barotrauma-related adverse events. Even though there was no significant difference in mortality between the two arms of the study, a significant difference was identified in ventilator-free days and organ failure–free days, which supported an increased recruitment PEEP strategy in the ALI/ARDS population and encouraged further examination.
Effect of Early versus Late Tracheostomy Placement on Survival in Patients Receiving Mechanical Ventilation
Authors: Guthrie J. Michael , Gudzenko Vadim
Published: February 2018

The TracMan randomized controlled trial examined mortality among patients randomized to receive early (first 4 days) versus late (after 10 days) tracheostomy. This chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. It briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study found that early tracheostomy did not improve mortality in mechanically ventilated ICU patients. Early tracheostomy did not improve important patient outcomes such as ICU or hospital length of stay. The study also demonstrated that clinicians’ ability to predict which ICU patients will require prolonged mechanical ventilation is severely limited.
Using Esophageal Pressures to Improve Oxygenation and Compliance in Acute Lung Injury
Authors: Wang Connie , Bittner Edward
Published: February 2018

The New England Journal of Medicine article, “Using Esophageal Pressures to Improve Oxygenation and Compliance in Acute Lung Injury,” showed that ventilator adjustments guided by using esophageal pressure for estimation of transpulmonary pressure demonstrated significant improvement in oxygenation and compliance for patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The study randomized patients with ALI or ARDS to either a positive end expiration pressure (PEEP) adjustment according to measurement of either esophageal pressures or ARDS network standard-of-care recommendations. Esophageal balloon catheters helped to determine the optimal level of PEEP that would sustain oxygenation but still prevent alveolar collapse or overdistention.
A Comparison of Four Methods of Weaning Patients from Mechanical Ventilation
Authors: Berg Sheri , Sharma Archit
Published: February 2018

This chapter provides a summary of the landmark study known as a comparison of four methods of weaning patients from mechanical ventilation. What is the best method for weaning mechanical ventilation in patients with an initial unsuccessful spontaneous breathing trial? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, 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. Among carefully selected patients who were difficult to wean from the ventilator, a once-daily trial of spontaneous breathing led to extubation about three times more quickly than intermittent mandatory ventilation and about twice as quickly as pressure-support ventilation.
Early versus On-Demand Nasoenteric Tube Feeding in Acute Pancreatitis
Authors: Fagenholz Peter J.
Published: February 2018

This study evaluated whether starting nasojejunal tube feeding within 24 hours of presentation would reduce the rate of death or major complications in patients with acute pancreatitis. This strategy was compared to allowing patients to take an “on demand” oral diet and only initiating nasojejunal tube feeding if there was poor oral intake by 96 hours after presentation. There was no difference between the two groups in any of the measured outcomes, though the study may have been underpowered. We conclude it is acceptable to allow an on-demand oral diet and reserve nasoenteric feeding for patients who have not achieved adequate nutrition by 96 hours after presentation. It is not necessary or beneficial to start nasojejunal tube feeds in the first 24 hours.
Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury
Authors: Ehieli Eric , Bronshteyn Yuriy
Published: February 2018

Patients with severe acute kidney injury who require renal replacement therapy have high mortality rates. Controversy exists over whether a mortality benefit occurs with use of a more intensive renal replacement therapy regimen. In this multicenter, prospective study, 1124 patients requiring renal replacement therapy for severe acute kidney injury were randomized to a more and a less intensive renal replacement therapy regimen and were followed for 60 days. There was no statistical difference in mortality at 60 days (53.6% intensive, 51.5% less intensive, P = 0.47) and no difference in kidney recovery or non-renal organ failure. Hypotension and electrolyte abnormalities were more common in the intensive renal replacement regimen. A less intensive renal replacement regimen (intermittent hemodialysis 3 times a week or continuous venovenous hemodiafiltration at 20ml/kg/hour) was found noninferior to a more intensive renal replacement strategy (dialysis 6 times per week or continuous venovenous hemodiafiltration at 35 ml/kg/hour).
Reducing Mortality Among Bleeding Trauma Patients with Tranexamic Acid
Authors: Kaafarani Haytham M. A.
Published: February 2018

The CRASH-2 trial is a randomized controlled trial performed in more than 270 hospitals across the world and aimed at studying the impact of tranexamic acid (TXA), an anti-fibrinolytic agent, on mortality in trauma patients presenting with hemorrhagic shock. With more than 20,000 patients, CRASH-2 showed a small but statistically significant decrease in mortality from 16% to 14.5% (p < 0.05), without any increase in thromboembolic events, in patients who received TXA versus placebo. Subset analyses suggested that the benefit was only present if TXA was administered within 3 h from injury. Two main criticisms of the study are (1) TXA reduced mortality but not the number of blood products used or the percentage of patients who needed transfusion, raising questions regarding the mechanism by which the drug worked; (2) the conductance of the study in moderate- to low-income countries, limiting its generalizability to high-income countries with advanced trauma systems.
Comparison of 8 versus 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults
Authors: Mark Laurie O. , Kwo Jean
Published: February 2018

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, 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. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.
The Normoglycemia in Intensive Care Evaluation
Authors: Niven Daniel J. , Stelfox Henry T.
Published: February 2018

The Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial compared the effectiveness of a strategy of intensive glucose control (blood glucose target 81–108 mg/dl or 4.5–6.0 mmol/l) to conventional glucose control (blood glucose target ≤ 180 mg/dl or 10.0 mmol/l) in 6,104 medical and surgical patients admitted to adult ICUs in 42 hospitals across four countries. Compared to conventional glucose control, this study found that intensive glucose control increased the risk for severe hypoglycemia (blood glucose ≤ 40 mg/dl or 2.2 mmol/l; 6.8% versus 0.5%, p < 0.001) and 90-day mortality (27.5% versus 24.9%, p = 0.02). The results of this large pragmatic trial suggest that blood glucose control using conventional targets (≤ 180 mg/dl or 10.0 mmol/l) should be the preferred approach for adult medical and surgical patients admitted to ICU.
Evaluation of the Shoulder
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

Establishing an accurate diagnosis and understanding the severity of the underlying condition are critical in order to provide the best possible treatment for patients presenting with a painful and/or dysfunctional shoulder. Shoulder surgeons need to acquire the knowledge and skills necessary to integrate elements of the patient’s history, physical examination findings, imaging, and other studies in order to understand where the pain is coming from and how to improve shoulder function. This chapter presents an organized approach to shoulder evaluation using the author’s preferred practices, which are distinguished between general examination maneuvers to be performed on everyone and focused maneuvers directed to specific conditions. The topics include patient history; various aspects of the physical examination; imaging studies; electromyogram and nerve conduction studies; diagnostic injections; and outcome tools. The chapter concludes with key points of shoulder evaluation.
Arthroscopic Shoulder Surgery
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

Arthroscopic surgery involves performing surgical procedures using a camera inserted in the joint for visualization and one or more additional access points (or portals) to the joint using stab incisions. Endoscopic surgery uses a camera and portals to complete similar procedures outside of joint cavities. Most shoulder surgeons do not distinguish between endoscopic and arthroscopic procedures, and the term shoulder arthroscopy is oftentimes used to refer to both. Currently, many shoulder surgeries are largely or exclusively performed arthroscopically. This is due to improvements in equipment, instrumentation, and implants; better surgeon understanding and training in arthroscopic anatomy and techniques; and interest by surgeons and patients in less invasive, more accurate surgeries.
Surgical Exposures
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

Adequate exposure is critical for any of the open surgical procedures described in this book. Although exposures may need to be modified, most of the time the same approaches are used for various procedures. Small variations on exposures also exist that are based on surgeons’ preferences. All shoulder exposures are somewhat complicated by three particular issues related to the anatomy of the shoulder region. First, the deltoid is a large muscle that wraps around the front, side, and back of the shoulder. Second, the rotator cuff, so important for shoulder function, oftentimes needs to be divided and repaired. Finally, a number of neurovascular structures are very close to the shoulder joint and at risk for injury.
The Rotator Cuff and Biceps Tendon
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

Rotator cuff disease is the most common condition responsible for shoulder pain worldwide. The understanding and treatment of rotator cuff disease has advanced tremendously over the last few years, mostly due to both technological advances (magnetic resonance imaging, ultrasonography, arthroscopic surgery, and reverse arthroplasty) and a better understanding of the biology of healing and of muscle changes over time. Not uncommonly, the long head of the biceps tendon presents structural pathology in patients with cuff disease; however, determining the contribution of biceps pathology to patients’ symptoms is not always straightforward. This chapter discusses these issues and covers aspects of assessment and treatment of rotator cuff disease such as anatomy and function, basic science, rotator cuff tears, calcifying tendinitis, neuropathies and the rotator cuff, and biceps tendon pathology.
Shoulder Instability and the Labrum
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

The glenohumeral joint architecture allows for a very ample range of motion. This same architecture, so beneficial for shoulder mobility, also makes the glenohumeral joint particularly prone to instability. Damage to the glenoid labrum is present in many patients with shoulder instability, although the complexity of the pathology involved in shoulder instability goes beyond labral tears. The rotator cuff and the biceps tendon, discussed in chapter 6, The Rotator Cuff and Biceps Tendon, are intimately involved with instability and the labrum; some of the concepts described in chapter 6 will apply here as well. This chapter covers shoulder instability and the labrum, including management of the acute glenohumeral joint dislocation, recurrent posterior instability and posterior labral tears, multidirectional instability, superior labral tears, failed instability surgery, and salvage procedures.
Shoulder Arthritis and Arthroplasty
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

Progressive degeneration of the articular cartilage and other articular structures is the hallmark of glenohumeral arthritis. These structural changes may occur primarily or they may be a consequence of a number of conditions, including dysplasia, inflammatory conditions, trauma, avascular necrosis, instability, infection, and prior surgery. The pathology underlying various arthritic conditions is different, and these differences have direct practical implications on treatment. Shoulder arthroplasty is the surgical treatment of choice for most patients with advanced symptomatic arthritis. This chapter addresses shoulder arthritis and arthroplasty as it relates to structural pathology in shoulder arthritis, evaluation, nonoperative treatment, shoulder arthroplasty, nonarthroplasty surgical options, surgical management of specific conditions, and complex and revision surgery.
Rehabilitation and Injections
Authors: Sanchez-Sotelo Joaquin
Published: February 2018

Rehabilitation modalities, particularly physical therapy exercises, are extremely important for the operative and nonoperative management of shoulder conditions. Shoulder surgeons must understand the principles of shoulder rehabilitation so that they can guide physical therapists and patients through treatment plans. Injections of local anesthetic, corticosteroids, or other pharmacological agents are used commonly in the diagnosis and treatment of shoulder conditions. Shoulder surgeons must know how to perform these injections (with and without imaging guidance); they must also be aware of the potential adverse effect of multiple corticosteroid injections to be able to inform patients and prevent unwanted sequelae.
Nature-based treatments as an adjunctive therapy for anxiety among elders
Authors: Detweiler Mark B. , Carman Jack , Meinersmann-Detweiler Jonna G.
Published: February 2018

Treatment of cognitive and functional impairment in older people is complex due to the increased risk of concurrent somatic and psychiatric co-morbidities. One goal of geriatricians is to reduce the pharmacological load of frail elders in the effort to improve quality of life. Horticultural therapy and the use of gardens specifically designed for the needs of this population is receiving increased attention as a nonpharmacological treatment modality. Preliminary studies support the effectiveness of horticultural therapy and the use of gardens to reduce agitation in dementia patients. Initial data suggest a direct correlation of time spent in the gardens with positive outcomes. Qualitative studies support improved quality of life when frail elders have access to and interact with outdoor spaces. Additional research with standardized methodology would assist in providing and evaluating appropriate outdoor spaces and evidenced-based treatment plans.
Responses to nature from populations of varied cultural background
Authors: Hägerhäll Caroline
Published: February 2018

This chapter initially outlines some of the definitional, theoretical, and methodological challenges in studying the effects of cultural background on responses to nature, challenges which partly also can explain the limited and fragmented research on this topic. By then focusing the chapter more narrowly on cultural background defined as a person’s origin or ethnicity and quantitative studies of general, mainly visual, preferences, we can identify some distinguishable patterns and lines of inquiry in the empirical research to date and suggest some key issues to address in future research. Future research needs to adopt clearer definitions and conceptualizations of culture and nature and aim to better understand factors which interact with ethnicity. Apart from factors like age, gender, education, and expertise, the rural–urban dimension would need more attention as studies have shown notable confounding effects of rural versus urban residence.
Vector-borne diseases and poisonous plants
Authors: Wong David
Published: February 2018

Vector-borne diseases, poisonous plants, and other environmental hazards are potentially encountered by outdoor recreationalists. Vector-borne diseases are found worldwide, particularly in tropical, subtropical, and temperate climates where suitable habitats support vector populations and their associated pathogens. The relative risk from vector species (e.g. ticks, mosquitoes, fleas) and the prevalence of specific vector-borne pathogens vary by continent. Recreationalists should be aware of or inquire about local disease risks from health agencies, educate others about these risks, and adhere to personal protective measures that can greatly reduce transmission risk. Broadly, these measures include using insect repellents, wearing long-sleeved shirts and trousers where possible, and avoiding high-risk areas (e.g. forest edges for tick-borne diseases) or high-risk time periods (e.g. dawn and dusk for mosquito-borne diseases) to decrease potential contact with vectors. Education and awareness is the most effective strategy for preventing vector-borne diseases and exposure to poisonous plants and other environmental hazards.
The health impact of natural disasters
Authors: Noji Eric K. , Khan Anas A.
Published: February 2018

The complex and multifaceted nature of health risks secondary to natural disasters will require innovative, holistic, and problem-oriented approaches to risk and disaster management. The Hyogo Framework for Action 2005–2015 (HFA), the goal of which is to strengthen the resilience of nations and communities to natural disasters, is the inspiration for much of the current knowledge, practice, implementation, experience, and the science for natural disaster risk reduction. Natural disaster risk reduction offers a comprehensive framework where stakeholders can take coherent and complementary actions through political, social, technological, economic, and humanitarian processes to build resilience. The aim of the recent Hyogo initiative is to globally increase resilience and reduce vulnerability. This chapter will describe the current state of knowledge of the health consequences of natural disasters, the implications of these consequences for policy, and conclude with recommendations for action.
Risk and the perception of risk in interactions with nature
Authors: Ball David J. , Ball-King Laurence N.
Published: February 2018

Evidence from research on the public’s understanding of risk suggests that a gradual distancing of the public from nature has occurred over recent decades, likely resulting in a loss of ‘affective’ feeling for the natural environment through loss of familiarity. This may induce a disproportionate perception of nature’s risks, making it more difficult to realize the health benefits brought by exposure to natural places. A traditional solution would be to communicate risk data to the public, but it is now believed that such an approach would be inadequate. Instead, closer engagement between professionals and the public is required, and the professions themselves need to adopt a more holistic approach to policy formulation which recognizes the unavoidability of trade-offs.
The shift from natural living environments to urban: population-based and neurobiological implications for public health
Authors: Lederbogen Florian , Haddad Leila , Meyer-Lindenberg Andreas , Ompad Danielle C. , van den Bosch Matilda
Published: February 2018

The transition of humankind from mainly rural to urban living has various implications for health and disease among populations. Losing certain environmental exposures from the countryside, while getting new urban exposures provide both risks and opportunities. The rapid pace of urbanization has caused a mismatch in human adaptive capacity, for example resulting in higher prevalence of diabetes in cities in various parts of the world. This can partly be explained by a change in lifestyle related to diet and physical activity associated with urban living. Also mental disorders, like schizophrenia and depression are more common in urban areas. A potential biological explanation may be structural and functional changes in certain brain structures, as a response to urban environments, rendering a higher vulnerability to social stress. Recent neuroscientific studies have indicated that this explanation is plausible.
Quantifying and valuing the role of trees and forests on environmental quality and human health
Authors: Nowak David J.
Published: February 2018

Understanding the economic and environmental benefits of nature, in particular trees and forests, can lead to better vegetation management and designs to optimize environmental quality and human health for current and future generations. Computer models have been developed to assess forest composition and its associated effects on environmental quality and human health. While research is still needed regarding many of the environmental services that trees and other ecosystem elements provide, resource managers can utilize existing models to better understand the role of vegetation in improving human health and environmental quality, lower costs of maintenance, and increase resource stewardship as an effective means to provide economic savings to society.
Using nature as a treatment option
Authors: Pálsdóttir Anna María , Sempik Joe , Bird William , van den Bosch Matilda
Published: February 2018

Natural environments have been used in healthcare for centuries. Modern approaches to incorporating nature in treatment include a range of methods, often named with the umbrella term ‘green care’. Nature can be seen either as a setting for the intervention (nature based), or as an integral part (nature-assisted). Common methods are horticultural therapy, care farming, green exercise, and wilderness therapy. A multitude of variations exists and there is yet no standardized protocol for how a nature-based or nature-assisted intervention shall be designed for a given diagnosis. Traditionally, green care has been used in mental healthcare, with some good results for symptoms of depression and schizophrenia. Green care has also been implied as rehabilitation after stroke and myocardial events, as well as for patients with autism, learning disabilities, dementia, and behavioural problems. Most research studies show positive results, but the current lack of consistently robust evidence prevents broader implementation.
Similarities, disparities, and synergies with other complex interventions—stress as a common pathway
Authors: Stenfors Cecilia , Horwitz Eva Bojner , Theorell Töres , Osika Walter
Published: February 2018

Both internal and external stimuli can cause stress, and suboptimal stress management is a major driver of ill health. There are several complex interventions, such as contemplative practices and cultural activities, which facilitate the process of becoming aware of and handling such stimuli. Participation in such activities can facilitate the connection with one’s emotions and values, and the integration of those in everyday coping. One contemplative practice is mindfulness, which involves bringing one’s complete attention to the present experience on a moment-to-moment basis, non-judgementally. Among cultural interventions we find, for example, dance and music therapy and combinations thereof. It is plausible that the health effects of nature, and contemplative and cultural activities share a mechanistic background. Several theoretical principles are similar and the same kinds of condition benefit from these interventions, all with a certain effect on stress and mental fatigue. There could be synergistic effects of the various approaches.
A life course approach to public health: why early life matters
Authors: Low Felicia M. , Gluckman Peter D. , Hanson Mark A.
Published: February 2018

This chapter describes the theoretical and mechanistic basis, and public health implications, of the Developmental Origins of Health and Disease (DOHaD) paradigm, which has emerged from overwhelming epidemiological, clinical, and experimental evidence demonstrating the importance of early life development in influencing an individual’s susceptibility to later life disease risk. DOHaD is underpinned by the evolutionarily conserved processes of developmental plasticity. These enable phenotypic adjustment to match the environment and are effected, in part, by epigenetic mechanisms that modulate patterns of gene expression. This chapter uses obesity and its co-morbidities to illustrate how a life course approach can provide an effective strategy for reducing disease risk and have major policy implications. It focuses on early life as a critical intervention point, and recognizes the importance of taking into consideration the full range of influencial biological, behavioural, and contextual factors that operate across the life course.
The physiology of stress and stress recovery
Authors: Währborg Peter , Pervanidou Panagiota , Chrousos George P.
Published: February 2018

Stress (i.e. the state of threatened homeostasis), is normally associated with adaptive physical and behavioural changes that promote individual survival. Successful maintenance of homeostasis leads to the state of eustasis, which represents health. The prolonged, excessive, or deficient response of the stress system to stress, however, may lead to a state of dyshomeostasis or cacostasis, which may lead to physical and mental health problems. Although research has focused on the detrimental effects of stress, only a few studies have been done on positive stress exposure adaptations. Increased resilience, post-traumatic psychological growth, and increased empathy may benefit chronically stressed individuals, enhancing their abilities to cope with distress. Therapeutic efforts in the treatment of short- or long-term stress aims at reducing its effect on neuroendocrine responses, behaviour changes, and so on. Community investments and interventions should focus on reducing threats and promoting positive adaptation during and after traumatic stress exposures.
Environmental enrichment: neurophysiological responses and consequences for health
Authors: Janssen Heidi , Bernhardt Julie , Walker Frederick R. , Spratt Neil J. , Pollack Michael , Hannan Anthony J. , Nilsson Michael
Published: February 2018

Environmental enrichment, providing greater sensory, physical, cognitive and social stimulation, triggers a cascade of anatomical and molecular changes within the brain and contributes to significant improvements in sensorimotor and cognitive function in animal models of disease. Exposure to and engagement with nature and other cultural activities such as dance, art and music are examples of environmental enrichment strategies which have been employed in the clinical setting to promote passive and active multisensory stimulation in numerous patient populations. This chapter provides a concise summary of the (i) evidence regarding the effect of environmental enrichment when used in animal models of disease and brain injury; (ii) proposed underlying mechanisms by which this multisensory stimulation exerts these effects; (iii) use of nature and other enrichment strategies in the clinical setting; and lastly (iv) role that the architectural design of health environments play in optimizing recovery and well-being.
The role of nature and environment in behavioural medicine
Authors: Venhoeven Leonie , Taufik Danny , Steg Linda , Bonaiuto Marino , Bonnes Mirilia , Ariccio Silvia , De Dominicis Stefano , Scopelliti Massimiliano , van den Bosch Matilda , Piff Paul , Zhang Jia Wei , Keltner Dacher
Published: February 2018

Human behaviour has had an immense impact on natural environments. Often this impact has caused environmental degradation and impaired the possibilities for living well across the planet and especially for future generations. This calls for a specific target in reversing the current trend—namely to change human behaviour itself. By changing human behaviour into a more environmental friendly mode, as well as more pro-social, we may increase the chances for continued prosperous lives for ourselves and for our children and grandchildren. This chapter outlines a few theories around how such changes may be encouraged and how exposure to nature may be one factor with certain impact on making people more pro-environmental and pro-social. Indirectly, such changes may improve health, both for humans and for the environment.
Promoting social cohesion—increasing well-being
Authors: Elands Birgit , Peters Karin , de Vries Sjerp
Published: February 2018

This chapter discusses how green places contribute to well-being and health through social cohesion. Social cohesion contributes positively to both mental and physical health and is influenced by neighbourhood characteristics (such as socioeconomic deprivation) and individual characteristics (such as age). As neighbourhood green spaces are often perceived as attractive places to visit, they provide ample opportunities for residents to meet other people and interact. These interactions form the basis of neighbourhood social cohesion. This chapter reveals that although people generally do not visit public green areas to meet strangers, they do like to engage in small talk with other visitors. These casual encounters appear to be very relevant as they create public familiarity, which results in feeling at home in a neighbourhood. Occasionally, this provides opportunities to perpetuate existing friendships and develop new ones. To facilitate neighbourhood social cohesion, the availability, functions, and quality of green areas are important.
Eyes
Authors: Bowker Lesley K. , Price James D. , Shah Ku , Smith Sarah C.
Published: February 2018

This chapter provides information on the ageing eye, visual impairment, blind registration, visual hallucinations, cataract, glaucoma, age-related macular degeneration, the eye and systemic disease, drugs and the eye, and eyelid disorders.
The back of the neck
Authors: Perry Mike
Published: February 2018

This chapter looks at diseases and conditions of the back of the neck that may present acutely to an emergency department, general practice, or ward. It aims to equip the reader with the necessary knowledge to enable them to quickly and accurately triage and diagnose common clinical problems. Referral pathways and management are also discussed. Generally speaking, patients do not present with a ready-made diagnosis, but rather with either a symptom located to an anatomical region (e.g. toothache, lump, or headache), or an obvious problem (e.g. nose bleed or injury). This is the starting point (‘Common presentations’ and ‘Common problems and their causes’). The next section (‘Useful questions and what to look for’) lists key diagnostic elements in relation to each symptom. The remainder of each chapter details how to examine each site, useful investigations (emergency department and outpatients), and some notes on the conditions themselves. This is a useful aid for the non-specialist and those preparing for clinical examinations.