bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion: A Sense of Place
Authors: Harding Dennis
Published: November 2020

It has often been supposed that the Anglo-Saxon poet lamenting the passing of an heroic society was referring to the ruins of Roman walls, for some reason decorated with serpentiform designs. But it seems more likely that the walls in question were those of an older order altogether, the grass-covered ramparts of a long-abandoned hillfort, winding serpent-like around the contours of a conspicuous local landmark like the Lambton Worm of Wearside folklore. However derelict, such sites must have retained a sense of place that heightened in collective memory the importance of people and events that were associated with them. Archaeology by convention characterizes ancient societies on the basis of the artefacts that they leave behind, whether structural and monumental, or portable and ephemeral. What survives will depend in significant measure upon the durability of material or construction, and upon a variety of taphonomic and environmental factors relating to the deposit or residual context. It will also self-evidently depend upon what communities chose to create and to leave behind, since artefacts are essentially proxy expressions of what they regarded as important, reflecting not just a basic utility but something of the identity and social values of the makers. As hillforts are the most substantial, monumental constructions of Late Bronze Age and Iron Age communities in north Alpine Europe, exceeding in scale even funerary monuments of those local groups that created lasting memorials to the dead, we may infer that they were the most potent expression of what mattered to the communities that built them. One of the recurrent frustrations of archaeology is that for periods or regions in which settlement remains are well represented, burial sites can prove elusive, and vice versa. What appears to be an exasperating demonstration of Murphy's Law nevertheless must have a significant explanation. In effect, some communities leave a mark predominantly in terms of settlement remains and others predominantly in funerary monuments. Diepeveen- Jansen (2007: 385) observed that in the Iron Age of the Marne-Moselle region, ‘the use of hillforts alternates with the employment of increasingly ostentatious burial practices’ (my emphasis), with the implication that this must reflect a meaningful shift in social expression.
Surgery in tropical diseases
Authors: Fisher Simon , Ledwidge Serena
Published: November 2020

Whether you exercise a desire to experience surgery abroad during your student elective or whether you want to take the opportunity to enhance your career aspirations in far-flung regions, knowledge of common surgi­cal presentations of tropical disease is a prerequisite. Moreover, with the ability conferred by modern jet travel to translocate to almost any area of the globe within 48h, you may well encounter these conditions in your local general hospital clinic or emergency department, in visitors to the country or in travellers returning home from foreign excursions. This chapter tests you on your knowledge of presentations, investi­gations, and management of diseases such as malaria, schistosomiasis, amoebiasis, and filariasis, conditions native to a variety of geographical locations. Some diseases such as hydatid still remain endemic in regions closer to the UK. A sound understanding of parasitic life cycles, modes of exposure to, and manifestations of infection, and principles of treatment, will help you to diagnose and manage these conditions whether they are encountered unexpectedly, or prevalent in your geographical location.
Understanding Chronic Obstructive Pulmonary Disease
Authors: Prigmore Samantha , Scullion Jane
Published: November 2020

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with chronic obstructive pulmonary disease (COPD) in an evidence-based and person-centred way. The chapter will provide a comprehensive overview of the causes, risk factors, and impact of COPD, before exploring best practice to deliver care, as well as to prevent or minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with COPD can be found in Chapters 2, 15, 18, and 22, respectively. Chronic obstructive pulmonary disease (COPD) is predominantly caused by smoking and is characterized by airflow obstruction that is not fully reversible (National Institute for Health and Clinical Excellence (NICE), 2010). This broad definition embraces previously used definitions such as chronic bronchitis, emphysema, and chronic asthma. Historically, perceptions of the treatment for and care of the patient with COPD were negative, because of the chronic nature of this progressive disease, which was often viewed as self-inflicted through its links with smoking. Current emphasis, regardless of aetiology, is that it is both preventable and treatable (National Institute for Health and Clinical Excellence (NICE), 2010). Currently around 1 million UK citizens are diagnosed with COPD; prevalence data are higher, at 1.7 million (Britton, 2003). This appears to be underreported because it is thought that there could be as many as another 2 million people currently undiagnosed (British Lung Foundation, 2006). COPD is already a significant burden of disease area, with expectations that, by 2020, it will be the third largest cause of mortality (Murray and Lopez, 1997). Reasons for increasing prevalence include that:… ● an ageing population increases the likelihood of chronic disease development; ● diagnosis of COPD is better guided by both national and international COPD guidelines, with inclusion in the Quality and Outcomes Framework (QOF) in general practice bringing financial incentives for maintaining COPD registers and improving COPD care; ● increasing public awareness leads to more people seeking help on symptom presentation; ● more women being diagnosed, correlating to more women smoking, perhaps owing to greater social acceptability; ● other as yet unknown causes....
Understanding Depression
Authors: Chellingsworth Marie
Published: November 2020

The aim of this chapter is to provide you with the knowledge to be able to recognize, assess, manage, and care for people with depression in an evidence-based and person-centred way. Depression is disabling and causes significant impact upon many areas of the person’s day-to-day functioning; it is therefore important that nurses have the knowledge and skills to recognize whether someone might be depressed and know how to take the appropriate course of action. This chapter will provide a comprehensive overview of the causes and impact of depression, before exploring best practice to deliver care, as well as to prevent or to minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with depression can be found in Chapter 14….I lost my balance. I fell flat on my face and I couldn’t get up again. And if that implies a certain grace, a slow and easy free-fall, then you have me wrong. It was violent and painful and, above all humiliating . . . I came to understand that we are not simply fighting an illness, but the attitudes that surround it. Imagine saying to someone that you have a life-threatening illness such as cancer, and being told to pull yourself together or get over it. Imagine being terribly ill and too afraid to tell anyone lest it destroy your career. Imagine being admitted into hospital because you are too ill to function and being too ashamed to tell anyone, because it is a psychiatric hospital. Imagine telling someone that you have recently been discharged and watching them turn away, in embarrassment or disgust or fear. Bad enough to be ill, but to feel compelled to deny the very thing that, in its worst and most active state, defines you is agony indeed. (Sally Brampton (2008) in Shoot The Damn Dog.)…Sally’s experience of her depressive episode from her memoir sets the scene of just what people with depression can experience and how big an impact it can have upon their lives. We may all feel low and ‘ fed up’ at times, and often we use the term ‘ depressed’ as an adjective to describe how we are feeling in general conversation.
Managing Continence
Authors: Fader Mandy , Norton Christine
Published: November 2020

This chapter addresses the fundamental role of continence management as a core nursing activity. Every nurse should possess the knowledge and skills to carry out an essential, but simple, continence assessment, as well as to select and implement evidence-based strategies to manage continence in all care settings (including hospital and community), and to review the effectiveness of these to inform any necessary changes in care. Despite being essential for dignity and compassionate care, continence needs are often not prioritized as highly by nurses as they are by patients and their relatives. For adults, the ability to control bladder and bowel emptying is very important to self-esteem and dignity. Continence is a complex specialty involving a number of disciplines, including specialist nurses, specialists in urology, gynaecology, physiotherapy, and elderly care, yet the prevalence of continence problems means that much depends on you as a registered nurse taking responsibility for initiating assessment and management. Continence issues frequently arise as a result of other healthcare problems, and you should remain constantly aware of this, identifying patients who are at risk of incontinence and helping embarrassed patients to seek help. Bladder and bowel control are taken for granted by most of us. Once continence is achieved during childhood, we expect to remain in charge of these bodily functions for the rest of our life. Temporary loss of continence commonly accompanies acute illness or hospitalization, particularly if mobility and/or cognition become impaired (Resnick et al., 1989), or if the disease or injury impacts directly on bladder or bowel function. If the bladder fails to function normally (such as an overactive bladder), lower urinary tract symptoms may be experienced, and these may include incontinence. If bowel habits are disrupted, this may result in faecal incontinence (FI), constipation, or both. Incontinence is also associated with long-term conditions, in particular those affecting the neurological system (Fowler et al., 2010). Dealing with incontinence is a very common activity for nurses, and it is easy to become inured to this, forgetting that, for the patient, the experience can be devastating. It is noteworthy that the International Continence Society defines urinary incontinence (UI) as being any involuntary leakage of urine (Abrams et al., 2002), and it is therefore a symptom (however slight) that you should never ignore.
Managing the Prevention of Skin Breakdown
Authors: Nelson Andrea
Published: November 2020

This chapter addresses the fundamental role of nurses in the prevention of skin breakdown. Every nurse should possess the knowledge and skills to identify people at risk of skin breakdown, to select and implement strategies to maintain skin integrity, and to review the effectiveness of these to inform any necessary changes in care. Skin breakdown is associated with long-term conditions such as diabetes, cardiovascular disease, and spinal cord injury, and with acute illnesses that cause mobility restriction such as surgery and severe illness. Diabetes is associated with foot ulcers, cardiovascular disease with leg ulcers, and acute or long-term mobility restriction is associated with pressure ulcers. This chapter focuses on these three categories of skin breakdown and illuminates the key responsibilities carried by nurses in each of these areas. The first section of this chapter provides detailed guidance on the nursing management of pressure ulcer prevention. This is followed by a subsidiary section on the prevention of diabetic foot ulcers. The final section provides a short overview of the nursing role in preventing or managing venous ulceration. Pressure ulcers, which are also called pressure sores, bed sores, and decubitus ulcers, have been defined as:…localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. (European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel, 2010)…Pressure ulcers may present as persistent redness (where the skin is damaged, but not yet broken), blisters, shallow sores, or necrotic wounds extending to the muscle and bone. An ‘avoidable pressure ulcer’ is one that developed and the provider of care did not do one of the following:…● evaluate the person’s clinical condition and pressure ulcer risk factors; ● plan and implement interventions consistent with the person’s needs and goals, and recognize standards of practice; ● monitor and evaluate the impact of the interventions; or ● revise the interventions as appropriate….
Oral cancer
Authors: Robinson Max , Hunter Keith , Pemberton Michael , Sloan Philip
Published: November 2020

The term ‘oral cancer’ encompasses all malignant neoplasms affecting the oral cavity. The majority, greater than 90%, are squamous cell car¬cinomas. The remainder are uncommon and comprise minor salivary gland adenocarcinomas, malignant melanoma, sarcomas, haemato-logical malignancies, and metastases to the oral cavity from cancers at other sites. Oral squamous cell carcinoma is a malignant epithelial neoplasm that arises from the lining mucosa of the oral cavity. The tumour shows vary¬ing degrees of squamous differentiation and is characterized by invasion of local structures and metastasis to regional lymph nodes, followed by metastasis to other organ systems (e.g. lungs and bones) later in the course of the disease. Epidemiological data pertaining to oral cancer can be difficult to evalu¬ate because of variations in the methods of data collection (Box 3.1). Notwithstanding these confounding variables, a database produced by the International Agency for Research on Cancer (GLOBOCAN), esti-mated there were over 400,000 new cases of lip, oral, and pharyngeal cancer worldwide in 2012, placing the disease in ninth position with breast, prostate, lung, colorectal, cervical, stomach, liver, and uterine cancer being more common. These data suggest that oral cancer is uncommon, but there are enormous variations worldwide. Whereas oral cancer is relatively uncommon in the UK, accounting for 2% of all cancers, in India and parts of South-East Asia it is the most common malignant neoplasm and accounts for around a third of all cancers. Furthermore, the incidence rates for large countries, such as India and the USA, conceal regional and ethnic variations. For example, incidence rates tend to be higher in urban as opposed to rural communities, and in the USA are higher for blacks than whites. In the United Kingdom, inci¬dence rates are slightly higher in Scotland than in England and Wales. In the United Kingdom the incidence of oral cancer is 9 per 100,000 of the population, which represents around 6,800 new cases per annum. The disease is more common in men than in women; the male:female ratio is currently 2:1. Oral cancer incidence increases with age, and the majority of cases (greater than two-thirds) are diagnosed after the age of 50 years old; less than 5% occur in individuals below the age of 40 years old.
Groups at Special Risk of Adverse Effects
Authors: Brack Graham , Franklin Penny , Caldwell Jill
Published: November 2020

In Chapters 3 and 4 the general principles of pharmacokinetics and pharmacodynamics were addressed. This chapter builds on these principles and looks at specific groups and situations. After reading this chapter you should be able to:… ● Identify groups of patients at extra risk of interactions, explain why, and relate this to nursing practice. ● Identify groups of patients at more risk of adverse events from medications, explain why, and relate this to nursing practice. ● Understand why some patients might be at higher risk and how this might be managed…. This chapter will look at a range of patients from the perspective of the nurse administering medicines. Whilst care must be taken when administering medication to any patient, there are groups of patients where the risk of problems occurring as a result of having to take medication are higher and it is therefore even more important to be vigilant. For some patients the treatment will have to be altered to reduce risk. While this is not the responsibility of the student nurse it is their responsibility to be vigilant to changes in the patient and to report this to trained staff. There are some circumstances in which the risk to patients is always higher because the treatment they are receiving carries more risk. For example, patients undergoing cancer chemotherapy are receiving drugs which tend to be highly toxic. While the risk of some degree of harm is high, this is justified by the great benefit that patients can derive. However, it is vital that every effort is made to reduce risk. Similarly there are features of care in acute settings such as operating theatres and intensive care units that could increase the risk to patients (Neale et al, 2001 ). Staff may be under acute pressure, so it becomes harder to follow all the steps in a routine.
Medicines Management: Drug Calculations
Authors: Brack Graham , Franklin Penny , Caldwell Jill
Published: November 2020

After reading this chapter you should be able to:.. ● Understand the importance of drug calculations ● Recognize different types of calculations ● Know where you can find help with numeracy ● Successfully complete basic calculations for medicines…. Are you good at drug calculations? This is a question you must ask yourself and be honest about the answer. There is no room for inaccuracies when calculating medicine dosages and if you are not happy working with numbers then you need to practise. Drug calculation is a critical area when managing medicines and is open to error. All health professionals who are dispensing, supplying, or administering drugs will need to perform drug calculations to a greater or lesser extent. Registered professionals are accountable and responsible for their decisions and actions and cannot rely on others to check the accuracy of their calculations. The NMC’s medicines management skills cluster for pre-registration nursing programmes (2010) states that patients can trust registered nurses to undertake medicines calculations correctly and safely. Numeracy skills are required to ensure this and to enable registered nurses to perform the drug calculations required to administer medicines safely via appropriate routes. All branches of nursing must also recognize the specific requirements for children and other groups with regard to medicines’ calculations. Within this chapter we offer some explanations and the chance to practise some calculations. There is an expectation that all pre-registration health care professionals will have at least GCSE mathematics or equivalent, such as the Scottish Certificate of Education, therefore explanations will assume you have this level of knowledge. Universities recognize that some students have real difficulty with numeracy and they make additional support available from local study skill centres. Your personal tutor will have details. One area of frequent confusion is the use of SI units (International System of Units). SI units are units of measurement for example grams, milligrams, or micrograms, which measure weight; and millilitres or litres, which measure volume. When calculating drug doses, make sure that you are aware of the SI unit that is being used, for example, grams or milligrams, litres or millilitres; see Table 8.1 for equivalences of weight and volume.
Algorithmic Puzzles
Authors: Levitin Anany , Levitin Maria
Published: November 2020

While many think of algorithms as specific to computer science, at its core algorithmic thinking is defined by the use of analytical logic to solve problems. This logic extends far beyond the realm of computer science and into the wide and entertaining world of puzzles. In Algorithmic Puzzles, Anany and Maria Levitin use many classic brainteasers as well as newer examples from job interviews with major corporations to show readers how to apply analytical thinking to solve puzzles requiring well-defined procedures. The book's unique collection of puzzles is supplemented with carefully developed tutorials on algorithm design strategies and analysis techniques intended to walk the reader step-by-step through the various approaches to algorithmic problem solving. Mastery of these strategies--exhaustive search, backtracking, and divide-and-conquer, among others--will aid the reader in solving not only the puzzles contained in this book, but also others encountered in interviews, puzzle collections, and throughout everyday life. Each of the 150 puzzles contains hints and solutions, along with commentary on the puzzle's origins and solution methods. The only book of its kind, Algorithmic Puzzles houses puzzles for all skill levels. Readers with only middle school mathematics will develop their algorithmic problem-solving skills through puzzles at the elementary level, while seasoned puzzle solvers will enjoy the challenge of thinking through more difficult puzzles.
Next Steps
Authors: Brown Jeannette
Published: November 2020

This book covers the stories of African American women chemists who entered the field before the civil rights era or shortly thereafter. The women in this book were swimming against the tide. They chose to enter a career in which they were among the first persons of their gender and race. There are many young American women currently active in the profession of chemistry. Young girls are still interested in becoming scientists; however, they still have to fight to make sure they receive a good education in science. This need for good education is discussed in a book titled, Swimming against the Tide: African American Girls and Science Education, by Dr. Sandra L Hanson. Dr. Hanson studied young African American girls in high school and their attitudes toward science, which has traditionally been a male profession. One of Dr. Hanson’s conclusions is that these young girls had never seen a role model, African American women chemists, either in books or in person. She also discovered that the young women were still interested in science, even though they received little encouragement from their teachers. Dr. Hanson found that the parents of the girls encouraged their interest in science, with mothers being their biggest cheerleaders. Dr. Hanson would like to see more science teachers encourage young African American girls to study science. One of the women in this book, Allene Johnson, served as a high school chemistry teacher and made a career both of mentoring science teachers and of encouraging African Americans, both male and female, to enter careers in chemistry. Most of the other women in this book also have mentored women who wanted to become chemists either in academia or in industry. What resources are available to young people if they are interested in chemistry as a career? There are many organizations that are focused on careers in chemistry. The major one is the American Chemical Society (ACS). However, one should first consider this question: What is chemistry? Chemistry is a varied profession.
Male Reproductive Function
Authors: Kovacs William J.
Published: November 2020

The testes are the source of both germ cells and hormones essential for male reproductive function. The production of both sperm and steroid hormones is under complex feedback control by the hypothalamic-pituitary system. The testis consists of a network of tubules for the production and transport of sperm to the excretory ducts and a system of interstitial cells (called Leydig cells) that express the enzymes required for the synthesis of androgens. The spermatogenic or seminiferous tubules are lined by a columnar epithelium composed of the germ cells themselves as well as supporting Sertoli cells surrounded by peritubular tissue made up of collagen, elastic fibers, and myofibrillar cells. Tight junctions between Sertoli cells at a site between the spermatogonia and the primary spermatocyte form a diffusion barrier that divides the testis into two functional compartments, basal and adluminal. The basal compartment consists of the Leydig cells surrounding the tubule, the peritubular tissue, and the outer layer of the tubule containing the spermatogonia. The adluminal compartment consists of the inner two-thirds of the tubules containing primary spermatocytes and germ cells in more advanced stages of development. The base of the Sertoli cell is adjacent to the basement membrane of the spermatogenic tubule, with the inner portion of the cell engulfing the developing germ cells so that spermatogenesis actually takes place within a network of Sertoli cell cytoplasm. The mechanism by which spermatogonia pass through the tight junctions between Sertoli cells to begin spermatogenesis is unknown. The close proximity of the Leydig cell to the Sertoli cell with its embedded germ cells is thought to be critical for normal male reproductive function. The seminiferous tubules empty into a network of ducts termed the rete testis. Sperm are then transported into a single duct, the epididymis. Anatomically, the epididymis can be divided into the caput, the corpus, and the cauda regions. The caput epididymidis consists of 8 to 12 ductuli efferentes, which have a larger lumen tapering to a narrower diameter at the junction of the ductus epididymidis.
Orbital Nerves
Authors: Jordan David , Mawn Louise , Anderson Richard L.
Published: November 2020

The orbit contains a vast array of motor, sensory, sympathetic, and parasympathetic nerve fibers. Some of these fibers can be seen during eyelid or orbital surgery and are often landmarks of one’s location within the orbit. It is important to know the various nerve pathways, appreciate that there might be some individual variation, and preserve these pathways during orbital surgery. The discussion of nerves begins with their superficial brainstem origin, proceeds to their intracranial course, and ends with their intraorbital course and eventual termination. The following nerves enter the orbit: 1. Optic nerve (cranial nerve II). 2. Oculomotor nerve (cranial nerve III). This motor nerve gives fibers to the levator, inferior oblique, and three of the four rectus muscles. It carries parasympathetic fibers destined for the ciliary ganglion. These fibers will eventually synapse in the ciliary ganglion and then travel to the iris sphincter muscles (sphincter pupillae). Sympathetic fibers have also been recently identified in this nerve. 3. Trochlear nerve (cranial nerve IV). This motor nerve distributes fibers to the superior oblique muscle. Sympathetic fibers have recently been identified within this nerve. 4. Trigeminal nerve (cranial nerve V). a. Ophthalmic division (V 1 ) . This sensory division gives fibers to the eyeball (iris, ciliary body, cornea), lacrimal gland, conjunctiva, and eyelids, as well as to the forehead. It also carries sympathetic nerves. b. Maxillary division (V 2 ) . As it enters the orbit, the maxillary division is known as the infraorbital nerve and lies beneath the periorbita. It gives off the zygomatic nerve, which is an important branch carrying parasympathetic and sympathetic fibers to the lacrimal gland. Within the infraorbital canal, alveolar nerves arise and provide sensation to the incisor and canine teeth. The infraorbital nerve provides sensation to the lower eyelid, nose, cheek area, and upper lip. 5. Abducens nerve (cranial nerve VI). This motor nerve goes to the lateral rectus muscle. Sympathetic fibers have recently been identified within this nerve.
What Might Philosophy of Science Look Like If Chemists Built It?
Authors: Hoffmann Roald
Published: November 2020

Implicit in the title might be two presumptions. The first one, that there is (or should be) a single philosophy of science, is not a claim I intend—I do think one should look for a common core, in a way that allows for differences. The second presumption, that philosophy of science, as it is construed today, would be different if it were based on chemistry, is what I wish to examine. And behind that latter supposition is the notion that philosophers of science, their professionalism and good will not impugned, nevertheless are likely to construct their worldview of science based on the sciences they know best. These are usually the sciences that they studied (a) as a part of their general education, or (b) the science they came from, so to speak, if they made their transition to philosophy at some later point in their career. I have not made a rigorous examination of the education of philosophers of science. But my anecdotal feeling is that, for those who entered the profession directly, an exposure to mathematical logic is more likely than to geology or chemistry. And, for many of the philosophers of science who came to their field after an initial scientific career, their scientific expertise was likely to be in the first instance physics, after that biology, and rarely chemistry. I will argue that this matters, for chemistry is different. There are exceptions. In the English-writing community, the most striking one is Michael Polanyi, a very distinguished physical chemist. In the French philosophical community, Pierre Duhem, Emile Meyerson, Gaston Bachelard, and Hélène Metzger had professional chemical backgrounds. Bernadette Bensaude-Vincent has argued convincingly that this background shaped their philosophical outlook, in contrast with the analytic philosophers of their time. In recent times the situation may have changed. A subfield of “philosophy of chemistry” has emerged, with annual meetings and two journals (Foundations of Chemistry, Hyle). The practitioners of this field are more likely to have had substantive experience in chemistry.
How Nice to Be an Outsider
Authors: Hoffmann Roald
Published: November 2020

Every one of my scholarly/literary activities is outside literary studies as such. Yet to a varying degree all that I do is the subject of the amoeboid activities of the field. I also have, in principle, no vested interest in the flow of students into your departments [this was a lecture to an audience in comparative literature], nor do I have to worry about jobs for them, nor the level of remuneration of your sluggers and sometime pinch hitters. It seems to me that given this practical disinterest (reading Burke and Kant) I am ideally situated to make aesthetic judgments if not prognoses of the future of literary studies. Which is the reason, I suppose, that I was asked to do so. But first let me count the ways in which I am marginal. First of all, I am a chemist, of the theoretical subspecies. I have done some good science, even shaped the way that chemists think of the motion of electrons in molecules, and how the electrons determine the shape and reactions of those persistent groupings of atoms we’ve learned to see without seeing. My and my collaborators’ work is divulged, some of my colleagues would say preached, in over 450 scientific articles (our stock in trade, rather than books). Such “texts” have become the subject of a burgeoning field of literary studies of science. But no one would bother with my texts; they are individually unimportant (though what they collectively teach is of value; I think of my articles as chapters in a serialized text, but please don’t tell the editors of the journals in which I publish). And perhaps when I write science I am too self-conscious of the central problem of representation for me to play the role of an innocent native (or his artifacts) awaiting the sage pseudo-anthropo/ sociological investigation of the way I construct knowledge. Also the cognitive, intrascientific background needed to assess my papers is moderately formidable; there is a reason why chemists spend five years in graduate school .
Intraocular Pressure Measurement
Authors: Desai Manishi
Published: November 2020

Intraocular pressure (IOP) measurement is a key test by which patients with glaucoma are clinically monitored. Clinical trials have demonstrated that a reduction in IOP results in a reduction in the risk of progression of glaucoma. Accordingly, measuring IOP with relative accuracy is very important in managing patients. There are multiple methods to measure IOP. The method used may depend on the particular clinical setting. All are surrogate measures in comparison to manometry (i.e., IOP measurement using an intracameral cannula), which is the most direct means to measure IOP. However, manometry is not practical for everyday clinical practice since it is invasive. This overview provides information about currently available methods to measure IOP and how they may be best applied. This section also outlines the advantages and disadvantages involved with these methods. Not all techniques are available to every practitioner, but knowing the principles behind these methods and the limitations should allow clinicians to more carefully interpret and reliably obtain IOP measurements using the techniques at their disposal. Goldmann applanation tonometry (GAT) is considered to be the standard by which IOP is measured for the average patient (i.e., average corneal thickness without apparent corneal abnormalities). GAT is also likely the measurement modality most readily available to practitioners. The Perkins tonometer is a handheld Goldmann applanation device (Fig. 1.1B). This is helpful when measuring IOP in children as it can be used in the upright or supine position and for patients unable to come to the slit lamp. Based on the Imbert-Fick principle
Applanation diameter is 3.06 mm (not the size of the applanation tip, which is larger), so that 1 g of force represents 10 mmHg.
Assumes the eye is a sphere, corneal thickness is estimated to be 0.52 mm, and volume displaced by contact is negligible Instill topical anesthetic and fluorescein dye. Clean tip (see recommended cleaning technique at end of this section). Position patient at slit lamp (for GAT). Set illumination to cobalt blue filter and set force knob/drum to 1 (which corresponds to 10 mmHg).
Trauma and Glaucoma Emergencies
Authors: Badlani Vandana K.
Published: November 2020

• A tear in the anterior face of the ciliary body, with damage to the major arterial circle of the iris, arterial branches to the ciliary body, or veins coursing between the ciliary body and episcleral venous plexus • In most cases, the hyphema clears in a few days, with the red blood cells exiting the eye through the trabecular meshwork • The size of initial hyphema has prognostic significance regarding final visual acuity. • 76% of subtotal hyphemas attain a visual acuity of 20/50 or better, whereas only 35% of total hyphemas attain a visual acuity of 20/50 or better. •Overall in literature: 3.5% to 38% • Scandinavian literature: 2% to 9% • Most studies in urban North American centers: 20% to 30% •Clot lysis and retraction from the traumatized vessel can lead to a rebleed. • Usually between the third and the fifth day Increase in the size of the hyphema, a layer of fresh blood over older blood, and dispersed erythrocytes over the clot once the blood has settled •Ocular hypotony, hypertension, use of aspirin, and African-American race • The incidence of rebleed does not seem to correlate with the size of hyphema. Therefore, the use of medications to prevent rebleed should not depend on the size of hyphema. • Approximately one third of all patients with hyphema have increased IOP. • Obstruction of the trabecular meshwork by erythrocytes and blood products or damage to the trabecular meshwork function • In larger hyphemas, pupillary block by a blood clot can also contribute to increase in IOP. • Peripheral anterior synechiae (PAS) •Persistence of hyphema for more than 1 week can result in the formation of PAS. •Approximately 6% of patients have optic atrophy, exhibited by optic nerve pallor. • Secondary to elevated IOP or optic nerve contusion •The risk of optic atrophy appears to be greater if the IOP is allowed to remain 50 mmHg or more for 5 days or 35 mmHg or more for 7 days in sickle cell-negative patients without prior optic nerve damage. •The incidence of corneal blood staining is between 2% and 11% and is much higher in patients with a total hyphema.
The Ever-Changing Delta
Authors: Bianchi Thomas S.
Published: November 2020

After his visit to Egypt in the year 500 B.C.E., Herodotus compared the triangular shape of the lowland region, where the Nile and sea meet, to the Greek letter Δ, thereby introducing the term delta to the geographic literature. In Chapter 1, we defined a delta as “a discrete shoreline protuberance formed where a river enters an ocean or lake … a broadly lobate shape in plain view narrowing in the direction of the feeding river, and a significant proportion of the deposit … derived from the river.” Coastal deltas are geologic structures that are also subcomponents of an estuary, which is commonly defined as a semienclosed body of water, situated at the interface between the land and ocean, where seawater is measurably diluted by the inflow of fresh water. James Syvitski, a world-renowned expert on deltas, describes how a delta’s area can be defined as “1) the seaward prograding [building outward] land area that has accumulated since 6,000 years, when global sea level stabilized a few meters of present level, 2) the seaward area of a river valley after the main stem of a river splits into distributary channels, 3) the area of a river valley underlain by Holocene marine sediment, 4) accumulated river sedi¬ment that has variably been subjected to fluvial, wave, and tidal influences, 5) the area drained by river distributary channels that are under the influence of tide, or 6) any combination of these definitions.” These delta-front estuaries, hereafter referred to as deltas, are dynamic ecosystems that have some of the highest biotic diversity and production in the world. Consequently, an estimated 25% of the world’s population lives in environments that are coastal deltas and their associated estuaries/ wetlands. Deltas provide not only a direct resource for commercially important estuarine species of fishes and shellfish but also shelter and food resources for commercially important shelf species that spend some of their life stages in estuarine marshes. For example, high fish and shellfish production in the northern Gulf of Mexico is strongly linked with discharge from the Mississippi and Atchafalaya river delta complexes and their associated estuarine wetlands.
Saving the Deltas
Authors: Bianchi Thomas S.
Published: November 2020

Coastal deltas occupy only 1% of Earth’s land surface, yet they are home to 500 million people; this translates to a population density that is 10 times the world average. More amazing, these people all live within only 5 m of sea level! The importance of deltas for global agriculture cannot be overstated, as they are the “rice bowls” of the world, providing one of the major food staples for human populations. Unfortunately, many of these systems are threatened by sea-level rise and flooding in the future. In fact, most coastal plains around the world less than 1 m above sea level are under the threat of being drowned within the next century, something that has not happened at this rate over the past 7,000 years. This means that major cities like Shanghai, Dhaka, and Bangkok are currently threatened and, in most cases, have no viable plan to deal with this threat. A concrete scientific plan is needed to manage and sustain these dynamic systems, or many will be lost. Although the effects of climate change on coastal regions and issues of management response have been topics of concern for at least the last 20 years, other human drivers of environmental change that are specific to certain regions, primarily linked with population expansion, have made it difficult to develop comprehensive plans for coastlines. The northern portion of the Nile River Delta, whose fertile soil allowed Egypt to become one of the cradles of civilization, is tilting and sinking toward the Mediterranean Sea at an alarming rate. In the northeastern part of the delta, near the Suez Canal, the land is sinking by as much as 0.5 cm/yr. Recent studies show that the weight of river sediments accumulated over the centuries has resulted in enhanced subsidence of deltaic sediments. Subsidence is an inherent problem in all delta systems because of the high accumulation of sediments, which over time continue to settle, resulting in compaction and dewatering of these thick mud layers.
Enantioselective Construction of Alkylated Stereogenic Centers
Authors: Taber Douglass
Published: November 2020

Carsten Bolm of RWTH Aachen developed (Angew. Chem. Int. Ed. 2008, 47, 8920) an Ir catalyst that effected hydrogenation of trisubstituted enones such as 1 with high ee. Benjamin List of the Max-Planck-Institut Mülheim devised (J. Am. Chem. Soc. 2008, 130, 13862) an organocatalyst for the enantioselective reduction of nitro acrylates such as 3 with the Hantzsch ester 4. Gregory C. Fu of MIT optimized (J. Am. Chem. Soc. 2008, 130, 12645) a Ni catalyst for the enantioselective arylation of propargylic halides such as 6. Both enantiomers of 6 were converted to the single enantiomer of 8. Michael C. Willis of the University of Oxford established (J. Am. Chem. Soc. 2008, 130, 17232) that hydroacylation with a Rh catalyst was selective for one enantiomer of the allene 9, delivering 11 in high ee. Similarly, José Luis García Ruano of the Universidad Autónoma de Madrid found (Angew. Chem. Int. Ed. 2008, 47, 6836) that one enantiomer of racemic 13 reacted selectively with the enantiomerically- pure anion 12, to give 14 in high diastereomeric excess. Ei-chi Negishi of Purdue University described (Organic Lett. 2008, 10, 4311) the Zr-catalyzed asymmetric carboalumination (ZACA reaction) of the alkene 15 to give the useful chiron 16. David W. C. MacMillan of Princeton University developed (Science 2008, 322, 77) an intriguing visible light-powered oxidation-reduction approach to enantioselective aldehyde alkylation. The catalytic chiral secondary amine adds to the aldehyde to form an enamine, that then couples with the radical produced by reduction of the haloester. Two other alkylations were based on readily-available chiral auxiliaries. Philippe Karoyan of the Université Pierre et Marie Curie observed (Tetrahedron Lett . 2008, 49, 4704) that the acylated Oppolzer camphor sultam 20 condensed with the Mannich reagent 21 to give 22 as a single diastereomer. Andrew G. Myers of Harvard University developed the pseudoephedrine chiral auxiliary of 23 to direct the construction of ternary alkylated centers. He has now established (J. Am. Chem. Soc. 2008, 130, 13231) that further alkylation gave 24, having a quaternary alkylated center, in high diastereomeric excess.
The Zakarian Synthesis of ( + )-Pinnatoxin A
Authors: Taber Douglass
Published: November 2020

( + )-Pinnatoxin A 3, isolated from the shellfish Pinna muricata, is thought to be a calcium channel activator. A key transformation in the synthesis of 3 reported (J. Am. Chem. Soc . 2008, 130, 3774) by Armen Zakarian, now at the University of California, Santa Barbara, was the diastereoselective Claisen rearrangement of 1 to 2. The alcohol portion of ester 1 was derived from the aldehyde 4, prepared from D-ribose. The absolute configuration of the secondary allylic alcohol was established by chiral amino alcohol catalyzed addition of diethyl zinc to the unsaturated aldehyde 5. The acid portion of the ester 1 was prepared from (S)-citronellic acid, by way of the Evans imide 7. Methylation proceeded with high diasterocontrol, to give 8. Functional group manipulation provided the imide 9. Alkylation then led to 10, again with high diastereocontrol. In each case, care had to be taken in the further processing of the α-chiral acyl oxazolidinones. Direct NaBH4 reduction of 8 delivered the primary alcohol. To prepare the acid 10, the alkylated acyl oxazolidinone was hydrolyzed with alkaline hydrogen peroxide. On exposure of the ester 1 to the enantiomerically-pure base 11, rearrangement proceeded with high diastereocontrol, to give the acid 2. This outcome suggests that deprotonation proceeded to give the single geometric form of the enolate, that was then trapped to give specifically the ketene silyl acetal 12. This elegant approach is dependent on both the ester 1 and the base 11 being enantiomerically pure. The carbocyclic ring of pinnatoxin A 3 was assembled by intramolecular aldol condensation of the dialdehyde 11. This outcome was remarkable, in that 11 is readily epimerizable, and might also be susceptible to β-elimination. Note that the while the diol corresponding to 11 could be readily oxidized to 11 under Swern conditions, attempts to oxidize the corresponding hydroxy aldehyde were not fruitful.
“Sin Maíz, No Hay País”
Authors: Broughton Chad
Published: November 2020

After Three Years of living in the shadows of the United States, Laura Flora Oliveros returned to Mexico in 2004 to reunite with her daughters and her parents in Tierra Blanca, Veracruz. Erika, her youngest, had just turned five and was now strong enough, Flora hoped, to make the arduous border crossing. If everything worked as planned, Flora’s entire family—four generations of them—would be together in central Florida in a couple of weeks. On her second voyage north, Flora’s intuition told her that something was not right. Flora was attuned to the news of rapes and disappearances of hundreds of female migrants and maquila workers at the border, which a United Nations mission had been investigating. Her three daughters dismissed her concerns and begged her to go through with it. Just before the dusk river crossing, and over the girls’ protests, Flora abandoned the trip, forfeiting, for the second time in three years, all her savings to a coyote. “I felt awful about not making the crossing, but I had a foreboding thought. It frustrated all of my plans. My daughters didn’t sense the danger. They were happy, saying ‘Let’s go, Mom! Let’s go!’ ” Right or not, her decision left Flora, her three girls, and her parents penniless, 1,300 miles from her older children in Florida, José and Deysy, and a new grandchild she had yet to hold. They each had a change of clothing and nothing else, stuck at the border with hundreds of thousands of other migrants, who came mostly from Veracruz. Reynosa had become one of the world’s premier meeting places for southern labor and northern capital, the archetypical neoliberal city. And yet nobody outside of the booming city itself seemed to know about it aside from the Veracruzanos who flowed into its slums. In the decade after the 1994 free trade agreement, rural Mexicans headed north in unprecedented numbers. Much of it was internal to Mexico. The channel from Veracruz to Tamaulipas—Reynosa being the main destination—became the busiest internal pathway in the country.