bluuebunny/crossref_metadata_2025 huggingface dataset:
Laboratory measurements of HDO/H2O isotopic fractionation during ice deposition in simulated cirrus clouds
Authors: Lamb Kara D. , Clouser Benjamin W. , Bolot Maximilien , Sarkozy Laszlo , Ebert Volker , Saathoff Harald , Möhler Ottmar , Moyer Elisabeth J.
Published: May 2017

Significance

The preferential deposition of heavy water (HDO orH218O) as ice is a fundamental tracer in the geosciences, used for understanding paleoclimate and water cycling, but the basic physical chemistry is not well measured. We describe here measurements of the preferential fractionation of HDO vs. H2O at the cold temperatures relevant to cirrus clouds on Earth and snow on Mars. We also provide a quantitative demonstration of kinetic isotope effects in nonequilibrium conditions, and show how targeted dynamic experiments can be used to understand processes at ice surfaces.
High-throughput biochemical profiling reveals sequence determinants of dCas9 off-target binding and unbinding
Authors: Boyle Evan A. , Andreasson Johan O. L. , Chircus Lauren M. , Sternberg Samuel H. , Wu Michelle J. , Guegler Chantal K. , Doudna Jennifer A. , Greenleaf William J.
Published: May 2017

Significance

Cas9, a protein derived from the bacterial CRISPR/Cas9 immune system, relies on a programmable single-guide RNA (sgRNA) to bind specific genomic sequences. Cas9 complexed with sgRNA readily binds on-target DNA, but models that can predict the specificity of this process have proven elusive. To investigate this system from a biophysical perspective, we applied a massively parallel method for profiling protein–DNA interactions to quantify nuclease-dead Cas9 (dCas9) binding across thousands of off-target sequences. We observe that mismatches at certain positions of the guide lead to complex dCas9 dissociation patterns, and multiple mismatches between the gRNA and DNA at nonseed bases can produce substantial changes in observed association and dissociation, suggesting the possibility of kinetic and thermodynamic tuning of Cas9 behavior.
Pride
Authors: Athanasiadou Angeliki
Published: May 2017

The aim of the paper1 is to discuss the linguistic and conceptual devices employed for the expression of the emotion of pride in English and Greek culture. The focus will be (a) on the way the emotion of pride is conceptualized in the two cultures, (b) on the way it is expressed, not only in terms of lexical entities but also in terms of expressions in which the two cognitive processes, metaphor and metonymy, feature, and moreover, how the interplay between them is realized, and (c) on the role of the emotion of pride in the English and Greek cultural framework.
Language rights in the constitutions, organic acts, and statutes of the territories of the United States and the Freely Associated States
Authors: Faingold Eduardo D.
Published: May 2017

The constitutions, organic acts, and statutes of the territories of the United States and the Freely Associated States are given an exhaustive screening to identify legal language defining the linguistic obligations of each territory or associated state and the language rights of individuals and groups dwelling within. The author suggests that the territories of the United States and the Freely Associated States are well served by “hands-on” policies declaring provisions that protect the rights of language minority groups, or of all people living in the territory (i.e., Guam, the Northern Mariana Islands, Puerto Rico, and American Samoa) and associated states (i.e., the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau). As in many states in the United States, the absence of an explicit language policy in the United States Virgin Islands has not prevented it from practicing implicit language policies that promote the use of English while also allowing minority languages to be used in the territory. Unlike many states in the United States which declare English as the sole official language and/or enact provisions to protect official English, none of the territories and associated states of the United States declares English as the sole official language or establishes provisions that hinder the rights of language minority groups.
Teop – an Oceanic language with multifunctional verbs, nouns and adjectives
Authors: Mosel Ulrike
Published: May 2017

The corpus-based analysis of Teop word classes demonstrates that lexical multifunctionality is not incompatible with the grammatical distinction between verbs, nouns, adjectives and adverbs, because this distinction does not manifest itself in their syntactic functions of heads of phrases, but in the kinds of modifier the words can combine with. Consequently, the Teop word class system falsifies all word class typologies that assume that a formal differentiation of event, object and property words presupposes a distinctive distribution across the head positions of determiner-marked referential expressions and TAM-marked predicative expressions. In addition to the multifunctionality of verbs, nouns and adjectives, the Teop lexicon shows regular patterns of conversion. The paper concludes with an assessment of the results and the limitations of the corpus-based approach and suggests four topics for further research: (1) the development of elicitation methods to supplement corpus-based analyses; (2) a typology of formally distinguished phrase types; (3) regular patterns of conversion across languages; and (4) possessive comparative constructions.
Roots and stems in Amis and Nêlêmwa (Austronesian)
Authors: Bril Isabelle
Published: May 2017

In constrast with Nêlêmwa (Oceanic, New Caledonia) whose lexemes are most generally subcategorised as nouns or verbs and undergo category-changing derivations, in Amis (Formosan), roots are pervasively categorially neutral, yet they contain semantic features and instructions that allow or disallow combination with primary derivational affixes which specify their class and category. Lexical categories are expressed after roots are derived into morphosyntactic words projected in a syntactic frame; they are then quite rigidly subcategorised as verbal, nominal or adjectival-modifying heads. Still, word forms display some functional flexibility; for instance, nouns and derived nouns, pronouns, numerals may be predicative in equative, ascriptive and focus constructions, simply by being in the syntactic position of the verb. Such functional flexibility is asymmetrical and does not apply to derived verb stems which must be nominalised to achieve argument function.
Describing spatial layouts as an L2M2 signed language learner
Authors: Ferrara Lindsay , Nilsson Anna-Lena
Published: May 2017

This study explores the L2M2 acquisition of Norwegian Sign Language by hearing adults, with a focus on the production and use of
depicting signs. A group of students and their instructors were asked to respond to prompt questions about directions and
locations in Norwegian Sign Language, and their responses were then compared. An examination of the students’ depicting signs
shows that they struggled more with the phonological parameters orientation and movement, rather than with handshape. In addition,
they used fewer depicting signs than their instructors, and instead relied more on lexical signs. Finally, students were found to
struggle with the coordination of depicting signs within the signing space and in relation to their own bodies. It is hoped that
the findings from this study can be used to inform future research as well as curricula development and pedagogy.
Emerging linguistic features of Sao Tome and Principe Sign Language
Authors: Mineiro Ana , Carmo Patrícia , Caroça Cristina , Moita Mara , Carvalho Sara , Paço João , Zaky Ahmed
Published: May 2017

In Sao Tome and Principe there are approximately five thousand deaf and hard-of-hearing individuals. Until recently, these people had no language to use among them other than basic home signs used only to communicate with their families. With this communication gap in mind, a project was set up to help them come together in a common space in order to create a dedicated environment for a common sign language to emerge.

In less than two years, the first cohort began to sign and to develop a newly emerging sign language – the Sao Tome and Principe Sign Language (LGSTP). Signs were elicited by means of drawings and pictures and recorded from the beginning of the project. The emergent structures of signs in this new language were compared with those reported for other emergent sign languages such as the Al-Sayyid Bedouin Sign Language and the Lengua de Señas de Nicaragua, and several similarities were found at the first stage.

In this preliminary study on the emergence of LGSTP, it was observed that, in its first stage, signs are mostly iconic and exhibit a greater involvement of the articulators and a larger signing space when compared with subsequent stages of LGSTP emergence and with other sign languages. Although holistic signs are the prevalent structure, compounding seems to be emerging. At this stage of emergence, OSV seems to be the predominant syntactic structure of LGSTP. Yet the data suggest that new signers exhibit difficulties in syntactic constructions with two arguments.
Vanishing simplicial volume for certain affine manifolds
Authors: Bucher Michelle , Connell Chris , Lafont Jean-François
Published: May 2017

We show that closed aspherical manifolds supporting an affine structure, whose holonomy map is injective and contains a pure translation, must have vanishing simplicial volume. As a consequence, these manifolds have zero Euler characteristic, satisfying the Chern Conjecture. Along the way, we provide a simple cohomological criterion for aspherical manifolds with normal amenable subgroups of

π
1

\pi _1

to have vanishing simplicial volume. This answers a special case of a question due to Lück.
Explicit formula for the solution of simultaneous Pell equations 𝑥²-(𝑎²-1)𝑦²=1, 𝑦²-𝑏𝑧²=1
Authors: Cipu Mihai
Published: May 2017

For

b
b

an odd integer whose square-free part has at most two prime divisors, it is shown that the equations in the title have a common solution in positive integers precisely when

b
b

divides

4

a
2

−
1

4a^2-1

and the quotient is a perfect square. The proof provides an explicit formula for the common solution, known to be unique. Similar results are obtained assuming the square-free part of

b
b

is even or has three prime divisors.
Triply imprimitive representations of GL(2)
Authors: Schmidt Ralf , Turki Salam
Published: May 2017

We give a criterion for an irreducible, admissible, supercuspidal representation

π
\pi

of

G
L

(
2
,
K
)

\mathrm {GL}(2,K)

, where

K
K

is a

p
p

-adic field, to become a principal series representation under every quadratic base change. We determine all such

π
\pi

that have trivial central character and conductor

2
2

, and explain their relevance for the theory of elliptic curves.
OMTools: a software package for visualizing and processing optical mapping data
Authors: Leung Alden King-Yung , Jin Nana , Yip Kevin Y , Chan Ting-Fung
Published: May 2017

Optical mapping is a molecular technique capturing specific patterns of fluorescent labels along DNA molecules. It has been widely applied in assisted-scaffolding in sequence assemblies, microbial strain typing and detection of structural variations. Various computational methods have been developed to analyze optical mapping data. However, existing tools for processing and visualizing optical map data still have many shortcomings. Here, we present OMTools, an efficient and intuitive data processing and visualization suite to handle and explore large-scale optical mapping profiles. OMTools includes modules for visualization (OMView), data processing and simulation. These modules together form an accessible and convenient pipeline for optical mapping analyses.

Availability and implementation

OMTools is implemented in Java 1.8 and released under a GPL license. OMTools can be downloaded from https://github.com/aldenleung/OMTools and run on any standard desktop computer equipped with a Java virtual machine.

Supplementary information

Supplementary data are available at Bioinformatics online.
Religious Heterogamy and Partnership Quality in Later Life
Authors: Schafer Markus H , Kwon Soyoung
Published: May 2017

Objectives

Prior research points to the importance of couple-level religious similarity for multiple dimensions of partnership quality and stability but few studies have investigated whether this association holds for older couples.

Method

The current article uses dyadic data from the National Social Life, Health, and Aging Project (NSHAP), a representative sample of 953 individuals age 62–91 plus their marital or cohabiting partners. We use modified actor-partner interdependence models.

Results

Religious service heterogamy predicted lower relationship happiness and satisfaction. Both associations were partially explained by the fact that religiously dissimilar partners report relatively little free time in joint activity. Further, religiously heterogamous couples had less frequent sex and engaged in less nonsexual touch than their more similar counterparts.

Conclusions

Taken together, results attest to the ongoing importance of religious similarity—service attendance, in particular—for partnership quality in late life. Future research is needed to more fully examine which mechanisms account for these patterns.
Interface Between Hospital and Outpatient Neurology
Authors: Misulis Karl E. , Baňez Monico Peter
Published: May 2017

Hospital neurology practice offers challenges and opportunities for care of our patients. We must ensure that there is continuity of care between the inpatient and outpatient arenas. We must assure that data returning post-discharge are addressed. And we must ensure that the community physicians, especially PCPs, are in the loop.
Motor and Sensory Disturbance
Authors: Murray E. Lee , Vedanarayanan Veda V.
Published: May 2017

Localization and characterization of motor and sensory deficits is often the first step in establishing a differential diagnosis of a neurologic presentation. This chapter discusses motor and sensory functions and deficits individually and collectively. The emphasis is on disorders commonly encountered in hospital practice.
Approach to Visual Deficits
Authors: Misulis Karl E. , Murray E. Lee
Published: May 2017

The most common visual complaints seen by the hospital neurologist are visual loss, diplopia, papilledema, anisocoria, and ptosis. The differential diagnosis of these and other ocular presentations is discussed.
Neurologic Complications in Surgical Patients
Authors: Murray E. Lee , Misulis Karl E.
Published: May 2017

Neurologic complications in surgical patients can be directly related to surgery, indirectly related to hospitalization, or related to the exacerbation of underlying medical conditions. Presentation and differential diagnosis of some common complications are discussed.
Neurologic Manifestations of Systemic Disease
Authors: Misulis Karl E. , Murray E. Lee
Published: May 2017

The presentation and differential diagnosis of acute neurologic complications of medical diseases were discussed in Chapter 11. In this chapter, the authors discuss selected disorders in greater detail, detailing their presentation, diagnosis, and management.
Brain Death and Persistent Vegetative State
Authors: Misulis Karl E. , Murray E. Lee
Published: May 2017

Neurologists are often asked to consult for determination of brain death or to advise families about prognosis and other aspects of the persistent vegetative state. Criteria for these conditions are discussed along with challenges in discussing them with families.
Seizures and Epilepsy
Authors: Abou-Khalil Bassel W. , Misulis Karl E.
Published: May 2017

Seizure evaluation and management is a core function of the hospital neurologist. Among the issues covered in the chapter are the presentation, diagnosis, and management of epilepsy and, status epilepticus.
Headache
Authors: Murray E. Lee , Misulis Karl E.
Published: May 2017

Most headaches are managed in an outpatient setting; however, patients with severe headache, intractable headache, or headache with atypical features will present to the ED and might be admitted. The chapter details the presentation, diagnosis, and management of common headache syndromes encountered in hospital practice.
Spinal Cord Disorders
Authors: Misulis Karl E. , Murray E. Lee
Published: May 2017

The differential diagnosis of myelopathy is broad and can include almost any of the cardinal mechanisms of disease. This chapter discusses the presentation, diagnosis, and management of common and important conditions that can cause myelopathy.
Psychiatric Disorders
Authors: Misulis Karl E. , Murray E. Lee
Published: May 2017

Neurology consultation in patients with psychiatric conditions is usually related to ruling-out neurologic disease or management of neurologic complications of psychiatric disorders.
A Model for Ethical Problem Solving
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

Chapter 1 begins with a five-step model for analyzing a case posing ethical questions in pharmacy: (1) responding to a “sense” or feeling that something is wrong, (2) gathering information and making an assessment, (3) identifying the ethical problem, (4) seeking a resolution, and (5) working with others to choose a course of action. This five-step model is illustrated by the book’s first case, one involving reporting a possibly lethal medical error. A patient dies after mistakenly being given heparin intended for another patient. The case is followed by commentary applying the model and concluding with possible resolutions of the dilemma. The pharmacist might share the information with all those involved, including the family of the now-deceased patient, or tell only the pharmacist who prepared the drugs. The implications of the ethical principles involved, such as nonmaleficence and veracity, are explored.
Values in Health and Illness
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

Chapter 2 is devoted to identifying value judgments in pharmacy and separating ethical from other evaluations. It first focuses on separating questions of fact from value judgments, focusing on a pair of cases. One involves a woman contemplating use of over-the-counter diet pills, which the pharmacist recognized as containing herbs that might lead to weight loss but could also present significant side effects. Among the claims, the pharmacist discovers a number of value judgments—that the drug should be used on a short-term basis, that certain effects are “bad,” and that it is bad to weigh more than a specified norm. The second case involves the treatment of dental pain and the question of whether pain is a fact or a value judgment. The second half of the chapter distinguishes between ethical and nonethical value judgments. It takes up a case of a patient needing a prescription refill when the prescribing physician is unavailable to authorize it.
What Is the Source of Moral Judgments?
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

This chapter examines the source or “grounding” of ethical duties. Some believe that for professional ethics, the professional association (in the case of pharmacy in the United States, the American Pharmacists Association) is the source, but, at most, the professional group seems to be only the place where ethical duties of pharmacists are identified, and even that claim is controversial. Others claim the source is the orders of the physician or other prescriber of therapy, the hospital’s policy, the patient’s values, or religious or philosophical traditions. This chapter presents cases raising these issues dealing with compounding lethal agents for the execution of criminals, dispensing a potentially lethal opiate, honoring a terminally ill patient’s wishes to refuse an antibiotic, medication errors, an employer’s exclusion of an infertility drug from insurance coverage, and the pharmacist’s right to refuse to dispense oral contraceptives that violate his religious beliefs.
Benefiting the Patient and Others
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

Chapter 4 begins Part II of the book, a series of chapters dealing with basic ethical principles. This chapter takes up the principles that an action of a pharmacist is morally right insofar as it produces benefit and wrong insofar as it produces harm. The names of these principles are beneficence and nonmaleficence. First, considering benefit to the patient, cases deal with the relation of health to other benefits and whether benefits should be assessed on a case-by-case basis. Then the duties of the pharmacist to benefit society, specific nonpatients, the profession, and the pharmacist’s family are considered. The subject matter of the cases includes antihypertensive medication, high-dose chemotherapy, outdated drugs, health maintenance organization cost saving, and the tension between the pharmacist’s duty to the patient and his or her duty to family.
Fidelity
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

In general, a pharmacist who is in an ongoing relationship with a patient has a duty to disclose information. This duty can be attributed to the principle of veracity (truthfulness, honesty, correctness, and accuracy), but it can also be associated with the principle of fidelity, where special duties derive from special relationships. This chapter focuses on situations when the pharmacist is faced with a question invoking the principle of fidelity and with related scenarios involving confidentiality. The different obligations of the principles of veracity and fidelity are explained, confidentiality is defined, and the moral limits of confidentiality are examined. The cases in this chapter describe the explicit and implicit ethics of promises, the promise of confidentiality and the limits on such a promise, and the principle of fidelity in terms of professional obligations and loyalty when dealing with incompetent, impaired, or dishonest colleagues.
Avoidance of Killing
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

Avoidance of killing is a moral consideration that arises in health care controversies involving the notions that human life is sacred or that killing is morally wrong. Pharmacists may find themselves in positions where they must reconcile the idea that generally killing is a harm to be avoided based on the principle of nonmaleficence with the idea that death might be perceived by a particular patient as a beneficial outcome. This chapter explores the principle of avoidance of killing, highlights differences between active, merciful killing and decisions to forgo treatment, and discusses the concept of proportionality. The cases presented involve topics such as withholding treatment and withdrawing treatment and direct versus indirect killing.
Abortion, Sterilization, and Contraception
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

Some of the most consistently debated ethical issues in health care are the moral conflicts regarding abortion, sterilization, and contraception. This chapter asks readers to consider these topics. These areas raise the same general moral themes covered in the field of biomedical ethics but do so in a dramatic and emotionally charged setting. These issues of reproductive ethics also pose a different kind of question: To whom do the basic principles of biomedical ethics apply? Cases in this chapter address the difficult considerations raised in cases of abortion, postcoital contraception following sexual assault, sterilization of the economically deprived, and teaching about birth control.
Genetics, Birth, and the Biological Revolution
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

As new technologies that aid in reproduction develop, new ethical questions emerge in connection with conception, prenatal development, and birth. Pharmacists may find themselves in situations where they need to address ethical controversies surrounding genetic screening, counseling, and gene therapy. This chapter addresses those topics. The authors also examine the soundness of ethical justifications for genetic screening and gene therapy. Cases cover the topics of genetic counseling on ambiguous results, disclosure of unanticipated findings, genetic screening to reduce the incidence of disease, in vitro fertilization, embryo biopsy, surrogacy, and gene therapy and genetic engineering.
Formularies and Drug Distribution Systems
Authors: Veatch Robert M. , Haddad Amy , Last E. J.
Published: May 2017

This chapter focuses on the purpose of formularies and the potential ethical problems or issues that formularies raise. Pharmacists will increasingly find themselves on committees, such as Pharmacy and Therapeutics Committees, that set the standards for formularies used by health system pharmacies and insurers responsible for paying for the cost of pharmaceuticals. Some ethical principles that are relevant to decisions on setting limits on prescribing and dispensing practices include justice, beneficence, and nonmaleficence. Reducing costs overall, which may serve the principle of justice, may threaten the well-being or limit the autonomy of a few. Cases in this chapter deal with these issues as well as the ethical justification for overriding formulary decisions.
Psychotherapy in An Age of Neuroscience
Authors: Paris Joel
Published: May 2017

Psychiatry, once proud of its biopsychosocial model, has now adopted a neuroscience-based approach that strongly favors psychopharmacological treatments and downplays the role of psychotherapies (or social interventions). This kind of practice can be sufficient for the psychoses, but it is neither evidence-based nor beneficial for patients with common mental disorders such as depression, anxiety, substance use, and personality disorders. Current practice derives from a theoretical model in which psychiatry is viewed primarily as an application of neuroscience, with little reference to the vast literature on psychology, social sciences, and psychotherapy. This book reviews research bearing on these issues, and it shows why existing data support a different set of conclusions from those held by many experts and most practitioners. Common mental disorders often require psychological interventions. This book reviews the evidence supporting the prescription of psychotherapy in these disorders. It shows how this option, particularly when time-limited, is both accessible and cost-effective. It discusses why psychiatrists are not offering psychological treatments, as well as the problem of access to these interventions. It also discusses why psychotherapy, like psychopharmacology, should not be considered a panacea for every kind of clinical problem but, rather, should be prescribed with care based on a large body of scientific evidence.
Psychiatry
Authors: Paris Joel
Published: May 2017

Decades ago, the psychiatrist Leon Eisenberg observed that whereas the psychological theories that previously dominated psychiatry were “brainless” (i.e., lacking in grounding in neuroscience), the biological theories that followed them were “mindless” (i.e., reducing all mental phenomena to cellular mechanisms). Eisenberg criticized the concept that mental disorders are nothing but brain disorders, which he viewed as narrowing the scope of psychiatry. This chapter reviews trends in the history of psychiatry that are most relevant to questions of “brainless” and “mindless.” It also shows that the field has often split into two extreme positions, making the middle ground difficult to sustain.
A Young Woman with Jerking Movements
Authors: O’Neal M. Angela
Published: May 2017

The case raises some of the important points to consider when choosing an antiepileptic drug, AED, for women with epilepsy, WWE. The most important factor is to define the epilepsy type, as many AEDs are not efficacious for primary generalized epilepsy. Knowing the interaction of an AED with contraceptives is also vital in order to prevent an unplanned pregnancy. Folate supplementation is recommended to decrease the risk of neural tube defects. It should be initiated at the same time as the prescription for an AED. For women in the reproductive years, the least teratogenic AED that is effective for their epilepsy should be chosen.
A Lady with a Headache in the Second Trimester
Authors: O’Neal M. Angela
Published: May 2017

This case illustrates a typical presentation of idiopathic intracranial hypertension (IIH) during pregnancy. The diagnostic criteria, complications, and treatment of the condition during pregnancy are explored. The major complication of IIH is visual loss. The International Headache Society 2013 criteria for idiopathic intracranial hypertension are: that the headache should remit after the CSF pressure is in the normal range, CSF pressure is greater than 250 mm, and the majority of patients have papilledema and other symptoms, which may include visual obscurations, pulsatile tinnitus, double vision, and neck or back pain. IIH treatment includes weight control, high-volume lumbar punctures, and medications.
A Pregnant Woman with Aphasia and Right-Sided Weakness
Authors: O’Neal M. Angela
Published: May 2017

This chapter discusses the evaluation and management of acute ischemic stroke in pregnancy. Stroke in pregnancy is rare, but is a significant cause of morbidity. The etiologies of stroke in pregnancy are diverse. The most common causes in hospital-based studies are cardioembolic or related to eclampsia. The use of intravenous tissue plasminogen activator (IV tPA) as well as intra-arterial clot retrieval in stroke have been validated by multiple trials. Small case series support the safety of both therapies in pregnancy. Therefore, the management of stroke in pregnancy should be based on the mechanism and severity of the stroke, not on obstetrical issues.
Memory Concerns in Middle Age
Authors: Pasinski Marie
Published: May 2017

This chapter on cognitive concerns in middle age reviews the modifiable risk factors for Alzheimer’s disease and recommends seven lifestyle changes to improve cognitive function and decrease the risk of Alzheimer’s disease and other forms of dementia. Memory concerns and word-finding difficulties in middle age are extremely common, typically benign, and can be improved by lifestyle modification. One-third of Alzheimer’s cases are estimated to be attributable to seven modifiable risk factors, including: diabetes, hypertension, obesity, smoking, depression, cognitive inactivity, and physical inactivity. In addition, sleep disorders are now a recognized risk factor for dementia. Rather than recommending simply performing a workup and reassuring patients that they are fine, this chapter provides guidelines to identify dementia risk factors and empower patients with the knowledge they need to maximize their brain health.
Telemental Health Modalities
Authors: Becker Jessica
Published: May 2017

This chapter reviews the different telemental health modalities from a technical and clinical perspective with regard to utility and challenges in implementation. It discusses the current state of evidence related to these different modalities. The chapter begins with a discussion of the technical basics of videoconferencing-based telemental health (VC-TMH) setup and a brief consideration of other technologies in telemental health such as store-and-forward and mobile health. It addresses the effectiveness of VC-TMH in the United States and internationally, including a discussion of recent data evaluating VC-TMH use. The chapter concludes with a discussion of the challenges facing implementation of telemental health in the United States and internationally, including policy, technical, infrastructure, financial, and patient-safety concerns.
Telemental Health Services for Indigenous Communities in Australia
Authors: Edirippulige Sisira , Bambling Matthew , Fernandez Pablo
Published: May 2017

Telemental health has been recognized as one of the key methods to closing disparities in health indices in the indigenous Australian populations. The conditions in which Australia’s indigenous communities are presently living have also been equated with parts of the world with limited resources. There is a rationale for exploring opportunities for using telemental health and study its effectiveness in this population This chapter discusses the high burden of mental health disorder among the indigenous population, the telemental health initiative to provide mental health services for these isolated communities, and the impact of these initiative on the wellbeing of the recipients. Chapter concludes with barriers to provide these services and potential solutions in the Australian context.
Refugee Telemental Health in Denmark
Authors: Mucic Davor
Published: May 2017

For asylum seekers, refugees, and migrants in Denmark access to mental healthcare is a problem due to lack of clinicians who understand their language, culture, and special needs. It is well known that patients who do not speak the language of respective care providers report feeling discriminated against in clinical settings, whereas communicating with health professionals in a common language is associated with increased trust and confidence. That is probably why “ethnic matching” appears to be the most desirable model used in addressing language barriers and cultural disparities in mental healthcare provision. Since early 2000, a telepsychiatry-based ethnic-matching model has been developed and established in outskirt areas of Denmark through various pilot projects. The aim of this approach was to improve access to scarce, culturally appropriate care providers (i.e., culturally competent, bilingual clinicians) by the use of videoconferencing.
Telemental Health Delivery for Rural Native American Populations in the United States
Authors: Sidhu Shawn S. , Fore Chris , Shore Jay H. , Tansey Erin
Published: May 2017

Telemental Health is a viable treatment model for delivering quality mental health care to Native American communities where the burden of mental health conditions and difficulty accessing care continue. This chapter reviews the available evidence supporting the acceptability and efficacy of Telemental health in Native American groups. While many barriers to the use of Telemental Health in Native communities exist, there are simultaneously many facilitators of this treatment model. Future directions include addressing these barriers, improving collaboration with Native communities, ensuring Telemental Health remains financially viable, and using technology to expand the reach of this treatment modality.
Telemental Health in Latin America and the Caribbean
Authors: Phillip Tammi-Marie
Published: May 2017

This chapter presents an in-depth look at the potential for telemental health within the diverse region of Latin America and the Caribbean. A review of history of mental health and the current needs and limited available services in the Caribbean and Latin America will be provided. The chapter will use the example of, yet primitive, experience of implementing telemedicine or telehealth in the region to infer the potential utility of technological means in bridging the existing mental health gap. Although this mode of treatment has not been implemented yet, horizons for implementation of telemental health are open in this region, as it promises increased access to mental health treatment to those who need it the most. Future steps will have address cost-effectiveness and cultural acceptability unique to this part of the world.
Neurology of Brain Death
Authors: Wijdicks Eelco F.M.
Published: May 2017

The diagnosis of brain death is based on a comprehensive neurological evaluation. First, physicians need to eliminate confounders to the clinical examination. Once excluded, a set of neurological tests and a formal apnea test (to document absent respiratory drive after CO2 challenge) often will suffice. Second, ancillary tests may be needed if some parts of the neurological examination cannot be accurately assessed. This chapter provides a full discussion of the clinical criteria in adults and children and is modeled after the guidelines of the American Academy of Neurology and the 2011 definition of pediatric brain death by a joint task force of the Society of Critical Care Medicine, the American Academy of Pediatrics, and the Child Neurology Society.
The Sacred Act of Healing
Authors: Harrod Molly , Saint Sanjay , Stock Robert W.
Published: May 2017

Attendings treated their patients with respect, empathy, and understanding. Even if their encounters were sometimes brief, attendings spent time getting to know their patients and building rapport. Developing these relationships helped the team plan for the patient’s care both within and outside the hospital. Attendings spent time explaining to patients, without the use of medical jargon, what they were thinking and how they were approaching the patient’s treatment. To the extent they could, they sat down or kneeled when speaking to patients. In order to stave off readmission, attendings not only focused their treatment on what brought the patient into the hospital in the first place, but they also looked for other potential issues that could be addressed while the patient was hospitalized.
Basics of the Law and Legal System
Authors: Schouten Ronald
Published: May 2017

The goal of this book is to help clinicians at all levels of training negotiate the complex legal issues that are an inherent part of modern clinical practice. This chapter provides an introduction to the origins of “law” in its many forms, the structure of the legal system, and fundamental legal principles that are of special relevance to mental health practitioners and that will recur throughout the book. It discusses concepts that are foreign to most clinicians that have a great impact on mental health practice: the adversarial process, sources of laws, constitutional principles, the concept of legal precedents, and the ethics of the legal system.
Clinicians in the Legal System
Authors: Schouten Ronald
Published: May 2017

The first 15 chapters of this book have described, and hopefully simplified, the major legal issues that are inherent in the practice of the mental health professions. However, there are a number of important issues that do not fit neatly into the preceding chapters and do not require a full chapter themselves, but are important to the clinician because they are so common and can cause considerable consternation. These issues, covered in this chapter, include record keeping, requests for release of information in a variety of contexts, patients’ requests for evaluation of fitness to return to work or carry firearms, and testimony at depositions and trials.
Hepato-pancreato-biliary (HPB) surgery
Authors: Agarwal Anil , Borley Neil , McLatchie Greg
Published: May 2017

This chapter on hepato-pancreato-biliary surgery covers the endoscopic retrograde cholangio pancreatogram (ERCP), liver resection, pancreatico-duodenectomy (Whipple’s procedure), and necrosectomy. Steps of surgery for chronic pancreatitis are mentioned, as are the procedures that are carried out for this condition.
Urology
Authors: Agarwal Anil , Borley Neil , McLatchie Greg
Published: May 2017

This chapter on urology describes such operations as circumcision, excision of epididymal cyst, hydrocele repair, suprapubic catheter insertion, operation for testicular torsion, vasectomy, inguinal orchidectomy, transurethral resection of prostate (TURP), transurethral resection of bladder tumour (TURBT), nephrectomy, prostatectomy, pyeloplasty, cystectomy, ileal conduit diversion, penile implant, trans-obturator/transvaginal tape, and cystoplasty. Besides procedures like cystoscopy, percutaneous nephrolithotomy (PCNL), and uretoscopy are described.
First Report of Puccinia coronata var. coronata sensu stricto Infecting Alder Buckthorn in the United States
Authors: Kenaley Shawn C. , Ecker Geoffrey , Bergstrom Gary C.
Published: May 2017

Field symptoms, host distribution, pathogen morphology, and phylogenetic analyses clearly demonstrated that the rust fungus infecting alder buckthorn in Connecticut is Puccinia coronata var. coronata sensu stricto. To our knowledge, this is the first report and confirmation of P. coronata var. coronata s.s. in the United States. Additional collections from purported aecial and telial hosts of P. coronata var. coronata s.s. are necessary to determine its host range, geographic distribution, and incidence within the United States and elsewhere in North America.
The Kinetics of Reversible Hyaluronic Acid Filler Injection Treated With Hyaluronidase
Authors: Juhász Margit L.W. , Levin Melissa K. , Marmur Ellen S.
Published: May 2017

BACKGROUND

Hyaluronidase is an enzyme capable of dissolution of hyaluronic acid (HA). There is a lack of evidence-based research defining time- and concentration-dependent reversal of HA filler using hyaluronidase.

OBJECTIVE

To explore the efficacy of different concentrations of hyaluronidase in digesting commercially available HA-based reversible fillers—Belotero Balance (BEL), Juvederm Ultra XC (JUVXC), Juvederm Ultra Plus (JUVX+), Juvederm Voluma XC (JUVV), Restylane-L (RESL), Restylane Silk (RESS), and Perlane/Restylane Lyft (RESLYFT).

MATERIALS AND METHODS

This was a blinded randomized study involving 15 participants. Participants received HA filler injection into their back, followed by no secondary injection, or injection with normal saline, 20 or 40 units of hyaluronidase. Using a 5-point palpation scale, the degradation of HA filler was monitored over 14 days.

RESULTS

In the authors' study, there is a significant decrease in HA filler degradation using 20 and 40 units of hyaluronidase compared with no secondary injection or normal saline. There is no significant difference in HA filler dissolution when comparing 20 to 40 units of hyaluronidase.

CONCLUSION

Lower concentrations of hyaluronidase may be just as effective as higher concentrations to degrade HA filler in situations where the reversal of cutaneous augmentation with HA filler arises.
Seroprevalence of Hepatitis A Twelve Years After the Implementation of Toddlers’ Vaccination
Authors: Bassal Ravit , Weil Merav , Cohen Daniel , Sofer Danit , Mendelson Ella , Shohat Tamy
Published: May 2017

Background:

In 1999, Israel became the first country to introduce an inactivated hepatitis A vaccine into its national childhood vaccination program. The objective of the present study was to evaluate the seroprevalence of hepatitis A virus antibodies in the Israeli population before and after the introduction of the program.

Methods:

A cross-sectional serosurvey using the National Serum Bank was conducted on 1883 and 2027 serum samples collected before and after introduction of the vaccine, respectively. Serologic tests for the presence of hepatitis A IgG antibodies were performed using an automated enzyme-linked fluorescent assay.

Results:

The age-adjusted seroprevalence rates of hepatitis A virus antibodies before implementation of hepatitis A vaccination program were 47.1% [95% confidence interval (CI): 44.7%–49.5%] among Jews and 82.8% (95% CI: 79.6%–85.9%) among Arabs, increasing 12 years after to 67.4% (95% CI: 64.7%–70.0%) and 88.2% (95% CI: 86.1%–90.2%), respectively.

Conclusions:

The seropositivity rate among Jews and Arabs increased significantly among the cohorts included in the program. However, among Jews, a significant increase in seropositivity was also detected among age groups not included in the vaccination program. The decrease in the incidence of hepatitis A in Israel is a consequence of high vaccine uptake, persistent seropositivity rates after vaccination and the considerable number of people vaccinated beyond the program.
Isolation of Xanthobacter Species and Bordetella trematum in a Patient With Polymicrobial Peritonitis
Authors: Tena Daniel , Medina María José , Sáez-Nieto Juan Antonio
Published: May 2017

We describe a case of peritonitis secondary to perforated appendicitis in which Xanthobacter species and Bordetella trematum were isolated from the peritoneal fluid associated with Klebsiella pneumoniae. Species of the genus Xanthobacter have never been isolated from human samples to date, and human infections caused by B. trematum are very rare. The patient was cured after surgery and treatment with piperacillin/tazobactam and ciprofloxacin. The clinical significance of Xanthobacter species and B. trematum remains unclear in our case. Further studies would be necessary to know the pathogenicity of these bacteria in human infections.
Oritavancin for the Treatment of Daptomycin Nonsusceptible Vancomycin-Resistant Enterococci Osteomyelitis
Authors: Foster Rachel A. , Philavong Kingsavanh Paul , Weissman Sharon , Tang Xiaonan , Bookstaver P. Brandon
Published: May 2017

Vancomycin-resistant enterococci (VRE) are a growing cause of health care–associated infections globally, and limited treatment options exist for invasive VRE infections. Daptomycin is commonly used with modest success in the treatment of deep-seated infections secondary to VRE; however, there is concern for the emergence of daptomycin nonsusceptible VRE, especially during protracted courses, as required in osteomyelitis. We report the clinical and microbiologic success of a once-weekly, 6-week course of oritavancin with therapeutic drug monitoring in the treatment of daptomycin nonsusceptible VRE osteomyelitis secondary to prosthetic hip replacement. Our data suggest favorable pharmacokinetics and no treatment-related adverse events with once-weekly dosing. This report provides compelling information for future studies of prolonged oritavancin regimens in deep-seated infections.
Defining the Hook Region Anatomy of the Guinea Pig Cochlea for Modeling of Inner Ear Surgery
Authors: Lo Jonathon , Sale Phillip , Wijewickrema Sudanthi , Campbell Luke , Eastwood Hayden , O’leary Stephen John
Published: May 2017

Hypothesis:

The aim of this study was to describe the hook region anatomy of the guinea pig cochlea to identify the optimal surgical approach for cochlear implantation and to determine what anatomical structures are at risk.

Background:

Animal studies investigating hearing loss after cochlear implantation surgery are currently constrained by the lack of a reproducible implantation model.

Methods:

Guinea pig cochleae were imaged using thin-sheet laser imaging microscopy. Images were stitched, reconstructed, and segmented for analysis. Insertion vectors were determined by tracing their paths to the outer wall and converting to Cartesian coordinates. Spherical surface and multiplane views were generated to analyze outer wall and radial forces of the insertion vector.

Results:

Thin-sheet laser imaging microscopy enabled quantitative, whole specimen analysis of the soft and bony tissue relationships of the complex cochlear hook region in any desired plane without loss of image quality. Round window or cochleostomy approaches in the anteroinferior plane avoided direct damage to cochlear structures. Cochleostomy approach had large interindividual variability of angular depth and outer wall forces but predictable radial force.

Conclusion:

The guinea pig hook region and lower basal turn have similar structural relationships to humans. Careful cochleostomy placement is essentially for minimizing cochlear trauma and for ensuring a straight insertion vector that successfully advances around the outer wall. Experiments with guinea pigs that control for the surgical approach are likely to provide useful insights into the aetiology and the development of therapies directed at postimplantation hearing loss.