bluuebunny/crossref_metadata_2025 huggingface dataset:
Traction and strain-rate at the base of the lithosphere: an insight into cratonic survival
Authors: Paul Jyotirmoy , Ghosh Attreyee , Conrad Clinton P
Published: February 2019

Cratons are the oldest parts of the lithosphere, some of them surviving since Archean. Their long-term survival has sometimes been attributed to high viscosity and low density. In our study, we use a numerical model to examine how shear tractions exerted by mantle convection work to deform cratons by convective shearing. We find that although tractions at the base of the lithosphere increase with increasing lithosphere thickness, the associated strain-rates decrease. This inverse relationship between stress and strain-rate results from lateral viscosity variations along with the model’s free-slip condition imposed at the Earth’s surface, which enables strain to accumulate along weak zones at plate boundaries. Additionally, we show that resistance to lithosphere deformation by means of convective shearing, which we express as an apparent viscosity, scales with the square of lithosphere thickness. This suggests that the enhanced thickness of the cratons protects them from convective shear and allows them to survive as the least deformed areas of the lithosphere. Indeed, we show that the combination of a smaller asthenospheric viscosity drop and a larger cratonic viscosity, together with the excess thickness of cratons compared to the surrounding lithosphere, can explain their survival since Archean time.
On Non-localization of Eigenvectors of High Girth Graphs
Authors: Ganguly Shirshendu , Srivastava Nikhil
Published: February 2019

We prove improved bounds on how localized an eigenvector of a high girth regular graph can be, and present examples showing that these bounds are close to sharp. This study was initiated by Brooks and Lindenstrauss [6] who relied on the observation that certain suitably normalized averaging operators o nhigh girth graphs are hyper-contractive and can be used to approximate projectors onto the eigenspaces of such graphs. Informally, their delocalization result in the contrapositive states that for any $\varepsilon \in (0,1)$ and positive integer $k,$ if a $(d+1)-$regular graph has an eigenvector that supports $\varepsilon $ fraction of the $\ell _2^2$ mass on a subset of $k$ vertices, then the graph must have a cycle of size $\log _{d}(k)/\varepsilon ^2)$, up to multiplicative universal constants and additive logarithmic terms in $1/\varepsilon $. In this paper, we improve the upper bound to $\log _{d}(k)/\varepsilon $ up to similar logarithmic correction terms; and present a construction showing a lower bound of $\log _d(k)/\varepsilon $ up to multiplicative constants. Our construction is probabilistic and involves gluing together a pair of trees while maintaining high girth as well as control on the eigenvectors and could be of independent interest.
On Automorphisms of Enveloping Algebras
Authors: Tikaradze Akaki
Published: February 2019

Given an algebraic Lie algebra $\mathfrak{g}$ over $\mathbb{C}$, we canonically associate to it a Lie algebra $\mathcal{L}_{\infty }(\mathfrak{g})$ defined over $\mathbb{C}_{\infty }$, the reduction of $\mathbb{C}$ modulo the infinitely large prime, and show that for a class of Lie algebras, $\mathcal{L}_{\infty }(\mathfrak{g})$ is an invariant of the derived category of $\mathfrak{g}$-modules. We give two applications of this construction. First, we show that the bounded derived category of $\mathfrak{g}$-modules determines algebra $\mathfrak{g}$ for a class of Lie algebras. Second, given a semi-simple Lie algebra $\mathfrak{g}$ over $\mathbb{C}$, we construct a canonical homomorphism from the group of automorphisms of the enveloping algebra $\mathfrak{U}\mathfrak{g}$ to the group of Lie algebra automorphisms of $\mathfrak{g}$, such that its kernel does not contain a non-trivial semi-simple automorphism. As a corollary, we obtain that any finite subgroup of automorphisms of $\mathfrak{U}\mathfrak{g}$ is isomorphic to a subgroup of Lie algebra automorphisms of $\mathfrak{g}.$
A Global Meta-analysis of the Prevalence of HIV, Hepatitis C Virus, and Hepatitis B Virus Among People Who Inject Drugs—Do Gender-Based Differences Vary by Country-Level Indicators?
Authors: Leung Janni , Peacock Amy , Colledge Samantha , Grebely Jason , Cunningham Evan B , Hickman Matthew , Vickerman Peter , Stone Jack , Trickey Adam , Dumchev Kostyantyn , Lynskey Michael , Hines Lindsey , Griffiths Paul , Mattick Richard P , Degenhardt Louisa , Larney Sarah
Published: February 2019

Background

Women-specific factors exist that increases vulnerability to drug-related harms from injection drug use, including blood-borne viruses (BBVs), but gender-based differences in BBV prevalence have not been systematically examined.

Methods

We conducted meta-analyses to estimate country, regional, and global prevalence of serologically confirmed human immunodeficiency virus (HIV), hepatitis C virus (HCV; based on detection of anti-HCV antibody), and hepatitis B virus (HBV; based on detection of HBV surface antigen) in people who inject drugs (PWID), by gender. Gender-based differences in the BBV prevalence (calculated as the risk among women relative to the risk among men) were regressed on country-level prevalence and inequality measures (Gender inequality index, Human development index, Gini coefficient, and high, low or middle income of the country).

Results

Gender-based differences varied by countries and regions. HIV prevalence was higher among women than men in sub-Saharan Africa (relative risk [RR], 2.8; 95% confidence interval [CI], 1.8–4.4) and South Asia (RR, 1.7; 95% CI, 1.1–2.7); anti-HCV was lower among women in the Middle East and North Africa (RR, 0.6; 95% CI, .5–.7) and East and Southeast Asia (RR, 0.8; 95% CI, .7–.9). Gender-based differences varied with country-levels of the BBV prevalence in the general population, human development, and income distribution.

Conclusion

HIV was more prevalent in women who inject drugs as compared to their male counterparts in some countries, but there is variation between and within regions. In countries where women are at higher risks, there is a need to develop gender-sensitive harm-reduction services for the particularly marginalized population of women who inject drugs.
Immunotherapy for skin cancer
Authors: Paulson Kelly G , Lahman Miranda C , Chapuis Aude G , Brownell Isaac
Published: February 2019

Among all tumor types, skin cancers are profoundly sensitive to immunotherapy. Indeed, the recently reported response rates for anti-PD-1 (anti-programmed-death 1) therapy for cutaneous malignant melanomas (MM), Merkel cell carcinomas, basal cell carcinomas, cutaneous squamous cell carcinomas and Kaposi sarcomas are all above 40%. This unique immunogenicity renders skin cancers as a paradigm for tumor–immune interactions and is driven by high mutational burdens, over-expressed tumor antigens and/or viral antigens. However, despite the clear demonstration of immunologic cure of skin cancer in some patients, most tumors develop either early (primary) or late (adaptive) resistance to immunotherapy. Resistance mechanisms are complex, and include contributions of tumor cell-intrinsic, T cell and microenvironment factors that have been recently further elucidated with the advent of single-cell technologies. This review will focus on the exciting progress with immunotherapy for skin cancers to date, and also our current understanding of the mechanisms of resistance to immunotherapy.
Assessing randomness in case assignment: the case study of the Brazilian Supreme Court
Authors: Marcondes Diego , Peixoto Cláudia , Stern Julio Michael
Published: February 2019

Sortition, i.e. random appointment for public duty, has been employed by societies throughout the years as a firewall designated to prevent illegitimate interference between parties in a legal case and agents of the legal system. In judicial systems of modern western countries, random procedures are mainly employed to select the jury, the court and/or the judge in charge of judging a legal case. Therefore, these random procedures play an important role in the course of a case, and should comply with some principles, such as transparency and complete auditability. Nevertheless, these principles are neglected by random procedures in some judicial systems, which are performed in secrecy and are not auditable by the involved parties. The assignment of cases in the Brazilian Supreme Court is an example of such a procedure, for it is performed using procedures unknown to the parties involved in the judicial cases. This article presents a review of how sortition has been historically employed by societies and discusses how Mathematical Statistics may be applied to random procedures of the judicial system, as it has been applied for almost a century on clinical trials, for example. A statistical model for assessing randomness in case assignment is proposed and applied to the Brazilian Supreme Court. As final remarks, guidelines for the development of good randomization procedures are outlined.
Obstructive Hydrocephalus
Authors: Baird Lissa C.
Published: February 2019

Obstructive hydrocephalus results from an obstruction of cerebrospinal fluid flow from the ventricular spaces to the subarachnoid space. Imaging findings will demonstrate enlarged ventricular volumes above the location of the obstruction and normal ventricular volumes below. Endoscopic treatment options for obstructive hydrocephalus should be considered when the anatomy is amenable. Preoperative MR imaging of the prepontine and interpeduncular cisterns should be obtained to localize the basilar apex and determine the presence of arachnoid adhesions. An endoscopic third ventriculostomy (ETV) must communicate the ventricular space to the subarachnoid space in order to be successful. When a subarachnoid communication cannot safely be performed with an ETV, a cerebrospinal fluid (CSF) shunt should be considered. The addition of choroid plexus cauterization in children under the age of 2 years will increase the likelihood of a successful ETV.
Unicoronal Synostosis
Authors: Lee Amy , Ellenbogen Richard G.
Published: February 2019

Unicoronal synostosis presents with a characteristic head shape including a palpable ridge over the fused suture, ipsilateral flattening of the frontal bone and bulging of the temporal bone, contralateral bulging of the frontal bone, deviation of the nasal radix to the ipsilateral side, and anterior displacement of the ipsilateral ear. Three-dimensional computed tomography will confirm the diagnosis and demonstrate a Harlequin deformity due to elevation of the sphenoid bone. Genetic testing should be considered to rule out an associated mutation. Surgical correction is necessary to allow for normal cranial and brain growth and alleviate future psychosocial impact. Both open and endoscopic techniques are effective treatments. Close monitoring for air embolism will minimize surgical complication.
Hemispheric Refractory Epilepsy
Authors: Dlouhy Brian J. , Smyth Matthew D.
Published: February 2019

Medically refractory epilepsy occurs when a patient has failed to become seizure-free on 2 antiepileptic medications. Hemispheric epilepsy is diagnosed with multifocal seizure onset occurring in the same cerebral hemisphere. Video EEG, along with imaging studies such as MRI, SPECT, PET, and MEG, may be helpful for further evaluating the seizure semiology and hemispheric physiology. A hemispherectomy or hemispherotomy can be considered if the remaining hemisphere is normal. The individual anatomy of the patient will determine variations on a hemispherotomy, and the falx and anterior cerebral arteries can be used as key landmarks. Hydrocephalus can be an early or late complication, and careful long-term post-operative follow-up should be established.
Moyamoya Disease
Authors: Smith Edward
Published: February 2019

Moyamoya disease is defined by stenosis of the distal intracranial internal carotid arteries up to and including the bifurcation, with segments of the proximal anterior and middle cerebral arteries, dilated basal collateral vessels, and bilateral findings. Detailed assessment with digital subtraction angiography will define the severity of disease (Suzuki stage) and presence of spontaneous transdural collateral vessels from external carotid artery branches. These collateral vessels must be protected during surgical intervention. The surgical goal is to establish a new vascular supply to the areas of the brain at risk for stroke, utilizing vessels from the external carotid circulation. Blood pressure control and avoidance of hyperventilation are key to minimize perioperative stroke risk. Preoperative hydration, ongoing use of aspirin, and good pain control will also minimize surgical complications.
Vein of Galen Malformation
Authors: Baird Lissa C.
Published: February 2019

Vein of Galen malformations consist of multiple arteriovenous fistulas shunting arterial blood into the persistent embryonic prosencephalic vein of Markowski. The mural type are characterized by fewer fistulas and commonly present with progressive hydrocephalus. The choroidal type malformations have more complex and numerous fistulas, have higher flow, and commonly present with severe high-output cardiac failure. Transfemoral transarterial embolization at the fistula sites of the malformation for complete obliteration of arteriovenous shunting is the optimal intervention. An interdisciplinary approach is critical from the time of diagnosis through the post-treatment follow-up period. Sequelae of cardiac failure and end-organ damage may be minimized with early endovascular intervention when indicated and complete embolization when feasible.
Pineal Tumor
Authors: Tomita Tadanori
Published: February 2019

A diagnosis of pineal region tumor requires a thorough history, physical exam, neuroimaging, and tumor markers. A computed tomography (CT) scan may demonstrate pineal calcification engulfed by the tumor or displaced peripherally. Magnetic resonance imaging (MRI) should be carefully evaluated for contrast enhancement patterns and multifocal disease. Hydrocephalus is common and may be the primary cause of the symptoms at presentation. Cerebrospinal tumor markers need to be performed if the physician suspects germ cell tumor. In children, germ cell tumors are a more common tumor pathology than pineal parenchymal tumors. If tumor markers are nondiagnostic, a histologic biopsy is indicated in order to determine appropriate therapeutic modalities. If surgical resection is indicated, an occipital transtentorial or an infratentorial supracerebellar approach may be used, depending on the tumor anatomy and surgeon preference.
Diffuse Brainstem Glioma
Authors: Gupta Nalin
Published: February 2019

Diffuse brainstem glioma commonly presents between the ages of 5–15 years with rapidly progressive cranial neuropathies, ataxia, and weakness. Brainstem gliomas, unlike primary tumors in other brain locations, tend to demonstrate a pathologic-anatomic correlation. Pontine gliomas are usually diffuse, unresectable, and WHO grade IV. Initial imaging studies should include MR scan to assess the tumor and brainstem anatomy, as well as evaluate for the presence of hydrocephalus. Surgical resection of intrinsic pontine gliomas is not indicated. Early decision for biopsy should be made for those tumors with atypical imaging appearances or if tissue is required for participation in a clinical trial. Palliative radiotherapy may be offered, but no treatment has been shown to significantly affect outcome.
Ventricular Shunt Infection
Authors: Sayama Christina
Published: February 2019

Shunt infections are most common within 2 weeks of a shunt intervention; however, they can occur at any time. Shunt infection should be considered in any patient presenting with fever during the post-operative period or redness along the shunt tract. Brain imaging and shunt x-rays should be obtained to evaluate shunt function, and contrast MRI should be obtained to evaluate for intracranial ventriculitis or abscess. Cerebrospinal fluid cultures should be obtained prior to starting antibiotics by performing a shunt tap. Broad spectrum antibiotics should be started, and when infection is confirmed, surgery to remove the shunt components and place an external ventricular drain should be performed in a timely manner. Duration and choice of antibiotic regimen depends on the speciation of the infectious agent.
Undergraduate Education
Authors: Klugman Craig M.
Published: February 2019

In undergraduate education, the health humanities are transforming premedical and pre–health professional education. With a 266% increase in majors, minors, and certificates since 2001, these courses and academic programs are popular. As a result of changing emphases in the MCAT, US and Canadian universities are responding by offering interdisciplinary health curricula that incorporate the social sciences, humanities, and arts. Teaching undergraduate students is different from engaging with medical and graduate students since they tend to be younger and more diverse and bring less background with them. Undergraduates are more open-minded, have more time in their curriculum, and are in the early stages of developing professional identities, all of which are advantageous for introducing the health humanities. This chapter shares several lessons for work with undergraduates including talking about all health professions, not just medicine; not assuming they bring knowledge or skills to the class; offering practical examples; demonstrating role-modeling; encouraging active learning; enforcing accountability; and teaching less material. This chapter presents several sample assignments, such as Gallery and Illness Narrative Ethnography, to demonstrate different pedagogical approaches in working with this population and discusses popular techniques such as hybrid and flipped classes.
The Health Humanities in Nursing Education
Authors: Shirley Jamie , Shannon Sarah
Published: February 2019

Nursing students generally come into entry-level nursing education with a well-developed understanding of emotion as a viable moral resource for responding to the world and to clinical situations. The health humanities can create a space for nursing students to explore not only the range of human emotions they will encounter when faced with the intimacy of health and illness but also their own judgments. Health humanities education can also deepen their critical analysis skills to develop a balanced voice that allows them to fully contribute to all aspects of their patients’ care and to the development of a just and equitable healthcare system. This chapter focuses particularly on strategies to build the skills of critical reading and to broaden students’ moral imagination. Undergraduate nurses benefit from building skills in critical reading—and particularly narrative analysis. While students may be well attuned to what they feel, they can gain insight into why they feel that way—and how the elements of a narrative construct those emotions through close reading and careful analysis. A second goal is to help them expand and develop complexity in their moral imagination as a resource for judgment. Giving students tools to help them slow down and listen well can facilitate their understanding of the positions of others—which in turn can assist them to develop robust positions of their own. Specific classroom strategies for both of these skills are presented.
Moral Imagination and More
Authors: Sharp Melinda A. McGarrah
Published: February 2019

How do I attend to suffering and inspire healing in the complex twenty-first century? Medical humanities and theological education share this question as a matter of life and death. In this chapter, theologian and trained clinical ethicist Melinda McGarrah Sharp describes how narratives can illuminate moral dilemmas relevant to both health humanities education and theological education. Drawing on her training as a bioethicist and practical theologian and her teaching experiences in theological education, McGarrah Sharp frames pedagogical insights by philosophies of teaching and learning moral imagination as a significant way in to moral conundrums surrounding both suffering and healing today.
Medical Education and the Challenge of Race
Authors: Hoberman John
Published: February 2019

Medical curricula in the United States have never addressed the racial dimension of American medicine in an adequate, let alone systematic, way. Medical schools have instead marginalized race and ethnicity as unnecessary for medical education. This chapter argues that medical students should understand the breadth and depth of the health crises in American minority communities. Many medical schools have implemented so-called cultural competency courses that are supposed to improve the interracial and cross-cultural medical relationships future doctors will have with their patients. The consensus is that this type of instruction has proven to be inadequate to its task. In fact, much “cultural competency” instruction actually excludes the examination of black–white relationships and other cross-cultural encounters and the racial scenarios that arise in medical settings. Medical students should be informed about the ways in which cross-racial relationships (doctor–patient and doctor–doctor) can go wrong and have dysfunctional effects on medical treatment. In addition, these often superficial, episodic, and underfunded activities tend to focus on patient behaviors while leaving unexamined the racial belief systems of medical students and doctors. The chapter offers two strategies for pedagogy to address these issues: interpersonal relations within the medical culture and the racial dimension of diagnoses and treatments within the medical subdisciplines that medical students study. Medical students should be aware of these habits of thought and how they can affect the diagnosis and treatment of minority patients. The chapter ends by describing the author’s initial course offering on the topic.
The Power of Black Patients’ Testimonies When Teaching Medical Racism
Authors: Ray Keisha
Published: February 2019

Finding comprehensive texts that help instructors teach the relationship between race and medicine can be difficult. If medical education texts do include a discussion of race, it typically recounts some historical and famous cases of racially motivated abuse, such as the “Tuskegee Study of Untreated Syphilis in the Negro Male,” but not much else. After years of using medical education textbooks in courses, the author began to reflect on the message that textbooks’ handling of race must send to bioethics and medical humanities students. Given how little attention these textbooks give to race, a student could easily receive the mistaken message that racist treatment of black patients is a thing of the past or that racism in medicine must be insignificant and infrequent. When teaching medical racism, historical cases of unethical treatment of black patients should be supplanted with recent testimonials from black patients, to put a contemporary face on the topic. This is an effective way to teach medical racism either to students who will have interactions with patients or to current medical practitioners. The chapter includes an exercise on the feminist concept of intersectionality to discuss the many social and cultural categories, other than just race, that we all occupy to help students learn to see black patients as more than just a skin color.
Pedagogy at the Borderlands
Authors: DasGupta Sayantani
Published: February 2019

Teaching and learning are fundamentally political acts. This is no less true in health humanities classes than in any other. Teaching and learning are predicated on intersubjective meaning-making between not only listener and teller but also professor and student, and what happens in the health humanities classroom is a parallel process to what happens in the clinic, modeling the sorts of relationships that can happen there between professional and patient. However, health humanities must recognize that it is not enough simply to read stories with medical students or have nurses write and share narratives together: this work must be done with careful attention to power and privilege, for power and privilege operate not only in our decisions about what texts to read and write together but also in the relational texts we live, breathe, and create in our classrooms and workshop spaces. Without recognizing and addressing this, humanities work in healthcare risks replicating the self-same hierarchical, oppressive power dynamics of traditional medicine that the field is designed to address. Teaching health humanities from the borderlands implies embracing marginality even as we seek spaces beyond the oppressive binaries of borders themselves. This essay explores why health humanities pedagogy needs diasporic and cultural studies—and how teaching can help students, colleagues, and the teachers themselves recover oppositional histories of embodiment and health.
Who’s Teaching Whom? Disability and Deaf Studies Approaches to the Health Humanities
Authors: Garden Rebecca
Published: February 2019

This chapter contributes to health humanities pedagogy by addressing the social and structural dimensions of health and healthcare through the theories and practices of disability studies. It begins by discussing the role of disability studies in health humanities approaches to social and structural determinants of health, as well as the sometimes vexed relationship between the two fields. It discusses shared commitments to the pedagogical use of narrative and provides a case study of inclusive education in practice. This chapter represents disability studies critiques of health humanities as welcome challenges to deepen its pedagogy and practices. It also maps out arguments for and some basic approaches to access in the classroom, describing pedagogy that is accountable to the claims of disability justice in practice as well as theory.
Introducing Climate Change to Medical Students
Authors: Kline David , Cole Thomas R. , Pacheco Susan
Published: February 2019

This chapter discusses using a broad humanities perspective to teach medical students about climate change. It argues that the humanities can recover a more robust approach to bioethics and serve as a bridge between students’ professional training and their own spiritual and moral convictions. The chapter describes a short elective course taught to first- and second-year students at the McGovern Medical School at the University of Texas Health Science Center in Houston. It concludes with a class exercise in which students read the Physician Charter and write a short paper that takes one commitment from the charter and applies it to climate change.
Queer Bioethics for Everyday Medical Technologies
Authors: Moesch Jarah
Published: February 2019

Multimodal tools and systems form the foundations of knowledge: the design of the tools, systems, and databases used everyday form what is known and how it is known. The health humanities can be energized by integrating a humanities-based approach to these tools so as to help students understand the politics such systems enact. In this chapter, the author presents a how-to guide for incorporating technologies as critical bioethical method into course pedagogy, including a short syllabus. The essay is oriented, in other words, to help those with little background in multimodal methods use it in their courses in a way that goes beyond only the instrumental. It articulates how to use such methods as critical inquiry about tools and systems themselves, by centering its example in the intersections between queer theory, critical media studies, and bioethical knowledges.
Music, Music Therapy, Disability Studies, Bioethics, and Health Humanities
Authors: Lubet Alex
Published: February 2019

This essay describes two disability-related courses—Disability Ethics and Music, Disability, and Society—which have become de facto requirements (one or both courses) for graduate students in music therapy. Music therapists comprise much of the majority of students in these courses who come from healthcare fields. This essay contemplates, in Disability Ethics, the roles of music/musicians/music therapists in bioethics and the role of bioethics in music therapy. In Music, Disability, and Society, students learn that music-making—presumably a talent or hyperability—offers a uniquely valuable perspective on disability. Disability Ethics proposes that mainstream bioethics takes too narrow a view of its potential reach. It marginalizes those professionals beyond doctors, nurses, policymakers, and administrators, such as health workers and other practitioners in mind–body praxis—including, for example, music teachers—who might benefit from its teachings, methods, and research and who at the same time themselves might have a beneficial impact on those teachings and methods. Music, Disability, and Society proposes that, through contemplating the place of talent in culture, the socially constructed aspects of disability are illuminated.
Using Podcasts in Health Humanities Education
Authors: Carlin Nathan
Published: February 2019

The discussion of cases in bioethics education—especially clinical ethics education in medical schools—has been the leading pedagogical strategy for several decades. There are good reasons for this. One is that because time spent on bioethics education in health professional schools is limited, students need to be introduced to key issues quickly. Cases accomplish this, with the added benefit that this pedagogical approach is structurally similar to the teaching of other clinical topics (e.g., morbidity and mortality rounds, team-based learning classes, and standardized patient encounters). Another is that the dominant theoretical approach to teaching bioethics is principlism, which involves the application of principles to scenarios in clinical ethics, research ethics, public health ethics, etc. Sometimes the discussion of cases centers on “classic cases,” such as that of Karen Ann Quinlan or of Terri Schiavo. Other times the discussion of cases entails focusing on short, fabricated, and specialty-related vignettes in, for example, psychiatric ethics. But a problem with case-based approaches is that the presentation of these cases often seems too “thin,” and therefore the discussion of the issues raised by a given case may be superficial. Thus, other pedagogical approaches in health professional education have emerged in recent years, narrative medicine being one of the most prominent. In this chapter, a new approach will be introduced: using podcasts in health humanities education. This approach retains the advantages of using cases but adds the advantages of narrative approaches.
Disorders of consciousness, memory, and will
Authors: Glannon Walter
Published: February 2019

This chapter examines major psychiatric disorders as disorders of consciousness, memory, and will. All of these disorders involve disturbances in how the brain processes and integrates information about the body and external world. Distorted mental content in these psychopathologies impairs the capacity to consider different action plans, and to form and execute particular plans in particular actions. Dysfunctional mental states correlating with dysfunctional neural states impair the capacity for flexible behavior and adaptability to the environment. This dysfunction also impairs the capacity for insight into a psychiatric disorder and understanding the need for and motivation to seek treatment.
Neuromodulation: Control, identity, and justice
Authors: Glannon Walter
Published: February 2019

This chapter addresses concerns that people with devices in their brains regulating neural and mental functions are not in control of their thoughts and actions. It defends the view that, by restoring motor and mental capacities, deep brain stimulation enables autonomous agency that has been impaired or undermined by a psychiatric disorder. There is shared control between the person and the device. Neuromodulation does not necessarily cause substantial changes in a person’s mental states and alter her identity. Rather than disrupting psychological connectedness and continuity, deep brain stimulation and other techniques can re-establish these relations and return the patient to her premorbid self. In some cases, symptom relief may result in significant personality changes. The chapter also considers social justice issues regarding access to neuromodulating devices.
Eluned Woodford-Williams
Authors: Ayeni Itunuayo V.
Published: February 2019

This chapter presents a profile of Eluned Woodford-Williams. Dr Woodford-Williams pioneered a holistic approach to caring for older people, and worked at the interface of geriatric medicine and old age psychiatry. She implemented age-based admittance of all patients over 65 years, irrespective of needs, for comprehensive geriatric assessment, and taught that the reintegration of mental health social workers into healthcare was crucial for elderly patients.
The Art of Listening
Authors: Wills Emily
Published: February 2019

This chapter presents a poem entitled ‘The Art of Listening’.
Respiratory emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter discusses respiratory emergencies, including pneumonia (acute, Mycoplasma, Legionella, viral, Chlamydia), psittacosis, acute asthma, acute severe asthma, mild to moderate asthmatic attacks, acute exacerbation of chronic obstructive pulmonary disease (COPD), respiratory failure, adult respiratory distress syndrome, pneumothorax (acute, tension), haemoptysis, pleural effusions, chronic massive effusion, empyema, and acute upper airway obstruction.
Gastroenterological emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter describes gastroenterological emergencies, including acute upper gastrointestinal (GI) bleeding, peptic ulcer disease, erosive gastritis/oesophagitis, variceal haemorrhage, Mallory–Weiss tear, gastroenteritis (acute, bacterial, viral), Clostridium difficile, giardiasis, travellers’ diarrhoea, bloody diarrhoea, dysentery (bacterial, amoebic), inflammatory bowel disease (IBD), jaundice, hepatitis (viral, alcoholic, drug-induced, autoimmune), acholuric jaundice, sepsis, ischaemic hepatitis, obstructive jaundice, gallstone disease, acute cholecystitis, biliary obstruction, ascites, acute liver failure, ‘acute-on-chronic’ liver failure, hepatic encephalopathy, liver abscesses, and acute pancreatitis.
Shock
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter explores shock in acute medicine, including assessment and management of shock, sepsis syndrome and septic shock, toxic shock syndrome, anaphylaxis, lactic acidosis, haemodynamic calculations, understanding circulatory failure, inotrope support, and sodium bicarbonate.
Diabetes and endocrine emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter describes diabetes and endocrine emergencies, including diabetic ketoacidosis (DKA; assessment, management, complications), hyperosmolar non-ketotic coma (HONK), hypoglycaemic coma, urgent surgery in patients with diabetes, diabetic foot complications, hyponatraemia, hypernatraemia, acute hypocalcaemia, hypercalcaemia, hypophosphataemia, Addisonian crisis, myxoedema coma, thyrotoxic crisis, pituitary apoplexy, hypopituitary coma, phaeochromocytomas, polyuria, malignant hyperthermia, and neuroleptic malignant syndrome.
Haematological emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter discusses haematological emergencies, including blood transfusion reactions, sickle-cell crisis, bleeding disorders, abnormal coagulation, circulating inhibitors of coagulation, abnormal platelets, anticoagulant therapy, bleeding with fibrinolytic therapy, bleeding in liver disease, bleeding in uraemia, massive transfusion/cardiopulmonary bypass, haemophilia and related disorders, combined thrombotic and haemorrhagic disorders, disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP) and haemolytic uraemic syndrome (HUS), microangiopathic haemolytic anaemia, heparin-associated thrombocytopenia, acute leukaemias, early complications of bone marrow transplantation (BMT), the febrile neutropenic patient, infections in the transplant patient, cytomegalovirus (CMV) infections in transplant patients, hyperviscosity syndrome, tumour lysis syndrome, hypercalcaemia of malignancy, superior vena cava obstruction, and massive mediastinal mass.
Psychiatric emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter outlines psychiatric emergencies, including acute confusion (assessment, management), rapid tranquillization, acute alcohol withdrawal, neuroleptic malignant syndrome, dealing with violent patients, deliberate self-harm, the Mental Health Act, treating patients without their consent, the Mental Capacity Act, the law on consent and capacity, treating patients who do not wish to stay in hospital, detaining a patient in an emergency, and mentally ill patients in hospital.
Practical procedures
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter discusses practical procedures in acute medicine, including arterial blood sampling, arterial line insertion, central line insertion, internal jugular vein cannulation, subclavian vein cannulation, ultrasound (US)-guided central venous catheterization, pulmonary artery catheterization, temporary cardiac pacing (ventricular pacing, atrial pacing, complications), pericardial aspiration, DC cardioversion, intra-aortic balloon counterpulsation, principles of respiratory support, mechanical ventilation, nasal ventilation, positive pressure ventilation, percutaneous cricothyrotomy, endotracheal intubation, aspiration of a pneumothorax, aspiration of a pleural effusion, insertion of a chest drain, ascitic tap (paracentesis), total paracentesis, insertion of a Sengstaken–Blakemore tube, percutaneous liver biopsy, transjugular liver biopsy, transjugular intrahepatic portosystemic shunt (TIPS), peritoneal dialysis, intermittent haemodialysis, plasmapheresis, renal biopsy, pH determination, joint aspiration, lumbar puncture, and needle-stick injuries.
Differential diagnosis of common presentations
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter explores the differential diagnosis of common presentations, including abdominal pain and distension, back pain, blackouts and collapse, breathlessness and dyspnoea, chest pain, confusion, constipation, cough, cutaneous manifestations of internal malignancy, diarrhoea, dysphagia, falls, fever, fits and seizures, haematemesis and melaena, haematuria, haemoptysis, headache, hemiparesis, hoarseness, itching and pruritus, joint pain and swelling, leg swelling, muscle weakness, nausea and vomiting, palpitations, tremor, unconsciousness and reduced consciousness, weak legs, and wheeze.
Acute medicine and the older patient
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir H.
Published: February 2019

This chapter discusses the older patient on the acute unit, including how to assess the older patient, assessing frailty, the comprehensive geriatric assessment (CGA), falls and collapse, fragility fractures, acute confusion syndrome (ACS), and palliative care and advance care planning.
Oxford Case Histories in Lung Cancer
Authors: Makker Himender K. , Ainley Adam , Popat Sanjay , Singer Julian , Hayward Martin , Hagena Antke
Published: February 2019

Oxford Case Histories in Lung Cancer contains 40 well-structured cases from clinical practice that give a comprehensive coverage of both commonly faced situations in clinical practice and incidents that pose particular challenges. Split into five sections, covering epidemiology, medical and clinical oncology, thoracic surgery, and palliative care, each case comprises a brief clinical history with relevant clinical examination findings. Questions are based on clinical investigations and aspects of management. Detailed answers follow, based on the best available evidence from the latest research, systematic reviews, meta-analyses, and guidelines. The resource is illustrated with over 75 pictures and diagrams.
Lung cancer in a 53 year old smoker
Authors: Ainley Adam , Gillibrand Rebecca , Makker Himender
Published: February 2019

This case study looks at Lung cancer in a 53 year old smoker, and provides questions with model answers.
Late recurrence or second primary lung cancer?
Authors: Ainley Adam , Makker Himender
Published: February 2019

This case study looks at Late recurrence or second primary lung cancer, and provides questions with model answers.
Endobronchial tumour in a smoker with a history of lymphoma
Authors: Ainley Adam , Sheinman Bryan , Makker Himender
Published: February 2019

This case study looks at Endobronchial tumour in a smoker with history of lymphoma, and provides questions with model answers.
Progressive breathlessness associated with a right-sided pleural effusion
Authors: Ainley Adam , Makker Himender
Published: February 2019

This case study looks at Progressive breathlessness associated with a right sided pleural effusion, and provides questions with model answers.
Pericardial and pleural effusions in a smoker with metastatic adenocarcinoma
Authors: Ainley Adam , Gillibrand Rebecca , Makker Himender
Published: February 2019

This case study looks at Pericardial and pleural effusions in a smoker with metastatic adenocarcinoma, and provides questions with model answers.
Right lower lobe squamous cell carcinoma associated with hilar and mediastinal lymphadenopathy
Authors: Ainley Adam , Sheinman Bryan , Makker Himender
Published: February 2019

This case study looks at Right lower lobe squamous cell carcinoma associated with hilar and mediastinal lymphadenopathy, and provides questions with model answers.
Metastatic small-cell cancer presenting with haemoptysis and left upper lobe collapse, treated with chemotherapy
Authors: Juan Oscar , Popat Sanjay
Published: February 2019

This case study looks at Metastatic small cell cancer presenting with haemoptysis and left upper lobe collapse, treated with chemotherapy, and provides questions with model answers.
Adenocarcinoma identified to be EGFR mutation positive
Authors: Juan Oscar , Popat Sanjay
Published: February 2019

This case study looks at Adenocarcinoma identified to be EGFR mutation positive, and provides questions with model answers.
Relapsed stage IV adenocarcinoma with insufficient material for genotyping at diagnosis
Authors: Tokaca Nadza , Popat Sanjay
Published: February 2019

This case study looks at Relapsed stage 4 adenocarcinoma with insufficient material for genotyping at diagnosis , and provides questions with model answers.
Squamous cell carcinoma of the lung in a patient with previous breast cancer
Authors: Gennatas Spyros , Popat Sanjay
Published: February 2019

This case study looks at Squamous cell carcinoma (SCC) of the lung in a patient with previous breast cancer, and provides questions with model answers.
Malignant pleural mesothelioma
Authors: Gennatas Spyros , Popat Sanjay
Published: February 2019

This case study looks at Malignant pleural mesothelioma (MPM), and provides questions with model answers.
A 76 year old female with an oligometastatic stage IV squamous cell carcinoma who developed diarrhoea on treatment with immune checkpoint inhibitors
Authors: Januszewski Adam , Popat Sanjay
Published: February 2019

This case study looks at A 76 year old with oligometastatic stage IV squamous cell carcinoma who developed diarrhea on treatment with immune checkpoint inhibitors, and provides questions with model answers.
Superior vena cava obstruction due to lung cancer
Authors: Ho Andrew , Singer Julian
Published: February 2019

This case study looks at Superior vena cava obstruction (SVCO) due to lung cancer, and provides questions with model answers.
Pancoast tumour
Authors: Sritharan Kobika , Singer Julian
Published: February 2019

This case study looks at Pancoast tumour , and provides questions with model answers.
High-dose palliative radiotherapy
Authors: Sritharan Kobika , Singer Julian
Published: February 2019

This case study looks at High dose palliative radiotherapy, and provides questions with model answers.
A patient with T2N1M0 squamous cell carcinoma
Authors: Hayward Martin , Mitsos Sofoklis
Published: February 2019

This case study looks at A patient with T2N1M0 squamous cell carcinoma, and provides questions with model answers.
Long-term complications of thoracotomy: chest wall paraesthesia and neuralgic chest pain
Authors: Hayward Martin , Mitsos Sofoklis
Published: February 2019

This case study looks at Long term complications of thoracotomy- chest wall paraesthesia and neuralgic chest pain , and provides questions with model answers.
Postoperative care of a 60 year old male with squamous cell carcinoma with severe COPD and no other comorbidities
Authors: Hayward Martin , Patrini Davide
Published: February 2019

This case study looks at Postoperative care of 60 year old man with Squamous cell carcinoma but with severe COPD and no other co-morbidities, and provides questions with model answers.
A former builder with pleural effusions secondary to mesothelioma
Authors: Hagena Antke
Published: February 2019

This case study looks at Case of Ex-Builder with pleural effusions secondary to mesothelioma, and provides questions with model answers.
Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines, Executive Summary
Authors: Kochanek Patrick M , Tasker Robert C , Carney Nancy , Totten Annette M , Adelson P David , Selden Nathan R , Davis-O’Reilly Cynthia , Hart Erica L , Bell Michael J , Bratton Susan L , Grant Gerald A , Kissoon Niranjan , Reuter-Rice Karin E , Vavilala Monica S , Wainwright Mark S
Published: February 2019

The purpose of this work is to identify and synthesize research produced since the second edition of these Guidelines was published and incorporate new results into revised evidence-based recommendations for the treatment of severe traumatic brain injury in pediatric patients. This document provides an overview of our process, lists the new research added, and includes the revised recommendations. Recommendations are only provided when there is supporting evidence. This update includes 22 recommendations, 9 are new or revised from previous editions. New recommendations on neuroimaging, hyperosmolar therapy, analgesics and sedatives, seizure prophylaxis, temperature control/hypothermia, and nutrition are provided. None are level I, 3 are level II, and 19 are level III. The Clinical Investigators responsible for these Guidelines also created a companion algorithm that supplements the recommendations with expert consensus where evidence is not available and organizes possible interventions into first and second tier utilization. The complete guideline document and supplemental appendices are available electronically (https://doi.org/10.1097/PCC.0000000000001735). The online documents contain summaries and evaluations of all the studies considered, including those from prior editions, and more detailed information on our methodology. New level II and level III evidence-based recommendations and an algorithm provide additional guidance for the development of local protocols to treat pediatric patients with severe traumatic brain injury. Our intention is to identify and institute a sustainable process to update these Guidelines as new evidence becomes available.