bluuebunny/crossref_metadata_2025 huggingface dataset:
Language Without Speech: Segregating Distinct Circuits in the Human Brain
Authors: Finkl Theresa , Hahne Anja , Friederici Angela D , Gerber Johannes , Mürbe Dirk , Anwander Alfred
Published: May 2019

Language is a fundamental part of human cognition. The question of whether language is processed independently of speech, however, is still heavily discussed. The absence of speech in deaf signers offers the opportunity to disentangle language from speech in the human brain. Using probabilistic tractography, we compared brain structural connectivity of adult deaf signers who had learned sign language early in life to that of matched hearing controls. Quantitative comparison of the connectivity profiles revealed that the core language tracts did not differ between signers and controls, confirming that language is independent of speech. In contrast, pathways involved in the production and perception of speech displayed lower connectivity in deaf signers compared to hearing controls. These differences were located in tracts towards the left pre-supplementary motor area and the thalamus when seeding in Broca’s area, and in ipsilateral parietal areas and the precuneus with seeds in left posterior temporal regions. Furthermore, the interhemispheric connectivity between the auditory cortices was lower in the deaf than in the hearing group, underlining the importance of the transcallosal connection for early auditory processes. The present results provide evidence for a functional segregation of the neural pathways for language and speech.
Integrating physiological data with the conservation and management of fishes: a meta-analytical review using the threatened green sturgeon (Acipenser medirostris)
Authors: Rodgers Essie M , Poletto Jamilynn B , Gomez Isaza Daniel F , Van Eenennaam Joel P , Connon Richard E , Todgham Anne E , Seesholtz Alicia , Heublein Joe C , Cech Joseph J , Kelly John T , Fangue Nann A
Published: May 2019

Reversing global declines in the abundance and diversity of fishes is dependent on science-based conservation solutions. A wealth of data exist on the ecophysiological constraints of many fishes, but much of this information is underutilized in recovery plans due to a lack of synthesis. Here, we used the imperiled green sturgeon (Acipenser medirostris) as an example of how a quantitative synthesis of physiological data can inform conservation plans, identify knowledge gaps and direct future research actions. We reviewed and extracted metadata from peer-reviewed papers on green sturgeon. A total of 105 publications were identified, spanning multiple disciplines, with the primary focus being conservation physiology (23.8%). A meta-analytical approach was chosen to summarize the mean effects of prominent stressors (elevated temperatures, salinity, low food availability and contaminants) on several physiological traits (growth, thermal tolerance, swimming performance and heat shock protein expression). All examined stressors significantly impaired green sturgeon growth, and additional stressor-specific costs were documented. These findings were then used to suggest several management actions, such as mitigating salt intrusion in nursery habitats and maintaining water temperatures within optimal ranges during peak spawning periods. Key data gaps were also identified; research efforts have been biased towards juvenile (38.1%) and adult (35.2%) life-history stages, and less data are available for early life-history stages (embryonic, 11.4%; yolk-sac larvae, 12.4%; and post yolk-sac larvae, 16.2%). Similarly, most data were collected from single-stressor studies (91.4%) and there is an urgent need to understand interactions among stressors as anthropogenic change is multi-variate and dynamic. Collectively, these findings provide an example of how meta-analytic reviews are a powerful tool to inform management actions, with the end goal of maximizing conservation gains from research efforts.
The intestinal microbiota and cardiovascular disease
Authors: Katsimichas Themistoklis , Antonopoulos Alexios S , Katsimichas Alexandros , Ohtani Tomohito , Sakata Yasushi , Tousoulis Dimitris
Published: May 2019

The intestinal microbiota of human hosts is the community of microorganisms living in the small and, mainly, the large intestine of humans. This microbial ecosystem has co-evolved with humans across the millennia, has come to play an important interactive role in human physiology and has been aptly called our forgotten organ. Significant properties of the microbiota benefiting its host include energy harvest from food sources indigestible by humans, protection from pathogen colonization, and vitamin synthesis. Mounting evidence has linked changes in the composition or metabolic profiles of the microbiota with human disease, including disorders of the cardiovascular spectrum. Although cause and effect mechanisms are as yet essentially unproven in the relevant literature, the established associations point to the importance of the microbiota in the pathophysiology of cardiovascular disease (CVD). In this review, we first summarize key information on the gut microbial communities and the elaborate tools developed to analyse their structure and metabolic functions. Ecological terms are explained and analytical techniques are simplified, to enhance the understanding of published studies. Statistical methods used in microbial analysis are also described in simple terms. We then present published literature on the association of the compositional and functional changes of the microbiota with CVD, including heart failure, hypertension, and atherosclerosis. Each section of the review deals with the underlying pathophysiology of the relevant associations, connecting the observational and mechanistic aspects. Finally, we discuss the challenges that remain to be met before this field of research can generate knowledge which can impact everyday clinical practice.
Apixaban enhances endogenous fibrinolysis in patients with atrial fibrillation
Authors: Spinthakis Nikolaos , Gue Ying , Farag Mohamed , Srinivasan Manivannan , Wellsted David , Arachchillage Deepa R J , Lip Gregory Y H , Gorog Diana A
Published: May 2019

Aims

Approximately 20% of ischaemic stroke patients exhibit spontaneous arterial recanalization, attributable to endogenous fibrinolysis, which strongly relates to improved functional outcome. The impact of oral anticoagulants on endogenous fibrinolysis is unknown. Our aim was to test the hypothesis that apixaban enhances endogenous fibrinolysis in non-valvular atrial fibrillation (NVAF).

Methods and results

In a prospective cross-sectional analysis, we compared endogenous fibrinolysis in NVAF patients (n = 180) taking aspirin, warfarin, or apixaban. In a prospective longitudinal study, patients were tested before and after apixaban (n = 80). Endogenous fibrinolysis was assessed using the Global Thrombosis Test (GTT) and thromboelastography (TEG). Endogenous fibrinolysis [measured by GTT lysis time (LT)] was shorter on apixaban compared with warfarin or aspirin [median 1850 (IQR 1591–2300) vs. 2758 (2014–3502) vs. 2135 (1752–2463) s, P < 0.0001]. Among TEG indices, a small but significant difference in clot lysis time (CLT) was observed [apixaban 60.0 (45.0–61.0) vs. warfarin 61.0 (57.0–62.0) vs. aspirin 61.0 (59.0–61.0) min, P = 0.036]. Apixaban improved endogenous fibrinolysis measured using the GTT [LT pre-treatment 2204 (1779–2738) vs. on-treatment 1882 (1607–2374) s, P = 0.0003], but not by using TEG. Change in LT (ΔLT) with apixaban correlated with baseline LT (r = 0.77, P < 0.0001). There was weak correlation between ΔLT and ΔCLT in response to apixaban (r = 0.28, P = 0.02) and between on-apixaban LT and CLT (r = 0.25, P = 0.022).

Conclusion

Apixaban enhances endogenous fibrinolysis, with maximal effect in those with impaired fibrinolysis pre-treatment. Apixaban-treated patients exhibit more favourable fibrinolysis profiles than those taking warfarin or aspirin. Whether apixaban may confer additional thrombotic risk reduction in NVAF patients with impaired fibrinolysis, compared to warfarin, merits further study.
Bio-surfactin stabilised silver nanoparticles exert inhibitory effect over New-Delhi metallo-beta-lactamases (NDMs) and the cells harbouring NDMs
Authors: Kumar N Ganesh , Kumar Gaurav , Mallick Sathi , Ghosh Sudip Kumar , Pramanick Panchanan , Ghosh Anindya S
Published: May 2019

Silver nanoparticles (AgNPs) are used as an antimicrobial agent since the ages. However, it is unknown whether AgNPs exert inhibitory effects over the bacterial cells carrying metallo-beta-lactamases (MBLs). Here, using bio-surfactin stabilised AgNPs having a size range from 5 to 25 nm we established its antimicrobial effects against NDMs harbouring cells. Antimicrobial effectiveness of AgNPs is assessed on the E. coli cells carrying New Delhi MBL (NDM) genes, which shows that the cells expressing NDM becomes susceptible to AgNPs and when combined with various groups of beta-lactam a synergistic increase in sensitivity is observed. Purified NDMs are also inhibited by AgNPs as revealed by the hydrolysis of nitrocefin (a chromogenic cephalosporin), though the expression NDM genes remain unchanged. Further, the results obtained from biochemical analysis attribute that the Ag+ ions possibly bind to sulfhydryl (SH) group of cystine in NDMs to inactivate these enzymes. Nonetheless, these AgNPs has the ability to exert antimicrobial activity without affecting the host cell viability when used at a moderate concentration. Overall, we conclude that bio-surfactin-stabilised AgNP is a good candidate to serve as an inhibitor of NDMs, either individually or in combination with beta-lactams.
Antibiotic resistance breakers: current approaches and future directions
Authors: Laws Mark , Shaaban Ali , Rahman Khondaker Miraz
Published: May 2019

Infections of antibiotic-resistant pathogens pose an ever-increasing threat to mankind. The investigation of novel approaches for tackling the antimicrobial resistance crisis must be part of any global response to this problem if an untimely reversion to the pre-penicillin era of medicine is to be avoided. One such promising avenue of research involves so-called antibiotic resistance breakers (ARBs), capable of re-sensitising resistant bacteria to antibiotics. Although some ARBs have previously been employed in the clinical setting, such as the β-lactam inhibitors, we posit that the broader field of ARB research can yet yield a greater diversity of more effective therapeutic agents than have been previously achieved. This review introduces the area of ARB research, summarises the current state of ARB development with emphasis on the various major classes of ARBs currently being investigated and their modes of action, and offers a perspective on the future direction of the field.
ARBoR: an identity and security solution for clinical reporting
Authors: Venner Eric , Murugan Mullai , Hale Walker , Jones Jordan M , Lu Shan , Yi Victoria , Gibbs Richard A
Published: May 2019

Motivation

Clinical genome sequencing laboratories return reports containing clinical testing results, signed by a board-certified clinical geneticist, to the ordering physician. This report is often a PDF, but can also be a paper copy or a structured data file. The reports are frequently modified and reissued due to changes in variant interpretation or clinical attributes.

Materials and Methods

To precisely track report authenticity, we developed ARBoR (Authenticated Resources in a Hashed Block Registry), an application for tracking the authenticity and lineage of versioned clinical reports even when they are distributed as PDF or paper copies. ARBoR tracks clinical reports as cryptographically signed hash blocks in an electronic ledger file, which is then exactly replicated to many clients.

Results

ARBoR was implemented for clinical reporting in the Human Genome Sequencing Center Clinical Laboratory, initially as part of the National Institute of Health's Electronic Medical Record and Genomics (eMERGE) project.

Conclusions

To date, we have issued 15 205 versioned clinical reports tracked by ARBoR. This system has provided us with a simple and tamper-proof mechanism for tracking clinical reports with a complicated update history.
Molecular Survey of Babesia microti (Aconoidasida: Piroplasmida) in Wild Rodents in Turkey
Authors: Usluca Selma , Celebi Bekir , Karasartova Djursun , Gureser A Semra , Matur Ferhat , Oktem M Ali , Sozen Mustafa , Karatas Ahmet , Babur Cahit , Mumcuoglu Kosta Y , Taylan Ozkan Aysegul
Published: May 2019

Babesia microti (Aconoidasida: Piroplasmida) (Franca, 1910) is an important tick-borne zoonotic parasite with rodents serving as reservoir hosts. In the present study, 536 rodents were captured from Burdur, Bartin, Giresun, and Yozgat provinces of Turkey between the years 2010 and 2012, and blood samples were examined for the presence of Babesia spp. using conventional PCR which targeted the 18S rRNA gene. The sequence analysis of PCR amplicons was tested for B. microti as well as for Hepatozoon spp., and Sarcocystis spp. Overall, 5.8% of the rodents were positive for B. microti: 41% in Myodes glareolus, 7.7% in Chionomys roberti, and 2% in Apodemus spp., whereas no Babesia DNA was detected in Mus macedonicus and Microtus spp. Six rodents were positive for Hepatozoon spp. and one rodent was positive for Sarcocystis spp. Overall, 14.9 and 4.5% of rodents captured from Bartin and Giresun provinces, respectively, were PCR positive for B. microti, whereas none of rodents captured in Burdur and Yozgat were positive for Babesia spp. The sequence data of B. microti from rodents revealed that all sequences belonged to the zoonotic genotype. Sequences of B. microti obtained from rodents of the Bartin province were genotypically closer to European isolates, whereas those obtained from rodents of the Giresun province were closer to Russian and Mongolian isolates.
Evidence-Based Psychotherapy Relationship: The Third Task Force
Authors: Norcross John C. , Lambert Michael J.
Published: May 2019

This chapter introduces and frames the third edition of Psychotherapy Relationships That Work, which features dozens of original meta-analyses on what works in the relationship. The authors frame the work within the Third Intradivisional Task Force on Evidence-Based Relationships and Responsiveness. To accommodate new research, the book has grown to two volumes: one on relationship elements (what works in general) and one on treatment adaptations/responsiveness (what works in particular). The centrality of the therapy relationship, its interdependence with treatment methods, and potential limitations of the task force work are all highlighted. Frequently asked questions are also addressed. The authors hope that the book serves to repair some of the damage incurred by the culture wars in psychotherapy and to promote rapprochement between the research and practice communities.
Emotional Expression
Authors: Peluso Paul R. , Freund Robert R.
Published: May 2019

Although emotion has long been considered important to psychotherapeutic process, empirical assessment of its impact has emerged only recently. This chapter reports two meta-analyses on the association between therapist expression of emotion and psychotherapy outcome and client expression of emotion and psychotherapy outcome. A significant medium effect size was found between impact of therapist emotional expression and outcomes (d = 0.56, 13 studies) and a significant medium-to-large effect size client emotional expression and outcomes (d = 0.85, 43 studies). Third-party rating of emotional expression emerged as a significant moderator of outcomes. Limitations of the research, diversity considerations, and therapeutic practices conclude the chapter.
Attachment Style
Authors: Levy Kenneth N. , Johnson Benjamin N. , Gooch Caroline V. , Kivity Yogev
Published: May 2019

Attachment style describes characteristic patterns of relating to close others and has important implications for psychotherapy. This chapter provides an original meta-analysis of 36 studies (3,158 patients) to determine the association of patient attachment with psychotherapy outcome. Patients with secure attachment pretreatment show better psychotherapy outcome than insecurely attached patients. Further, improvements in attachment security during therapy coincides with better treatment outcome. Moderator analyses suggest that those who experience low attachment security may find better treatment outcome in therapy that focuses on interpersonal interactions. The chapter closes with research limitations, training implications, diversity considerations, and therapeutic practices.
Total Shoulder Arthroplasty
Authors: Sobey Christopher , Byrne David
Published: May 2019

This chapter describes patients undergoing total shoulder arthroplasty (TSA), who often present an array of challenging considerations regarding anesthetic management and perioperative pain control. Unlike in other types of shoulder surgery, patients undergoing TSA often have more significant comorbidities such as advanced age and morbid obesity that can affect outcomes in the perioperative period. Preoperative screening should be performed to allow adequate planning for the day of surgery and to ensure adequate postoperative monitoring. Because the procedure is an open surgical approach, it can be very stimulating, and extra consideration for perioperative analgesia should be taken. Careful consideration of multimodal (balanced) analgesic modalities to account for potential respiratory compromise, and incorporation of regional anesthetic modalities can contribute to successful delivery of anesthesia and safe recovery thereafter.
Distal Radius Fracture
Authors: Jiang Sharon , Berger Jack M. , Nicholson Luke
Published: May 2019

This chapter discusses distal radius fractures, which are one of the most commonly encountered orthopedic injuries and cause significant pain in both the nonoperative and operative setting. Regional anesthesia, administered commonly in the form of brachial plexus blocks, provides for reliable analgesia during closed reduction, operative fixation, and the postoperative period. Complications related to distal radius fractures include carpal tunnel syndrome, compartment syndrome, symptomatic malunion, persistent wrist pain, and complex regional pain syndrome (CRPS). Following distal radius fracture management, follow-up is warranted for the development of CRPS, for which a variety of pharmacologic and interventional therapies may be considered.
Total Knee Arthroplasty
Authors: Chokshi Rishi , Elkassabany Nabil
Published: May 2019

This chapter reviews key concepts regarding acute pain management in patients undergoing total knee arthroplasty (TKA). Patients presenting to TKA often have multiple relevant comorbidities that may complicate perioperative pain management. Furthermore, the pain resulting from this procedure is particularly challenging to address with otherwise common systemic analgesics, necessitating more advanced interventions that consider both pain intensity alongside patient function and rehabilitation. Many intraoperative anesthetic management decisions carry important implications for both early and longer-term postoperative function and pain management in this patient population. This chapter will provide a broad, case-based, evidence-supported review of modern approaches to enhanced recovery after surgery (ERAS) principles for patients presenting for total knee arthroplasty.
Total Hip Arthroplasty
Authors: Rose Sydney E. , Gonzalez-Sotomayor Julio A.
Published: May 2019

This chapter discusses the goals, procedure, and potential outcomes of total hip arthroplasty (THA). Patients may be candidates for a THA when they have severe arthritis of their hip(s) (degeneration of cartilage covering the ends of the bones creating the hip joint). Arthritic hip pain is often progressive and gets worse as the cartilage continues to deteriorate. Typically, at the time a patient seeks hip arthroplasty, his or her quality of life has become very compromised. In a total hip arthroplasty, damaged bone and cartilage of the hip joint are removed and replaced with prosthetic components. THA can be performed under neuraxial anesthesia (spinal or epidural) or general anesthesia or a combination of both.
Ankle Arthrodesis
Authors: Berlin Jill , Halaszynski Thomas
Published: May 2019

This chapter discusses ankle arthrodesis (i.e., ankle fusion) surgery, the goal of which is to relieve pain and maintain or improve patient function. Candidates for ankle arthrodesis are those in whom more conservative treatments have failed and also those with severe ankle arthritis (degeneration of the cartilage covering the ends of the bones that form the ankle). The bones that form the ankle joint include the tibia, fibula, and talus. Pain can be made worse with movement of the ankle. To reduce pain is to take bones of the ankle and fuse them into one bone (to eliminate ankle motion).
Thoracic Surgery in the Elderly Patient
Authors: Donnelly Melanie , Wilson Elizabeth
Published: May 2019

Pain management in elderly patients poses unique challenges due to altered physiology (such as chronic renal insufficiency) and altered pharmacodynamics that make them more sensitive. Elderly patients undergoing thoracic surgery generally benefit from analgesic techniques that reduce the use of opioids and rely more on regional and neuraxial analgesic techniques using local anesthetics. In this chapter we provide an overview of the challenges of managing acute pain in the aged, discuss the benefits of using multimodal non-opioid analgesics in preventing chronic post-thoracotomy pain, and review the different regional and neuraxial analgesic techniques (i.e. paravertebral blocks, epidural analgesia) that can positively affect outcomes in the elderly after thoracic surgery.
Open Abdominal Aortic Aneurysm Repair
Authors: Cobb Danielle , Dangler Lori , Robinson Albert
Published: May 2019

This chapter describes the significant challenge that open repair of abdominal aortic aneurysms poses for acute pain medicine physicians. In particular, acute pain medicine physicians must have a solid understanding of ischemic pain mechanisms and temporizing analgesic strategies. Epidural analgesia is often optimal for postoperative pain control, but risks must be weighed in the setting of commonly used anticoagulants in this population. Patient-controlled opioid-based analgesia is an option; an advantage of its use is that the patient typically spends less time in pain and tends to use less medication than when medication is given according to a set schedule. However, it is characterized by numerous concerns related to safety and adverse events; if the PCA device is not programmed properly, it can result in the under- or overdosing of narcotics.
Complex Regional Pain Syndrome
Authors: Hanling Steven R. , Fowler Ian M. , Phillips C. Ryan
Published: May 2019

Complex regional pain syndrome (CRPS) is a chronic pain condition that typically occurs after injury to a limb or directly to a nerve. Progression of the disease can result in multiple debilitating symptoms including pain disproportionate to the inciting event. The Budapest criteria cateforize the constellation of signs and symptoms of CRPS (sensory, vasomotor, sudomotor/edema, and motor/trophic changes) and are used to diagnose the syndrome. Treatments include rehabilitation (physical and occupation therapy), multimodal pain medication (medications that target neuropathic pain such as antidepressants, membrane stabilizers, and ion channel blockers), interventional treatments (sympathetic blocks, infusion catheters, neuromodulation), and psychological therapy.
Hip Fracture
Authors: Arias Franchesca , Price Catherine C. , Gadsden Jeffrey C.
Published: May 2019

This chapter discusses hip fracture, which is a significant public health problem associated with substantial morbidity and mortality. Pain with hip fracture is often severe but despite this is frequently undertreated in the elderly population. Untreated pain not only is inhumane but also is a significant risk factor for delirium in this population that is already at increased risk due to age-related cognitive decline. Hip fracture patients benefit from early intervention with regional analgesic techniques such as femoral or fascia iliaca block, as well as a scheduled regimen of nonopioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory medications. While opioids are known to contribute to risk for delirium, pain itself is a much stronger risk factor, and when nonopioid options are exhausted, opioids should be carefully considered. Continuous nerve block techniques provide opportunities for extended pain relief, which is associated with improved recovery profile, greater satisfaction, and a decreased risk for complications.
Inguinal Hernia Repair in a Neonate
Authors: Franklin Andrew D. , Kynes J. Matthew
Published: May 2019

This chapter describes inguinal hernia repair in the neonatal infant, which is one of the most commonly performed pediatric surgeries on an ambulatory basis. However, as many patients were born prematurely, a variety of analgesic concerns exist such as comorbid chronic lung disease or the concurrent risk of postoperative apnea depending on age at presentation. Additionally as acute pain in the neonatal population is often underappreciated and may have a lasting impact, numerous analgesic modalities should be considered. Intraoperatively, while general anesthesia is an option, numerous regional anesthetic techniques are available that may minimize the use of sedating agents. Both neuraxial (epidural, spinal, caudal injection) and peripheral (ilioinguinal/iliohypogastric blockade, paravertebral blockade, or transversus abdominis plane blockade) are available as analgesic modalities and in some scenarios surgical modalities. With the use of any of these modalities, complications such as nerve damage, failed block, and local anesthetic toxicity may occur. Following surgery, some neonates may require further monitoring for apneic events. Upon discharge, non-opioid analgesia including acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) if age permits should be emphasized.
Pediatric Orthopedic Surgery
Authors: Boretskty Karen
Published: May 2019

This chapter discusses the importance of using a comprehensive multimodal approach to analgesia following pediatric orthopedic surgery. Prior to opioid use, nonopioid adjuncts such as acetaminophen and short-course nonsteroidal anti-inflammatory use is preferred. Because breakthrough pain is common, targeted opioid therapy is often appropriate, and dosing guidelines are described in the chapter. Codeine is not recommended in the pediatric population. Following surgery, the use of peripheral regional anesthesia and perineural infusions has been shown to provide superior analgesia and opioid-sparing characteristics. While compartment syndrome is a concern in the pediatric population, few data exist to suggest peripheral regional anesthesia delays diagnosis. Pediatric patients with the appropriate amount of support may be discharged home with a perineural catheter. Additional postdischarge nonopioid analgesics should be encouraged, and a short course of opioid therapy may be provided if needed.
Pediatric Tonsillectomy
Authors: Franklin Andrew
Published: May 2019

Pediatric tonsillectomy and adenotonsillectomy are two of the most common surgical procedures performed on children. Tonsillectomy is a painful procedure and strategies to provide adequate analgesia are often complicated by opioid related adverse effects, particularly when the child has coexisting obstructive sleep apnea, obesity, or congenital disorders. A safe and effective multimodal analgesic plan for post-tonsillectomy pain may include adjuncts such as acetaminophen, ibuprofen, dexamethasone, and/or dexmedetomidine to reduce overall opioid usage during the perioperative period. The goal of perioperative analgesia after tonsillectomy is not necessarily to provide a pain-free state, but rather to preserve adequate respiratory function and provide enough analgesia to promote enteral hydration and adequate nutrition during the first few days following surgery, as most children recover quite rapidly from this surgical procedure.
CDC Yellow Book 2020
Authors: (CDC) Centers for Disease Control and...
Published: May 2019

The CDC Yellow Book offers everything travelers and healthcare providers need to know for safe and healthy travel abroad. This 2020 edition includes: country-specific risk guidelines for yellow fever and malaria, including expert recommendations and 26 detailed, country-level maps; detailed maps showing distribution of travel-related illnesses, including dengue, Japanese encephalitis, meningococcal meningitis, and schistosomiasis; guidelines for self-treating common travel conditions, including altitude illness, jet lag, motion sickness, and travelers’ diarrhea; expert guidance on food and drink precautions to avoid illness, plus water-disinfection techniques for travel to remote destinations; specialized guidelines for non-leisure travelers, study abroad, work-related travel, and travel to mass gatherings; advice on medical tourism, complementary and integrative health approaches, and counterfeit drugs; health insights around 15 popular tourist destinations and itineraries; advising travelers with specific needs, including those with chronic medical conditions or weakened immune systems, health care workers, humanitarian aid workers, long-term travelers and expatriates, and last-minute travellers; considerations for newly arrived adoptees, immigrants, and refugees.
Travelers with Additional Considerations
Authors: Brunette Gary W. , Nemhauser Jeffrey B.
Published: May 2019

Immunocompromised Travelers

Camille Nelson Kotton, Andrew T. Kroger, David O. Freedman

Travelers with Disabilities

Cynthia F. Hinton, John Eichwald

Travelers with Chronic Illnesses

Deborah Nicolls Barbeau, Gail A. Rosselot, Sue Ann McDevitt

Immunocompromised travelers make up 1%–2% of travelers seen in US travel clinics and pursue itineraries largely similar to those of immunocompetent travelers. The pretravel preparation of travelers with immune suppression due to any medical condition, drug, or treatment must take into consideration several issues:...
Hypertension
Authors: Zweiker Robert , Perl Sabine
Published: May 2019

Hypertension has a major impact on cardiovascular and overall morbidity and mortality of patients. In most cases, the condition is caused by polygenetic predisposition and environmental lifestyle factors. General practitioners and other health-care providers should seek to screen for high blood pressure (BP) in all adults. Public knowledge about the disease can also help to detect previously unknown hypertension. First-degree family members of hypertensive patients deserve special attention because of the hereditary nature of the disease. Most measurements are made as in-office BP readings (>140/>90mmHg), which should be confirmed by out-of-office BP measurements in order to uncover white-coat effects. The basis for treatment decisions is ideally a calculation of the overall cardiovascular risk. Treatment of hypertension consists of both non-pharmacological lifestyle changes and pharmacological therapy. Several classes of antihypertensive drugs are available. The choice of medication is mainly dependent on compelling indications, as their main effect is BP lowering per se. From a hypertensiologist’s view, renin–angiotensin system inhibition seems an appropriate first choice of treatment for younger patients, whereas the elderly benefit more from calcium channel blockers and diuretics. Nevertheless, therapy based on the combination of 2–3 drugs is preferable in most cases.
Pulmonary hypertension
Authors: Tonkin James , Ryan Kate , Madden Brendan
Published: May 2019

Pulmonary hypertension is characterized by a mean pulmonary artery pressure greater than 25mmHg at rest. Pulmonary hypertension is divided into groups 1 to 5, according to the underlying cause. Group 1 diseases are characterized by plexogenic pulmonary arteriopathy, which occurs through nitric oxide, endothelin, and prostacyclin pathways. Investigations for diagnosis include echocardiography, computed tomography pulmonary angiography, and right heart catheterization. Treatment options for group 1 pulmonary hypertension include phosphodiesterase-5 inhibitors, endothelin receptor antagonists, prostacyclin analogues, and novel therapies such as selexipag and riociguat. However, chronic thromboembolic pulmonary hypertension is often treated surgically with pulmonary thromboendarterectomy.
Characterization of the pleiotropic LysR-type transcription regulator LeuO of Escherichia coli
Authors: Fragel Susann M , Montada Anna , Heermann Ralf , Baumann Ulrich , Schacherl Magdalena , Schnetz Karin
Published: May 2019

LeuO is a pleiotropic LysR-type transcriptional regulator (LTTR) and co-regulator of the abundant nucleoid-associated repressor protein H-NS in Gammaproteobacteria. As other LTTRs, LeuO is a tetramer that is formed by dimerization of the N-terminal DNA-binding domain (DBD) and C-terminal effector-binding domain (EBD). To characterize the Escherichia coli LeuO protein, we screened for LeuO mutants that activate the cas (CRISPR-associated/Cascade) promoter more effectively than wild-type LeuO. This yielded nine mutants carrying amino acid substitutions in the dimerization interface of the regulatory EBD, as shown by solving the EBD’s crystal structure. Superimposing of the crystal structures of LeuO-EBD and LeuO-S120D-EBD suggests that the Ser120 to Asp substitution triggers a structural change that is related to effector-induced structural changes of LTTRs. Corresponding functional analyses demonstrated that LeuO-S120D has a higher DNA-binding affinity than wild-type LeuO. Further, a palindromic DNA-binding core-site and a consensus sequence were identified by DNase I footprinting with LeuO-S120D as well as with the dimeric DBD. The data suggest that LeuO-S120D mimics an effector-induced form of LeuO regulating a distinct set of target loci. In general, constitutive mutants and determining the DNA-binding specificity of the DBD-dimer are feasible approaches to characterize LTTRs of unknown function.
John Dewey
Authors: Shook John R.
Published: May 2019

John Dewey (b. 1859–d. 1952) was America’s foremost philosopher and public intellectual during the first half of the 20th century. As a leading representative of the Progressive movement, Dewey’s educational, ethical, economic, and political views embodied that movement’s demands for the expansion of liberty and opportunity in more democratic societies. Prominent examples of this liberalism are his support for women’s suffrage, equal rights for immigrants and minorities, economic justice, and world peace. He would be rightly categorized as a democratic socialist, and he rejected Communism and governments tending toward fascism or totalitarianism. Dewey’s intellectual foundations lay in his seminal contributions to psychology, pedagogy, and pragmatism. Both functionalist and behaviorist psychology partly sprang from his work at the University of Chicago during the 1890s, and this dynamic view of intelligence infused his original theories about childhood education and life-long learning. Since all learning is basically experimental, Dewey partnered with Charles Peirce and William James to develop pragmatism’s view that the knowable is what is empirically confirmable after putting thoughts into action. From epistemology to philosophy of mind, pragmatism abandons Platonic, Cartesian, and Kantian views that reality and knowledge are statically structured by necessary and unchanging principles. For Dewey, only experience’s explorations of the world ultimately determine the meaning, value, and validity of ideas and propositions, including those of mathematics, logic, science, and philosophy itself. His version of pragmatism, which he usually labeled as “instrumentalism” or empirical naturalism,” has also been influential in the fields of aesthetics, ethics, social theory, philosophy of technology, and philosophy of religion. Dewey taught at Columbia University from 1905 until he retired in 1929 and was a presence there as professor emeritus until 1939. He also traveled the world; major journeys include lecturing in Japan and China from 1919 to 1921, a 1924 stay in Turkey as Ataturk’s educational consultant, and a tour of USSR schools in 1928. Dewey’s thought is respected in many countries, and it has been productively compared and blended with aspects of Asian philosophy in particular.
Hinduism in Pakistan
Authors: Schaflechner Jürgen
Published: May 2019

The Islamic Republic of Pakistan is a Muslim-majority country in western South Asia. In addition to Hindus, other non-Muslim groups in Pakistan include Christians, Baha’is, Sikhs, Parsis, and Buddhists. The Ahmadiyya community, an Islamic sect originating in the 19th century around Mirza Ghulam Ahmad, is also considered a non-Muslim minority in Pakistan. Hindus comprise around 1.6–2.9 percent of Pakistan’s overall population, and 90 percent of them live in the province of Sindh. The study of Hinduism in Pakistan, therefore, needs to take the sociopolitical and economic particularities of Sindh into account. Both in Sindh and Pakistan, Hinduism is as complex as in other parts of the world. Hindus, especially in rural areas, follow local Sufi pīrs (Urdu, “spiritual guides”) and adhere to the 14th-century saint Ramdevji, whose main temple is in the Sindhi city of Thando Allah Yar. Many urban Hindu youths in Pakistan participate in the Westernized ISKCON society. Some Hindus worship Mother Goddesses as clan or family patrons, whom, at times, they appease with animal blood sacrifices. Others (e.g., Nanakpanthis) follow the teachings of the Guru Granth Sahib or the holy book of the Sikhs. This diversity challenges the taxonomies that separate Hinduism, Sikhism, and Islam as distinct religions. It also complicates the relationship between Hinduism in Pakistan and the Islamic Republic’s nationalism. This relationship has its roots in the two-nation theory (Urdu, do qaumī naz̤ariyah), which claims that Muslims and Hindus are two distinct nations that can only thrive through geopolitical separation—an idea that arguably led to Partition in 1947. Pakistani historiography often represents the two-nation theory as a necessary Muslim reaction to Hindu suppression and dominance during the period of British rule. After Pakistan’s creation in 1947 (and especially after wars with India in 1965 and 1971), Hindus became increasingly perceived and portrayed as a national threat. While frequently free to practice their faith, the historical predicament of the two-nation theory impacts the everyday lives of Hindus in Pakistan on many different levels.
Stereotypes in Political Reasoning
Authors: Oxley Zoe M.
Published: May 2019

Group-based assessments are a core ingredient of many political judgments. Characteristics such as a candidate’s political party, race, ethnicity, or gender influence voter evaluations. Opinions toward a wide range of public policies are shaped by beliefs about and affect toward policy beneficiaries. Of the many group-related attitudes that play a role in political reasoning, stereotypes are among the most important. Stereotypes are beliefs we hold about the characteristics, tendencies, and competencies of social groups. Research in psychology has demonstrated the functional role stereotypes play in helping us navigate through a complex social world, but also that stereotypes can operate automatically, are resistant to updating, and can lead to prejudice and discrimination. Academics across disciplines have grappled with how to best measure stereotypes, notably whether to use explicit or implicit measurement strategies. Despite valid concerns that explicit items might not be answered honestly, due to societal pressures, these measures continue to be common in the political science literature. As for which groups’ stereotypes have been studied, political stereotyping based on gender and race/ethnicity has received much more attention than have other characteristics, such as sexuality, religion, or class. The research has documented a decline in stereotyping in some domains, such as gender stereotyping of candidates, yet a persistence of stereotyping in others, such as the influence of racial and ethnic stereotypes on policy opinions. Scholars have also uncovered the nuanced role that stereotypic thinking can play in political judgment. Factors that influence whether stereotypes are influential include whether an actor displays stereotypic-consistent versus inconsistent behavior, the ideology of the perceiver or the target, and whether stereotypes of an ingroup or outgroups are relevant. A notable emerging line of inquiry focuses on intersectional stereotyping, or stereotyping based on multiple identities simultaneously. Significant progress has been made toward our understanding of stereotyping at the gender-race intersection, especially regarding women of color, as well as the intersecting nature of gender and party stereotypes.
Student Access, Equity, and Diversity in Higher Education
Authors: Harvey Andrew , Stokes Jennifer
Published: May 2019

The global expansion of higher education continues apace. According to the typology in Trow’s chapter in 2007, many nations have now entered an era of universal higher education. Despite high overall growth, many groups nevertheless remain under-represented. Most notably, university access is typically limited for people who are financially disadvantaged, have a disability, hail from certain ethnic groups, are Indigenous, and/or live in rural areas. Unequal access raises issues both of social justice and of economic productivity. Nations unable to broaden access to under-represented groups may suffer negative social, democratic, and economic consequences. Despite this imperative, few nations maintain a higher education system that is reflective of their broader population. Higher education is often perceived as a positive force for social mobility, yet it can also serve to reify established structures of class, gender, and ethnicity. Equity remains a contested concept. Proponents of formal equality argue that meritocratic higher education is possible where formal, legal barriers of discrimination are removed. An opposing view holds that structural inequity is so deep that the removal of formal university barriers is necessary but insufficient to deliver fairness. By this view, equity requires more active measures to promote access and success for under-represented groups. Conflicting views of student equity are often represented in affirmative action debates. Many countries provide compensation, bonus points, or other forms of preferential access to support identified disadvantaged groups. Most notably, the United States remains deeply conflicted over the merits and legality of race-based affirmative action, whereby African American, Latino, and other students may be provided preferential access to public and private universities. While attempts to broaden access are made on equity grounds, the importance of student diversity is also often emphasized. Diversity may include ethnicity, gender, age, religion, and other geo-demographic characteristics. Advocates of student diversity highlight research that shows increased quality of learning where the student group holds a wide range of views informed by different backgrounds. This idea of “inclusive excellence” is informed by broader economic arguments of productive diversity and research into behavioral psychology. Alongside growing student diversity in higher education has been a focus on how universities manage that diversity. Studies on campus climate have explored how different student groups experience and identify with their university and the strengths that different groups can bring to higher education.
Diglossia
Authors: Sayahi Lotfi
Published: May 2019

Diglossia describes a situation of a complementary functional distribution of two or more language varieties. The varieties in question may belong to the same historical language, as in the case of standard Arabic and the Arabic dialects across the Arabic-speaking world (this first type of diglossia is referred to in the literature as classical, genetic, or endoglossic diglossia), or they may be more separate and genetically distant languages, as in the case of Spanish and Guarani in Paraguay (this second type of diglossia is referred to as extended, non-genetic, or exoglossic diglossia). The complementary functional distribution is often assumed, as opposed to strictly adhered to. Domains of use tend to overlap, and increasingly so since the advent of digital communication. In cases when the varieties that are in a diglossic situation are part of the same language, the differences between them are usually more prominent at the lexical level, but there may also be divergent phonological and morphosyntactic features. Most commonly, diglossia implies the existence of one High (H) variety and one Low (L) variety (Ferguson 1959, cited under Ferguson’s Classical Diglossia: Definition). The H variety is the code associated with education, government, religion, and other institutional domains. The H variety is also the one that tends to be the standardized form of the historical language and the one used for writing and scripted communication. By contrast, the L variety is the code used extemporaneously for daily communication within the family and in other informal domains of interaction. Generally, the L variety is not standardized and shows a wide range of variation along geographical and socioeconomic lines. Another distinction between the H variety and the L variety has to do with attitude and language ideology: while speakers may not naturally transmit the H variety to their children, and while these children acquire the L variety as a native language, speakers in diglossic situations tend to have much more favorable attitudes toward the H variety. In fact, the L variety often is perceived as a “corrupt” form of the H variety, or in cases of separate languages, as a less sophisticated form of communication. Diglossia is a central concept for the study of both dialect drift and the emergence of new varieties, and language contact and contact-induced change, with implications for a variety of issues that relate broadly to language in society.