bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a statistically explicit understanding of de novo sequence assembly
Authors: Howison Mark , Zapata Felipe , Dunn Casey W.
Published: September 2013

Motivation: Draft de novo genome assemblies are now available for many organisms. These assemblies are point estimates of the true genome sequences. Each is a specific hypothesis, drawn from among many alternative hypotheses, of the sequence of a genome. Assembly uncertainty, the inability to distinguish between multiple alternative assembly hypotheses, can be due to real variation between copies of the genome in the sample, errors and ambiguities in the sequenced data and assumptions and heuristics of the assemblers. Most assemblers select a single assembly according to ad hoc criteria, and do not yet report and quantify the uncertainty of their outputs. Those assemblers that do report uncertainty take different approaches to describing multiple assembly hypotheses and the support for each.

Results: Here we review and examine the problem of representing and measuring uncertainty in assemblies. A promising recent development is the implementation of assemblers that are built according to explicit statistical models. Some new assembly methods, for example, estimate and maximize assembly likelihood. These advances, combined with technical advances in the representation of alternative assembly hypotheses, will lead to a more complete and biologically relevant understanding of assembly uncertainty. This will in turn facilitate the interpretation of downstream analyses and tests of specific biological hypotheses.

Contact:  mhowison@brown.edu
Electronic Bits and Ten Gallon Hats
Authors: Benke Gavin
Published: September 2013

My dissertation uses the Enron Corporation to examine how companies use culture to shape political and economic systems. Throughout the 1980s and 1990s, the company morphed from a vertically integrated natural company into a derivatives trading house. An emphasis on innovation, free markets and knowledge work in the firm’s marketing efforts accompanied this organizational shift. Because the change was so dramatic, after its 2001 collapse the company became an ideal site for Americans to express cultural anxieties about the move away from Fordist production and toward an emphasis on working with complicated pieces of information. Drawing on archival sources such as issues of the employee magazine and executive correspondence, this study contributes to an understanding of the cultural work that must be performed in order to establish and maintain political economic systems, as well as the ways in which cultural production is used to make sense of economic change.
Anesthesia for Diagnostic and Therapeutic Radiologic Procedures
Authors: Cutter Thomas W.
Published: September 2013

As minimally invasive techniques in radiology suites become more common, the need for anesthesia support will increase. While recognizing and addressing a patient’s comorbidities and other concerns are similar to what is already done in the surgical setting, the additional requirements and constraints of the imaging environment and the procedure are unique and call for specific solutions. Just as in the operating room, there is frequently no single best anesthetic technique for a given procedure. The anesthetic should be aligned with the demands of the procedure and the skill sets of the providers. Patient safety always takes precedence, and the location should never be permitted to compromise care.
Anesthesia for In Vitro Fertilization
Authors: Sequeira Patricia M.
Published: September 2013

In vitro fertilization (IVF) is a broad term used to describe the process of obtaining an egg and uniting it with sperm in a laboratory setting, and subsequently placing the fertilized egg into the uterus in hopes of achieving a live birth. In terms of anesthesiology, IVF primarily means oocyte retrieval. Historically the oocytes were retrieved laparoscopically. With the introduction of the vaginal ultrasound, the method of retrieval changed to a less invasive and costly procedure. Transvaginal ultrasound-guided oocyte aspiration changed the requirements of anesthesia. In this chapter, the anesthesia for oocyte retrieval and related IVF procedures are described.
Anesthesia for Procedures in the Emergency Department
Authors: Andruchow James E. , Zane Richard D.
Published: September 2013

The practice of emergency medicine has changed significantly over the past several decades, having evolved into a separate and distinct specialty with a unique knowledge base and training program. As the specialty has evolved, so have the types of patients being cared for in the emergency department (ED), as well as the range of therapies and procedures being performed. For many of these patients, the acute management of pain and anxiety will be an essential component of their ED care and fundamental to the performance of many diagnostic and therapeutic interventions. Possessing an arsenal of anesthesia techniques is invaluable to the practice of emergency medicine. This chapter reviews anesthesia techniques that have special relevance in the ED setting.
Office-Based Anesthesia
Authors: Hausman Laurence M.
Published: September 2013

There are many advantages to office-based procedures for both patients and practitioners. The patient is afforded more privacy with a more personal experience, as well as decreased facility fee if paying out of pocket and less risk of exposure to nosocomial infections. The practitioner will generally have improved ease in scheduling of cases, the convenience of being able to perform surgery within the same office as preoperative and postoperative care, and in some cases will receive an enhanced professional fee.5

An office practice cannot provide the same level of care as a tertiary care medical center or even a small community hospital. For this reason, not all surgical procedures or patient populations are appropriate for this venue. For example, procedures associated with large fluid shifts, blood loss, excessive postoperative pain, or respiratory compromise should continue to be performed in the hospital setting. Likewise, patients with significant comorbidities, potentially difficult airways, or those at risk for aspiration should not be considered suitable candidates for an office-based procedure. The American Society of Anesthesiologists (ASA) has published specific recommendations regarding what types of surgery and patient populations should be excluded from this venue.6
Anesthesia Considerations in Dental Practice
Authors: Joseph Michael
Published: September 2013

Dental anesthesia is indicated for most procedures of the oral cavity. Soft tissue (mucosal tissues such as the buccal mucosa and gingiva), teeth, and the pulp tissue (composed of nerve fibers, vasculature, lymphatics, and connective tissue inside of the tooth), and supporting structures of the tooth (bone and periodontal ligament) are all necessary structures to be anesthetized. Choice of tissue to be anesthetized depends on the goal of the procedure.

Restorative procedures (amalgam and composite restorations, inlays, onlays), prosthetic procedures (crowns and veneers), endodontic procedures (root canals, apicoectomy or root-end surgery, pain diagnosis), periodontal procedures (scaling and root planing, crown lengthening, sinus lift, connective tissue grafting, guided bone regeneration, gingivectomy), and oral surgery procedures (extractions, implant placement, incision and drainage, and biopsy) all will require anesthesia to reduce patient pain and anxiety.
Promoting child development
Authors: Hall David M.
              B. , Elliman David
Published: September 2013

Chapter 3 emphasizes the central role of parents in promoting child development, defines helpful parenting, describes the Sure Start programme, sets out the growing evidence that education for parenthood is effective, considers the primary prevention of behavioural and psychological disorders, reviews the relationship between depression, social isolation, and child development, stresses the importance of post-natal depression and mental illness associated with pregnancy and the post-natal period, describes how language acquisition and literacy skills could be encouraged, examines child protection and the prevention of child abuse, reviews the overall effectiveness of primary prevention and intervention programmes, and presents a concept of ‘school readiness’ in terms of an ‘outcome measure for community intervention programmes.
Child health promotion—opportunities for primary prevention
Authors: Hall David M.
              B. , Elliman David
Published: September 2013

Chapter 4 reviews ways of reducing the incidence of infectious diseases (including immunization), reducing the risk of sudden infant death, ways of reducing parental smoking, unintentional injury prevention, nutrition and prevention of dental disease, and situations requiring specialized services.
Laboratory and radiological screening tests
Authors: Hall David M.
              B. , Elliman David
Published: September 2013

Chapter 9 cover phenylketonuria and hypothyroidism, other metabolic disorders, cystic fibrosis, Duchenne muscular dystrophy, urine analysis and urine infections, reflux, haemoglobinopathies, liver disease in infancy, hypercholesterolaemia, lead poisoning, neuroblastoma, and coeliac disease.
Children with disabilities and special educational needs
Authors: Hall David M.
              B. , Elliman David
Published: September 2013

Chapter 14 reviews the legislative framework for children with disabilities and special educational needs, statutory duties and underlying principles, joint agency working, service planning, service provision for individuals, standards for services for disabled children and for child development centres, disability registers, special educational needs (SEN), and the role of the designated doctor for liaison with the education authority.
Children in special circumstances
Authors: Hall David M.
              B. , Elliman David
Published: September 2013

Chapter 16 considers the needs of children in special circumstances, including ssylum seekers, refugees, and international adoptions, entitlements, emotional health and health care, screening and management of health problems, immunizations for children with no records, health care needs of traveller families, homeless families, and children and young people in prison.
Personal Child Health Records and minimum dataset
Authors: Hall David M.
              B. , Elliman David
Published: September 2013

Chapter 17 deals with Personal Child Health Records: their ownership and use, the content and format of the record, confidentiality, information, distribution, recommendations for use of a National Personal Child Health Record, and information collection and management.
Comparing two groups
Authors: Peacock Janet
              L. , Kerry Sally
              M.
Published: September 2013

Chapter 7 discusses comparing two groups, and covers graphical presentation of
continuous unpaired data, the two-sample t-test, the Mann-Whitney U test, comparing two
proportions, and further reading.
Anaphylaxis
Authors: Brown Anthony F.T.
Published: September 2013

The term anaphylaxis describes both IgE immune-mediated reactions and nonallergic, nonimmunologically triggered events. Comorbidities such as asthma or infection, exercise, alcohol, or stress and concurrent medications such as β‎-blockers and aspirin increase the risk known as ‘summation anaphylaxis’.

Aetiology and pathogenesis—activated mast cells and basophils release preformed, granule-associated mediators and newly formed lipid mediators, and generate cytokines and chemokines. These cause vasodilatation, increased capillary permeability, and smooth muscle contraction, as well as attract new cells to the area. Positive feedback mechanisms amplify the reaction in a ‘mast cell—leucocyte cytokine cascade’, although conversely reactions can be self-limiting. Parenteral penicillins, hymenopteran stings, and food are the most common causes of IgE immune-mediated fatalities, with radiocontrast media, aspirin, and other nonsteroidal anti-inflammatory drugs most commonly responsible for nonallergic fatalities....
Anthropometry, physique, body composition, and maturity
Authors: Claessens Albrecht
                L. , Beunen Gaston , Malina Robert
                M.
Published: September 2013

The appropriate normalization of exercise performance data for differences in body size underpins the clarification of growth and maturational influences on physiological function. Therefore, scaling is an issue of fundamental importance for all paediatric exercise scientists. The selection and application of a scaling method appropriate for the data and research question being addressed is at least as important as ensuring that the methodology used to collect the data is valid, reliable, and appropriate for use with young people. Several scaling methods are available and some methods can be applied in different ways. Unfortunately, taken as a whole, the extant literature presents a confusing picture as to which of these techniques is preferable, how they should be applied, and the meaning of the results obtained. The aim of this chapter is to clarify these issues through a description of the techniques available for analysing both cross-sectional and longitudinal data sets, highlighting their statistical and theoretical derivations.
Motor development
Authors: Sugden David
                A. , Soucie Helen
                C.
Published: September 2013

This chapter examines motor development from a number of perspectives. The first two sections overview a description followed by possible explanations of motor development. These sections are predicated on the assumption that two major questions permeate motor development: the first question asks what happens during development, describing and analysing the changes that occur; the second, a more difficult question, examines the possible explanations as to what are the mechanisms that are driving these changes. A third section provides an overview of recent work in the area of infant and early childhood development utilizing concepts from dynamic systems theory and ecological psychology. A fourth part examines two relatively recent ideas from early childhood and motor development. The first one promotes the idea of embodied cognition where a child’s physical, social, and linguistic interaction with the environment may be the root of flexible intelligent behaviour. The second one looks at the way in which some development is atypical, through an examination of precursors in early infancy being possible predictors for later problems. Finally, an example of atypical development is illustrated through a description of the condition known as developmental coordination disorder.
Gene–physical activity interactions and their role in determining cardiovascular and metabolic health
Authors: Franks Paul
                W. , Looker Helen
                C.
Published: September 2013

Chapter 26 investigates the mechanisms that underlie children’s health-related behaviours and the way in which physical activity interacts with genetic factors, which may help improve our understanding of how and why children become obese and develop cardiovascular risk factors, how these children should be treated, and ultimately how the development of cardiovascular risk in childhood can be prevented.
Physical activity, physical fitness, and social, psychological, and emotional health
Authors: Garza Julie
                C. , Murray Nancy
                G. , Sharma Shreela , Drenner Kelli
                L. , Tortolero Susan
                R. , Taylor Wendell
                C.
Published: September 2013

Physical activity is consistently associated with favourable physical health1; however, the impact of physical activity on social, psychological, and emotional health is not consistent. Given the importance of these facets of health for children and adolescents, we reviewed the literature, identified important gaps in knowledge, and recommended future research. This review includes recent literature hereby updating the earlier version of this chapter.2
Sport, physical activity, and other health behaviours
Authors: Trost Stewart
                G.
Published: September 2013

Millions of children worldwide are involved in organized sports. In the United States alone, an estimated 38 million children are involved in agency sponsored programmes, such as U.S. Youth Soccer, Little League Baseball, and Pop Warner football.1,2 Survey data from the U.S. Centers for Disease Control and Prevention (CDC) indicates that ∼56% of U.S. high school students participate in at least one school or community-based sports team annually, with just over 38% of U.S. children between the ages of 9–13 years participating in sport or an organized physical activity of some kind.3,4
The elite young athlete
Authors: McManus Alison
                M. , Armstrong Neil
Published: September 2013

This chapter will focus on the development of elite young athletes. The chapter begins by identifying who becomes an elite young athlete. A broader discussion of how potential sporting expertise is best developed follows. The chapter then concludes with the consideration of key risks faced by youngsters involved in elite sport.
Young athletes with a physical or mental disability
Authors: Zetaruk Merrilee , Mustapha Shareef
Published: September 2013

This chapter reviews the prevalence of some of the more common physical and mental impairments and addresses the particular challenges faced by individuals with disabilities who are participating in sports. Although the incidence of sport-significant abnormalities detected amoung able-bodied individuals on preparticipation screening is relatively low (1–3%), the rate may be as high as 40% in disabled populations.9 As such, the injuries that athletes with disabilities are predisposed to and general strategies for prevention are reviewed in this text. In addition, the multitude of benefits that are achieved through physical activity and sport participation are discussed. Some adaptations via adjustments in rules and use of prosthetic devices that allow participation in a more diverse range of athletic activity are also reviewed. Finally, some of the opportunities that exist for athletes with disabilities who wish to participate at high levels of competition such as the Paralympic Games and Special Olympics are highlighted. Given the utility of physical activity for all and the increasing number of athletes with disabilities, it is imperative that health professionals become familiar with the unique challenges faced by these athletes. Knowledge of injuries encountered in this population as well as disability-specific modes of injury prevention is imperative.10
Aetiology and prevention of injuries in youth competitive non-contact sports
Authors: Bo Mahler Per
Published: September 2013

Unfortunately, most studies quoted in the following sections are based on case reports and case series rather than randomized prospective or intervention studies and therefore give limited significant information about risk factors and the influence of prevention on injury.6–9 It is also noteworthy that little information is available on children in certain sports10,11 and that adult data have therefore been used to extrapolate when appropriate. Taking this in to consideration, the present chapter underlines certain trends that can be drawn from the literature and that give a reasonable basis on which to develop and promote prevention strategies.
Basic biostatistical and epidemiological terms
Authors: Bye Louise A.
Published: September 2013

This chapter discusses basic biostatistical and epidemiological terms in ophthalmology, including basic descriptive statistics (average, spread, normal (Gaussian) distribution) clinical study design (case-control studies, clinical trial), statistical tests (parametric and non-parametric, choice of test, commonly used statistical terms), and basic epidemiological terms.
Transfusion Therapy
Authors: Wu Peter , Hsiung Rob
Published: September 2013

Chapter 13 contains 42 questions and answers regarding transfusion therapy.
High-Yield Board Review Topics
Authors: Aslani Kaveh , Han Richard , Monterosso Dominic
Published: September 2013

Chapter 21 contains 60 topics frequently missed by examinees sitting for the board certification examination in anesthesiology.
Electrolyte Disturbance in Pyloric Stenosis
Authors: Turner Ben
Published: September 2013

Pyloric stenosis is a common condition that represents a challenge to the pediatric anesthesiologist. Managing these children requires an understanding of fluid, electrolyte, and acid–base abnormalities, induction techniques where there is potential for a full stomach, and postoperative pain-management choices in small babies. The key perioperative message is to realize this is a medical rather than a surgical emergency. Preoperative correction of the fluid, electrolyte, and acid–base abnormalities is vital in reducing perioperative morbidity. The anesthesiologist needs to be able to accurately assess when a baby's condition is adequately optimized before proceeding to pyloromyotomy.
Obstructive Sleep Apnea
Authors: Squire Peter
Published: September 2013

Adenotonsillectomy has become first-line treatment for obstructive sleep apnea (OSA) and it is increasingly performed as a day-case procedure. A diagnosis of OSA increases the risk for postoperative respiratory morbidity from 1% to approximately 20% and unfortunately, the clinical history may be unreliable at distinguishing which children are at greatest risk. The gold standard investigation is overnight polysomnography (PSG), but this is a scarce resource considering the number of procedures performed. Fortunately, overnight home pulse oximetry also provides a useful stratification of severity and may predict postoperative problems. Children with OSA have a respiratory drive and airway tone that may be exquisitely sensitive to anesthetic and analgesic agents. Accordingly, the anesthesiologist needs to identify which patients are most at risk, and therefore which patients can be managed as “day cases,” what is an appropriate anesthetic regimen, and how best to monitor these patients postoperatively.
Management of Acutely Burned Children
Authors: McDougall Robert
Published: September 2013

The resuscitation of the child with burns poses a number of challenges to the anesthesiologist. It is vital that there is a systematic approach to managing the airway, breathing, and circulation. This requires an understanding of the pathophysiology of burn injury. Particular attention must be paid to the timing and technique of securing the airway. Appropriate vascular access and pain management are also of high priority in the burned child.
Sickle Cell Disease
Authors: Szabova Alexandra , Goldschneider Kenneth R
Published: September 2013

0.2% of African-Americans have sickle cell anemia while, with 8% to 10% have sickle cell trait. This chapter provides an overiew of the etiology, pathophysiology, and treatment of sickle cell anemia as they affect anesthetic management—before, during, and after surgery.
Hemophilia
Authors: McIntyre Rebecca
Published: September 2013

Recent advances in the management of patients with hemophilia have led to significantly improved outcomes. Transmission of infectious diseases through blood product administration and severe arthropathies from recurrent joint bleeds are now rare. In the past, hemophilia was considered a contraindication to having some elective surgery such as adenotonsillectomy due to the risk of life-threatening bleeding complications. Nowadays, management of elective surgery in these patients can be straightforward and safe, provided adequate planning and consultation with a hematologist occur.
Opioid-Tolerant Patient
Authors: Szabova Alexandra , Goldschneider Kenneth R
Published: September 2013

Caring for patients who are taking chronic opioids may present several challenges for clinicians in the operating room and in the immediate postoperative period. Factors such as tolerance and opioid-induced hyperalgesia can complicate perioperative pain management.
Neuroblastoma Resection
Authors: Sabato Stefan
Published: September 2013

Neuroblastoma is the most common extracranial solid tumor of childhood, and limited or complete surgical resection is performed in most cases. Anesthesia for these children can be challenging because of the size and location of the tumor, the secretion of vasoactive metabolites from the tumor, and because it involves major surgery in a potentially immunocompromised patient. Adequate preparation for these procedures can avoid intraoperative instability.
Diabetic Ketoacidosis During Appendicitis with Perforation
Authors: Soler Ximena , Aronson Lori A
Published: September 2013

Type 1 diabetes mellitus (DM) is a chronic disease of carbohydrate, fat, and protein metabolism caused by a functional lack of insulin. Diabetic ketoacidosis (DKA) involves a combination of hyperglycemia, acidosis and ketosis, and is more often associated with type 1 DM. A child in DKA who presents for emergency surgery may be critically ill and requires expert management of his or her metabolic state to ensure a safe outcome.
Tracheoesophageal Fistula Repair
Authors: Rankin Lorna
Published: September 2013

Tracheoesophageal fistula (TEF) and esophageal atresia (EA) is a congenital malformation occurring in 1:3,000 to 4,500 births. The condition presents specific challenges to the anesthesiologist in the perioperative period. The presence of a fistula means that infants born with TEF/EA are at risk of aspiration and positive-pressure ventilation may be hazardous. These babies often have coexistent problems associated with prematurity and low birth weight, and 50% have associated abnormalities, most commonly congenital cardiac malformations.
Cerebral Palsy
Authors: Chalkiadis George
Published: September 2013

Cerebral palsy (CP) is the most common cause of childhood disability. Children with CP have a number of problems, resulting in frequent need for surgery and anesthesia. They present a series of added challenges to the anesthetist that may have an impact on perioperative anesthesia and pain management. Theses include spasticity and other movement disorders, cognitive impairment, seizure management, behavioral disturbances, malnutrition, and difficulties in communication and swallowing. An understanding of these issues will help the anesthetist formulate a management plan that is tailored to the individual child's needs.
Clinical Course and Adult Outcome in Tourette Syndrome
Authors: Bloch Michael H.
Published: September 2013

This chapter summarizes the existing literature on the long-term course of Tourette syndrome. Tic symptoms typically reach their worst-ever severity between 10 and 12 years of age. One half to two thirds of children with Tourette syndrome experience a significant decline of tic symptoms that roughly coincides with adolescence. The impact of pharmacological or behavioral treatments upon the long-term prognosis remains an unexplored aspect. Some comorbid symptoms such as obsessive-compulsive symptoms in adulthood may also influence tic persistence into adulthood. Finally, potential predictors of tic outcome in adulthood include performance on some specific fine-motor skills and caudate volumes during childhood.
The Prevalence of Tourette Syndrome and its Relationship to Clinical Features
Authors: Scahill Lawrence , Dalsgaard Soren , Bradbury Kathryn
Published: September 2013

This chapter will summarize the results of and discuss the methodological issues related to the prevalence studies on Tourette syndrome conducted over the past 12 years. The best estimate for the prevalence of Tourette syndrome in school-age children is likely to fall between 5 and 7 cases per 1,000. The prevalence of chronic motor tic disorder in school-age children ranges from 3 to 8 per 1,000, whereas estimates of prevalence for chronic vocal tic disorder are less stable and await further study. Children with chronic tic disorders, even those with mild conditions, have a higher likelihood of other problems such as attention-deficit/hyperactivity disorder, disruptive behavior, and obsessive-compulsive disorder. The classic two-stage design seems an acceptable approach for prevalence studies of Tourette syndrome and related tic disorders; however, this requires sample sizes greater than 5,000 to ensure relatively narrow confidence intervals. From a public health perspective, chronic tics may serve as a marker of neurodevelopmental vulnerability. Community-based studies that improve case finding are likely to increase our understanding of the health impact of tic disorders in children.
Cellular and Molecular Pathology in Tourette Syndrome
Authors: Vaccarino Flora M. , Kataoka-Sasaki Yuko , Lennington Jessica B.
Published: September 2013

This chapter summarizes the available literature data on pathological findings in Tourette syndrome. In Tourette syndrome there are decreases in parvalbumin + gamma-aminobutyric (GABA)-ergic interneurons and cholinergic interneurons in the caudate and putamen. There is also loss of the normal distribution (highest in associative regions, intermediate in sensorimotor regions, and lowest in limbic regions) of cholinergic interneurons. There are no evident changes in choline acetyl-transferase distribution in striosomes versus matrix. There may also be changes in another interneuron population, the nitric oxide synthase (NOS)-containing interneurons. These findings are discussed in light of current views on the pathogenic mechanisms underlying tic disorders.
Alternative Treatments in Tourette Syndrome
Authors: Zolovska Beata , Coffey Barbara J.
Published: September 2013

Complementary and alternative medicine (CAM) approaches are among the most popular and widely used treatments for Tourette syndrome (TS). This chapter is a systematic and critical review of the scattered evidence available on this topic. The five major groups of CAM practices are mind–body medicine, biologically based therapies, manipulative and body-based therapies, energy medicine, and whole medical systems. Research on CAM approaches is limited but rapidly expanding and improving in its quality. The CAM approaches most frequently reported to be used by patients with TS are dietary modification, allergy treatment, prayer, vitamins, massage, nutritional and dietary supplements, chiropractic manipulation, meditation, yoga, acupuncture, hypnosis, homeopathy, and biofeedback. Research evidence suggests that a number of CAM approaches are potentially useful in TS, yet there are methodological limitations in all studies. The approaches that appear to have the most promise based on the evidence to date are hypnosis, biofeedback, omega-3 fatty acids, cannabinoids, and traditional Chinese medicine (Ningdong granule).
Vertigo and Ataxia
Authors: von Brevern Michael
Published: September 2013

Vertigo can be defined as the sensation of self-motion when no self-motion is actually occurring or the sensation of distorted self-motion during an otherwise normal head movement. The term encompasses false spinning sensations, and also other false sensations like swaying, tilting, bobbing, bouncing, or sliding. Vertigo can be discriminated from dizziness, which is the sensation of disturbed spatial orientation without a false sense of motion (Bisdorff et al., 2009). Vertigo ranks among the most frequent symptoms in medicine. A large epidemiological study of the general population in Germany yielded a lifetime prevalence of vertigo of 7.4%. In the vast majority of cases (88%) vertigo was recurrent (Neuhauser et al., 2005). Vertigo often indicates, but is not synonymous with, acute dysfunction of the vestibular system, occurring also in non-vestibular disorders such as phobia, cardiovascular disease, and, more rarely, epilepy (Newman-Toker et al., 2008). The history is of paramount importance to identify the cause of episodic vertigo, as patients often present in the symptom-free interval and laboratory testing in the interval may be normal. Beside the quality of symptoms, essential components of the history are timing, triggers, and accompanying symptoms. This chapter will focus on disorders presenting with episodic vertigo and ataxia.
Migraine
Authors: Yankovsky Alexei E. , Andermann Frederick
Published: September 2013

Epilepsy and migraine have been associated since William Richard Gowers’ time. Both are common, paroxysmal, chronic neurologic disorders that share many clinical and epidemiologic features. Both conditions may present with visual, cognitive and sensorimotor features, arise from the cerebral cortex, and are modulated by subcortical connections. They are linked to genetic factors, and often have good prognoses. At times, the clinical distinction between migraine and epilepsy can be difficult and the differential diagnosis problematic. The electroencephalogram (EEG) is very helpful in the differentiation of migralepsy (seizures triggered by a migraine aura), confusional migraine, and certain epilepsy syndromes associated with migraine-like headaches such as benign occipital epilepsy. Migraine and epilepsy occur together in a number of infrequent genetic disorders (eg. MELAS, MERRF and CADASIL). The pathophysiology of migraine is not completely understood but significant advances have recently been made. The treatment options for abortive interventions for the two conditions are different, but the options for preventive treatments are surprisingly similar. This chapter discusses Gowers’ contribution to migraine and epilepsy, the epidemiology of the two conditions, diagnostic challenges, and our current understanding of genetics, pathophysiology and treatment.
Transient Ischemic Attacks and Stroke
Authors: Salvesen Rolf , Thomassen Lars
Published: September 2013

Transient ischaemic attacks (TIAs) and stroke are very common medical conditions. They are of major importance because of their potentially catastrophic consequences for the stroke sufferer and their family, and because of the severe associated economic burden associated with the consequences of strokes. Sometimes TIAs, and less often minor strokes, may be mistaken as manifestations of epilepsy and vice versa. The most frequent situations in which confusion is likely to arise are “limb-shaking TIAs” due to severe carotid occlusive disease, or transient speech disturbances and seizures due to insufficient cerebral perfusion. This chapter will deal with these situations in some detail. It will also give a short account of relevant pathophysiological considerations and describe a rapid approach to the clinical management of TIAs.
Transient Global Amnesia
Authors: Butler Christopher , Zeman Adam
Published: September 2013

Transient global amnesia (TGA) is a neurological syndrome characterized by a self-limiting episode of isolated memory impairment. The etiology of TGA is unknown but it is widely thought not to be an epileptic phenomenon. Nevertheless, epileptic seizures can cause a very similar clinical picture – the syndrome of transient epileptic amnesia (TEA). It is important to distinguish between these two phenomena, as their treatment and prognosis are different. In this chapter, we describe the principal clinical features of transient amnesic syndromes, highlighting those that help to distinguish TGA from TEA. We also discuss recent advances that are beginning to unravel the etiology of TGA.
Sleep Disorders
Authors: Tinuper Paolo , Bisulli Francesca
Published: September 2013

About a third of a human being’s life is spent sleeping. Many physiological and pathological motor events (including epileptic seizures) may arise from sleep. The differential diagnosis of paroxysmal motor phenomena during sleep can therefore represent a true diagnostic challenge. When the British neurologist Sir William Richard Gowers discussed paroxysmal conditions “in the borderland of epilepsy near it, but not of it” in 1907, one chapter of his book was devoted to “sleep symptoms” and to the problem of their differentiation from epilepsy. More than a century has passed since Gowers’ invaluable contribution to the understanding of epilepsy mechanisms. However, the search for clinical parameters distinguishing epileptic attacks occurring during sleep and non-epileptic paroxysmal motor phenomena related to normal or pathological sleep continues. In the meantime, technological advances have led to a more accurate description of paroxysmal phenomena arising from sleep, providing a better definition of their different clinical and polygraphic features, and helping to explain the underlying pathophysiological mechanisms. However, prompt and correct diagnosis may still prove difficult in routine neurological practice. This chapter revisits the borderland of epilepsy, focusing on those sleep disorders, namely parasomnias and narcolepsy, that most frequently create problems in the differential diagnosis. For each condition, clinical features distinguishing it from epileptic seizures are pointed out, and an account of the current understanding of the molecular pathophysiology is provided.
Alcohol-Related Seizure Disorders
Authors: Samokhvalov Andriy V. , Araki Keyghobad Farid , Selby Peter , Rehm Jürgen
Published: September 2013

This chapter describes the complex relationships between alcohol consumption and seizure disorders, which include alcohol withdrawal seizures and seizures that occur due to alcohol intoxication per se. We also present an update on the controversial but historically important concept of 'alcoholic epilepsy'. The current understanding of pathophysiological changes leading to alcohol withdrawal seizures is described in detail and illustrated by a typical case of excessive long-term alcohol consumption with multiple withdrawals and the associated medical and social sequelae. Potential causes and pathophysiological grounds for seizures due to alcohol intoxication are described in detail and a state-of-the-art understanding of the development of epilepsy in drinkers is presented. Special attention is paid to effects of alcohol consumption on existing seizure disorders. The differential diagnosis between different kinds of alcohol-related seizures and seizures in the context of epilepsy as well as appropriate management strategies are outlined.
Primarily Nonepileptic Encephalopathies
Authors: Lewis Mark
Published: September 2013

Encephalopathy is a syndrome, not a diagnosis. There are many causes, both those that directly affect the brain and those that produce neurological disturbance by more indirect mechanisms. There is even overlap between these two groups. The syndrome is characterized by global cerebral dysfunction, with a number of cognitive domains and cerebral functions being affected. A problem with arousal is almost universal, though can be absent. A careful clinical history, including that taken from relatives, carers and friends will elucidate the cause in most cases and usually only simple tests are required to confirm a diagnosis. Occasionally second line tests are required, and in these settings, the need to perform these tests is often highlighted by lack of progress made with the initial diagnostic steps. Treatment is usually of the underlying cause, though good general medical and nursing care are vital when dealing with patients in such a vulnerable state of mind.
Epileptic Encephalopathies and Clinical Manifestations of Abnormal Electroencephalographic Patterns
Authors: D’Argenzio Luigi , Pujar Suresh , Holmes Gregory L. , Scott Rod C.
Published: September 2013

Epileptic encephalopathies (EEs) are currently defined as electroclinical epilepsy syndromes associated with a high probability of encephalopathic features that present or worsen after the onset of epilepsy. The severity of the epilepsy and associated cognitive and behavioral impairments make EEs amongst the most challenging epilepsies to manage. The common features of EEs are the presence of abnormal epileptiform brain activity, either continuously or with high recurrence, and a severe impairment of cognitive abilities. The latter has been historically considered as a direct consequence of the former by many authors, although the exact pathophysiology of EEs is still unclear. This chapter discusses the epilepsies currently considered as EEs, their clinical and neurophysiological phenotypes, their medical management and prognosis. The pathophysiology of the impairments of EEs is also discussed.
Autism
Authors: Hughes John R.
Published: September 2013

The clinical phenomenology of autism (A) includes repetitive behavior, language impairment, sleep disorders, social problems, joint attention disorders, seizures, allergic reactions, behavioral, cognitive and sensory changes, especially visual and perceptual changes. Patients with seizures do not commonly become autistic, but 30 to 50% of patients with autism may develop epilepsy. The pathophysiology and possibly etiologies of autism include genetic factors, various maternal conditions, a deficient mirror-neuron system, a discussion of vaccines, underconnectivity within the cortex, mitochrondrial and immunological dysfunctions, deficient proteins and metabolic disorders. Relevant neuroanatomic relationships include abnormal function of prefrontal, frontal, temporal cortices, especially the amygdala, as well as cingulate and visual cortex and subcortical structures. Clinical improvement may come from drugs including risperidone, atypical antipsychotic drugs and psychostimulants. Therapeutic procedures include acupuncture, massage, robots, hyperbaric oxygen, music, transcranial magnetic stimulation, positive parenting programs, service dogs, transcranial micropolarization and childcare services.
Epileptic Prodromes
Authors: Mormann Florian , Lehnertz Klaus
Published: September 2013

For patients with epilepsy who do not achieve complete seizure control, it is the sudden, unforeseen way in which seizures strike ‘like a bolt from the blue’ that represents one of the most disabling aspects of their disorder. Apart from the risk of serious injury, seizures are often associated with an intense feeling of helplessness that has a strong impact on patients' everyday lives. The ability accurately to anticipate the occurrence of seizures could significantly improve the quality of life of people with epilepsy. This chapter critically reviews the scientific evidence for the existence of prodromal pre-seizure states, including clinical as well as electrophysiological pre-ictal phenomena.
From daily movements to population distributions: weather affects competitive ability in a guild of soaring birds
Authors: Shepard Emily L. C. , Lambertucci Sergio A.
Published: September 2013

The ability of many animals to access and exploit food is dependent on the ability to move. In the case of scavenging birds, which use soaring flight to locate and exploit ephemeral resources, the cost and speed of movement vary with meteorological factors. These factors are likely to modify the nature of interspecific interactions, as well as individual movement capacity, although the former are less well understood. We used aeronautical models to examine how soaring performance varies with weather within a guild of scavenging birds and the consequences this has for access to a common resource. Birds could be divided broadly into those with low wing loading that are more competitive in conditions with weak updraughts and low winds (black vultures and caracaras), and those with high wing loading that are well adapted for soaring in strong updraughts and moderate to high winds (Andean condors). Spatial trends in meteorological factors seem to confine scavengers with high wing loading to the mountains where they out-compete other birds; a trend that is borne out in worldwide distributions of the largest species. However, model predictions and carcass observations suggest that the competitive ability of these and other birds varies with meteorological conditions in areas where distributions overlap. This challenges the view that scavenging guilds are structured by fixed patterns of dominance and suggests that competitive ability varies across spatial and temporal scales, which may ultimately be a mechanism promoting diversity among aerial scavengers.
Bacillus pervagus sp. nov. and Bacillus andreesenii sp. nov., isolated from a composting reactor
Authors: Kosowski Kornelia , Schmidt Marie , Pukall Rüdiger , Hause Gerd , Kämpfer Peter , Lechner Ute
Published: September 2013

Two strains, 8-4-E12T and 8-4-E13T, were isolated from a biowaste composting reactor. Based on 16S rRNA gene sequences, both strains belong to the genus

Bacillus

. Strain 8-4-E12T was most closely related to the type strains of

Bacillus shackletonii

,

B. acidicola

,

B. sporothermodurans

and

B. oleronius

(96.4, 96.3, 96.0 and 95.6 % 16S rRNA gene similarity, respectively), whereas strain 8-4-E13T was most closely related to the type strain of

Bacillus humi

(96.5 % sequence similarity). Strains 8-4-E12T and 8-4-E13T shared 94 % 16S rRNA gene sequence similarity. The fatty acid profile of strain 8-4-E12T was dominated by saturated iso- and anteiso-branched fatty acids (iso-C15 : 0, anteiso-C15 : 0, anteiso-C17 : 0 and iso-C16 : 0), and also contained considerable amounts of C16 : 0. The fatty acid profile of strain 8-4-E13T showed a predominance of iso-C15 : 0 (65 %), with smaller amounts of other saturated branched-chain fatty acids along with an unsaturated alcohol. Both strains contained diphosphatidylglycerol, phosphatidylglycerol and phosphatidylethanolamine as major polar lipids. Additionally, strain 8-4-E12T contained an unknown lipid and strain 8-4-E13T two unknown (amino-)phospholipids. The diagnostic diamino acid found in the cell-wall peptidoglycan of 8-4-E12T and 8-4-E13T was meso-diaminopimelic acid. The predominant menaquinone was MK-7. The results of physiological and biochemical tests also allowed phenotypic differentiation of the two strains from each other and from related

Bacillus

species. On the basis of their phylogenetic, phenotypic and chemotaxonomic properties, strains 8-4-E12T and 8-4-E13T represent novel species of the genus

Bacillus

, for which the names Bacillus pervagus sp. nov. (type strain 8-4-E12T = DSM 23947T = LMG 27601T) and Bacillus andreesenii sp. nov. (type strain 8-4-E13T = DSM 23948T = LMG 27602T) are proposed.
The impact of pelvic floor surgery on female sexual function: a mixed quantitative and qualitative study
Authors: Roos AM , Thakar R , Sultan AH , de Leeuw JW , Paulus ATG
Published: September 2013

Objective

To assess whether the current condition‐specific sexual function questionnaire provides full insight into sexual function following pelvic floor surgery.

Design

Prospective, mixed quantitative and qualitative study.

Setting

Urogynaecology clinic in a large university hospital.

Population

Thirty‐seven women undergoing surgery for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI).

Methods

Women were seen before surgery and 3 months postoperatively. At both visits the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) was completed and a qualitative face‐to‐face semi‐structured interview was conducted. PISQ total and domain scores, as well as the change in the preoperative and postoperative score, were calculated and analysed using Wilcoxon signed rank test and one‐sample t‐test. The qualitative data were systematically analysed using data‐matrices.

Main outcome measures

The impact of pelvic floor surgery on female sexual function.

Results

Significant improvement was seen for PISQ total score (P = 0.003) as well as Physical (P < 0.001) and Partner‐related (P = 0.002) domains, but not for the Behavioural/Emotive domain (P = 0.220). Analysis of qualitative data showed that improvement in sexual function was a result of cure of POP and SUI symptoms. Deterioration of sexual function was due to dyspareunia, fear of causing damage to the surgical result, new symptoms and a disappointing result of surgery.

Conclusions

Our qualitative data show that PISQ is limited in the assessment of sexual function after pelvic floor surgery as it does not assess most surgery‐specific negative effects on sexual function.