bluuebunny/crossref_metadata_2025 huggingface dataset:
Facile Fabrication of Platinum Nanoparticles Supported on Nitrogen-doped Carbon Nanotubes and Their Catalytic Activity
Authors: Wang Ling-ling , Shen Long , Jin Hai-ying , Zhu Lu-ping , Wang Li-jun
Published: July 2014

A facile impregnation method under mild condition is designed for synthesis of highly dispersed Pt nanoparticles with a narrow size of 4–7 nm on nitrogen-doped carbon nanotubes (CNx). CNx do not need any pre-surface modification due to the inherent chemical activity. The structure and nature of Pt/CNx were characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy and energy dispersive spectroscopy spectrum. All the experimental results revealed that the large amount of doped nitrogen atoms in CNx was virtually effective for capturing the Pt(IV) ions. The improved surface nitrogen functionalities and hydrophilicity contributed to the good dispersion and immobilization of Pt nanoparticles on the CNx surface. The Pt/CNx served as active and reusable catalysts in the hydrogenation of allyl alcohol. This could be attributed to high dispersion of Pt nanoparticles and stronger interaction between Pt and the supports, which prevented the Pt nanoparticles from aggregating into less active Pt black and from leaching as well.
Preparation and Photocatalytic Activity of Ce, H3PW12O40 co-doped TiO2 Hollow Fibers
Authors: Yao Shu-hua , Chen Shuang , Shi Zhong-liang
Published: July 2014

A series of Ce, H3PW12O40 co-doped TiO2 hollow fibers photocatalysts have been prepared by sol-gel method using ammonium ceric nitrate, H3PW12O40 and tetrabutyltitanate as precursors and cotton fibers as template, followed by calcination at 500 °C in N2 atmosphere for 2 h. Scanning electron microscopy, X-ray diffraction, nitrogen adsorption-desorption measurements, and UV-Vis spectroscopy are employed to characterize the morphology, crystal structure, surface structure, and optical absorption properties of the samples. The photo-catalytic performance of the samples has been studied by photodegradation phenol in water under UV and visible light irradiation. The results show that the TiO2 fiber materials have hollow structures, and the co-doped TiO2 hollow fibers exhibit higher photocatalytic activities for the degradation of phenol than un-doped, single-doped TiO2 hollow fibers under UV and visible light. In addition, the recyclability of co-doped TiO2 fibers is also confirmed that the TiO2 fiber retains ca. 90% of its activity after being used four times. It is shown that the co-doped TiO2 fibers can be activated by visible light and may be potentially applied to the treatment of water contaminated by organic pollutants. The synergistic effect of Ce and H3PW12O40 co-doping plays an important role in improving the photocatalytic activity.
Synthesis and Characterization of ZnO Bicrystalline Nanosheets Grown via Ag-Au Alloy Catalyst
Authors: Gao Zhi-wei , Lin Yue , Li Jun-wen , Wang Xiao-ping
Published: July 2014

ZnO bicrystalline nanosheets have been synthesized by using Agx Au1−x alloy catalyst via the vapor transport and condensation method at 650 °C. High resolution transmission electron microscopy characterization reveals a twin boundary with {01–13} plane existing in the bicrystalline. A series of control experiments show that both AgxAu1−x alloy catalyst and high supersaturation of Zn vapor are prerequisites for the formation of ZnO bicrystalline nanosheet. Moreover, it is found that the density of ZnO bicrytalline nanosheets can be tuned through varying the ratio of Ag to Au in the alloy catalyst. The result demonstrates that new complicated nanostructures can be produced controllably with appropriate alloy catalyst.
Real-Time Characterization of Fibrinogen Interaction with Modified Titanium Dioxide Film by Quartz Crystal Microbalance with Dissipation
Authors: Zhao An-sha , Wang Zhao , Zhu Xiao-hua , Maitz Manfred F. , Huang Nan
Published: July 2014

The adsorption of fibrinogen can be used as a quick indicator of surface haemocompatibility because of its prominent role in coagulation and platelet adhesion. In this work the molecular interaction between fibrinogen and a modified titanium oxide surface/platelet has been studied by quartz crystal microbalance with dissipation (QCM-D) in situ. In order to further characterize the conformation of adsorbed fibrinogen, αC and γ-chain antibody were used to check the orientation and denaturation of fibrinogen on solid surface. QCM-D investigations revealed the fibrinogen have the trend to adsorb on hydrophilic surface in a side-on orientation by positively charged αC domains, which would reduce the exposure of platelet bonding site on γ chain and enable less platelet adhesion and be activated. These observations suggest that certain conformations of adsorbed fibrinogen are less platelet adhesive than others, which opens a possibility for creating a non-platelet adhesive substrates.
Transformation of Biomass into Aromatics with Zeolite Catalysts
Authors: Deng Shu-mei , Fan Ming-hui , Wang Tie-jun , Li Quan-xin
Published: July 2014

Biomass is a nature renewable resource which can be used for the production of high value chemicals and bio-fuels. In the present work, the transformation of sawdust into aromatics such as benzene, toluene and xylenes was investigated over a series of zeolite catalysts (NaZSM-5, HZSM-5, ReY and HY catalysts). Among the tested catalysts, the HZSM-5 catalyst shows the highest activity for the production of aromatics. The yield and carbon selectivity of aromatics reached about 26.5% and 62.5C-mol%, respectively over the HZSM-5 catalyst under the optimal condition of T=450 °C, f(N2)=300 cm3/min, and catalyst/lignin ratio of 2. The effects of the reaction conditions including temperature, gas flow rate, and catalyst/sawdust ratio on the production of aromatics were investigated in detail and the formation of aromatics from lignocellulosic biomass was also addressed.
Mean Size as a Unit of Visual Working Memory
Authors: Im Hee Yeon , Chong Sang Chul
Published: July 2014

Visual environments often contain multiple elements, some of which are similar to one another or spatially grouped together. In the current study we investigated how one can use perceptual groups in representing ensemble features of the groups. In experiment 1 we found that participants' performance improved when items were easily segmented by a grouping cue based on proximity, suggesting that spatial grouping facilitates extracting and remembering ensemble representations from visual arrays consisting of multiple elements. In experiment 2 we found that spatial grouping improved performance only when the grouped subsets were tested for the memory task, whereas it impaired performance when other subsets that were not grouped were tested, suggesting that the benefit from grouping may come from better extraction for storage, rather than later decision processes such as accessibility. Taken together, our results suggest that perceptual grouping of multiple items by proximity facilitates extraction of ensemble statistics from groups of items, enhancing visual memory of the ensembles in a visual array.
Localization of 9- and 13-oxo-octadecadienoic acids in tomato fruit
Authors: Takahashi Haruya , Kamakari Kosuke , Suzuki Hideyuki , Mohri Shinsuke , Goto Tsuyoshi , Takahashi Nobuyuki , Matsumura Yasuki , Shibata Daisuke , Kawada Teruo
Published: July 2014

We previously reported that the two peroxisome proliferator-activated receptor-α agonists, 9- and 13-oxo-octadecadienoic acids (oxo-ODAs), were found in the tomato fruit. However, their localization remains unknown. Herein, we showed that oxo-ODAs localize primarily in the fruit peel and their amount increases after the homogenization of the tomato fruit.
Cysteine-2 and Cys30 are essential for chlorophyll-binding activity of the water-soluble chlorophyll-binding protein (WSCP) ofChenopodium album
Authors: Takahashi Shigekazu , Seki Yumiko , Uchida Akira , Nakayama Katsumi , Satoh Hiroyuki
Published: July 2014

Chenopodium album has a non-photosynthetic chlorophyll protein known as the water-soluble chlorophyll (Chl)-binding protein (WSCP). The C. album WSCP (CaWSCP) is able to photoconvert the chlorin skeleton of Chl a into a bacteriochlorin-like skeleton. Reducing reagents such as β-mercaptoethanol or dithiothreitol inhibit photoconversion, indicating that S–S bridge(s) in CaWSCP are quite important for it. Recently, we found that the mature region of CaWSCP contains five cysteine residues; Cys2, Cys30, Cys48, Cys63, and Cys144. To identify which cysteine residues are involved in the photoconversion, we generated five mutants (C2S, C30S, C48S, C63S, and C144S) by site-directed mutagenesis. Interestingly, C48S, C63S, and C144S mutants showed the same Chl-binding activity and photoconvertibility as those of the recombinant wild-type CaWSCP-His, while the C2S and C30S mutants completely lost Chl-binding activity. Our findings indicated that the S–S bridge between Cys2 and Cys30 in each CaWSCP subunit is essential for Chl-binding activity.
Preventing the Transmission of Multidrug-Resistant Organisms: Modeling the Relative Importance of Hand Hygiene and Environmental Cleaning Interventions
Authors: Barnes Sean L. , Morgan Daniel J. , Harris Anthony D. , Carling Phillip C. , Thom Kerri A.
Published: July 2014

Objective

Hand hygiene and environmental cleaning are essential infection prevention strategies, but the relative impact of each is unknown. This information is important in assessing resource allocation.

Methods

We developed an agent-based model of patient-to-patient transmission—via the hands of transiently colonized healthcare workers and incompletely terminally cleaned rooms—in a 20-patient intensive care unit. Nurses and physicians were modeled and had distinct hand hygiene compliance levels on entry and exit to patient rooms. We simulated the transmission of Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant enterococci for 1 year using data from the literature and observed data to inform model input parameters.

Results

We simulated 175 parameter-based scenarios and compared the effects of hand hygiene and environmental cleaning on rates of multidrug-resistant organism acquisition. For all organisms, increases in hand hygiene compliance outperformed equal increases in thoroughness of terminal cleaning. From baseline, a 2∶1 improvement in terminal cleaning compared with hand hygiene was required to match an equal reduction in acquisition rates (eg, a 20% improvement in terminal cleaning was required to match the reduction in acquisition due to a 10% improvement in hand hygiene compliance).

Conclusions

Hand hygiene should remain a priority for infection control programs, but environmental cleaning can have significant benefit for hospitals or individual hospital units that have either high hand hygiene compliance levels or low terminal cleaning thoroughness.

Infect Control Hosp Epidemiol 2014;35(9):1156-1162
Translating Evidence into Practice Using a Systems Engineering Framework for Infection Prevention
Authors: Yanke Eric , Carayon Pascale , Safdar Nasia
Published: July 2014

The current infection prevention era is defined by the rise of healthcare-associated infections (HAIs) and multidrug-resistant organisms (MDROs). Efforts to combat these and other emerging pathogens have resulted in rapid and ongoing evolution of the contemporary infection prevention environment. Currently, HAIs impose a significant burden on the US healthcare system. Recent analysis of National Healthcare Safety Network data from the early 2000s suggests that at least 1.7 million HAIs occur yearly in US hospitals, associated with at least 99,000 deaths. These numbers have likely increased over the past decade and suggest that HAIs are among the leading causes of death in the United States.
Maximal freedom at minimum cost: linear large-scale structure in general modifications of gravity
Authors: Bellini Emilio , Sawicki Ignacy
Published: July 2014

We present a turnkey solution, ready for implementation in numerical codes, for the study of linear structure formation in general scalar-tensor models involving a single universally coupled scalar field. We show that the totality of cosmological information on the gravitational sector can be compressed — without any redundancy — into five independent and arbitrary functions of time only and one constant. These describe physical properties of the universe: the observable background expansion history, fractional matter density today, and four functions of time describing the properties of the dark energy. We show that two of those dark-energy property functions control the existence of anisotropic stress, the other two — dark-energy clustering, both of which are can be scale-dependent. All these properties can in principle be measured, but no information on the underlying theory of acceleration beyond this can be obtained. We present a translation between popular models of late-time acceleration (e.g. perfect fluids,f(R), kinetic gravity braiding, galileons), as well as the effective field theory framework, and our formulation. In this way, implementing this formulation numerically would give a single tool which could consistently test the majority of models of late-time acceleration heretofore proposed.
On the irreducibility of irreducible characters of simple Lie algebras
Authors: Rajan C.
Published: July 2014

We establish an irreducibility property for the characters of finite dimensional, irreducible representations of simple Lie algebras (or simple algebraic groups) over the complex numbers, i.e., that the characters of irreducible representations are irreducible after dividing out by (generalized) Weyl denominator type factors.

For

S
L
(
r
)

SL(r)

the irreducibility result is the following: let

λ
=
(

a
1

≥

a
2

≥
⋯
≥

a

r
−
1

≥
0
)

\lambda =(a_1\geq a_2\geq \cdots \geq a_{r-1}\geq 0)

be the highest weight of an irreducible rational representation

V

λ

V_{\lambda }

of

S
L
(
r
)

SL(r)

. Assume that the integers

a
1

+
r
−
1
,
 

a
2

+
r
−
2
,
⋯
,

a

r
−
1

+
1

a_1+r-1, ~a_2+r-2, \cdots , a_{r-1}+1

are relatively prime. Then the character

χ

λ

\chi _{\lambda }

of

V

λ

V_{\lambda }

is strongly irreducible in the following sense: for any natural number

d
d

, the function

χ

λ

(

g
d

)
,
 
g
∈
S
L
(
r
,

C

)

\chi _{\lambda }(g^d), ~g\in SL(r,\mathbb {C})

is irreducible in the ring of regular functions of

S
L
(
r
,

C

)

SL(r,\mathbb {C})

.
Brauer’s generalized decomposition numbers and universal deformation rings
Authors: Bleher Frauke
Published: July 2014

The versal deformation ring

R
(
G
,
V
)

R(G,V)

of a mod

p
p

representation

V
V

of a profinite group

G
G

encodes all isomorphism classes of lifts of

V
V

to representations of

G
G

over complete local commutative Noetherian rings. We introduce a new technique for determining

R
(
G
,
V
)

R(G,V)

when

G
G

is finite which involves Brauer’s generalized decomposition numbers.
Quasi-conformal rigidity of multicritical maps
Authors: Peng Wenjuan , Tan Lei
Published: July 2014

We combine the enhanced nest constructed by Kozlovski, Shen and van Strien, and the analytic method proposed by Avila, Kahn, Lyubich and Shen to prove quasi-conformal rigidity properties of multicritical maps.
Systematic analysis of gene properties influencing organ system phenotypes in mammalian perturbations
Authors: Vogt Ingo , Prinz Jeanette , Worf Karolina , Campillos Monica
Published: July 2014

Motivation: Diseases and adverse drug reactions are frequently caused by disruptions in gene functionality. Gaining insight into the global system properties governing the relationships between genotype and phenotype is thus crucial to understand and interfere with perturbations in complex organisms such as diseases states.

Results: We present a systematic analysis of phenotypic information of 5047 perturbations of single genes in mice, 4766 human diseases and 1666 drugs that examines the relationships between different gene properties and the phenotypic impact at the organ system level in mammalian organisms. We observe that while single gene perturbations and alterations of nonessential, tissue-specific genes or those with low betweenness centrality in protein–protein interaction networks often show organ-specific effects, multiple gene alterations resulting e.g. from complex disorders and drug treatments have a more widespread impact. Interestingly, certain cellular localizations are distinctly associated to systemic effects in monogenic disease genes and mouse gene perturbations, such as the lumen of intracellular organelles and transcription factor complexes, respectively. In summary, we show that the broadness of the phenotypic effect is clearly related to certain gene properties and is an indicator of the severity of perturbations. This work contributes to the understanding of gene properties influencing the systemic effects of diseases and drugs.

Contact:  monica.campillos@helmholtz-muenchen.de

Supplementary information:  Supplementary data are available at Bioinformatics online.
Inferring condition-specific miRNA activity from matched miRNA and mRNA expression data
Authors: Zhang Junpeng , Le Thuc Duy , Liu Lin , Liu Bing , He Jianfeng , Goodall Gregory J. , Li Jiuyong
Published: July 2014

Motivation: MicroRNAs (miRNAs) play crucial roles in complex cellular networks by binding to the messenger RNAs (mRNAs) of protein coding genes. It has been found that miRNA regulation is often condition-specific. A number of computational approaches have been developed to identify miRNA activity specific to a condition of interest using gene expression data. However, most of the methods only use the data in a single condition, and thus, the activity discovered may not be unique to the condition of interest. Additionally, these methods are based on statistical associations between the gene expression levels of miRNAs and mRNAs, so they may not be able to reveal real gene regulatory relationships, which are causal relationships.

Results: We propose a novel method to infer condition-specific miRNA activity by considering (i) the difference between the regulatory behavior that an miRNA has in the condition of interest and its behavior in the other conditions; (ii) the causal semantics of miRNA–mRNA relationships. The method is applied to the epithelial–mesenchymal transition (EMT) and multi-class cancer (MCC) datasets. The validation by the results of transfection experiments shows that our approach is effective in discovering significant miRNA–mRNA interactions. Functional and pathway analysis and literature validation indicate that the identified active miRNAs are closely associated with the specific biological processes, diseases and pathways. More detailed analysis of the activity of the active miRNAs implies that some active miRNAs show different regulation types in different conditions, but some have the same regulation types and their activity only differs in different conditions in the strengths of regulation.

Availability and implementation: The R and Matlab scripts are in the Supplementary materials .

Contact:  jiuyong.li@unisa.edu.au

Supplementary information:  Supplementary data are available at Bioinformatics online.
FisHiCal: an R package for iterative FISH-based calibration of Hi-C data
Authors: Shavit Yoli , Hamey Fiona Kathryn , Lio Pietro
Published: July 2014

Summary: The fluorescence in situ hybridization (FISH) method has been providing valuable information on physical distances between loci (via image analysis) for several decades. Recently, high-throughput data on nearby chemical contacts between and within chromosomes became available with the Hi-C method. Here, we present FisHiCal, an R package for an iterative FISH-based Hi-C calibration that exploits in full the information coming from these methods. We describe here our calibration model and present 3D inference methods that we have developed for increasing its usability, namely, 3D reconstruction through local stress minimization and detection of spatial inconsistencies. We next confirm our calibration across three human cell lines and explain how the output of our methods could inform our model, defining an iterative calibration pipeline, with applications for quality assessment and meta-analysis.

Availability and implementation: FisHiCal v1.1 is available from http://cran.r-project.org/ .

Contact:  ys388@cam.ac.uk

Supplementary information:  Supplementary Data is available at Bioinformatics online.
The Relationship between Article 101(1) and Article 101(3) TFEU
Authors: Jones Alison , Sufrin Brenda
Published: July 2014

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter examines the relationship between Article 101(1) and Article 101(3). It focuses on the substantive question of which agreements restrict competition and/or meet the Article 101(3) criteria.
Article 102 TFEU: Dominant Position
Authors: Jones Alison , Sufrin Brenda
Published: July 2014

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. Article 102 only applies to undertakings in a dominant position. Thus, whether or not an undertaking holds a ‘dominant position’ is of central importance to Article 102. This chapter discusses the following: the definition of a dominant position; the definition of a dominant position in the case law; establishing dominance; market definition in Article 102 cases; and assessing market power.
Cartels and Oligopoly
Authors: Jones Alison , Sufrin Brenda
Published: July 2014

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter examines how EU competition law applies both to undertakings operating cartels and to undertakings that tacitly coordinate their behaviour on an oligopolistic market. It starts by looking at the difference between ‘explicit’ and ‘tacit’ collusion. The chapter then deals with cartels and other agreements that may be used to bolster cartels, or which may facilitate explicit or tacit collusion on a market. Next, it considers the problem of tacit collusion and whether, in particular, Articles 101 and 102 operate as effective mechanisms for dealing with the problem. The chapter also considers other options that EU competition law might offer to deal with tacit collusion, either ex ante or ex post.
Horizontal Cooperation Agreements
Authors: Jones Alison , Sufrin Brenda
Published: July 2014

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter discusses EU competition policy towards horizontal cooperation agreements. It covers joint ventures; the contents of the 2010 Guidelines; the general approach to horizontal cooperation agreements in the Guidelines; information agreements; research and development agreements; production agreements; purchasing agreements; commercialisation agreements; standardisation agreements; and agreements in particular sectors.
Pneumonia and Respiratory Infections
Authors: Katz Joel T.
Published: July 2014

Respiratory symptoms are among the most frequent reasons for patients to seek medical attention. Seventy percent of patients presenting with a new cough will be diagnosed with acute bronchitis. Other common causes of a new cough include pneumonia, cough-variant asthma, congestive heart failure, rhinosinusitis, and aspiration of oral contents. Among patients presenting to their primary care provider with a cough, clinical predictors of the 10–15% who will have pneumonia are advanced patient age (OR 4.6), shortness of breath (2.4), fever (5.5), tachycardia (3.8), and localizing chest auscultation findings such as focal respiratory crackles (23.8) or rhonchi (14.6). The etiology, prognosis, and treatment of these major respiratory tract infections are vastly different and are reviewed in this chapter.
HIV Infection and AIDS
Authors: Plank Rebeca M. , Sax Paul E.
Published: July 2014

Internists often provide medical care both to patients with as yet undiagnosed human immunodeficiency virus (HIV) infection and to those with known infection. Through early diagnosis and management of patients with HIV infection, physicians can significantly impact both individual patient health and public health. Early diagnosis and appropriate management of patients with HIV are crucial for the health of the individual and for the public's health, as those with known HIV infection can take measures to avoid transmitting the virus to others.
Infective Endocarditis
Authors: Nohria Anju
Published: July 2014

Infective endocarditis (IE) is an infection of the endocardial surface of the heart. It is characterized by one or more vegetations, which comprise a mass of platelets, fibrin, microorganisms, and inflammatory cells. IE primarily involves the heart valves (native or prosthetic). Other structures may also be involved, including the interventricular septum, the chordae tendineae, the mural endocardium, or intracardiac devices such as a pacemaker. The most common infective causes are bacterial; however, fungal endocarditis can be seen in patients who are immunocompromised. There is controversy about the existence of viral endocarditis. Valvular involvement in IE may lead to congestive heart failure, conduction abnormalities, and myocardial abscesses. Systemic complications in IE include embolization of both sterile and infected emboli, abscess formation, and mycotic aneurysms.
Sexually Transmitted Diseases
Authors: Yawetz Sigal , Johnson Jennifer A.
Published: July 2014

Awide variety of infectious agents are sexually transmitted (see table 6.1), causing an array of disease manifestations that are frequently not confined to the genital tract. According to the most recent Centers for Disease Control (CDC) surveillance data from 2009, the most common reportable sexually transmitted diseases (STDs) in the United States are chlamydia, gonorrhea, and primary and secondary syphilis, respectively, and the annual incidence of chlamydia and early syphilis is still increasing. Case reporting for more common STDs, such as genital herpes simplex virus (HSV), trichomonas, and human papilloma virus (HPV) infections is not required. In this chapter several of the most common ulcerative and nonulcerative STDs are discussed. The viral hepatitides (A, B, and C) and HIV merit individual attention and are not addressed in this chapter. Vaginitis and HPV are also not discussed here.
Lung Cancer
Authors: Nguyen Kim-Son , Neal Joel
Published: July 2014

Cancer of the lung is a group of heterogeneous malignant disorders composed of small cell lung cancer (13%), non-small cell lung cancer (NSCLC) (86%), and rare thoracic malignancies such as mesothelioma and carcinoid tumors. In 2008 the American Cancer Society estimated that 215,020 people in the United States would develop lung cancer, and 161,840 people would die of their disease. In men the age-adjusted cancer death rate for lung cancer peaked in 1990 at approximately 90 deaths per 100,000 and has since decreased to 70 per 100,000. In women, the incidence reached a plateau in 1990 at 40 per 100,000. These changes are in part due to alterations in smoking patterns, but the overall incidence of lung cancer continues to increase with the aging population. Despite the trend of decreased smoking rates in industrialized countries, lung cancer remains the leading cause of cancer death in both men and women in the United States (American Cancer Society, 2008). Lung cancer is also the leading cause of cancer death worldwide.
Disorders of Platelets and Coagulation
Authors: Battinelli Elisabeth M. , Handin Robert I.
Published: July 2014

This chapter begins with an outline of the process of normal hemostasis and reviews the laboratory tests used to assess hemostasis. It then reviews the pathophysiology, clinical presentation, diagnosis, and treatment of the most important hemostatic disorders. Although diagnosis and treatment rely heavily on laboratory tests, it is crucial to emphasize the critical importance of the history and physical examination in assessing patients suspected of having a hemostatic disorder. A careful history will provide an assessment of the likelihood of a disorder and is sometimes positive even when initial screening tests are normal. In addition, the history can help focus the workup on platelets or coagulation proteins. The physical exam can provide important clues to the nature of the bleeding disorder and should not be overlooked.
Medical Oncology Board Review Questions
Authors: Shulman Lawrence N.
Published: July 2014

This chapter provides 18 Medical Oncology Board Review Questions based on the previous ten chapters.
Oncology Summary
Authors: Bunnell Craig A.
Published: July 2014

This chapter provides a summary on Oncology.
Acute Monoarticular Arthritis
Authors: Antolini C. Ryan , Castelino Flavia V. , Reginato Anthony M.
Published: July 2014

Acute monoarticular arthritis represents one of the few rheumatologic emergencies that internists, emergency room physicians, and rheumatologists will encounter in their clinical practice. The possibility of joint infection leading to the loss of joint function is a serious potential consequence in delayed diagnosis of a septic joint. Despite advances in diagnosis and treatment, the morbidity and mortality from septic arthritis remains high; therefore, timely recognition of an infected joint is imperative for a favorable outcome. The differential diagnosis of acute monoarticular arthritis is broad and includes septic arthritis, crystalline disorders, inflammatory disorders, and mechanical problems with the joint (table 24.1).
Systemic Lupus Erythematosus and Related Disorders
Authors: Bermas Bonnie L.
Published: July 2014

Systemic lupus erythematosus (SLE) is a multisystem disease that preferentially affects women of childbearing age. This disorder is both more common and more severe in individuals of African and Asian ancestry. The etiology of SLE is not well understood, although genetics and environmental stimuli clearly are involved. Whether this disease is caused by a T-cell, B-cell, or other immunologic malfunction is debated, but all would agree that clearly autoantibodies such as antinuclear antibodies and anti–double-stranded DNA contribute to the pathophysiology of this disorder. This multisystem disease can affect the skin, joints, lungs, heart, kidneys, and central nervous system. Most of the morbidity and mortality is from renal and central nervous system (CNS) involvement, although accelerated atherosclerosis has recently been appreciated as a major contributor to disease burden. The treatment of SLE has improved over the past decade with less reliance on high-dose corticosteroids and more emphasis on immunosuppressive agents. It is our hope that future research into the pathophysiology of this disorder and the development of more specific therapy, such as biologics, will improve the outcome of this disease.
Systemic Vasculitis
Authors: Dellaripa Paul F.
Published: July 2014

The vasculitides are a group of disorders that are characterized by the presence of inflammation in vessel walls, which leads to vascular occlusion and tissue necrosis. Systemic vasculitic syndromes can present clinically in protean fashion and may be due to a variety of mechanisms involving immune dysregulation that leads to endovascular inflammation. However, these immune mechanisms are still not well understood, and thus, one must rely on clinical, descriptive parameters for classification and treatment. This chapter focuses on well-recognized patterns of presentation, treatment guidelines, and emerging insights on pathogenic mechanisms and implications for future treatment options.
Rheumatology Summary
Authors: Todd Derrick J. , Coblyn Jonathan S.
Published: July 2014

This chapter provides a summary on Rheumatology.
Asthma
Authors: Fanta Christopher H.
Published: July 2014

The 2007 National Asthma Education and Prevention Program Expert Panel defines asthma as “a common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness, and an underlying inflammation. The interaction of these features of asthma determines the clinical manifestations and severity of asthma and the response to treatment.”
Pleural Disease
Authors: Schissel Scott L.
Published: July 2014

The pleural space is lined by the parietal and visceral pleurae. The parietal pleura covers the inner surface of the thoracic cavity, including the mediastinum, diaphragm, and ribs. The visceral pleura covers all lung surfaces, including the interlobar fissures. The right and left pleural spaces are separated by the mediastinum. The pleural space contains a relatively small amount of fluid, approximately 10 mL on each side (approximately 0.13 mL/kg of body weight). The pleural space plays an important role in respiration by coupling the movement of the chest wall with that of the lungs in two ways. First, a relative vacuum in the space keeps the visceral and parietal pleurae in close proximity. Second, the small volume of pleural fluid serves as a lubricant to facilitate movement of the pleural surfaces against each other in the course of respirations. The small volume of fluid is maintained through the balance of hydrostatic and oncotic pressure and lymphatic drainage, a disturbance of which may lead to pathology. A pleural effusion is defined as an abnormal amount of pleural fluid accumulation in the pleural space and is the result of an imbalance between excessive pleural fluid formation and pleural fluid absorption.
Chronic Obstructive Pulmonary Disease
Authors: Reilly John J.
Published: July 2014

Virtually every health care practitioner who provides care to adults will encounter individuals with chronic obstructive pulmonary disease (COPD). Current estimates of the prevalence of the condition vary based on the method of ascertainment: most surveys show that approximately 6% of adults report a doctor's diagnosis of COPD but that approximately 25% have airflow obstruction when assessed by spirometry. COPD is common, morbid, mortal, and expensive: estimates are that 〉20 million U.S. adults have COPD and that it is responsible for 〉120,000 deaths annually with a cost to the U.S. economy of more than $38 billion. This chapter describes the definition of COPD, presenting clinical symptomatology and evaluation, natural history, differential diagnosis, current concepts of pathogenesis, therapeutic options, and the evaluation of a patient with known or suspected COPD considering surgery.
Critical Care Board Review Questions
Authors: Baron Rebecca Marlene
Published: July 2014

This chapter provides 24 Pulmonary Board Review Questions.
Pulmonary Medicine Board Review Questions
Authors: Fanta Christopher H.
Published: July 2014

This chapter provides a summary on Pulmonary and Critical Care medicine.
Pituitary Disorders
Authors: Halperin Florencia , Kaiser Ursula B.
Published: July 2014

Chapter 46 discusses screening for thyroid disease, followed by a more in-depth discussion of the evaluation, treatment, and follow-up options for hyperthyroidism, hypothyroidism, and thyroid nodular disease and cancer.
Endocrine Board Review Questions
Authors: Turchin Alexander
Published: July 2014

This chapter provides a summary on Endocrine medicine.
Acute Kidney Injury
Authors: Denker Bradley M.
Published: July 2014

This chapter discusses electrolyte disorders, including sodium, hyponatremia, hypernatremia, potassium disorders, hypokalemia, hyperkalemia,
Hematuria and Proteinuria
Authors: Bazari Hasan
Published: July 2014

Hematuria and proteinuria are common problems encountered in medicine that may be benign conditions or be harbingers of severe systemic illness and require vigorous evaluation and treatment. This chapter is categorized into conditions that are defined by the presence of hematuria alone, conditions limited to proteinuria alone, or those in which proteinuria is combined with hematuria. The evaluation and therapy of conditions that combine both is dealt with in the latter part of the chapter.
Urinalysis
Authors: Lim Kenneth , Steinman Theodore I. , Hsiao Li-Li
Published: July 2014

Urinalysis is an integral part of the initial evaluation of renal and urinary tract disease. It may also provide an indication of the presence of systemic disease affecting the kidneys. Analysis of the urine should consist of (1) examination of the physical properties of urine; (2) examination of the chemical properties by dipstick urinalysis; and (3) microscopic examination of the sediment. Techniques employed in the collection and laboratory handling of urine are of primary importance and may have significant bearing on results.
Esophageal Disorders
Authors: Saltzman John R. , Jajoo Kunal
Published: July 2014

Chapter 68 discusses esophageal diseases, including symptoms, GERD, epidemiology, management, prognosis, Barrett's esophagus, structural abnormalities, inflammatory and infectious disorders, and motility disorders.
Liver Disease
Authors: Hyett Brian , Chopra Sanjiv
Published: July 2014

An ideal liver function test would be one that could detect minimal liver disease, point to a particular liver function disorder, and be capable of reflecting the severity of the underlying problem. Because no such laboratory test exists, the term, liver function tests, generally refers to a group of serologic tests that evaluate different aspects of liver function; it is a term that is best utilized keeping in mind the clinical context and in conjunction with serial determinations to ascertain the evolution of the hepatic disorder. In addition, cholangiography, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and histologic assessment (via liver biopsy) are often utilized to delineate the nature of the liver disease and as such may also be viewed in the broad context as tests of liver function.
Cirrhosis
Authors: Nayeb-Hashemi Hamed , Ukomadu Chinweike
Published: July 2014

Cirrhosis is defined as a diffuse process characterized by fibrosis and conversion of normal architecture to structurally abnormal nodules. These regenerative nodules lack normal lobular organization and are surrounded by fibrous tissue. The word “cirrhosis” derives from Greek meaning tawny (the orange-yellow color of the diseased liver). René Laennec in 1819 coined the name cirrhosis to describe livers so diseased. The progression of liver injury to cirrhosis may occur over weeks to years. The chief complications are ascites, encephalopathy, and variceal bleeding.
Acute Coronary Syndromes
Authors: Cheng Susan , Sabatine Marc S.
Published: July 2014

In total, ACS presentations account for over 2 million annual hospital admissions in the United States. Almost 1.4 million people suffer an ACS each year, of which 55% are new events, 31% are recurrent events, and 14% are silent events. Of all diagnosed MIs, approximately 30% are STEMI and 70% are NSTE-ACS events. Despite recent declines in associated mortality, coronary artery disease causes one out of every five deaths in the United States. Notably, half of MI-related deaths occur within the first hour, primarily due to ventricular dysrhythmias. Therefore, the presentation of ACS challenges the clinician to rapidly integrate key aspects of the history, physical examination, and diagnostic tests in order to diagnose correctly and manage effectively this potentially life-threatening condition.
Valvular Heart Disease
Authors: Ruff Christian T. , O’Gara Patrick T.
Published: July 2014

The physiological importance of valvular heart disease relates to its effects on cardiopulmonary performance. Symptom onset equates with a distinct change in natural history. The development of atrial fibrillation (AF), ventricular remodeling, hypertrophy, and/or pump dysfunction impacts long-term survival. Diagnosis is most commonly triggered by the appreciation of a heart murmur, following which a decision is made regarding the need for echocardiography for further assessment. Many heart murmurs are benign and need not prompt additional testing. Institution of medical therapy to ameliorate symptoms or prevent complications, such as the use of vitamin K antagonists for patients, should be coupled with an appraisal of the indications for surgical or percutaneous intervention. An integrated understanding of natural history based on the severity of the valve lesion within the context of individual patient comorbidities is the foundation for appropriate clinical decision making. We review here the major valve lesions; treatment and prevention of infective endocarditis are covered elsewhere.
Heart Failure
Authors: Stewart Garrick C.
Published: July 2014

Heart failure is a complex clinical syndrome occurring in patients with an abnormality of cardiac structure or function that impairs the ability of the heart to fill with or eject blood. Patients with heart failure develop a constellation of symptoms (dyspnea and fatigue) and signs (edema and rales) that lead to frequent hospitalizations, poor quality of life, and a shortened life expectancy. Heart failure has also been defined as the failure of the heart to pump enough blood to meet the metabolic demands of the body, or the ability to do so only at elevated filling pressures. Congestive heart failure is the end stage for many cardiac diseases. Cardiomyopathy refers to any condition in which there is a structural abnormality of the myocardium itself.
Cardiovascular Disease Prevention
Authors: Brown Jonathan D. , Plutzky Jorge
Published: July 2014

This chapter focuses on how cardiovascular risk factors contribute to the initiation and progression of coronary heart disease (CHD). Cardiovascular risk factors are currently grouped into traditional and nontraditional types. Traditional risk factors include hyperlipidemia (or dyslipidemia), tobacco use, hypertension, diabetes mellitus, age, male gender, and family history, all of which have been linked to CHD, an association substantiated through multiple large prospective population studies. The categories can be further subdivided into modifiable and nonmodifiable factors: with dyslipidemia, tobacco use, hypertension, and diabetes comprising the former. In spite of their undeniable diagnostic and prognostic value, a portion of the population lacking these traditional risk factors remains at significant residual risk for CHD.
Cardiology Summary
Authors: Maron Bradley A.
Published: July 2014

This chapter provides review topics in Cardiology.
Stroke: Prevention, Diagnosis, and Management
Authors: Henderson Galen V.
Published: July 2014

Primary prevention of stroke, which remains a major healthcare problem and a leading cause of functional impairments, is particularly important because >70% of strokes are first events. As discussed in the evidence-based guideline-supported sections that follow, high-risk or stroke-prone individuals can now be identified and targeted for specific interventions for primary prevention and some information regarding secondary prevention treatments and emergency management of ischemic stroke.
Palliative Care
Authors: Jackson Vicki A. , Billings J. Andrew
Published: July 2014

A palliative care evaluation begins with a comprehensive history and physical examination with particular attention to such common symptoms as pain, nausea and vomiting, dyspnea, fatigue, anxiety, depression, and family stress. Of equal importance is providing an opportunity for a discussion of hopes and fears about the future, including an exploration of goals for the remainder of the patient's life—information that is vital in guiding future care. Below, we emphasize the management of physical symptoms.
Board Practice 1
Authors: Bejar Rafael , Berzin Tyler M. , Berman Rebecca A. , Ndumele Chiadi E.
Published: July 2014

This chapter contains 30 questions in a Board Practice Test.
Oxford Handbook of Clinical Examination and Practical Skills
Authors: Thomas James , Monaghan Tanya
Published: July 2014

Fully updated and revised for this second edition, the Oxford Handbook of Clinical Examination and Practical Skills is a guide to all aspects of history taking, physical examination, practical procedures, data interpretation, and communication skills. Packed with expert knowledge and practical guidance it gives realistic advice on coping with common situations. The structure allows rapid reference of key information, and aids understanding with concise and practical clinical guidance. With over 140 detailed photographs and diagrams of all common examination skills, it shows exactly what to do along with the related theory, practice, and complications. Each system chapter covers applied anatomy, history, examination, and the presentation of common and important disorders. Data interpretation covers the basics of x-rays, ECGs and other key areas. A new chapter on the eyes is included, along with the sections on body language and non-verbal communication, and the section on practical procedures has been expanded.
The cardiovascular system
Authors: Thomas James , Monaghan Tanya
Published: July 2014

Introduction

History

Chest pain

Breathlessness and oedema

Fatigue

Palpitations

Syncope

Claudication

Rest pain

The rest of the history

Examination

Outline cardiovascular examination

General inspection and hands

Peripheral pulses

The face and neck

The precordium: inspection and palpation

The precordium: auscultation

Murmurs

Extra sounds

Examining beyond the chest

Important presentations

The elderly patient
The respiratory system
Authors: Thomas James , Monaghan Tanya
Published: July 2014

Introduction

History

Dyspnoea

Cough and expectoration

Other respiratory symptoms

The rest of the history

Examination

General appearance

Hands, face, and neck

Inspection of the chest

Palpation

Percussion

Auscultation

Important presentations

The elderly patient
The eyes
Authors: Thomas James , Monaghan Tanya
Published: July 2014

Important symptoms

The rest of the history

Visual acuity

Visual fields

The pupils

Eye movements

III, IV, and VI palsies

Other eye movement disorders

Anterior segment examination

Posterior segment examination

Eye trauma

The red eye

Eye signs in thyroid disease

Important presentations
The male reproductive system
Authors: Thomas James , Monaghan Tanya
Published: July 2014

Introduction

History

Symptoms

Examination

Examining the male genitalia

Important presentations

The elderly patient
The obstetric assessment
Authors: Thomas James , Monaghan Tanya
Published: July 2014

History

History taking in obstetrics

Bleeding

Abdominal pain

Hypertension

Minor symptoms of pregnancy

Examination

Outline obstetric examination

Abdominal inspection

Palpation

Percussion

Auscultation

Vaginal examination
Introduction: Life after the ICU
Authors: Herridge Margaret
Published: July 2014

Chapter 1 introduces a section about recovery from critical illness, and discusses the magnitude and burden of critical illness (including acute respiratory distress syndrome (ARDS) and post-ARDS residual pulmonary disease, and compromised health-related quality of life (HRQoL)), its mortality, detailed morbidity (ICU-based risk factors for long-term disability), and costs. It also examines the central role of the family caregiver as outcome and risk modifier.