bluuebunny/crossref_metadata_2025 huggingface dataset:
+Cerenkov emission of terahertz acoustic phonons generated electrically from monolayers of transition metal dichalcogenides
Authors: Kubakaddi S. S.
Published: April 2017

We have studied theoretically the Cerenkov acoustic phonon emission from monolayers of transition metal dichalcogenides (TMDs) driven by an electric field. The features of emitted phonon spectrum P(ωq,θ) are investigated as a function of the phonon frequency ωq, electron concentration ns, electric field E, and phonon emission angle θ. Numerical evaluations are made for n-MoS2. Acoustic phonons in the terahertz (THz) frequency region are found to be generated when the Cerenkov emission condition is satisfied. Frequency dependence of P(ωq,θ) shows a maximum at a frequency ωqm, position which shifts to larger frequency for larger E and ns. We predict ωqm/ns1/2 and ωqm/E1/4 to be nearly constant. The angular dependence of P(ωq,θ) and the phonon intensity P(θ) show emission to be maximum along the direction of electric field, i.e., for θ = 0. Both P(ωq,θ) and P(θ) are found to be larger for larger E. In the Bloch-Gruneisen regime P(ωq,θ) and P(θ) ∼ ns−3/2 and P(θ) ∼ T4. The results are compared with those in the bulk and conventional two-dimensional semiconductors and graphene. It is suggested that monolayers of TMDs can find potential applications as a new source of electrical generation of acoustic phonons in the THz frequency region.
Ion implantation in titanium dioxide thin films studied by perturbed angular correlations
Authors: Schell Juliana , Lupascu Doru C. , Carbonari Artur Wilson , Domingues Mansano Ronaldo , Souza Ribeiro Junior Ibere , Dang Thien Thanh , Anusca Irina , Trivedi Harsh , Johnston Karl , Vianden Reiner
Published: April 2017

The local environment in titanium dioxide was studied by the time dependent perturbed γ-γ angular correlation of 111In/111Cd and 181Hf/181Ta at the Helmholtz-Institut für Strahlen-und Kernphysik, Bonn. An introduction to the implantation methodologies performed at the Bonn Radioisotope Separator is presented. The investigation was carried out on thin films, which were deposited by magnetic sputtering on Si. The results show two different sites for both probe nuclei with unique electric quadrupole interaction. Using 111Cd one of them has been attributed to the substitutional Ti at the rutile structure. For 181Ta, the spectra show the anatase phase, with a well-defined electric quadrupole frequency.
Effects of high-k dielectric environment on the full ballistic transport properties of monolayer MoS2 FETs
Authors: Song Xian-Jiang , Xu Li-Chun , Bai Hui-Fang , Li Ying , Ma Zhiyuan , Yang Zhi , Liu Ruiping , Li Xiuyan
Published: April 2017

High-k dielectric materials are indispensable as gate layers for micro- and nano-electronic devices. Using first-principles calculations and non-equilibrium Green's function simulations, we studied the electrical transport characteristics of p-type and n-type monolayer MoS2 field effect transistors (FETs) under various gate dielectric environments. We found that the intrinsic dielectric property of the gate insulator played an important role in the transport performance of nanodevices. For both types of MoS2 FETs, a high-k gate insulator enhances the current on/off ratio and reduces the subthreshold swing by properly shifting the valence (p-type) or conduction (n-type) bands around the bias energy window, which has benefits for the design of MoS2-based short-channel nanodevices in the future.
Proton and anion transport across the tonoplast vesicles in bromeliad species
Authors: Pereira Paula Natália , Smith James Andrew Charles , Purgatto Eduardo , Mercier Helenice
Published: April 2017

Crassulacean acid metabolism (CAM) is one of the key innovations in the Neotropical family Bromeliaceae that has enabled many of its species to occupy seasonally water-limited terrestrial environments or microclimatically arid epiphytic niches. However, the relationship between CAM activity and the transport processes responsible for vacuolar organic-acid accumulation at night has not been systematically explored in this family. In the present investigation, ATP- and PPi-dependent proton transport rates were studied in tonoplast membrane vesicles isolated from leaves of six CAM and one C3 species of bromeliads. A consistent feature of these species was the high activity of the tonoplast ATP-driven H+ pump, which, when averaged across the seven species tested, showed a higher specific activity than the tonoplast PPi-driven H+ pump. For all CAM species, the rate of ATP-dependent proton transport into the tonoplast vesicles was strongly influenced by the nature of the balancing organic-acid anion, which displayed the following order of effectiveness: fumarate > malate > citrate. Measurements of leaf organic-acid content in six CAM bromeliads at dusk and dawn showed that nocturnal accumulation of malate exceeded citrate by a factor of ~2.4–20.0-fold in five of six bromeliad species used in this study, demonstrating a close correlation between the CAM rhythm and the intrinsic properties of the vacuolar membrane across which these organic acids are transported.
Understanding gesture
Authors: Kelly Spencer D. , Church R. Breckinridge , Alibali Martha W.
Published: April 2017

Gestures offer additional information that is not captured in speech. This essential finding is a bouncing off point for the chapters in this book, which attempt to explain what purpose gesture serves when we speak, think and communicate. Aristotle’s framework is used to describe how the research on gesture can be classified into efficient causes (what factors drive gesture) and final causes (what purpose does gesture potentially serve). The chapters of the book are laid out by research that examines how gesture functions in language and thinking for the producer (Part 1) and the observer (Part 2) with a final section that discusses some theoretical implications (Part 3).
The asymmetric redundancy of gesture and speech
Authors: de Ruiter J.P.
Published: April 2017

A number of studies from the last decades have demonstrated that iconic gestures are shaped not only by our mental imagery but also, quite strongly, by structural properties of the accompanying speech. These findings are problematic for the central assumption in the Sketch Model (De Ruiter, 2000) about the function of representational gesture. I suggest a seemingly small but fundamental modification to the processing assumptions in the Sketch Model that not only accommodates the discussed empirical findings, but also explains many other well-known gesture phenomena. The new model also generates new and testable predictions regarding the relationship between gesture and speech.
Exchange on gesture-speech unity
Authors: Lopez-Ozieblo Renia , McNeill David
Published: April 2017

The following is the edited version of an exchange that took place in 2013 between Renia Lopez-Ozieblo and David McNeill on McNeill’s paper Gesture – Speech Unity – What it is, where it comes from(in this volume) and his 2012 book How Language Began: Gesture and Speech in Human Evolution. The exchange began as a series of questions on the synchronicity of gesture and speech in the Growth Point (GP). This led to some basic questions on the GP itself and Mead’s Loop. The GP is created through the translation of our experiences (embodiment) as a combination of gesture and speech that allow us to capture, describe and transmit those experiences as thoughts.
Multi-modal communication of common ground
Authors: Holler Judith , Bavelas Janet
Published: April 2017

Until recently, the literature on common ground depicted its influence as a purely verbal phenomenon. We review current research on how common ground influences gesture. With informative exceptions, most experiments found that speakers used fewer gestures as well as fewer words in common ground contexts; i.e., the gesture/word ratio did not change. Common ground often led to more poorly articulated gestures, which parallels its effect on words. These findings support the principle of recipient design as well as more specific social functions such as grounding, the given-new contract, and Grice’s maxims. However, conceptual pacts or linking old with new information may maintain the original form. All together, these findings implicate gesture-speech ensembles rather than isolated effects on gestures alone.
Understanding gesture as representational action
Authors: Novack Miriam A. , Goldin-Meadow Susan
Published: April 2017

A great deal of attention has recently been paid to gesture and its effects on thinking and learning. This chapter sets forth a theoretical framework for exploring why gesture serves the functions that it does. The framework distinguishes gestures, which are representational actions, from instrumental actions, which interact directly with objects and cause physical changes to the world. The theory proposes that gesture’s status as representational action is what best explains its functions with respect to thinking and learning. Most notably, because gestures are abstracted representations and are not actions tied to particular events and objects, they can play a powerful role in thinking and learning beyond the particular, specifically, in supporting generalization and transfer of knowledge.
So how does gesture function in speaking, communication, and thinking?
Authors: Church R. Breckinridge , Goldin-Meadow Susan
Published: April 2017

This concluding chapter reflects on the book’s collected works that encapsulate, in the Aristotelian sense, gesture’s efficient causes (i.e., mechanisms that stimulate gesture) and its final causes (i.e., purposes that gesture serves). We conclude that gesture is multifunctional, operating on all levels of analysis (biological, psychological, and social levels), in all time frames (moment-to-moment, ontogenetic, and evolutionary time) and under many different discourse requirements. One over-arching theme emerges. Gesture functions simultaneously for both its producers and its observers, and thus provides a dual function that shapes thinking and language in the producer, which, in turn, shapes thinking and language in the observer – a process that underlies how we share ideas and create community.
Truths, lies and figurative scenarios
Authors: Musolff Andreas
Published: April 2017

This article studies one of the key-metaphors that has dominated British EU-debates for the past 25 years, i.e. the slogan, Britain at the heart of Europe. The discourse career of this metaphor up to the Brexit referendum shows a decline in its affirmative, optimistic use, and a converse increase of deriding uses to the point of declaring the heart of Europe irredeemably diseased, dead, non-existent or rotten. We argue that these changes in the metaphor scenario of the heart of Europe concept helped to entice the British public to integrate the information supplied by pro-Brexit campaigners into a narrative of a dying EU, which motivated their voting preferences. Even statements that were exposed as factually wrong or implausible before the Brexit referendum were still accepted as fitting the narrative and thus considered as more reliable than unframed pieces of counter-information supplied by the Brexit critics.
Microstructural and crystallographic features of hydrogen-related fracture in lath martensitic steels
Authors: Shibata Akinobu , Momotani Yuji , Murata Tamotsu , Matsuoka Takahiro , Tsuboi Mizuki , Tsuji Nobuhiro
Published: April 2017

This paper summarised the microstructural and crystallographic features of hydrogen-related fracture under tensile deformation in martensitic steels. The specimens with relatively low strength exhibited quasi-cleavage fracture. Crystallographic orientation analysis demonstrated that the quasi-cleavage fracture occurred on {011} planes. On the other hand, the macroscopic fracture surface morphologies of the specimens with relatively high strength appeared to be intergranular-like. However, nature of the fracture was somewhat different from a typical intergranular fracture, and the fracture surfaces consisted of facets parallel to {011} planes on a microscopic level. Based on the experimental results, we concluded that the crystallographic feature of {011} plane itself had an important role on the hydrogen-related fracture.

This paper is part of a thematic issue on Hydrogen in Metallic Alloys
Education after sustainability
Authors: Gough Steve
Published: April 2017

There is nothing at all new about societies collapsing as a result of environmental crises caused by poor choices made under uncertainty. Indeed, such instances have been very well documented by, in particular, Jared Diamond; and some have been further explored from an educational perspective. However, and as Diamond himself points out, it can very well be argued that, because of the globalised nature of contemporary societies, a situation now arises in which it is the human species as a whole, rather than any particular and relatively isolated community, that faces possible collapse. It would seem, therefore, that the scale of the problem has increased; but we still might ask whether its underlying nature has changed all that much and, if not, whether in fact human societies have ever or even, ultimately, could ever be sustainable. The environmental extinction of societies has usually occurred when long, slow and powerful trends in nature have coincided with inappropriate social preoccupations that either ignore or are ignorant of them. The paper identifies education as a common denominator; itself both a long-term characteristic of evolved social behaviour and a short-term social preoccupation.
Decreased cohesin in the brain leads to defective synapse development and anxiety-related behavior
Authors: Fujita Yuki , Masuda Koji , Bando Masashige , Nakato Ryuichiro , Katou Yuki , Tanaka Takashi , Nakayama Masahiro , Takao Keizo , Miyakawa Tsuyoshi , Tanaka Tatsunori , Ago Yukio , Hashimoto Hitoshi , Shirahige Katsuhiko , Yamashita Toshihide
Published: April 2017

Abnormal epigenetic regulation can cause the nervous system to develop abnormally. Here, we sought to understand the mechanism by which this occurs by investigating the protein complex cohesin, which is considered to regulate gene expression and, when defective, is associated with higher-level brain dysfunction and the developmental disorder Cornelia de Lange syndrome (CdLS). We generated conditional Smc3-knockout mice and observed greater dendritic complexity and larger numbers of immature synapses in the cerebral cortex of Smc3+/− mice. Smc3+/− mice also exhibited more anxiety-related behavior, which is a symptom of CdLS. Further, a gene ontology analysis after RNA-sequencing suggested the enrichment of immune processes, particularly the response to interferons, in the Smc3+/− mice. Indeed, fewer synapses formed in their cortical neurons, and this phenotype was rescued by STAT1 knockdown. Thus, low levels of cohesin expression in the developing brain lead to changes in gene expression that in turn lead to a specific and abnormal neuronal and behavioral phenotype.
Aep3p-dependent translation of yeast mitochondrialATP8
Authors: Barros Mario H. , Tzagoloff Alexander
Published: April 2017

Translation of mitochondrial gene products in Saccharomyces cerevisiae depends on mRNA-specific activators that bind to the 5’ untranslated regions and promote translation on mitochondrial ribosomes. Here we find that Aep3p, previously shown to stabilize the bicistronic ATP8-ATP6 mRNA and facilitate initiation of translation from unformylated methionine, also activates specifically translation of ATP8. This is supported by several lines of evidence. Temperature-sensitive aep3 mutants are selectively blocked in incorporating [35S]methionine into Atp8p at nonpermissive but not at the permissive temperature. This phenotype is not a consequence of defective transcription or processing of the pre-mRNA. Neither is it explained by turnover of Aep3p, as evidenced by the failure of aep3 mutants to express a recoded ARG8mwhen this normally nuclear gene is substituted for ATP8 in mitochondrial DNA. Finally, translational of ATP8 mRNA in aep3 mutants is partially rescued by recoded allotopic ATP8 (nATP8) in a high-expression plasmid or in a CEN plasmid in the presence of recessive mutations in genes involved in stability and polyadenylation of RNA.
Human adenine nucleotide translocases physically and functionally interact with respirasomes
Authors: Lu Ya-Wen , Acoba Michelle Grace , Selvaraju Kandasamy , Huang Tai-Chung , Nirujogi Raja S. , Sathe Gajanan , Pandey Akhilesh , Claypool Steven M.
Published: April 2017

Members of the adenine nucleotide translocase (ANT) family exchange ADP for ATP across the mitochondrial inner membrane, an activity that is essential for oxidative phosphorylation (OXPHOS). Mutations in or dysregulation of ANTs is associated with progressive external ophthalmoplegia, cardiomyopathy, nonsyndromic intellectual disability, apoptosis, and the Warburg effect. Binding partners of human ANTs have not been systematically identified. The absence of such information has prevented a detailed molecular understanding of the assorted ANT-associated diseases, including insight into their disparate phenotypic manifestations. To fill this void, in this study, we define the interactomes of two human ANT isoforms. Analogous to its yeast counterpart, human ANTs associate with heterologous partner proteins, including the respiratory supercomplex (RSC) and other solute carriers. The evolutionarily conserved ANT–RSC association is particularly noteworthy because the composition, and thereby organization, of RSCs in yeast and human is different. Surprisingly, absence of the major ANT isoform only modestly impairs OXPHOS in HEK293 cells, indicating that the low levels of other isoforms provide functional redundancy. In contrast, pharmacological inhibition of OXPHOS expression and function inhibits ANT-dependent ADP/ATP exchange. Thus ANTs and the OXPHOS machinery physically interact and functionally cooperate to enhance ANT transport capacity and mitochondrial respiration.
A method for learning a sparse classifier in the presence of missing data for high-dimensional biological datasets
Authors: Severson Kristen A , Monian Brinda , Love J Christopher , Braatz Richard D
Published: April 2017

Motivation

This work addresses two common issues in building classification models for biological or medical studies: learning a sparse model, where only a subset of a large number of possible predictors is used, and training in the presence of missing data. This work focuses on supervised generative binary classification models, specifically linear discriminant analysis (LDA). The parameters are determined using an expectation maximization algorithm to both address missing data and introduce priors to promote sparsity. The proposed algorithm, expectation-maximization sparse discriminant analysis (EM-SDA), produces a sparse LDA model for datasets with and without missing data.

Results

EM-SDA is tested via simulations and case studies. In the simulations, EM-SDA is compared with nearest shrunken centroids (NSCs) and sparse discriminant analysis (SDA) with k-nearest neighbors for imputation for varying mechanism and amount of missing data. In three case studies using published biomedical data, the results are compared with NSC and SDA models with four different types of imputation, all of which are common approaches in the field. EM-SDA is more accurate and sparse than competing methods both with and without missing data in most of the experiments. Furthermore, the EM-SDA results are mostly consistent between the missing and full cases. Biological relevance of the resulting models, as quantified via a literature search, is also presented.

Availability and implementation

A Matlab implementation published under GNU GPL v.3 license is available at http://web.mit.edu/braatzgroup/links.html.

Supplementary information

Supplementary data are available at Bioinformatics online.
Genetic Skin Disorders
Authors: Sybert Virginia P.
Published: April 2017

This book is a readable, reliable guide to the diagnosis and differential of inherited skin disorders to which generalists, paediatricians, dermatologists, and geneticists can refer during an examination. The new edition reflects the most up-to-date understanding of the molecular and genetic bases of heritable skin diseases. Each chapter describes the signs and symptoms of heritable skin diseases and enumerates pertinent associated clinical features and differential diagnoses. Non-dermatological signs are symptoms round out the information on each condition. Where appropriate, descriptions of histopathology at both the light and electron microscopic levels are included. Over 800 full-colour photographs illustrate the concepts discussed in the text. Annotated bibliographies at the end of each section direct readers to more extensive sources, and an updated listing of support groups for patients and their families supplements the resources for medical professionals.
Lymphedema
Authors: Sybert Virginia P.
Published: April 2017

Chapter 7 covers Cholestasis-Lymphedema Syndrome, Distichiasis and Lymphedema, and Hereditary Lymphedema. Each condition is discussed in detail, including dermatologic features, associated anomalies, histopathology, basic defect, treatment, mode of inheritance, prenatal diagnosis, and differential diagnosis.
Patient Centered Medicine
Authors: Rosen David H. , Hoang Uyen
Published: April 2017

Patient-Centered Medicine: A Human Experience emphasizes the health professional’s role in caring for patients as unique individuals by focusing on patients’ psychological and social realities as well as their biological needs. The text concerns itself with caring for the whole patient, and outlines the basic principles (acceptance, empathy, conceptualization, and competence) involved in developing a biopsychosocial approach to medical practice. This is a volume of guidelines to help you to develop and master the following: basic attitudes (awareness, disorganization, and reorganization) and interviewing skills; the realization that the experience of illness depends on the person, challenges of illness, coping, problem patients, the nature of the healing process, touching, healing and the biopsychosocial model, medicine’s existential quest, and desiderata. According to Andrew Weil, MD, “Patient-Centered Medicine: A Human Experience is a timely and welcome publication …. Integrative medicine also emphasizes the importance of the practitioner–patient relationship in the healing process…. Medical students and doctors in training will find it especially useful” (Foreword, this edition) According to Norman Cousins, “[this is] a book filled with compassion and insight … attach the highest value to your science… it is our respect for the human soul that determines the worth of our science” (Foreword, 1st edition).
The Nature of the Healing Process
Authors: Rosen David H. , Hoang Uyen B.
Published: April 2017

This chapter examines the nature of the healing process. Healing is an intrinsic activity in all natural systems that comprise known tangibles of scientific healthcare in the broadest sense coupled with intangibles such as compassion, empathy, hope, and meaning. Three patients trying to heal are discussed. Opportunities for a healing partnership were missed because of the doctors’ narrow view of a biomedical perspective. Medical students who uphold broad-minded, humanistic attitudes are the first to detect something awry, and as reflected in this chapter, are so often at the vanguard expressing their ideals. Intangibles that make up such humanistic attitudes are embedded in the essence of medicine, although they may not fit neatly in the systems hierarchy and should not be rejected because there is so much yet to be understood. Healing can occur even where there is no cure.
Pathophysiology of Alzheimer’s disease
Authors: Allen Shelley J.
Published: April 2017

We now know that the onset of the pathological processes leading to Alzheimer’s disease (AD) may be 15–20 years before symptoms appear. This focuses attention on synaptic changes and the early role of tau, and less on the hallmark amyloid plaques (Aβ‎) and neurofibrillary tau tangles. Sensitive biomarkers to allow early screening will be essential. Familial autosomal AD is the result of mutations in one of three genes (APP, PSEN1, or PSEN2), each directly related to increased Aβ‎, and informs pathological mechanisms in common sporadic cases, but are also subject to influence by many risk genes and environmental factors. The essential role of apolipoprotein E in neuronal repair and Aβ‎ clearance provides a therapeutic target but also a challenge in carriers of the risk gene APOE4. Current treatments are symptomatic, derived from neurotransmitter deficits seen; particularly cholinergic, but emerging data suggest alternative targets which may prove more productive.
Clinical course of Alzheimer’s disease
Authors: Lleó Alberto , Blesa Rafael
Published: April 2017

Alzheimer’s disease (AD) is an age-related neurodegenerative disorder, with onset usually in late life, characterized by progressive cognitive impairment, a variety of behavioural symptoms, and impairment in the activities of daily living. The initial symptom in typical AD is episodic memory loss, which reflects hippocampal dysfunction. The memory deficits are very characteristic with low recall performance despite retrieval facilitations with cueing. These initial deficits can be identified by appropriate cognitive tests. Behavioural symptoms can be present at early stages of the disease (even in pre-clinical states), although the frequency increases as the disease progresses. In the past decade there has been a growing interest in characterizing these pre-clinical and prodromal stages as treatments are expected to be more effective in these phases.
Disclosing the diagnosis of Alzheimer’s disease
Authors: Fetherston Anne A. , Hughes Julian C.
Published: April 2017

Diagnostic disclosure of Alzheimer’s disease is generally accepted to be good practice; however, there are important factors for clinicians to consider when preparing to impart such a serious diagnosis. In particular, this chapter explores the issues around timing of the disclosure and determining the correct amount of information to give. It highlights the need for good knowledge of the individual—knowledge of the person’s current mental capacity, the person’s own views, as well as those of the family—in order to provide really good care. It also addresses issues of uncertainty such as making a very early diagnosis and giving an accurate prognosis. The chapter suggests that it is the person (rather than the professional) who should control the situation, and that professionals must be attuned to what the person and family require from them. It also highlights the need for sound post-diagnostic support and follow-up.
Supporting the person with dementia and the caregiver
Authors: Brodaty Henry , Seeher Katrin
Published: April 2017

This chapter addresses the challenges of supporting a person with dementia and his/her caregiver. The level and type of support depend on the disease stage and each person’s individual needs. Raising community awareness and reducing stigma can prompt timely help-seeking and access to clinical assessment. After the diagnosis, clinical management should focus on enabling the person to live as full a life as possible and on maintaining the quality of life of the patient and caregiver. Guidance on life planning and legal matters and referral to a local Alzheimer’s association are helpful. As physical care demands increase, caregivers benefit from practical help, respite services, and continued emotional support, while the person with dementia requires increased supervision, affectionate reassurance, and companionship. The transition into residential care can be traumatic for both the person with dementia and the caregiver. After bereavement of their loved one, caregivers often benefit from support.
Clinical significance, disability, and biomarkers: Shifts in thinking between DSM-IV and DSM-5
Authors: Bolton Derek
Published: April 2017

Proposals have been made in connection with ICD and DSM revisions to separate the concepts of mental disorder and of impairments in social, occupational, or other important areas of functioning. The proposals are consistent with viewing disability as a social concept rather than a medical one. It is argued here on the basis of two main premises that mental disorder specifically cannot be conceptualized independently of social impairments. The first premise is that in general medicine the definition of disease essentially turns on impairments of normal function of an organ or system leading to poor outcomes. The second, compound premise is that one normal function of the central nervous system is the regulation of behaviour in the external world, and that this function is approximately the domain of the mental. The conclusion is drawn that mental disorder conceptually involves downturn in social, occupational, or other important areas of functioning.
Introduction to “The hard question in psychiatric nosology”
Authors: Parnas Josef , Kendler Kenneth S.
Published: April 2017

This chapter presents an introduction to the points raised in the following chapter, which focuses on principles and criteria to which mental disorders are classified, and the “natural” or “construct” nature of a classificatory object. It discusses the “meaningful but arbitrary” nature of many DSM criteria, interrelation or “meta-structure” of disorders, and the indeterminacy of factor analysis.
Representation and explanation in psychometric modeling
Authors: Borsboom Denny
Published: April 2017

This chapter presents a commentary on representation and explanation in psychometric modelling, as discussed in the previous chapter. It explores Turkheimer’s arguments that standard psychometric techniques involve assumptions, conventions, and definitions that introduce an arbitrary component into the models used.
“A messy business”: Balancing considerations in revising the psychiatric nosology
Authors: Solomon Miriam
Published: April 2017

This chapter presents a commentary on revisions in psychiatric nosology, as discussed in the previous chapter. It explores five themes present in the previous chapter: the prematurity of the science of psychiatry; pluralism of nosologies; the role of historical contingency; patient advocacy; and “integration” in approach.
I bet on Borsboom
Authors: Turkheimer Eric
Published: April 2017

This chapter presents a commentary on the reification of mental illness, as discussed in the previous chapter. It explores the major reasons why there is a monolithic scientific establishment and isolated communities of intellectual dissidents, and there exists no meaningful debate about the nature of psychopathology or the best methods to study it.
Introduction to “On reification of mental illness: Historical and conceptual issues from Emil Kraepelin and Eugen Bleuler to DSM-5”
Authors: Parnas Josef
Published: April 2017

This chapter presents an introduction to the fundamental issue in nosology of reification of mental illness. It briefly outlines the arguments of the following chapter, including the ontological status of mental and social phenomena, as well as operational criteria and operationalism.
Factors in the development of psychiatric epidemics
Authors: First Michael B.
Published: April 2017

The term “epidemic” is broadly employed to refer to any occurrence of illness that is clearly in excess of normal expectancy. Whenever there is an apparent increase in the number of cases over a relatively short time, there are three possibilities: (1) a true epidemic in which the actual incidence of the disorder is increasing; (2) an increase in the number of previously undiagnosed individuals coming to clinical attention; or (3) a broadening of diagnostic definitions over time. Although reports of greatly increased rates of some psychiatric disorders in the past 30 years suggest possible “epidemics,” a closer examination raises questions about whether any of these truly represent increased incidence of the disorder in the community. In most cases, claims for the existence of an epidemic depend on reports of increased numbers of diagnoses made by mental health providers as opposed to evidence of increased rates of the symptomatic presentation.
Reflections on culture-bound syndromes
Authors: Appelbaum Paul S.
Published: April 2017

This chapter presents a commentary on culture-bound syndromes, as discussed in the previous chapter. It explores how cultural preconceptions can shape the symptomatic manifestations of physical or mental disease, as well as the concept of a gradient of cultural-responsiveness.
Introduction to “Epistemic iteration and natural kinds: Realism and pluralism in taxonomy”
Authors: Parnas Josef
Published: April 2017

This chapter presents an introduction to epistemic iteration, realism, and pluralism, as further discussed in the following chapter. It discusses the nature of epistemic iteration as a linear cumulative improvement of knowledge which may be contrasted with revolutionary changes of scientific paradigms, as well as the issue of realism-antirealism.
Introduction to “Validity and the causal structure of a disorder”
Authors: Kendler Kenneth S.
Published: April 2017

This chapter presents an introduction to validity and the causal structure of a disorder; as further discussed in the following chapter. It outlines the critique of validation in modern psychiatric nosology; but highlights the importance of gradual processes of iteration.
Saving the explananda
Authors: Repnikov Georg , Murphy Dominic
Published: April 2017

This chapter presents a commentary on validity and the causal structure of a disorder, as discussed in the previous chapter. It addresses questions about reference to diagnostic terms, syndromes and causal structure as possible referents, successful use of reference, and also outlines an alternative view of validity and validation
Epistemic iteration or paradigm shift: The case of personality disorder
Authors: Zachar Peter
Published: April 2017

This chapter explores the concept of scientific progress by contrasting a gradual epistemic iteration approach to the classification of personality disorder with a revolutionary paradigm-shifting approach. Commitment to one or the other approach partly fueled disagreements about whether to adopt a dimensional model for personality disorder in DSM-5. One of the Scientific Review Committee’s concerns was that over-reliance on the preferences of small groups of experts will not support cumulative progress, rather; the trajectory will either resemble a random walk or it will “wobble” based on shifting conceptual preferences.Work group members who wanted to transition to a more dimensional model believed that the DSM-IV model was a classificatory dead end, and a gradual iteration strategy could not support progress. For both groups progress was construed as an increasingly accurate approximation of psychiatric reality. The chapter offers an alternative account of scientific progress based on coherentist and pragmatist perspectives.
Progressive validation of psychiatric syndromes: The example of panic disorder
Authors: Kendler Kenneth S.
Published: April 2017

Prior validation approaches for psychiatric disorders, as used in DSM-IV and DSM-5, have been synchronic—snapshots of results typically taken out of temporal context. This chapter explores the advantages of a diachronic approach to validation. The discovery of juvenile-onset and adult-onset diabetes is explored as an example of a successful division of a broad biomedical syndrome into subtypes. This division has yielded fruitful insights into etiology and treatment. A psychiatric example, reviewed in detail, is the division of anxiety neurosis into panic disorder and generalized anxiety disorder. A range of etiologic and treatment studies have supported the distinction between these two forms of anxiety. These findings are interpreted in the context of Lakatos’s conceptual framework of a progressive versus degenerative scientific paradigm. The conclusion is that considering a diachronic or historical view of validity of psychiatric disorders adds a valuable perspective to the discipline and its nosology.
Comments on “What is progress in psychiatric research?”
Authors: Bolton Derek
Published: April 2017

This chapter presents a commentary on what constitutes progress in psychiatric research, as discussed in the previous chapter. It explores methods of conceptualizing progress in science, including the correspondence theory of truth, and the conceptualization of progress as an ever increasing power of prediction, as well as technological applications of progress.
How do we improve the DSM?
Authors: Heckers Stephan
Published: April 2017

This chapter comments on the continuous improvement process of the DSM-5, as outlined in the previous chapter. This chapter focuses on three aspects: the process of implementing changes, the scientific rationale to accept or reject proposals for change, and the aims and values guiding the continuous improvement process.
Basics of Fluoroscopy
Authors: Patel Vikram B.
Published: April 2017

This chapter reviews the basics of fluoroscopy, including its safe use and the dangers of radiation. Although various interventions have been used to treat pain for decades, use of fluoroscopy has been more prevalent since the mid-1990s. Several studies have shown that using any form of guidance is superior to “blind” procedures, providing better outcomes while reducing the rate of complications. Ultrasound may be safer than fluoroscopy for certain procedures such as joint injections near and around blood vessels. Ultrasound avoids the harmful radiation to the patient, the treating physician, and staff, and also helps significantly by allowing the physician to visualize blood and fluid flow. Nevertheless, fluoroscopy may never be replaced for certain procedures that require full view of osseous structures or for open but minimally invasive surgical procedures such as implantable devices and intradiscal procedures.
Cervical Transforaminal/Nerve Root Injections: Ultrasound
Authors: Narouze Samer N.
Published: April 2017

Ultrasound provides direct visualization and imaging of various soft tissues without radiation exposure. Thus, it is a very appealing modality in neck injections, with the magnitude of critical soft-tissue structures compacted in a very vascular area. Moreover, ultrasound imaging allows real-time needle advancement and monitoring the spread of injectate, which improves the accuracy of the block and minimizes the risk of intravascular injection. This chapter reviews the feasibility and safety of the ultrasound-guided approach. It also provides a new insight into the technique and why some practitioners prefer an “extraforaminal” nerve root approach rather than the traditional “transforaminal” epidural approach.
Cervical Transforaminal/Nerve Root Injections: Computed Tomography
Authors: Wolter Tilman
Published: April 2017

Computed tomography (CT)–guided selective cervical nerve root blocks, particularly in the dorsal/posterior access, are sensitive, specific, efficacious, and safe. If performed with a lateral/anterolateral access, the CT-fluoroscopic technique with real-time visualization should be chosen. In comparison to fluoroscopy-guided nerve root blocks, CT guidance offers a more precise visualization of the contrast agent. While the advantages of CT guidance seem to outweigh the slightly higher exposure to radiation, this specific topic is debatable and requires additional scientific inquiry. Comparative studies are needed to address the sensitivity, specificity, efficacy, complication rates, and radiation exposure of CT- and fluoroscopy-guided cervical nerve root blocks.
Cervical Interlaminar Epidural Injections: Fluoroscopy
Authors: Souzdalnitski Dmitri , Narouze Samer N.
Published: April 2017

Interlaminar cervical epidural steroid injections (CEI) have been considered an effective treatment for neck pain accompanied by radicular pain or radiculopathy secondary to the herniated cervical disc. Also, CEI may be useful in the treatment of intracranial hypotension secondary to a spontaneous cerebrospinal fluid (CSF) leak. Computer tomography (CT) uses significantly higher doses of radiation for patients. Fluoroscopy uses less radiation than CT, and helps to correctly identify the site of injection and guide the procedure with, likely, less trauma to ligaments, periosteum, epidural vessels, cervical spinal cord, nerve roots, and other important structures. It may help to avoid technical difficulties and complications associated with CEI in patients with postsurgical conditions, congenital deformities, and others. Digital subtraction angiography (DSA) fluoroscopy can help to identify intravascular injection during CEI; it advisable to use it for all CEI if there are no contraindications.
Atlanto-Axial Joint Injection: Ultrasound
Authors: Narouze Samer N.
Published: April 2017

The atlanto-axial joint accounts for up to 16% of patients with occipital headache. Distending the lateral atlanto-axial joint with contrast agent produces occipital pain, and injection of local anesthetic into the joint relieves the headache. The clinical presentation of atlanto-axial joint pain is not specific and therefore cannot be used alone to establish the diagnosis. The only means of establishing a definite diagnosis is a diagnostic block with intra-articular injection of local anesthetic. Intra-articular steroids are effective in short-term relief of pain originating from the lateral atlanto-axial joint. The major complication and limitation of the fluoroscopy-guided approach is the inability to identify and hence avoid vertebral artery injury. This chapter describes a new ultrasound-guided approach that will add more safety to the procedure.
Atlanto-Axial Joint Injection: Computed Tomography and Fluoroscopy
Authors: Lirette Lesley , Huntoon Marc A.
Published: April 2017

Atlanto-axial (AA) joint injections can be helpful in the diagnosis and management of occipital headaches stemming from the AA joint. Because of the complicated anatomic landscape, imaging guidance is vital in addition to a sound understanding of the anatomy. Several different image modalities are available for use in AA joint blocks. Fluoroscopy is the most widely used for its familiarity, relative low cost, and wide availability. The addition of digital subtraction angiography to the conventional fluoroscope offers an additional safety benefit when performing injections near critical blood vessels. Computed tomography guidance offers a better view that allows for visualization of the soft-tissue structures; however, its risk/benefit ratio limits its use in the everyday pain practice. Flat detector CT may offer a promising compromise, incorporating delayed CT images into the conventional fluoroscopy procedure. Safety is the highest priority when performing AA joint blocks to prevent potentially devastating outcomes.
Lumbar Transforaminal and Nerve Root Injections: Fluoroscopy
Authors: Grami Vahid , Hayek Salim M. , Narouze Samer N.
Published: April 2017

The transforaminal approach, compared with the interlaminar approach, allows injectate delivery directly at the target nerve root, placing greater amounts of medication at the location of the suspected pathology. The utility of selective nerve root injections includes blocking with local anesthetics specific nerve roots suspected of transmitting radicular symptoms. These diagnostic radicular blocks are often used for presurgical planning. The fluoroscopic-guided lumbar transforaminal epidural steroid injection approaches mentioned in this chapter have been described to safely and effectively deposit medication in the epidural space, adjacent to affected nerve roots transmitting pain signals. It is imperative that proper patient selection, physician training, thorough knowledge of anatomy, vigilance, and effective use of fluoroscopy and radiocontrast dye help to avoid catastrophic tissue damage and embolization.
Lumbar Transforaminal and Nerve Root Injections: Ultrasound
Authors: Gofeld Michael
Published: April 2017

Ultrasound (US) guidance has gained recognition in the field of regional anesthesia mainly because of its definite advantage of visually localizing the desired target and also due to perceived benefits of safety, accuracy, and efficiency when peripheral nerve blocks are performed. On the contrary, ultrasonography of the spinal structures may be challenging because of depth, bony acoustic shadowing, and complex three-dimensional anatomy. Nevertheless, US allows satisfactory imaging of the posterior elements of spine column and paraspinal soft tissues. This makes US applicable and practical in the outpatient clinical setting, and thus ultrasonography has been increasingly penetrating into chronic spinal pain management. Perhaps the major advantage of ultrasound-guided spine interventions is the lack of radiation exposure. Lumbar transforaminal injections are frequently performed for managing acute and chronic radicular pain, and US guidance may reduce overall radioactive contamination.
Central Neuraxial Blockade: Ultrasound
Authors: Chin Ki Jinn
Published: April 2017

Successful central neuraxial blockade requires entry into the epidural or intrathecal space, and is contingent on the ability to guide a needle into the desired interlaminar space between adjacent vertebrae. Ultrasonography of the spine has been shown to be an effective tool for guiding epidural and spinal anesthesia. The use of ultrasound to central neuraxial blockade can broadly be divided into either preprocedural ultrasound imaging to delineate the underlying anatomy, or real-time ultrasound imaging of the needle as it is advanced toward the target. This chapter focuses only on preprocedural ultrasound imaging of the thoracic and lumbar spine, as real-time ultrasound-guided central neuraxial blockade is a challenging technique that requires much more investigation before it can be recommended for routine use. There is ample evidence to support the utility of ultrasound imaging of the spine in facilitating central neuraxial blockade. It is particularly useful in patients with challenging surface landmarks.
Superior Hypogastric Block and Neurolysis: Fluoroscopy, Ultrasound, Computed Tomography
Authors: Nouri Kent H. , Huh Billy K.
Published: April 2017

The superior hypogastric block (SHB) is an effective treatment for chronic or cancer-related pelvic pain. The CT-guided block offers the advantage of being able to visualize the target structure, soft tissue, disc, and bony structures to minimize complications. But CT has its own limitations such as being unable to visualize the needle at off angle, higher level of exposure to ionizing radiation, and longer procedure time compared to the fluoroscopy-guided procedure. Several variations to CT-guided techniques have been published. Each has its own advantages and disadvantages, but depending on the anatomical variations in spinal structure, any one of the techniques may be used. Fluoroscopy is used in the majority of superior hypogastric blocks because of the ease of use, availability, and quicker procedure times. The anterior approach to SHB using ultrasound guidance is useful technique in relieving pelvic pain in gynecological malignancies.
Ganglion Impar Block: Fluoroscopy and Ultrasound
Authors: Lin Chia Shiang (Sean)
Published: April 2017

Blockade of the ganglion impar (also known as ganglion of Walther or sacrococcygeal ganglion) is indicated for evaluating and managing visceral or sympathetic-maintained pain in the coccygeal and perineal area. Ganglion impar neurolysis has been reported in the palliative treatment for malignancies of the pelvis with cancer pain in the perineal area. Ultrasound can be successively used to locate the sacrococcygeal joint (SCJ) and facilitate the performance of ganglion impar block. However, ultrasound can also complement fluoroscopy, as lateral fluoroscopy is still needed to establish safe depth and monitor the spread of the injectate, especially with neurolytic injections.