bluuebunny/crossref_metadata_2025 huggingface dataset:
Comment on “A planar refractive x-ray lens made of nanocrystalline diamond” [J. Appl. Phys. 108, 123107 (2010)]
Authors: Kroon R. E.
Published: May 2013

The material LuAG (lutetium aluminium garnet) has been confused with LAG (lanthanum aluminium garnet). In general, aluminium garnet phases only occur for the smaller trivalent metal cations and LAG is not known to have been synthesized.
Scanning ion sensitive probe for plasma profile measurements in the boundary of the Alcator C-Mod tokamak
Authors: Brunner D. , LaBombard B. , Ochoukov R. , Whyte D.
Published: May 2013

A new Ion Sensitive Probe head has been created for the outer-midplane scanning probe system on the Alcator C-Mod tokamak. The new probe head contains three elements: an ion sensitive probe to measure ion temperature and plasma potential, a Langmuir probe to measure electron temperature, density, and floating potential, and a second Langmuir probe to measure ion saturation current and the density fluctuations arising from ‘‘blob’’ events. The ion sensitive probe current is normalized to this measurement to reduced deleterious effects of the strong fluctuations. Design of the high heat flux probe (>100 MW/m2) and initial results are presented.
Rapid thermal conductivity measurements for combinatorial thin films
Authors: McDowell Matthew G. , Hill Ian G.
Published: May 2013

A simple and inexpensive automated method for determining the thermal conductivity of a combinatorial library of thin films is demonstrated by measuring the thermal conductivity of a sputtered silicon dioxide film of varying thickness deposited on single crystal silicon. Using 3ω measurements, two methods for calculating the substrate thermal conductivity and two methods for determining the film thermal conductivity are demonstrated and compared. The substrate thermal conductivity was found to be 139 ± 3 W/m·K. Using the measured variation in film thickness, the film thermal conductivity was found to be 1.11 ± 0.05 W/m·K, in excellent agreement with published values for sputtered SiO2, demonstrating the accuracy of the method.
A numerical study of low- and high-field carrier transport properties in In0.18Al0.82N lattice-matched to GaN
Authors: Shishehchi Sara , Bertazzi Francesco , Bellotti Enrico
Published: May 2013

This work presents a numerical study of the carrier transport properties of In0.18Al0.82N lattice-matched to GaN. Using a full-band Monte-Carlo model, we have evaluated the low- and high-field transport coefficients of this alloy. We have computed the carrier mobilities as a function of temperature for different doping concentrations and areal dislocation densities. Furthermore, we have evaluated the electron and hole drift velocities with and without considering the effect of the alloy scattering. Finally, we have computed the carrier impact ionization coefficients for transport along both the Γ−A and Γ−M crystallographic directions.
Design of two-dimensional open cloaks with finite material parameters for thermodynamics
Authors: He Xiao , Wu Linzhi
Published: May 2013

A two-dimensional (2D) finite open cloak for thermodynamics with an arbitrary cross-section is designed based on the transformation thermodynamics. The open cloak consists of a portion of a finite closed cloak and an independent system whose position and parameters can be controlled. The temperature of the cloaked object will be sharply lower than that in the closed cloak when the window is located at the side of low-temperature. However, the situation will be totally opposite when the window is located at the side of high-temperature. Full wave simulations show good agreement with the analytical results of this cloak.
A cell-laden nanofiber/hydrogel composite structure with tough-soft mechanical property
Authors: Jang Jinah , Oh Hana , Lee Jongwan , Song Tae-Ha , Hun Jeong Young , Cho Dong-Woo
Published: May 2013

Connective tissue is a factor of great importance in tissue engineering and regenerative medicine because it has a limited life but complicated mechanical properties. In this study, we present a reinforcement method of hydrogel using patterned nanofibers to mimic native connective tissues with selective engagement of load carrying constituents. We incorporated a three-dimensional nanofibrous frame fabricated using direct-write electrospinning with a hydrogel matrix. Three types of nanofiber-reinforced hydrogel composite were fabricated and their dual aspects of mechanical properties for compressive load were identified. It was demonstrated that the constructed composite had sufficient biocompatibility as well as connective tissue-like mechanical properties.
Planar plasmonic metamaterial on a thin film with nearly zero thickness
Authors: Shen Xiaopeng , Jun Cui Tie
Published: May 2013

We propose a planar plasmonic metamaterial on thin corrugated metal films in microwave and terahertz frequencies. From theoretical simulation and experiment, we show that spoof surface plasmon polaritons (SPPs) can propagate along a thin metal film by corrugating its edge with periodic array of grooves. We demonstrate that such a planar plasmonic metamaterial can sustain highly localized SPPs along two orthogonal directions. We have designed and simulated a planar ring resonator in the terahertz frequency, and made experiment in the microwave frequency, both of which exhibit excellent performance. The proposed planar plasmonic metamaterials can play important roles in integrated plasmonic circuits and systems.
The decline and current status of the Christmas Island shrew Crocidura Attentuata Trichura on Christmas Island, Indian Ocean
Authors: Meek Paul D
Published: May 2013

The Christmas Island shrew (Crocidura Attentuata Trichura) is listed as an endangered species an Australian legislation. The cause of decline and its current status are unknown. In 1997-98 surveys were conducted at 15 sites on Christmas Island to determine the status of Crocidura Attentuata Trichura.
During 17 months, 4,150 trap nights of surveys were conducted using Longworth traps, hair tubes and pitfall maps.
An expanded view of the eukaryotic cytoskeleton
Authors: Moseley James B.
Published: May 2013

A rich and ongoing history of cell biology research has defined the major polymer systems of the eukaryotic cytoskeleton. Recent studies have identified additional proteins that form filamentous structures in cells and can self-assemble into linear polymers when purified. This suggests that the eukaryotic cytoskeleton is an even more complex system than previously considered. In this essay, I examine the case for an expanded definition of the eukaryotic cytoskeleton and present a series of challenges for future work in this area.
Retromer maintains basolateral distribution of the type II TGF-β receptor via the recycling endosome
Authors: Yin Xueqian , Murphy Stephen J. , Wilkes Mark C. , Ji Yan , Leof Edward B.
Published: May 2013

Transforming growth factor β (TGF-β) is critical for the development and maintenance of epithelial structures. Because receptor localization and trafficking affect the cellular and organismal response to TGF-β, the present study was designed to address how such homeostatic control is regulated. To that end, we identify a new role for the mammalian retromer complex in maintaining basolateral plasma membrane expression of the type II TGF-β receptor (TβRII). Retromer and TβRII associate in the presence or absence of TGF-β ligand. After retromer knockdown, although TβRII internalization and trafficking to a Rab5-positive compartment occur as in wild-type cells, receptor recycling is inhibited. This results in TβRII mislocalization from the basolateral to both the basolateral and apical plasma membranes independent of Golgi transit and the Rab11-positive apical recycling endosome. The data support a model in which, after initial basolateral TβRII delivery, steady-state polarized TβRII expression is maintained by retromer/TβRII binding and delivery to the common recycling endosome.
COPRED: prediction of fold, GO molecular function and functional residues at the domain level
Authors: López Daniel , Pazos Florencio
Published: May 2013

Summary: Only recently the first resources devoted to the functional annotation of proteins at the domain level started to appear. The next step is to develop specific methodologies for predicting function at the domain level based on these resources, and to implement them in web servers to be used by the community. In this work, we present COPRED, a web server for the concomitant prediction of fold, molecular function and functional sites at the domain level, based on a methodology for domain molecular function prediction and a resource of domain functional annotations previously developed and benchmarked.

Availability and implementation: COPRED can be freely accessed at http://csbg.cnb.csic.es/copred. The interface works in all standard web browsers. WebGL (natively supported by most browsers) is required for the in-line preview and manipulation of protein 3D structures. The website includes a detailed help section and usage examples.

Contact:  pazos@cnb.csic.es
Drug–target interaction prediction through domain-tuned network-based inference
Authors: Alaimo Salvatore , Pulvirenti Alfredo , Giugno Rosalba , Ferro Alfredo
Published: May 2013

Motivation: The identification of drug–target interaction (DTI) represents a costly and time-consuming step in drug discovery and design. Computational methods capable of predicting reliable DTI play an important role in the field. Recently, recommendation methods relying on network-based inference (NBI) have been proposed. However, such approaches implement naive topology-based inference and do not take into account important features within the drug–target domain.

Results: In this article, we present a new NBI method, called domain tuned-hybrid (DT-Hybrid), which extends a well-established recommendation technique by domain-based knowledge including drug and target similarity. DT-Hybrid has been extensively tested using the last version of an experimentally validated DTI database obtained from DrugBank. Comparison with other recently proposed NBI methods clearly shows that DT-Hybrid is capable of predicting more reliable DTIs.

Availability: DT-Hybrid has been developed in R and it is available, along with all the results on the predictions, through an R package at the following URL: http://sites.google.com/site/ehybridalgo/.

Contact:  apulvirenti@dmi.unict.it

Supplementary information:  Supplementary data are available at Bioinformatics online.
5. Liability for Damage Caused: Causation and Remoteness
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter examines the third element of the tort of negligence, namely, causation. The defendant’s carelessness must be shown to have caused the loss or damage in question. The finding of a sufficient causal link is an essential ingredient in all forms of tort liability (with the exception of torts actionable without proof of damage). The discussions cover the nature of the causal inquiry; but-for causation; and remoteness of damage.
7. Breach of Statutory Duty
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter begins by considering the nature of the action for breach of statutory duty. The action for breach of statutory duty enables the claimant to recover compensation for losses brought about by the defendant’s failure to comply with a statutory obligation. Increasing areas of commercial and business activity are regulated by legislation designed to protect the health and safety of employees, consumers, and road-users; regulation may also have the aim of protecting certain property and financial interests. The second part of the chapter discusses the components of a liability covering the availability of a civil remedy; the scope of the civil remedy; causation, remoteness, and defences; and liability for breach of obligations arising under EU law.
8. Liability of Public and Statutory Bodies
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter discusses the following: the distinctive nature of the liability of the government, public authorities, and statutory bodies; the liability of statutory bodies in negligence; liability for breach of statutory duty; public law as a source of liability; public law as a source of immunity; Crown proceedings in tort; liability for breaches of EU law; and liabilities arising under the Human Rights Act 1998.
15. The Economic Torts
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

Economic torts seek to protect a person in relation to his trade, business, or livelihood. However, he will only be protected from certain kinds of interference, principally those inflicted intentionally or deliberately. Nor will an intention to harm suffice, on its own, to ground liability. There are three broad sub-categories of liability: those torts based on the defendant’s wrongful interference with the claimant’s pre-existing legal rights (inducing breach of contract and inducing breach of statutory duty, in particular); the tort of interference with trade or business by unlawful means; and the tort of conspiracy. This chapter considers each of these in turn followed by an outline of the statutory immunities in relation to trade disputes.
Sinus Headache
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Migraine and other primary headache types are often misdiagnosed as “sinus headache” because of location and nasal symptoms. However, there are some rhinological and sinus conditions that do lead to head and facial pain. Sphenoid sinus inflammation is particularly likely to produce headache. The causes and ways of diagnosing of headache due to rhinosinusitis and related conditions are discussed in this chapter.
Childhood Migraine
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Headache diagnosis and treatment in children differ from clinical approaches in adults. One example is the category of “migraine precursors,” such as abdominal migraine and cyclic vomiting. This chapter provides a clear diagnostic schema for these childhood conditions and reviews the basics of migraine treatment in children.
Carotid Dissection
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Carotid dissection is a not uncommon cause of headache and neurological disturbance in young patients but is unfortunately often misdiagnosed. This chapter reviews the clinical features, diagnostic work-up, and treatment options for this condition.
Chiari Malformation and Migraine
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Chiari malformations are rare congenital lesions that may be asymptomatic and discovered incidentally or may produce a number of clinical symptoms. This chapter reviews the spectrum of headaches produced by these malformations and discusses the need for surgical intervention.
Vasculitis Headache
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Inflammation of cerebral arteries is virtually always painful. Both primary and secondary forms (including drug-induced cerebral arteritis) may present primarily with headache and must be excluded. This chapter outlines diagnostic and treatment considerations in cerebral vasculitis. The curious disorders “headache with associated neurological deficits and cerebrospinal fluid lymphocytosis” and “reversible cerebral vasoconstriction syndrome” share some features of cerebral vasculitis and are also discussed in this chapter.
Cough Headache
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Headaches that occur during exertion or coughing may be primary or secondary. This chapter reviews the clinical features, indications for work-up, and treatment options in these disorders.
Nummular Headache
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Nummular (“coin-like” ) headache pain refers to a localized area of scalp pain and is thought to be due to a local neuropathic process, akin to trigeminal or cervical root branch neuralgia. Diagnosis and treatment options (including local anesthetic procedures) are discussed in this chapter.
Menstrual Headaches
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Headaches occurring around the time of menses tend to be very disabling. Most headaches associated with menses are migraines without aura. Fortunately, there are a number of good treatment strategies, both for acute pain relief as well as for prophylaxis which can be limited to several days surrounding the onset of menses (“miniprophylaxis” ). This chapter discusses the identification and clinical management of menstrually related headaches.
Analgesic Overuse
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Patients with medication overuse headache (MOH) must overcome their dependence on acute medications in order for improvement to occur. Most patients with MOH can be treated on an outpatient basis. This chapter reviews strategies for treating patients with MOH due to simple analgesics, combination medications, butalbital-containing compounds, and opioids.
Headache Recurrence
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Recurrence of headache following initially successful treatment occurs in approximately 20% of patients who use triptans for acute relief. This chapter outlines the clinical features of recurrence and provides strategies to avoid it.
Headache and Allergy
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Many patients feel that environmental and dietary allergens or other agents (including additives in medications) can cause them to experience headache. This chapter outlines a reasonable approach to the investigation of dietary and environmental triggers of migraine and other headaches, as well as nonpharmaceutical approaches to pain relief.
Headache Treatment in Human Immunodeficiency Virus Infection and Drug Addiction
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Headaches in patients with active HIV infection may stem from a number of causes, including primary headaches unrelated to HIV. Diagnostic approaches are outlined. This chapter also discusses the pitfalls encountered in headache and pain management when treating patients with substance abuse.
Pseudotumor
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Pseudotumor cerebri, or idiopathic intracranial hypertension, often affects young obese women. Hallmarks are headaches of various types, papilledema, and increased opening pressure on lumbar puncture. When headaches or visual dysfunction fail to respond to acetazolamide, there are several other alternatives, which are explained in this chapter.
Posttraumatic Headaches
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

One of the more controversial areas in headache medicine is the diagnosis and prognosis of trauma-related headache. Either mild or severe head and/or neck trauma can lead to chronic headaches, which are also associated with the broader postconcussive syndrome. These conditions, along with their prognostic and legal ramifications, are discussed.
Transient Global Amnesia and Migraine
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Transient global amnesia (TGA) is a well-recognized neurological syndrome resulting in a short-lasting inability to create new memory. The pathophysiology of the disorder is not known, but it has been linked to migraine, transient ischemic attack, and perhaps epilepsy. This chapter reviews the work-up needed prior to prescribing triptans in migraine sufferers who have had TGA or other transient neurological events.
Migraines and Arteriovenous Malformations
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Unruptured arteriovenous malformations (AVMs) are occasionally discovered incidentally during the work-up of a patient with headaches. This chapter discusses the clinical features of unruptured AVMs, the link between AVMs and headache, and the risks and benefits of treatment.
Migraine and Patent Foramen Ovale
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

The observation of the significantly increased incidence of patent foramen ovale (PFO) in migraine sufferers has raised questions about causality and the potential benefit of PFO repair in otherwise asymptomatic patients. This chapter addresses the nature of the relationship between migraine and PFO as well as the pros and cons for transcatheter PFO repair in migraine patients.
Electricity and Electronics for Clinical Neurophysiology
Authors: Lagerlund Terrence D.
Published: May 2013

This chapter reviews the basic principles of electric and electronic circuits that are important to clinical neurophysiology. Knowledge of these basic principles and how to solve simple circuit problems is necessary for a complete understanding of the proper operation of equipment used in clinical neurophysiology and of the terminology and specifications given in equipment manuals.
Electric Safety in the Laboratory and Hospital
Authors: Lagerlund Terrence D.
Published: May 2013

This chapter reviews the principles of electric safety that are relevant to clinical neurophysiologic studies. Knowledge of these principles is necessary both for those involved in evaluating and purchasing test instruments and for those involved in maintaining and using them. All those who order, perform, interpret, or supervise electrophysiologic testing share the legal responsibility for patient safety, including electric safety.
Epileptiform Activity
Authors: Drazkowski Joseph F.
Published: May 2013

EEG continues to be an important test to functionally evaluate people with suspected seizures. Although few specific EEG patterns exist for specific diseases, the presence of epileptiform discharges and patterns on the EEG may help identify certain syndromes. Clinicians using EEG in the evaluation and management of people with suspected epilepsy should be familiar with the different epileptiform discharges and their associated clinical significance.
Electroencephalography: Electroencephalograms of Infants and Children
Authors: Westmoreland Barbara F.
Published: May 2013

This chapter discusses the normal and abnormal EEG patterns in neonates, infants, and children. Because the EEG is a neurophysiologic test that reflects a disturbance of cerebral function, it is an important tool in evaluating infants and children. The EEG helps determine whether there is an underlying organic disorder, indicates the degree and extent of cerebral dysfunction, confirms or helps make the diagnosis of a specific disorder such as seizures, indicates whether there is a focal or generalized process, and, in certain instances, aids in determining the prognosis.
Sensory Nerve Action Potentials
Authors: Sorenson Eric J.
Published: May 2013

Nerve conduction studies are an invaluable addition to clinical electrophysiology testing. SNAPs are a sensitive and specific measure of function in the peripheral sensory pathways. These studies confirm whether large myelinated axons are affected by an underlying abnormality. When an area that is affected is clinically tested, nerve conduction studies can help to distinguish between a preganglionic (i.e., root level or higher) and a postganglionic (i.e., peripheral) process.
Audiogram, Acoustic Reflexes, and Evoked Otoacoustic Emissions
Authors: Bauch Christopher D. , Olsen Wayne O.
Published: May 2013

Audiologic testing in the form of pure-tone air-conduction and bone-conduction audiograms provides diagnostic information about the type of hearing loss (conductive, sensorineural, or mixed) and the degree of hearing loss and attendant communication difficulties. The addition of speech tests that use specific types of speech stimuli directly assesses the patient’s ability to hear and to understand speech. Acoustic reflex and reflex decay tests are used to evaluate the integrity of a complicated neural network involving not only the auditory tracts to and through the brain stem but also decussating pathways in the brain stem and the course of CN VII to the innervation of the stapedius muscle. EOAE tests provide an objective measurement of the peripheral hearing system from the external ear through the cochlear outer hair cells. They are useful screening tests for hearing in infants, in patients suspected of auditory neuropathy/dys-synchrony, and in patients suspected to have pseudohypacusis, that is, feigned or exaggerated hearing loss.
Quantitative Electromyography
Authors: Smith Benn E.
Published: May 2013

The quantitative evaluation of individual MUPs, decomposition of the interference pattern, IPA of turns and amplitude, and frequency and power-spectrum analyses of the interference pattern are all useful techniques. They evaluate different features of the voluntary activity of skeletal muscle, with results probably reflecting different properties of the function and dysfunction of motor units. One method is not necessarily superior to the others. It is likely that the more methods used, the closer the examiner will come to understanding the functional structure of the muscle being studied and whether or not a neuromuscular disorder is present.
Single Fiber Electromyography
Authors: Harper C. Michel
Published: May 2013

SFEMG is a highly selective technique that permits recording of individual components of the motor unit. The selectivity of SFEMG depends on the use of a low-frequency filter of 500 Hz and a small electrode size. Voluntary activation or electric stimulation is used to activate the muscle fiber in SFEMG. Voluntary activation allows measurement of fiber density, whereas jitter and blocking are recorded with both voluntary and stimulated SFEMG.
Quantitative Motor Unit Number Estimates
Authors: Daube Jasper R.
Published: May 2013

The all-or-none increment, the STA, DQEMG, MPS, and the STAT MUNE methods of obtaining MUNE give similar values in each of the muscles compared in normal subjects. Alternative MUNE methods continue to be developed, but none have been used sufficiently in a clinical setting to assess them. 64 In addition, Felice has shown that MUNE is more reliable than other measurements in documenting the course of ALS. 38 Thus each of these methods can be used whenever and wherever it is most feasible and that different methods may be appropriate in different settings. For example, when each of the motor units can be identified with small increments of stimuli in a severe neurogenic process, MUNE is defined most rapidly and accurately by actually counting the total number of increments. When the number of motor units is too large to do this or their size is too small for them to be identified accurately in the CMAP, the STAT MUNE or multipoint methods are appropriate. In muscles in which CMAPs cannot be obtained reliably, as in proximal muscles that are difficult to immobilize during stimulation of the motor nerve, the STA and DQEMG methods are most appropriate. The value of other methods of MUNE remains to be determined. 65–69
Assessment of Sleep and Sleep Disorders
Authors: Silber Michael H. , Harris Cameron D. , Hauri Peter J.
Published: May 2013

This chapter reviews the techniques that are available to study sleep and disorders that may occur during sleep. Multiple physiologic parameters can be assessed using one or a combination of polysomnography, multiple sleep latency or maintenance of wakefulness tests, actigraphy, and portable monitoring. The use of these tests is helpful to not only identify different stages of sleep, but to assess sleep disorders, such as abnormal movements in sleep and disorders manifesting with excess somnolence. The field of Sleep Medicine and the associated sleep neurophysiology continues to grow and expand our understanding of sleep-related disorders.
Assessing Central Nervous System Symptoms
Authors: So Elson L.
Published: May 2013

The major value and primary application of clinical neurophysiology is in the assessment and characterization of neurologic disease. Selection of appropriate studies for the problem of an individual patient requires a careful clinical evaluation to determine possible causes of the patient’s symptoms. The nature of the symptoms and the conclusions of the clinical evaluation are the best guides to appropriate use of clinical neurophysiologic testing.
Optic Neuritis
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Optic neuritis is the most frequent cause of optic neuropathy in young adults and is often encountered in clinical practice. In this chapter, we summarize the cardinal signs of optic neuropathy, and discuss the diagnostic evaluation and management of idiopathic optic neuritis.
Arteritic Anterior Ischemic Optic Neuropathy
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Arteritic anterior ischemic optic neuropathy occurs in the setting of giant cell arteritis and is a medical emergency, because there is a high risk of fellow eye involvement if corticosteroid treatment is not initiated in a timely fashion. In this chapter, we review the clinical features of arteritic anterior ischemic optic neuropathy. We also discuss the evaluation and treatment of patients with suspected giant cell arteritis.
Idiopathic Intracranial Hypertension
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Idiopathic intracranial hypertension is a syndrome of raised intracranial pressure of unknown cause that most often occurs in obese young women. Bilateral papilledema is usually present and can cause severe, irreversible vision loss if left untreated. In this chapter, we review the symptoms, signs, evaluation, and management of idiopathic intracranial hypertension.
Migraine Aura
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Migraine aura is a common cause of transient positive and negative visual phenomena. Similar symptoms can occasionally occur with occipital lesions or as a manifestation of occipital seizures. In this chapter, we review the clinical features of migraine aura, with specific reference to those features that help distinguish it from occipital seizures.
Ocular Myasthenia
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Ocular myasthenia typically causes intermittent or fluctuating ptosis and diplopia but is often difficult to diagnose definitively. We discuss the approach to the patient with suspected ocular myasthenia but no acetylcholine-receptor antibodies, and review the treatment options for ocular myasthenia.
Complete Bilateral External Ophthalmoplegia
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Complete bilateral external ophthalmoplegia is characterized by global weakness of the extraocular and levator muscles. It has a broad differential diagnosis, which varies depending on the tempo of onset. In this chapter, we review the approach to the patient with complete bilateral external ophthalmoplegia and discuss the common causes.
Superior Oblique Myokymia
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Monocular oscillopsia is an uncommon symptom that is often due to superior oblique myokymia. The diagnosis is frequently missed, because the eye oscillations in this condition are intermittent and often subtle. We discuss the evaluation and management of patients with suspected superior oblique myokymia in this chapter.
Upbeat Nystagmus
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Upbeat nystagmus is a less common type of central vestibular nystagmus that is often transient. However, it can be persistent and responsible for visual symptoms. We review the characteristics and causes of upbeat nystagmus in this chapter. We also discuss the management of upbeat nystagmus occurring in the setting of Wernicke’s encephalopathy.
Eyelid Ptosis
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Upper-eyelid ptosis is frequently encountered in clinical practice but has a broad differential diagnosis. We discuss the approach to the patient with upper-eyelid ptosis in this chapter, with special attention to levator dehiscence.
Physiologic Anisocoria
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

A difference in the size of the pupils (anisocoria) is a frequent finding on physical examination. While often a cause for alarm, it is not uncommonly physiologic and of no concern. In this chapter, we summarize the approach to the patient with anisocoria.
Horner’s Syndrome
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Horner’s syndrome can be caused by a lesion anywhere along the oculosympathetic pathway. Although there may be other signs that might help with localization of the lesion, the syndrome often occurs in isolation. We review the approach to the patient with suspected Horner’s syndrome, with special attention to the role of investigations such as pharmacologic pupil testing and imaging.
Syndromes of the Orbital Apex, Superior Orbital Fissure, and Cavernous Sinus
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Lesions in the orbital apex, superior orbital fissure, and cavernous sinus can give rise to characteristic combinations of cranial nerve palsies. In this chapter, we briefly review the possible causes of these syndromes. We discuss rhino-orbital mucormycosis in detail, because it has a grave prognosis if it is not diagnosed and treated in a timely fashion.
Dorsal Midbrain Syndrome
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Lesions of the dorsal midbrain give rise to a characteristic and highly localizing constellation of neuro-ophthalmic signs. We review the clinical features and common causes of the dorsal midbrain syndrome in this chapter, with special reference to the clinical features and management of ventriculoperitoneal shunt malfunction.
Research synthesis: systematic reviews and meta-analysis
Authors: Moncrieff Joanna
Published: May 2013

The process of synthesizing data from different studies is known as metaanalysis. The techniques were developed in the social sciences and only recently applied to medical research. There has been intense debate about the validity of the process and its potential contribution to research. In medicine the widest application of research synthesis techniques has been with intervention studies. In particular the Cochrane Collaboration1 has promoted the use of systematic reviews and meta-analysis to evaluate medical treatments. Recently there has been increasing attention paid to meta-analysis with other types of study (Altman 2001). This overview will focus on intervention studies, and, after describing the uses and limitations of research synthesis and the particular issues arising for psychiatric researchers, will illustrate the stages in conducting a systematic review or meta-analysis.

Definitions

For the purposes of this chapter systematic reviews will be taken as referring to reviews which aim to achieve comprehensive coverage of the relevant literature and meta-analysis refers to the statistical process of combining quantitative data from different studies.

The need for research synthesis

(1) The exponential increase in medical research over recent decades makes it impossible for doctors to have a comprehensive knowledge of research in every area relevant to their practice.

(2) By virtue of bringing a fresh perspective to an area, systematic reviews may be able to reach a more objective view of the evidence.

(3) Health economists and policy makers need an overview of research and a reliable estimate of efficacy to facilitate the process of resource allocation.

(4) Collation of research in different settings is valuable in order to obtain a picture of the range of action of a particular intervention.

(5) Many studies are not large enough to detect small effects that may be clinically useful. Combining data enhances the power of the analysis to detect such effects.

(6) Systematic collation of evidence indicates which areas require more research.
Qualitative research
Authors: Murray Joanna
Published: May 2013

Qualitative research is an increasingly popular method of enquiry in biomedical, clinical and behavioural research. Once regarded as the preserve of social scientists and psychologists, qualitative methods have entered the mainstream of epidemiology and clinical research, as evidenced by the publication of a series of papers in the British Medical Journal (Britten 1995; Mays and Pope 1995; Pope and Mays 1995; Pope et al. 2000). The qualitative methods to be described in this chapter offer a scientific approach to understanding and explaining the experiences, beliefs, and behaviour of defined groups of people. The contrasting features and the complementary roles of qualitative and quantitative methods of enquiry will be described.

While the majority of chapters in the present volume are concerned with research methods designed to answer questions such as ‘how many?’ or ‘how frequently?’, qualitative methods enable us to explore the ‘why?’, ‘what?’, and ‘how?’ of human behaviour. Since the aim is to understand the meaning of the phenomena under study from the perspective of the individuals concerned, the direction of enquiry is guided more by respondent than researcher. This approach is particularly appropriate to complex phenomena such as the range of beliefs that underlie illness behaviour and the aspects of health care that matter to different service users. Qualitative enquiry would focus on identifying beliefs and describing the circumstances that surround particular behaviours, while quantitative research would focus on measurable characteristics of the sample and the frequency and outcome of their behaviour.

An example of the contribution of the two methodological approaches is the study of variations in treatment of depression in older people. Epidemiological studies in the community and in primary care settings have found that the prevalence of depression in older adults far exceeds the prevalence of the disorder among those consulting their general practitioners. To identify the factors associated with this disparity, qualitative researchers would set out to explore the reasons why older people with depression do and do not present their symptoms to the GP. The aim would be to describe the range of beliefs about depression among attenders and non-attenders. The quantitative approach would involve establishing the strength of associations between personal characteristics, external factors, and behaviour of older people with depression. It is clear from this example that both approaches are complementary in identifying the nature of the disparity.

Qualitative research is based on the premise that each individual's experience is unique and the beliefs that underlie illness behaviour can only be measured once identified and described from a variety of individual perspectives. When information of this type is combined with data on prevalence and variable risk, more appropriate services and outcome measures can be developed.
Demyelinating disorders of the central nervous system
Authors: Chandran Siddharthan , Compston Alastair
Published: May 2013

Clinicians suspect demyelination when episodes reflecting damage to white matter tracts within the central nervous system occur in young adults. The paucity of specific biological markers of discrete demyelinating syndromes places an emphasis on clinical phenotype—temporal and spatial patterns—when classifying demyelinating disorders. The diagnosis of multiple sclerosis, the most common demyelinating disorder, becomes probable when these symptoms and signs recur, involving different parts of the brain and spinal cord. Other important demyelinating diseases include post-infectious neurological disorders (acute disseminated encephalomyelitis), demyelination resulting from metabolic derangements (central pontine myelinosis), and inherited leucodystrophies that may present in children or in adults. Accepting differences in mechanism, presentation, and treatment, two observations can usefully be made when classifying demyelinating disorders. These are the presence or absence of inflammation, and the extent of focal vs. diffuse demyelination. Multiple sclerosis is prototypic for the former, whereas dysmyelinating disorders, such as leucodystrophies are representative of the latter....
Pleural tumours
Authors: Davies Robert J.O. , Gary Lee Y.C.
Published: May 2013

Case History—A 54 yr old Asian man, and a 19 yr old Chinese man, both with pleural effusions.

Case History—A 68 yr old man with a pleural effusion.

Benign tumours are rare in the pleural cavity, with solitary fibrous tumour of the pleura, the most frequent of these rarities....
Leucocytes in health and disease
Authors: Sinning Joseph , Berliner Nancy
Published: May 2013

White cells (leucocytes) mediate inflammatory and immune responses and are key to the defence of the host against microbial pathogens. Subpopulations of leucocytes include (1) granulocytes—neutrophils, eosinophils (see Chapter 22.4.6) and basophils, (2) monocytes, and (3) lymphocytes (see Section 5 and Chapter 22.4.2)....
Anaemia as a challenge to world health
Authors: Roberts D.J. , Weatherall D.J.
Published: May 2013

Anaemia is a very common problem in the developing world: 47% of women aged 15 to 49 years have haemoglobin less than 12 g/dl; 59% of pregnant women have haemoglobin less than 11 g/dl; 26% of men aged 15 to 49 years have haemoglobin less than 13 g/dl. About 20% of perinatal mortality and 10% of maternal mortality in developing countries is attributable to iron deficiency....
Iron metabolism and its disorders
Authors: Cox T.M. , Porter John B.
Published: May 2013

Iron is a component of haem proteins and nonhaem enzyme systems required for oxygen transport, mitochondrial respiration, and other key metabolic reactions. The metal exists in two readily interconvertible redox states (divalent ferrous and trivalent ferric iron) that are highly reactive and toxic to tissues. High-affinity iron-binding proteins, which form stable ferric complexes, have evolved to facilitate iron transport and delivery to sites of storage and utilization, including haem biosynthesis....
Genetic disorders of coagulation
Authors: Pollak Eleanor S. , High Katherine A.
Published: May 2013

Much of what is understood about specific coagulation proteins has emerged from the careful study of hereditary disorders of blood coagulation.

Haemophilia is a familial X-linked disorder due to deficiency of either factor VIII (haemophilia A) or factor IX (haemophilia B), components of the intrinsic enzymatic complex that activates factor X. The severity of the disease correlates with predicted concentrations of activated factor protein, and those with activity levels below 1% are defined as having severe disease....
Breast
Authors: Allen Steve
Published: May 2013

Chapter 3 discusses the breast, and includes incidence, screening, diagnosis and staging, radiological staging, planning, therapeutic assessment, and follow-up.
Lymphoma
Authors: Hoskin Peter , Fowler Charlotte
Published: May 2013

Chapter 5 discusses lymphoma, which covers a broad spectrum of disease entities that is reflected in a wide range of imaging involved in its diagnosis and management. Whilst the pathological subtypes are of considerable importance in disease management, they do not greatly influence the staging processes in which imaging is used, although the two main groups, Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) have very different patterns of disease distribution which can influence imaging strategies.
Oesophageal tumours
Authors: Jane Chambers R. , Geh Ian
Published: May 2013

Chapter 6 discusses oesophageal tumours, including clinical background, diagnosis and staging, planning, therapeutic assessment, and follow-up.
Hepatic and biliary tumours
Authors: Miller Ben , Geh Ian , Roy-Choudhury Shuvro
Published: May 2013

Chapter 8 covers hepatic and biliary tumours, and covers clinical background, diagnosis and staging, planning, therapeutic assessment, and follow-up.
Rectal cancer
Authors: Goh Vicky , Glynne-Jones Rob
Published: May 2013

Chapter 11 covers rectal cancer, and presentation includes rectal bleeding, change in bowel habit, frequency of defecation, tenesmus, rectal fullness, and pelvic pain. Distant spread occurs to the liver, lung, retroperitoneum, ovary, and peritoneal cavity. Advances in surgical technique and more accurate radiotherapy planning and delivery have improved rectal cancer treatment in the past two decades. Anterior resection combined with total mesorectal excision (TME) has become the standard surgical procedure, facilitating the radial clearance of the primary tumour, mesorectal tissue, and associated vascular, lymphatic, and perineural deposits, thus improving local recurrence rates.
Anal cancer
Authors: Goh Vicky , Glynne-Jones Rob
Published: May 2013

Chapter 12 covers anal cancer, and covers squamous cell carcinomas, which are the commonest type, and the remainder, which consist of adenocarcinomas, neuroendocrine tumours, undifferentiated carcinomas, melanomas, gastrointestinal stromal tumours, and lymphomas.
Connective tissue (soft tissue sarcoma)
Authors: Svasti-Salee Derek , Moskovic Eleanor , Saran Frank
Published: May 2013

Chapter 17 discusses connective tissue (soft tissue sarcoma), and includes clinical background, diagnosis and staging, imaging during radiotherapy planning and treatment, therapeutic assessment, and follow-up.
Drugs in Britain: the history
Authors: Plant Martin , Robertson Roy , Plant Moira , Miller Patrick
Published: May 2013

This chapter provides a brief overview of the history of drug use in the British Isles.
Lower limb
Authors: Harrison Dr Mark
Published: May 2013

2.1 Anterior thigh, 23

2.2 Medial thigh, 26

2.3 Hip joint and gluteal region, 27

2.4 Posterior thigh compartment, 30

2.5 Popliteal fossa and knee, 31

2.6 Anterior leg, 33

2.7 Dorsum of the foot, 33

2.8 Lateral leg, 34

2.9 Posterior leg (calf), 35...
Thorax
Authors: Harrison Dr Mark
Published: May 2013

3.1 Thoracic body wall, 40

3.2 The diaphragm, 45

3.3 Thoracic inlet, 46

3.4 Trachea, 47

3.5 Thymus, 48

3.6 Heart and pericardium, 48

3.7 Oesophagus, 51

3.8 Pleura and lungs, 51

• See Figure A.3.1.

• Thoracic part of the vertebral column...
The head and neck
Authors: Harrison Dr Mark
Published: May 2013

5.1 Fascial layers of the neck, 93

5.2 Tissue spaces of the neck, 93

5.3 Triangles of the neck, 94

5.4 Thyroid, 95

5.5 Trachea, 96

5.6 Oesophagus, 96

5.7 Cervical sympathetic trunk, 97

5.8 Root of the neck, 98

5.9 The face, 99

5.10...
Controlling infection
Authors: Harrison Dr Mark
Published: May 2013

3.1 Endogenous and exogenous infection sources, 156

3.2 How infection spreads, 156

3.3 Hospital-acquired infection, 156

3.4 Control of hospital-acquired infection, 157

• Invasion under specific conditions by the normal flora (making them opportunistic pathogens).

• For example: aspiration pneumonia; neutropenic sepsis; cannulation.
Principles of investigation
Authors: Harrison Dr Mark
Published: May 2013

4.1 Specimen types, 158

4.2 Specimen culture, 158

4.3 Specimen examination, 158

4.4 Serology, 159

4.5 Molecular techniques, 159

• UTI: MSU/CSU

• Skin wounds: Wound swab

• Meningitis: CSF and blood

• Non-specific pyrexia: Blood and serology

• Pneumonia: Blood and sputum

•...
Streptococci and Staphylococci
Authors: Harrison Dr Mark
Published: May 2013

1.1 Streptococci, 163

1.2 Staphylococci, 165

• Gram positive cocci

• Facultative anaerobes

• Encapsulated, alpha haemolytic cocci

• Methods of spread -

▪ Streptococcus pneumoniae is a common nasopharyngeal commensal

▪ Spread is by droplet

▪ Exogenous (respiratory droplet spread from carrier infecting another host) or endogenous (carrier develops impaired resistance to organism) infection may occur...
Tuberculosis
Authors: Harrison Dr Mark
Published: May 2013

2.1 Transmission and establishment in host, 167

• Mycoplasma tuberculosis

• Gram negative, acid fast bacilli, obligate aerobe

• 95% of all cases of TB worldwide occur in developing countries

• Large numbers of organisms are released by coughing, therefore transmission is primarily via respiratory droplet (aerosol), and frequently the initial site of infection is pulmonary....